Agenda item

To receive a briefing from the Care Quality Commission on their work in relation to scrutiny. 

In particular the CQC have been asked to outline the following:-

·         Their work with GP Practices.

·         The partnership working arrangements with NHS England.

·         An overview of any inspections carried out in Leicester.

·         The protocols, if any, for notifying local authority scrutiny functions of planned inspections. 

Note: The following documents have been made available since the agenda was originally published.

a)         Response to the background questions submitted to the CQC. Appendix A (Page)

b)         Copy of the presentation notes.  Appendix A1 (Page)

Michelle Hurst, Inspection Manger Central Region and Yin Niang, Interim Inspection Manager, gave a presentation on the work off the Care Quality Commission in relation to scrutiny.  A copy of the presentation had been circulated to Members prior to meeting and had been published with the agenda together with a written to response to background questions relating to the work of the CQC in relation to the following:-

•           Their work with GP Practices.

•           The partnership working arrangements with NHS England.

•           An overview of any inspections carried out in Leicester.

The protocols, if any, for notifying local authority scrutiny functions of planned inspections.

In addition to the information in the presentation and the response to the background questions, the following comments were made:-

a)         There were three directorates responsible for Hospitals (NHS and private), Primary Medical Services and Adult Social Care (Care home and domiciliary care).  Each directorate had a Chief Inspector.

b)         New regulations were introduced in April which made changes to the changes the inspections and reporting mechanisms.

c)         Inspections were now carried out around five key lines of enquiries:-

            i)          Safe – people protected from abuse and avoidable harm.

ii)         Effective – good outcomes achieved for care, treatment and support, good quality of life is promoted and is based upon best available evidence.

iii)        Caring – people are treated with compassion, kindness, dignity and respect.

            iv)        Responsive – services meet people’s needs.

v)         Well led – leadership, management and governance delivers high quality care supports learning, innovation and promotes an open and fair culture.

d)         There were now four ratings for inspections – ‘inadequate’, ‘requires improvement’, ‘good’ and ‘outstanding’.  If an establishment received a rating of inadequate it was put into special measures immediately and not after six months as previously.  This meant that the NHS England and the CCG were able to put in additional assistance immediately to drive up standards.

e)         Inspections of all NHS Acute Trusts and NHS Hospital Trusts began in April 2014.  Inspections covered the 8 core services which were outlined in the presentation.  Trusts were given 2-3 months’ notice of planned inspections and requested to submit preliminary information.  Inspections usually took approximately a 1 week for acute services trusts.  Unannounced inspections also took place in both acute and community services establishments.

f)          Inspection reports were shared with the establishments for them to comment upon the accuracy of the report.  A Quality Summit was the held with the establishment and the stakeholders, Trust Development Agency, Healthwatch, CCG’s NHS England, after which the report was published on the CQC’s website.

g)         The size of the inspection team varied depending upon the type of establishment being inspected.  The Team Leader for each inspection would usually be a member of the CQC Inspection Directorate.  The Team could comprise around 30 people for a district general hospital and more for a multi-site trust or combined acute/community trust.  The composition of the various inspection teams for hospitals, primary medical services and adult social care inspections were contained in the presentation notes.

Following questions from Members, it was noted that:-

a)         All inspection report were published on the CQC’s website and that ultimately the Department of Health monitored the quality of the inspections.

b)         Staff in the Lincolnshire and Leicestershire area worked collaboratively to take part in the inspections across the region.

c)         The public could report any issue of concern on-line and submissions were reviewed daily by inspectors to determine if the issues warranted a Focused Inspection or could wait until the next scheduled inspection.  Inspections could also be triggered by the information received from CCGs.  Issues could also be reported by telephone (03000 616161).  Contact details should also be available in GPs surgeries.

d)         The CQC were currently recruiting to the inspectorate.

e)         The priority for inspections of GP surgeries were determined by regular planning meeting with Inspection Teams based upon data packs provided by the CCG and the GP practices, together with any ‘soft intelligence’ that had been recorded.  Quarterly inspections were carried out and whilst not every risk could be inspected, every identified high risk was inspected.

f)          The CQC were developing protocols for working with local authority scrutiny committees and would welcome the opportunity to discuss these with the Council’s Commissions.

g)         Primary Medical Services Inspections began in April 2014 and whilst inspections were undertaken from April to October, these were undertaken in the pilot phase when the methodology was being developed and ratings could not be made public as a result.  The CQC would provide a comparison of how the City CCG compared to other areas and would supply what information they could.

h)        Generally, if primary medical services performed well against Regulation 10 which related to systems and processes for service provision, and assurance/governance (audits and health and safety etc), then it usually followed that other aspects also worked well.  The inspection process was not confined to a single visit but was an on-going process with regular reviews and staff were given regular feedback on any identified issues or examples of good practice.

i)          Anyone could apply to the CQC to be considered as an ‘Expert by Experience’ for the purposes of taking part in inspections across all three directorates.  Age Concern and partner organisations could provide Experts by Experience’ for inspections of Adult Social Care establishments, but anyone could still apply.

j)          The Adult Social Care inspection was still developing and the CQC offered to provide statistics etc for the City in relation to establishments that had been inspected.  The CQC were also willing to meet members and officers to discuss other soft intelligence between formal meetings of Commissions.

RESOLVED:-

That the CQC be thanked for their informative presentation and that the Chair and Vice-Chair of the Joint Commission discuss the information they would wish to see in future CQC reports to the Commissions and inform the CQC in due course.