Agenda item

To consider the following documents on the Care Quality Commission (CQC):

      Report of the Borough Solicitor;

      Introduction and overview of the assessment process for health and adult social care commissioners 2009/10;

      The aims and principles of the review of commissioners;

      Key milestone dates;

      Voices into Action – guidance for Overview and Scrutiny Committees.

Deborah Westhead, Ann Gray and Hayley Moore from the Care Quality Commission will attend to present to the Committee on:

      Annual Assessment of Commissioners of Health and Adult Social Care 2009-10 and

      the role of Overview and Scrutiny and the relationship with the CQC.

The Committee was briefed on the Care Quality Commission by Deborah Westhead and Hayley Moore. 

Members were advised that the main aim of the CQC was to “Make sure people get better care” and this was facilitated by:

      Driving improvement;

      Putting people first and championing their rights;

      Acting swiftly to remedy bad practice;

      Gathering and using knowledge and work with others.

There was now a requirement for providers of health and social care to register with the CQC - NHS providers were required to register by April 2010, adult social care and independent healthcare providers by October 2010 and primary medical and dental services and others from 2011.  CQC had been given stronger enforcement powers including the power to fine, suspend or ultimately close a service. 

The CQC would undertake periodic reviews to assess the performance of organisations that commissioned and provided care and make sure they worked together better, would undertake special reviews of specific services or pathways of care or themes and also contribute information on care services to guide Comprehensive Area Assessments.

The key driver for change was to focus on how health and adult social care commissioners worked together to make care better for people. 

A CQC assessment would replace the Annual Healthcheck for commissioner PCTs.  The CQC would report on the PCT’s performance against a number of commitments indicators and national priorities that were part of the Vital Signs framework as well as reporting on various scores the PCT received under other assessment processes such as World Class Commissioning.

Adult Social Care departments would receive an aggregated grade from the CQC based on outcomes for people who use services, CQC would report on the two domains covering leadership, commissioning and use of resources and score each Council in relation to the quality of regulated services it commissioned.  A self assessment would be completed and to score “performing excellently” 4 out of the 7 outcomes must be judged as performing excellently with Outcome 7 “Maintaining Personal Dignity and Respect” judged as performing well.

The timescale meant that in September 2010 the CQC would share the grades/ratings from commissioner assessments with PCTs and Councils.  Then in late November/December 2010 the CQC would publish adult social care grades and PCT ratings together as a single publication focusing on commissioners and around the same time the Comprehensive Area Assessment of commissioners would also be published.

The CQC was committed to listening and working with people and published Voices into Action to show how people’s views would feed into its work.  People would be involved in decision making, assessments, reviews and studies, surveys, as “Experts by Experience” and through bodies such as Scrutiny Committees and Local Involvement Networks.

The CQC would not need a commentary to be submitted about core standards for the NHS but had adopted a more flexible system that allowed information to be sent at any time via a form on the website, such information would be used as part of monitoring services.  Any urgent concerns could be raised if local solutions could not be found.

Members of the Committee were then given the opportunity to ask questions and make points as follows:

      What reassurances could be given that inspection services would be effective?  In response, D Westhead explained that the CQC had new powers, would seek views from a wide variety of groups including service users and carers, would conduct visits to all types of sites;

      Was there a role for Members in contributing to the Council’s Self Assessment?  The committee was advised that the Self Assessment for Cheshire East Adult Social Care service had been submitted but part of the budget consultation process had included Members challenging officers about performance.  There was also a quarterly performance meeting attended by the Portfolio Holder and a representative of Overview and Scrutiny could attend these meetings too;

      It was possible to get lists of providers from the Third Sector but how could safeguards be built into this?  In response, the Committee was advised that any detail about providers could be found by looking on the CQC website;

      Whether patients were asked how they liked to be addressed?  It was explained that case notes should indicate this and monitoring this was a role that could be undertaken by the Local Involvement Network;

      What did the power to suspend services mean in practice?  The Committee was advised that this was a new power but risks arising from suspending a service would be high, there may be a case for suspending a specific service but it was unlikely that a whole hospital would be suspended.  It was vital that CQC were satisfied that services were safe.  The ultimate sanction was to deregulate and close a service.

RESOLVED:  That the presentation be noted and the Care Quality Commission be invited back to a meeting in the autumn 2010.