CQC inspections, DUQ and NHS England’s quangos

03 November 2015

I visited 12 services last week including all those in the London Borough of Sutton. I met a number of long standing staff working in those services who are the real backbone of CMG. We are introducing a recognition scheme for long service scheme in the New Year as a way of thanking people who have stayed with CMG over many years.

We have experienced a considerable number of CQC inspections in the last couple of weeks as the regulator tries to catch up with its back log and hit its target of services being inspected by September 2016. A big congratulations to Florence Regonye and her two teams at 1 and 5 Fengates in Surrey. Both services received very good inspection reports and were rated as ‘good’ in each of the five areas that CQC looks at: safe, effective, responsive, caring and well-led and were rated as good overall. We are hoping that we may get one of two more ‘outstanding’ rated services following this recent round of inspections. However there are a couple of services which may be rated as ‘requires improvement’. This is either because there has been concerns about the performance of the registered manager which we have been addressing or because there has been several changes of manager in a relatively short period of time, disrupting continuity in the service. Registered Managers are absolutely key to ensuring that high quality services are delivered. I would personally like to see them given a higher status in social care and the recognition of the difficult, challenging and professional job that they do.

On the subject of Registered Managers, I jointly facilitated a workshop for Registered Managers, together with Sarah Maguire, from Choice Support, on Friday, looking at implementation of the Driving Up Quality Code. As well as carrying out self assessments of your organisation, using the Code, it can also be used at an individual service level as a way of getting feedback from families, people we support and external professionals and a really effective way of both Driving Up Quality and demonstrating that the service is well-led to CQC. I was very impressed with the calibre of the managers we met, a number of whom, had already been involved in doing a self assessment, either in their organisation or their service. One of the things that we explored at the workshop was culture. We all know that the culture of organisations is important but it is quite an intangible concept. With the help of the managers, we identified a number of measurable criteria of what makes a good culture in a social care organisation. We will be looking forward to share this nationally through the Driving Up Quality steering group and I would also like to share it in future on my blog.

To end with, I would just like to comment on the NHS England report which was published on Friday, which sets the target of closing between 30 and 50% of hospital beds for people with learning disabilities. I fully support the ambition, but I was rather concerned that the report lacked substance on how the change will happen. NHS England appears to believe that establishing 49 quangos involving local government, CCG’s and NHS England specialist commissioning will deliver this complex change. After many years of dealing with such quangos when I was in the NHS, I am feeling rather sceptical that the bureaucratic challenges involved can be overcome and the service change driven through. NHS England is also assuming that 49 highly competent people can be identified to lead each of these quangos effectively. Unfortunately I doubt there are 49 people in the country with the experience and skills to drive through such complex project management. I also don’t think that the money provided by NHS England to support change is anywhere near sufficient. For example, £15 million of capital is being made available to develop new schemes. Given that a number of people leaving hospitals will have particularly complex needs requiring specially designed and expensive accommodation, that money might only house 30-40 people when new services are required for 1,200 to 1,300.

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