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Innovation in care focus of new CQC report

The Care Quality Commission (CQC) is aiming to deliver regulation that supports innovation in care.

The CQC is actively developing its approach to supporting innovation in careEngland’s care watchdog says a new report has identified unique opportunities for it to support innovation in care services and deliver “innovation-friendly” regulation.

In their 2021 Strategy, the CQC committed to accelerating improvement in health and care. Now, as part of a grant-funded project called ‘Capturing innovation to accelerate improvement’, they have been working with care providers and representative groups over a period of 8 months in order to understand their experience of innovation.

The regulator has taken part in and overseen roundtables, surveys and pilot projects to understand what works well and where they can do things differently to better support those care providers who want to develop or adopt new, innovative ways of working.

The CQC heard how good outcomes for the people using services must remain at the heart of any innovation in care, stating clearly: “People matter most.”

This was set down in their recent report to the Department of Science, Innovation and Technology (DSIT), supported by the Regulators’ Pioneer Fund (RPF), which identified six key areas where the CQC can deliver regulation that supports innovation in care and help drive improvements in care services.

Greater clarity needed for innovation in care

These include providing greater clarity around their role in innovation and the role of other bodies working in health and social care who can provide support.

In the report’s executive summary, the CQC states:

“Working with people from across the health and social care sectors, we explored what barriers to innovation might exist, what we could do to mitigate these and what opportunities existed to improve their experience.

“We also undertook focused test and learn tasks to ask registered providers and system partners their thoughts on specific issues. These included their use of data in the innovation process, the legacy of COVID innovations and looking for ways to encourage more conversations around innovation within CQC.

“There was a notable appetite for clarifying the regulatory landscape so that health and social care stakeholders could engage with the right organisation at the right stage of their innovation journey.

“Innovators need more information and clarity on our regulatory approach to innovative practice, including safety and risk management implications. Innovators are unsure where to find information about innovation requirements and support. This extends to organisations building a culture where each part of the system, including CQC, has a shared understanding and approach to innovation.”

Innovation in care requires ‘improvement culture’

The CQC says that innovation in care must always focus on the people receiving careThe CQC are currently rolling out their new Single Assessment framework for care. This includes quality statements that are commitments that providers, commissioners and system leaders should live up to. One quality statement focuses on quality improvement and innovation, providing the care watchdog with the opportunity to promote innovation in care within local authorities (LAs) and Integrated Care Systems (ICS).

Later in their executive summary the CQC says:

“It became clear that the ability to innovate does not have a one-size-fits-all solution but depends upon a thriving improvement culture.

“Effective innovation relies on an improvement culture; a culture where the people feel supported to try new things and have the space to reflect on progress and setbacks.

“People told us that successful innovation is not built around technology, large budgets, or distinct teams. People working in services need clarity, an enabling environment, and a continued focus on outcomes. Effective innovation support requires us to develop our approach to using our impact mechanisms, particularly the way we work with stakeholders and the way we use softer influencing skills in relationships with providers and systems.”

CQC ‘actively developing’ approach to innovation in care

Innovation in care requires an improvement culture and greater clarity from regulatorsThe report details how the CQC is applying what it has learned and how it will continue to put this into practice.

The report outlines the 6 key conclusions that the CQC has drawn from the project.

Overall, they say it is clear there is more they can do to deliver regulation that supports innovation in care while also ensuring more people receive high-quality care. They are now going to actively develop their innovation approach “while continuing to focus on the impact of innovation on the quality of care people receive.”

The CQC’s key findings are:

  1. Effective innovation relies on an improvement culture – Innovators require support and recognition throughout their journey to improvement, accepting false starts and ensuring that learnings are made when tings go wrong.
  2. Innovators need more information and clarity on CQC’s regulatory approach to innovative practice, including safety and risk management implications – Improved transparency will help providers feel safer to share and explore best practice. The CQC will look to build on the positive collaboration in projects such as the AI and Digital Regulations Service and will also ensure that language and messaging on innovation is consistent and always focuses on the impact and outcomes for people receiving care.
  3. Effective innovation support requires CQC to develop its approach to using their impact mechanisms, particularly stakeholder and relational impacts – participants in the project’s roundtables said they would like to see the CQC use stakeholder and relational impact mechanisms and exercise softer influence through relationships and influencing to support innovation over direct regulatory action. The CQC says that developing its approach to these impact mechanisms will support and inform its implementation of the new single assessment framework, which has been developed to promote improvement cultures that support effective innovation.
  4. People matter most – The CQC learned that they should not be prescriptive in describing the best ways for care providers to innovate but instead should use their strategic insight to identify gaps. To enable innovation in care, the regulator should:
  • Focus on the impact on outcomes for people using services
  • Actively look for innovation cultures
  • Signpost and work with other relevant bodies
  • Actively share stories and examples
  • Support care providers to become more innovative
  • Embody these characteristics itself as an organisation with an improvement culture
  1. Innovators are unsure where to find information about innovation requirements and support – the CQC needs to work closely with system partners so that providers and innovators can be more aware of risks, opportunities and support available. The idea is that speaking to the right organisation at the right time will help avoid duplication and burden, while better collaboration will lead to greater clarity and efficiency, and add value through shared knowledge and experience.
  2. There are unique opportunities now to improve our impact on innovation through our new powers and the single assessment framework – The CQC received feedback that it needs to hold LAs and ICSs to account around how they are supporting innovation in care. The new single assessment framework is intended to promote improvement cultures and be more flexible and responsive to changing or innovative care provision, but it should also help the CQC collect evidence and knowledge in a way that makes it easier to share learning about good practice.

You can read the full report online, and you can also view the CQC’s innovation journey map and example case studies showing how innovation in care can link in to the quality statements in their new single assessment framework.

Ongoing development for care services

Support innovation in care with innovative training solutionsFirst Response Training (FRT) is a leading, national training provider.

They deliver over 7,000 courses each year in the fields of health and safety, first aid, fire safety, food safety, mental health, health and social care and other special focus topics.

Their diverse portfolio includes training awards designed for care workers, such as Infection Control and Prevention, Safeguarding Adults, Duty of Care, Equality, Diversity and Inclusion, Person Centred Care and Support and many others.

Their course portfolio spans Care Certificate standards, mandatory training awards, clinical skills, special focus courses and training for supervisors and managers.

A Trainer at FRT, says:

“It is clear that health and social care services need to innovate and we have heard much about the digital transformation of care and new ways of working, including Digital Health Passports.

“It’s great that the CQC is looking at how they can support this with their regulatory practices while always ensuring the focus is on high quality, safe, effective and compassionate care and support for the people using services.

“We provide a range of innovative training solutions for those working in health and social care, including e-learning, live and interactive webinar sessions and blended learning solutions.”

For more information on the training provided by FRT, please call them on freephone 0800 310 2300 or send an e-mail to info@firstresponsetraining.com.

CQC publishes data showing Covid-19 death notifications

The Care Quality Commission has praised the efforts of care staff during the pandemic as it published data showing death notifications involving Covid-19 received from individual care homes over the past 12 months.

CQC publishes data showing Covid-19 death notificationsThe CQC’s latest Insight Report has also drawn on this data to establish key points and provides crucial context to help understand what the data means.

The data, featuring notifications received between 10th April 2020 and 31st March 2021 from care homes across all regions, shows that Covid-19 has contributed to a significant increase in the number of deaths in nursing and residential care settings.

Death notifications do not equal poor care

England’s care watchdog was quick to point out, however, that death notifications “do not in themselves indicate poor quality care.”

Covid-19 death notifications from individual care homes are reviewedIn fact, in a press release accompanying the publication of the data, they emphasised that, across all types of care settings, “staff have gone to great lengths to try to contain the effects of this virus, as our report published today on infection prevention and control in hospitals shows.”

They explained that many factors, including the rate of transmission in the local community, the size of the care home and the age, health and care needs of residents can all potentially influence the number of deaths.

Many of the notifications also relate to the deaths of care home residents which occurred when they were receiving care in other settings, meaning the death notification does not necessarily indicate that Covid-19 was present in the care home.

Data used in inspection decisions

The figures have been presented alongside government data on all Covid-19 deaths. This is because care homes form part of the local community and so are impacted when Covid-19 is prevalent in the area.

Data on Covid-19 death notifications is available onlineDeaths are counted as involving Covid-19 based on the statement made by the care home provider. This may or may not correspond to an official medical diagnosis or test result and may or may not be reflected on the death certificate.

The CQC has used information from individual care homes about deaths involving Covid-19 alongside other information to make decisions about where to inspect.

The watchdog conducted 5,577 inspections of residential adult social care providers during the period the data covers. These included wider ongoing monitoring of adult social care services and specific infection prevention control inspections, which focused on eight key criteria to ensure services had an effective approach.

These inspections looked at whether staff had been properly trained to deal with outbreaks and whether there was adequate Personal Protective Equipment (PPE) available for both staff and residents.

While enforcement action had to be taken in a small number of cases, CQC inspectors found “generally high levels of assurance.”

A duty to be transparent

Commenting on the publication of the data on death notifications, the Chief Inspector for Adult Social Care at the CQC, Kate Terroni, explained:

“In considering this data it is important to remember that every number represents a life lost – and families, friends and those who cared for them who are having to face the sadness and consequences of their death.

“We are grateful for the time that families who lost their loved ones during the pandemic have spent meeting with us and the personal experiences they have shared. These discussions have helped us shape our thinking around the highly sensitive issue of publishing information on the numbers of death notifications involving Covid-19 received from individual care homes.”

She said that, as an independent regulator, the CQC has “a duty to be transparent and to act in the public interest” and that this has dictated their decision to publish the data.

“In doing so, we aim to provide a more comprehensive picture of the impact of Covid-19 on care homes, the people living in them and their families,” she added.

“It is important to be clear, however, that although this data relates to deaths of people who were care home residents, many of them did not die in or contract Covid-19 in a care home.”

“As we publish this data, we ask for consideration and respect to be shown to people living in care homes, to families who have been affected, and to the staff who have done everything they could, in incredibly difficult circumstances, to look after those in their care.”

The data can be viewed on an online dashboard.

Further support and training for care settings

First Response Training (FRT) is a leading, national training provider. They deliver over 7,000 courses each year in the fields of health and safety, first aid, fire safety, food hygiene, mental health, health and social care and more.

Their health and social care range includes Infection Control and Prevention, Handling and Recording Information, Dignity in Care, Duty of Care, Safeguarding Adults and many more.

They can also provide an e-learning course in COVID-19 Infection prevention, identification and control.

As a Skills for Care Endorsed Provider, FRT have also recently been awarded grant funding to provide free Covid-19 Essential Training for adult social care workers, including Rapid Induction training for new starters.

A trainer from FRT says: “The adult social care workforce is full of dedicated, compassionate workers who do their best for the people they support each and every day.

“The past year has been incredibly challenging across the sector, and it’s important to understand the full impact that the Covid-19 pandemic has had on adult social care services and the people receiving care and support from them, while remembering the wider context and local community picture.”

For more information on the training that FRT can provide, please call them today on freephone 0800 310 2300 or send an e-mail to info@firstresponsetraining.com.

CQC focuses on learning disability care during the pandemic

The Care Quality Commission (CQC) has released its latest insight report, which focuses on care provided for people with a learning disability during the Covid-19 pandemic.

Ahead of the publication of their provider collaboration review (PCR) on people with a learning disability living in the community this month (July 2021), England’s care watchdog has looked at how services have worked together to meet people’s needs over the past year.

It follows concerns previously highlighted by the CQC about the care and treatment of people with a learning disability and people with autism. A swing can help a sensory seeking child to self-regulate.

The regulator says that the pandemic has “served to shine a light on some of these pre-existing challenges, gaps and poor-quality care.”

The right care at the right time

Introducing their latest insight report, the CQC explains:

“Support and services for people with a learning disability are often not good enough. For too long, people and their families have face significant and ongoing challenges in getting care at the right time that meets their individual needs.

“We have seen how this can lead to people staying for long periods in appropriate environments, being cared for by people who do not know them and who do not have the skills or knowledge to support them well.”

As part of their forthcoming PCR, the CQC have examined these issues and the impact they have had on people who use services, providers and stakeholders.

The 11th insight report from the watchdog outlines some key approaches to care delivery which can help ensure people receive the care and support they need, which enables them to lead fulfilling lives. These include:

  • Ensuring people are given choice, control and independence. This can include supporting them to live independently or to be cared for in the community close to their friends, family or support networks and ensuring they are not left isolated in hospital settings far from home.
  • Providing access to the right care and support at the right time. This includes providing access to suitable health care and support services, including in emergency and crisis situations.
  • Ensuring collaboration between services and with the person receiving care and their families. This includes sharing information when appropriate about the person, such as their likes, dislikes, interests and preferences, as well as information about their health and wellbeing.

Concerns remain

The CQC remains concerned about the lack of joint working and collaboration between services and how well they have shared information to ensure people receive the right care at the right time.

Particular issues have also been noted with transitioning people from children to adult services and the fact that people can often end up in inappropriate settings when things go wrong.

During the pandemic, people with a learning disability – who already have an increased risk of respiratory illnesses – have also been more vulnerable to Covid-19.

There has been an increase in deaths among people using services who have a learning disability.

While examining the problems faced accessing appropriate care and treatment for people with a learning disability during the Covid-19 pandemic, the CQC is also seeking to highlight examples of good practice where joint working has made a positive difference and improved outcomes for people.

Improving regulation of learning disability care

The insight report presents three areas of focus to improve the CQC’s regulation of services for people with a learning disability and people with autism:

  • Registering the right services – enabling people to use services that will support them with where and how they want to live.
  • Supporting providers to improve – ensuring that people are not moved in to services that are not safe or do not meet their needs.
  • Influencing the improvement of care pathways and ensuring that people are receiving the right care at the right time – accessing local services that meet people’s needs and ensuring they get the right healthcare when needed.

Training and support

First Response Training (FRT) is a leading, national training provider. They deliver over 7,000 courses each year in the fields of health and safety, first aid, fire safety, food hygiene, mental health, health and social care and more.

Their health and social care range includes Learning Disability Awareness, Introduction to the Autistic Spectrum, Person Centred Care, Dignity in Care, Duty of Care, Safeguarding Adults and many more.

A trainer from FRT says: “The adult social care workforce is full of dedicated, compassionate workers who do their best for the people they support each and every day.

“However, the system is under significant pressure and it is very important that lessons are learned and improvements made to ensure that all individuals receive the person-centred, compassionate and dignified care that they deserve.”

For more information on the training that FRT can provide, please call them today on freephone 0800 310 2300 or send an e-mail to info@firstresponsetraining.com.