14/12/05 - CSCI Stakeholder briefing session

The focus of the briefing was the plans for the implementation of, "Inspecting for Better Lives". Dame Denise Platt announced that it was likely that new legislation to facilitate CSCI's strategy for adult services would in introduced post October 2006.

David Behan, Chief Inspector, posed the question as to why change was desireable. The principle reasons are that service users should have more input to the process of regulation. Secondly that the Government wants a 'modern' regulation. He went on to say that the aims of the changes included:

" To empower service users

"To make regulation simpler

" Regulation to use its restricted resources more effectively.

He said that CSCI's role is to encourage improvement but to be tough on bad practice. However the responsibility for the quality of care lay with the care providers and those in local authorities who commissioned it.

David Behan went on to explain what would be different in CSCI's approach and methodology for inspection. The differences included:

" The introduction of clearer reports. He gave an example of a recent visit he had made to a service where the report exactly reflect the service he saw on his visit and that he had written to the Inspector congratulating her on her efforts. (One would have liked to ask him whether he writes to admonish Inspectors who write inaccurate and poor reports.)

The frequency of Inspections will be based upon an Annual Assessment although a change in legislation will be required to vary the current requirement to carry out two inspections. A move away from announced inspections had already been put into practice, he said.

There will be less 'traditional' inspection for providers of high quality care but this will be balanced by a requirement for providers to carry out self assessment programmes which should have the development of Improvement Plans as a required outcome.

In respect of Inspectors the changes would include:

" A great emphasis on providing a record of evidence

" Having the new of a new Risk Assessment tool. This is likely to be available by April 2006.

" The development of improvements in professional judgement.

" The flexibility to concentrate on poor services. These are to be identified in the enhanced 'traffic light' system, providers being placed the Blue category - excellent, Green - good, Amber - requires increased attention, Red - real concern and frequent visits, Grey - proceeding to cancellation of registration. Dame Denise stated that the 'traffic light' categorisation for each home will be in the public domain.

" A greater focus on service users to facilitate all of these changes.

Sheila Scott, NCHA asked how the CSCI's vision was to be transferred to the Inspectors on the ground. The question having been stimulated by NCHA's recent survey which identified that over 50% of care providers were frightened by Inspectors. David Behan replied saying that all Inspectors and management were going through Change Training. Sheila Scott was concerned that the senior CSCI management were just not aware of how bad things were on the ground.

Martin Green, ECCA asked apropos of LAs having a responsibility for quality of care what CSCI was going to do about poor commissioning practice. Dame Denise stated that LA's should concentrate on care planning delivery and not evaluating the environment which CSCI already covered exhaustively. She went on to give an example of a London Borough that rightly ceased to purchase from one poor care home but two neighbouring boroughs then bought up these 'spare' beds. She said that this was very bad practice and in future it would have a detrimental impact upon the LA's Star Rating.

The question of quality assurance was raised from the floor. David Behan said that he had visited a major corporate provider recently and had asked upon which it based its QA Programme. On being told that it was based upon the National Minimum Standards, he said that he had told them that "CSCI is now moving away from NMS as they don't manage the right things". He would not say what CSCI did believe was appropriate but informed the audience that CSCI would have its QA system ready to be launched in April 2006. When asked whether the rumour was true that CSCI would be requiring all care providers to hold their QA system electronically he denied it and said it was an ambition and that they had no powers to make a requirement.

It is clear that QA is to feature prominently in the future but CSCI is not going to release its plans as yet. If NMS are deemed to be 'out of date' as David Behan suggested it is to be hoped that care providers will be given sufficient time for implementing their replacement. The advice clearly has to be, do not invest in a new QA system at this time.