Kate Terroni’s blog

Monthly column for providers and professionals working in adult social care from Kate Terroni, Chief Inspector of Adult Social Care.

In my column this month I want to talk to you about something that is really important to me — working together across adult social care to improve outcomes for people.

Some of you might have heard of the Quality Matters initiative, where CQC is working alongside national bodies, trade associations, and organisations from the voluntary and independent sector . It sets out a shared commitment to achieve high quality adult social care for people who access services, families, carers and everyone working in the sector.

There are four key pillars of work for Quality Matters, with a key focus being the goal of having a single shared view of quality.

As we move into the second year of Quality Matters, we are currently progressing work to reduce duplication of information requests across the adult social care sector.

Reducing duplication and beyond…

Primarily, this is about working more effectively with our partners so that providers are not responding to multiple calls for the same, or very similar, information from the regulator and commissioning authorities. This means that providers can be freed up to focus on what matters; ensuring people get good quality, person-centred care.

Developing a common language of quality

We know this isn’t going to happen overnight, but we are striving to develop a common language across the whole sector that describes what good and outstanding care look and feel like to the people who receive it.

So, how can we do this?

Taking the issue of duplication first, we have tried to tackle this several times over recent years without success. This is because local authorities, CQC, Healthwatch and clinical commissioning groups all have their own quality frameworks and so have their own specific information requirements that help them make judgements about quality. We also have national standards and guidelines about best practice from NICE.

But we know that everyone is united in a single aim — better quality care for everyone who needs it.

We have proposed that the way to tackle this is to come up with some way of aligning all these quality frameworks so that we broadly know what is being measured and what is being asked for to do that measuring. It is essential that quality is measure against what matters to people to “have a life and not just a service” — as so articulately put by Clenton Fracqueson, chair of Think Local Act Personal (TLAP) and current chair of the Quality Matters Board.

TLAP in partnership with a wider group of people with lived experience have developed the Making It Real “I statements” which, in 6 areas of focus, outline what good quality care is for people and includes statements such as “I am supported to be connected with my community”. We think that this is an excellent opportunity to hear the voice of people with lived experience and the main determinant of what good quality care should be assessed against.

Quality Matters Board approval

On 1st July 2019, the Quality Matters Board agreed that we should test how we can use Making It Real to combine what all agencies are currently doing in relation to quality so that we can;

· identify the information that we are all requesting and move towards collecting it once and sharing it many times

· develop an agreed common language that sets out what quality care means at the individual level, at the provider level and at the system level

How can CQC embed Making It Real into our work?

As well as this, at CQC we want to explore how we can use Making It Real in our assessments; are there changes we can make in the short term that will more clearly embed people’s expectations of care into our approach. For instance, should we set out for providers and the public how our 5 key questions, Key Lines of Enquiry and Rating Characteristics line up with Making It Real? Are there more ambitious things we should be looking at? For instance, should Making It Real sit alongside our Rating Characteristics to help underpin our judgements — or should it replace those characteristics?

Over the coming months, we want to have this conversation with our stakeholders so that the wishes and expectations of people shine through in everything that we do even more clearly than they do today.

In future columns I will be updating you on how this work is moving forwards and how you can have your say.