Roles of organisations that regulate and inspect health and social care services

Question 1

What does CQC in England do?

Answer 1

The CQC is responsible for monitoring and inspecting health services and adult social care services in England. It aims to ensure health and social care services deliver safe, effective, compassionate, high-quality care.

Question 2

Who does the CQC monitor and inspect?

Answer 2

Monitors and inspects:
* NHS trust and independent hospitals
* GP provision – GP practices, walk-in services and out-of-hours provision.
* Clinics (Family planning, slimming, GP and hospital clinics)
Dentists
* Residential/ Nursing homes
* Domiciliary or home care services
* Community care provision- Day centres, other community support, for people with physical, social, mental health problems or learning disability
Mental health provision-Including for the detained, for people whose rights are restricted under mental health act 2007, those in voluntary hospital/ community care
Accommodation for substance misuse patients
All service providers (Individual, partnership, organisation) must register with CQC

Question 3

What is the national institute for health and social care excellence?

Answer 3

Following the health and social care act (2012), National institute for health and clinical excellence (NICE) was renamed National institute for health and social care excellence (NICE), reflects change in responsibility to social care.

Question 4

What does NICE monitor?

Answer 4

NICE is responsible for providing guidance on current, best practice in health and social care. Provides guidance to control and improve health and care provision. For example, NICE provides:
Guidance on treatments to people with specific conditions and diseases such as cancer or diabetes
Evaluation on effectivity and safety of procedures
Guidance about use of specific health technologies and procedures, existing medicines, treatments, procedures.
Assessment of cost and effectiveness of treatments
Recommendations about best practice based on most recent research
Support for health promotion campaign and health living advice

Question 5

Who does the NICE provide recommendations for?

Answer 5

NICE recommendations are for use of NHS practitioners, local authorities, and any government financed organisations who provide health and social care services

Question 6

What is NICE aims?

Answer 6

Aims to provide smoother transition for service users moving from health to social care services and children’s services to adult social services. NICE has jurisdiction in England and Wales due to making national recommendations, providing consistent approaches to service users based on where they live

Question 7

What is Public Health England?

Answer 7

Sponsored by department of health and social care that was set up in 1 April 2013, following implementation of health and social care act 2012, aim to protect and improve public health and wellbeing of all people in England and reduce health inequalities. Focus of all Public Health organisations is protection and improvement of the health of a community or population.

Question 8

What are measures of Public Health England?

Answer 8

Some measures that PHE uses to carry out responsibility are:
Health promotion programmes to improve nation’s health, spread awareness
Research projects to expand knowledge of Public Health issues
Measures to protect nation’s health when threatened
An example of a Public Health England campaign is the 2015 stay well this winter campaign

Question 9

What is Ofsted?

Answer 9

Office for standards in education, children’s service and skills

Question 10

Who does Ofsted inspect?

Answer 10

Regulates and inspects services that educate children, young people and adults or care through children through inspection of:

State funded schools and colleges, some independent providers
Adult education providers
Initial teacher education
Many teacher agencies who provide workplace training (Apprenticeship education and training)
Education services in prisons and armed forces

Question 11

Who does Ofsted inspect in care provision of children and young people?

Answer 11

Regulates and inspects care provision of children and young people:
* Nurseries, pre-schools, child minders
* Fostering and adoption agencies
* Children residential care settings

Question 12

What may Ofsted make judgements on?

Answer 12

Makes judgements relating to:
Quality of leadership and management
Quality of teaching, learning, assessment
Personal development, behaviour, welfare
Outcomes for children and learners
Ofsted grade boundaries –
1- Outstanding
2- Good
3- Requires improvement
4-Poor

Question 13

What is health and social care inspection like in Wales?

Answer 13

Wales
In Wales, health services and social care services are separately inspected.
Care and quality inspectorate Wales (CSSIW) is responsible for monitoring quality of care and social service provision, and healthcare inspectorate Wales (HIW) is responsible for monitoring healthcare provision quality

Question 14

Who does the care and social services inspectorate Wales inspect?

Answer 14

Care and social services inspectorate Wales:
Residential/ Nursing homes
Domiciliary or home care provision
Nurse agencies
Children’s homes
Child minders and day care services for children under age eight
Fostering and adoption agencies
Boarding schools
Educational colleges for people under 18
CSSIW publishes inspection outcome reports

Question 15

What are the aims of the CSSIW?

Answer 15

CSSIW aims to:
Provide independent assurance about quality and availability of social care
Safeguard adults and children, protecting rights
Improve care by encouraging and promoting improvements in the safety, quality, and availability of social care services
Provide independent professionals who plan health and social care provision in Wales

Question 16

Who does the Health inspectorate Wales inspect?

Answer 16

Healthcare Inspectorate Wales
Inspects all healthcare provision by NHS and other independent (Private, charitable) organisations, inspects:
* Hospitals and clinics
* Mental health and substance misuse services
* Nursing agencies and midwifery
* Youth offending teams
* Prison death and homicide organisations

Question 17

What are the aims of Health Inspectorate Wales?

Answer 17

HIW aims to:
* Contribute to improving safety and quality of healthcare services in Wales
* Improve citizen’s healthcare experience in Wales
* Strengthen patient voice and public
* Ensure timely, useful, accurate and relevant information about healthcare quality in Wales is provided to all

Question 18

What is Her Majesty’s inspector of education and training in Wales (Estyn)?

Answer 18

Her Majesty’s inspector of education and training in Wales (Estyn)
Estyn is the organisation solely responsible for inspection of education and training in Wales, inspection of children’s services is CSSIW responsibility.

Question 19

Who does Estyn inspect?

Answer 19

Estyn’s responsibilities may include inspection of
* Schools
* Further education colleges
* Work-based learning providers
* Adult and community learning provision
* Initial teacher education and training
* Education is justice sector (Prisons and young offender institutions)

Question 20

What questions does Estyn address?

Answer 20

Addresses three questions:
How good are the outcomes?
How good is provision?
How good is leadership and management

Question 21

What are Estyn’s four grade scales?

Answer 21

Four grade scales-
Grade 1- Excellent
Grade 2- Good
Grade 3- Average
Grade 4- Unsatisfactory

Question 22

What is Northern Ireland’s Regulation and Quality Improvement Authority?

Answer 22

RQIA has similar responsibilities to CQC in England, responsible for regulations of health and care services.

Question 23

Who does RQIA inspect?

Answer 23

Inspects services provided by statutory and independent organisations:
* Children’s homes
* Day care settings for older people, disabled people, people with learning difficulties or mental health problems.
* Boarding schools
* Domiciliary care services
* Residential care services
* Nursing agencies

Question 24

What is Public health agency for Northern Ireland?

Answer 24

PHA was established in 2009 and brought together numerous public health organisations.

Question 25

How does PHA improve health and social wellbeing of people living in Northern Ireland?

Answer 25

Effective health prevention strategies such as immunisation
Policies to improve populations health and wellbeing
Conducting research and development activities to identify causes of poor health
Recommending strategies to improve nations health
In 2015 PHA Northern Ireland campaigned for people to take steps to reduce likelihood of stroke as part of World Stroke Day in October

Question 26

What is NICE in Northern Ireland?

Answer 26

National institute for Health and social care excellence
Doesn’t have direct responsibility for the control and improvement of health and social care in Northern Ireland as it does in England and Wales, however it has a direct link with Northern Ireland Department of Health, Social Services and Public Safety, department regularly reviews and applies NICE recommendations to Northern Ireland where appropriate

Question 27

Who does Education and Training Inspectorate inspect?

Answer 27

Improvement of educational services in Ireland
Early year, pre-school education
Primary and secondary schools
Further education colleges
Youth work
Teacher education
Prison and young offenders’ institutes in Northern Ireland and other areas of criminal justice system.

Question 28

What descriptors do ETI use?

Answer 28

When reporting on provision quality in schools and colleges, ETI uses following descriptors
* Achievements and standards
* Learning provision
* Leadership and management

Question 29

What is ETI six point scale?

Answer 29

Six-point scale is used to describe provision quality, 1 is outstanding, 2 is very good, 3 is good, 4 is satisfactory, 5 is inadequate, 6 is unsatisfactory.

Question 30

What do the CQC,CCSIW,HIW, and RQIA, all have in common?

Answer 30

The CQC in England, CCSIW, and the HIW and RQIA in Northern Ireland all require service providers to register with them before providing care. There are checks during registration to ensure standards of safety and care are met (Including staff standards and amount of qualified staff), services are then continuously monitored and inspected.

Question 31

Where may inspectors be from and what may they do?

Answer 31

Inspectors are drawn from range of backgrounds, including being experienced health and care professionals, members of related professions, care users and informal carers. Inspection team makes judgements and supported by robust evidence on provision quality, safety and effectivity as well as provision management. Each of the national regulators produces National Minimum Standards (NMS) on provision in the areas for the setting types they inspect.

Question 32

What Main Evidence is used to support judgement?

Answer 32

Main sources of evidence to support judgement are:
Feedback from service users, their family, friends, and staff at setting
Written reports of care practices and procedures
Information from other linked local organisations
Complaint records
On-site inspection of practical care provision

Question 33

How May organisations and individuals respond to regulations and inspection?

Answer 33

Weaknesses which managers are unaware of may be identified. Managers and staff may feel confused. To support care providers, regulators publish expectation guidelines. CQC publishes outcomes of each inspection and the health care provision is graded in alignment with care quality. In Northern Ireland the RQIA asses whether the National Minimum Standards are fully, partially, or not met.

Question 34

What may be some Changes in working practice required by Inspection?

Answer 34

Regulations can enforce changes such as:
Requiring or recommending improvements to provider’s policy and practice in specific respects
Issuing a requirement or warning notice to suggest improvements and when they should be done by
Making changes to care provider’s registration to limit care they can provide
Criminal prosecution which may be due to inadequate safeguarding

Question 35

What is NMC?

Answer 35

NMC (Nursing and midwifery council)
Statutory organisation set up by parliament in 2002. Responsible for regulating standards of professional practice for nurses and midwives in UK (England, Scotland, Wales, Northern Ireland) and wherever they’re working. This applies to paid and volunteer improvement.

Question 36

What does NMC set high standards for?

Answer 36

Education and training of nurses and midwives
Continuous professional development
Standards of professional practice
Standards of professional conduct in work and leisure time

Question 37

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Answer 37

NMC sets standards and formal code of practice for all nurses and midwives. Nurses and midwives must provide evidence of continuing learning and training to remain on register. All practising nurses and midwives must register with NMC who investigate allegations of members not meeting the set standards. NMC has power to restrict a nurses practice so that they work under supervision, or undergo more training, or limited to working in number of areas, or to be removed from professional register, which results in them not being permitted to practice.

Question 38

What is the royal college of nursing?

Answer 38

World’s largest union and professional body representing nursing. Represents private, public, voluntary nurses and aims to maintain high nurse standards through education and research.

Question 39

What is Health and care professions council?

Answer 39

HCPC was set up under Health and Social care act 2012. Promotes good practice and protects public in the UK from poor care standards. HCPC regulates number of health and care related professions, 16 to be exact: physiotherapists, OTS, speech therapists, social workers, paramedics.

Question 40

What must members of social care professions do with HCPC?

Answer 40

Members of these professions much register with HCPC and to do this they must:
Have achieved relevant qualifications
Meet standards of professional practice and personal behaviour required by council.

Question 41

What will HCPC do with complaints?

Answer 41

If member of the public feels that HCPC registered person is not meeting standards, they have a right to complain, the HCPC will investigate complaints, take appropriate action and may suspend or permanently remove individuals from register.

Question 42

What is GMC (General medical council)?

Answer 42

Oversees UK medical education/training
Decides which doctors are qualified to work
Sets standards for doctors to meet in professional practice
Take action to address treatment issues that may compromise patient safety
GMC may restrict doctor’s right from practice if a concern is made, they may force doctor to work under supervision, undertake further training, or may remove doctors from register temporarily or permanently.

Question 43

What is care council for Wales?

Answer 43

CCW was set up under care standards act 2000 with the aim of registering and regulating the social workforce in Wales, the CCW confirms and registers the staff working in children/ adult social care and early years in Wales. Includes social workers, social care workers, pre-school staff, nursery staff, play workers

Question 44

What does CCW check about practitoners?

Answer 44

Checks the practitioners:
* Qualifications
* Physical and mental fitness to practice and work
* DBS checks
* Comply with CCW code of practice for social care workers
CCW investigates complaints and takes appropriate action to protect public if professional standards aren’t met.

Question 45

What is Northern Ireland social care council (NISCC)?

Answer 45

Set up under the health and personal services act (Northern Ireland) 2001. CCW in Wales and General social care council were established at the same time.

Question 46

What is the aim of NISCC?

Answer 46

Aim of NISCC is to protect the public and all service users by regulating registration and practice of social work and social care workforce

Question 47

What is NISCC responsibilities?

Answer 47

Responsible for:
* Monitoring and regulating social care workforce in Northern Ireland (Social workers, social care workers and managers, probation officers) who work in residential/day care, homes and other community care settings
* Set standards for training and practice of care professionals
* Promoting professional development

Question 48

How are services improved by regulation?

Answer 48

Sets standards of education, training, professional conduct/practice to ensure high standards through health and social care professionals career. Continuous professional development is necessary due to fast paced changes in health and social care.
If allegation is made against practitioners education, skill ,or professional conduct, regulator will investigate the complaint and suspend members, make them take professional training, restrict types of work they can do, or remove them from professional register.