Quarter 2 - September 2018 
During the second quarter of this there has been a marginal decrease of 1% in the percentage of Care at Home services rated Good or Outstanding by the Care Quality Commission.  This is the first time there has been a decline in performance under this measure, since the change to measuring performance of Care at Home Services in West Sussex against the CIPFA nearest statistical neighbours in Quarter 1 of the current year, which is outlined in the methodology below. 
This marginal decline in current performance is not reflective of the performance of the CIPFA group where the performance of the upper quartile of the group has increased by 3%.
 There continues to be a deficit of people with the appropriate skills and qualifications wishing to work within social care services in West Sussex, as reflected nationally.  West Sussex County Council is continuing to invest in recruitment and retentions initiatives to support the market in addressing this.
Quarter 1 - June 2018
During the last Quarter of 2017/18, the Council reviewed this performance area to consider the Quality of Care at Home in West Sussex measured against performance in the other local authority areas.
 Using the Chartered Institute of Public Finance and Accountancy’s (CIPFA), which takes account of  size of population and geographical area, and size of social care market, we have identified the list below of 15 Local Authorities who have statistical similarities to West Sussex.
Our aim is for the number of Outstanding and Good Care Quality Commission(CQC) ratings, of Care at Home services in West Sussex, to be in the top quartile of statistical neighbours by 2022.  
 The percentage of Care at Home services rated Good or Outstanding by the CQC in West Sussex has increased by 2% during the last Quarter, this represents a trend across the other local authorities within the CIPFA statistical neighbour group, where the group’s average also increased by 2%.
 Recent changes in the CQC inspection regime are beginning to impact the outcomes nationally which is reflected in the outcomes for this quarter; a change in frequency for re-inspection of services rated Good or Outstanding has been applied by CQC along with the introduction of new Key Lines of Enquiry within the inspections.
Staffing has a significant contribution to the quality of services and we are aware of a deficit of people with the appropriate skills and qualifications wishing to work within social care services within West Susses, which is reflected nationally.
West Sussex County Council is investing in recruitment and retention initiatives to support the market in addressing this.
Quarter 4 - March 2018
The year-end result is 88% and is close to target. The main reasons for the improvements during 2017/18 are:-
  •  Prioritising inspections to focus on those Providers whom were previously rated non-compliant.
  • Providing increased support and coaching by WSCC and other commissioners of services to the care markets to promote the sustaining of enhanced quality of care for residents of the County.

Quarter 3 - December 2017

The Percentage of Care at Home Providers rated as Good or Outstanding by the Care Quality Commission (CQC) during 2017 followed an upward trend beyond the target. This is partly due to the prioritisation of inspections focusing on those Providers whom were rated non-compliant under the new inspection regime and also, partly due to West Sussex County Council and other commissioners of services increasing the support and coaching offered to care markets to promote the sustaining of enhanced quality of care for residents of the County.

During 2017 CQC commenced a public consultation process to seek views on their proposals to;

“regulate primary medical services and adult social care services, improve the structure of registration,and clarify their definition of registered providers, monitor, inspect and rate new models of care and large or complex providers, use their unique knowledge to encourage improvements in the quality of care in local areas, carry out their role in relation to the fit and proper persons requirement”

The consultations proposed a number of changes to the way that care services are registered and inspected by the CQC:
  • Key Lines of Enquiry (KLOEs), including the combination of the separate KLOEs currently used for community and residential based services into one new framework. There are 3 additional adult social care Key Lines Of Enquiry (that support the five key questions) with new prompts included in the sub-criteria under each KLOE.
  • Changes to frequency of inspections, including increasing the maximum interval between ratings for services rating Good or Outstanding from 24-months to 30-months.
  • Changes to response where services are repeatedly rated as Requires Improvement
  • Publication of refreshed guidance for ‘fit and proper’ persons requirements in relation to registration to for Providers and improved information sharing.
  • Introduction of an online Provider Information Collection which will allow care providers to submit up-to-date information about the quality of the service they provide directly to the CQC.

Adult Social Care Services were not planned to be inspected under the new revised framework until November 2017 and the maximum interval between inspections for services rated Good and Outstanding is due to be increased from 24 months to 30 months from April 2018, therefore; it may be some time before the impact of this is realised but as CQC implement the new inspection framework this will be a change for providers, consequently we anticipate there being a slight decrease in the quality ratings in the last 2 quarters of the year (services rated Good and Outstanding) compared to those during the last 12-months stabilise.


Quality of Care Homes and Care received at Home

The Care Quality Commission (CQC) is the independent inspector and regulator of health and social care services in England. They make sure health and social care services, such as Care Homes and Care and Support in peoples’ own homes are safe, effective and high-quality. The CQC monitor, inspect and regulate services to make sure that they meet fundamental standards of quality and safety and they publish what they find to help people make informed decisions about their choice of care.

The CQC focus on 5 key questions:

Are they safe?

Are they effective?

Are they caring?

Are they responsive to people’s needs?

Are they well-led?

In order to answer these questions CQC Inspectors will gather information and intelligence from a range of sources including: Local Authorities, NHS and the Care Provider, and then carry out an on-site inspection. Once the inspector has considered all of the evidence related to each question a judgement is made on the compliance rating for each question and an overall rating for the care provider.

There are four ratings which the CQC give to health and social care services: 

Outstanding - The service is performing exceptionally well.

Good - The service is performing well and meeting our expectations.

Requires improvement - The service isn't performing as well as it should and we have told the service how it must improve.

Inadequate - The service is performing badly and we've taken action against the person or organisation that runs it.