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Care Quality Commission – Annual Report and Accounts 2016/17

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Care Quality Commission – Annual Report and Accounts 2016/17 Annual report and accounts 2016/17 HC 200 Care Quality Commission Annual report and accounts 2016/17 Presented to Parliament pursuant to paragraph 10(4) of Schedule 1 of the Health and Social Care Act 2008. Ordered by the House of Commons to be printed on 18 July 2017. HC 200 © Care Quality Commission copyright 2017 The text of this document (this excludes, where present, the Royal Arms and all departmental or agency logos) may be reproduced free of charge in any format or medium provided that it is reproduced accurately and not in a misleading context. The material must be acknowledged as Care Quality Commission copyright and the document title specified. Where third party material has been identified, permission from the respective copyright holder must be sought. Any enquiries related to this publication should be sent to us at [email protected]. This publication is available at https://www.gov.uk/government/publications Print ISBN 9781474144971 Web ISBN 9781474144988 ID 15051708 07/17 Printed on paper containing 75% recycled fibre content minimum Printed in the UK by the Williams Lea Group on behalf of the Controller of Her Majesty’s Stationery Office. Contents Who we are and what we do 2 Performance report 4 Foreword 7 Progress against our strategy for 2016 to 2021 10 Performance summary 12 Performance analysis 16 Accountability report 76 Corporate governance report 78 Remuneration and staff report 105 Parliamentary accountability and audit report 121 Certificate and report of the Comptroller and Auditor General 123 to the Houses of Parliament Financial statements 126 Statement of Comprehensive Net Expenditure 128 Statement of Financial Position 129 Statement of Cash Flows 130 Statement of Changes in Taxpayers’ Equity 131 Notes to the financial statements 132 Care Quality Commission Annual report and accounts 2016/17 1 Who we are and what we do Who we are... ...and what we do The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England. Our role Register Monitor, inspect Enforce Independent and rate voice We register health We monitor and We use our legal We speak and adult social care inspect services to powers to take action independently, OUR providers. see whether they where we identify publishing regional and PURPOSE are safe, effective, poor care. national views of the caring, responsive major quality issues We make sure health and well-led, and in health and social and social care services we publish what care, and encouraging we find, including improvement by provide people with safe, quality ratings. highlighting good effective, compassionate, practice. high-quality care and we encourage care services to improve. 1 2 3 4 We are focused on Encourage Deliver an Promote a Improve our four strategic improvement, intelligence- single shared efficiency and innovation and driven approach view of quality effectiveness priorities Our values How we sustainability to regulation underpin are in care everything organised we do ●● We are independent, but we report to Parliament through the Department of Health. ●● We work with other regulators, local authorities and commissioning ●● EXCELLENCE We are organised under five directorates: groups, health and social care organisations, and organisations that Who we represent people who use services, including the Healthwatch network. ●● CARING ●● ADULT SOCIAL CARE work with ●● Healthwatch England, the national consumer champion for users of ●● INTEGRITY ●● HOSPITALS health and social care services, is a statutory committee of CQC’s Board. ●● TEAMWORK ●● PRIMARY MEDICAL SERVICES AND INTEGRATED CARE ●● The National Guardian’s Freedom to Speak Up Office (NGO) is jointly ●● STRATEGY AND INTELLIGENCE funded by CQC, NHS Improvement and NHS England. CQC’s Chief ●● CUSTOMER AND CORPORATE SERVICES Executive has responsibility as Accounting Officer for the NGO. 2 Care Quality Commission Annual report and accounts 2016/17 Care Quality Commission Annual report and accounts 2016/17 3 Performance report 1 The performance report consists of four sections: Foreword from CQC’s Chair and Chief Executive 7 Progress against our strategy for 2016 to 2021 10 Performance summary 12 ●● A performance summary for 2016/17 that highlights important achievements, progress towards our objectives and targets, and our impact as a regulator Performance analysis 16 ●● A performance analysis for 2016/17 that is a detailed explanation of our performance during the year, with evidence to support the performance summary Foreword Peter Wyman Sir David Behan Chair Chief Executive Four years ago, we set out on the first phase of an ambitious journey PERFORMANCE REPORT to radically change the way health and adult social care in England is regulated. The past year has been a successful one for CQC, having delivered on our business plan, including completing our comprehensive inspection and ratings programme. As a result, we now have a robust baseline of quality across health and social care. We are the only country in the world to have an independent assessment of the quality of health and social care by a single regulator. Always at the centre of our work is our clear purpose: to make sure health and social care services provide people with safe, effective, compassionate, high-quality care and to encourage services to improve. With our programme now complete for NHS trusts, adult social care services, GP practices, out-of-hours care, urgent care, NHS 111 and the independent healthcare sector (as well as our annual inspections of 10% of dental services), we can now see the fruits of our commitment to delivering on that purpose. It has provided a strong foundation on which to build our next phase of regulation. We want to thank our staff for the immense hard work they have put into the last 12 months and for their commitment and dedication to our purpose and values. We want to be a catalyst for changes that improve the quality of care that people receive. Our ratings allow us to highlight improvements in care and identify excellence, as well as to see where care might not be improving. They show that when we re-inspect, most providers do improve, particularly those rated inadequate or requires improvement. If providers do not improve, we take enforcement action to protect people from poor care. Care Quality Commission Annual report and accounts 2016/17 7 Performance report Our performance during the year has been strong and sustained in most areas. With our inspector recruitment programme now complete, our inspector workforce is in line with our plans and we have robust recruitment and retention policies in place. We also saw an increase in enforcement actions taken compared with last year, including our first four prosecutions using our new powers. While we have made good progress in many areas, there are some areas where we need to improve. We still took too long to publish our inspection reports – we are continuing to examine how we can streamline our systems and simplify our reports to make sure people can access a report as quickly as possible after an inspection. Also, although our registration performance improved from last year and we were close to achieving our targets, we still need to do better. Our achievements have been in the context of a reducing budget – from £249 million in 2015/16 to £236 million in 2016/17. At the same time, the main source of our funding has moved from the Department of Health to fees paid by providers. Our budget will continue to reduce and we need to deliver our purpose with fewer resources. This year we have focused on strengthening our systems and processes to become more efficient and effective, and to ensure we can deliver value for money to the public, people who use services and their carers, and providers. We have managed to significantly reduce the cost of our inspections for the first time since 2010/11 and we will look to achieve further reductions. We appointed a Chief Digital Officer to oversee delivery of our information management and technology strategy, setting out to overhaul our systems over the next few years. This will include putting far more of our transactions with providers online, helping to improve the information we collect and rationalising the burden, particularly in data collection and processing. Public accessibility to our data will also be enhanced. Our annual report to Parliament, State of Care, signalled the changing health and social care landscape in a context of increasing demand for services and financial challenge. Our unique view across all the different types of care enabled us to highlight our concerns that adult social care services were approaching a ‘tipping point’. This led to national and high-profile debates, including in Parliament, about how quality can be improved in adult social care and, in this case, discussions about additional funding for the sector. New ways of providing care, such as online GP services and innovative solutions to managing hospital discharge processes, present us with important challenges and considerations for the way we regulate. We wish to encourage innovation while ensuring that all care, however provided, is safe and effective. 8 Care Quality Commission Annual report and accounts 2016/17 Foreword Building on our strong foundation, we have started the evolution to the next phase of our work in line with our strategy for 2016 to 2021, Shaping the future, which set out our vision for a more targeted, responsive and collaborative approach to regulation. We spent a large part of the year talking to members of the public, people who use services, providers and our stakeholders to help shape and develop our plans. Our next phase of regulation of NHS trusts, alongside simpler and consolidated assessment frameworks, is being rolled out early in 2017/18 after formal consultation.
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