Annual report and accounts 2012/13 Raising standards, Putting people first Care Quality Commission Annual report and accounts 2012/13 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 11 July 2013. HC 374 London: The Stationery Office £38.75 © Care Quality Commission 2013 The text of this document (this excludes, where present, the Royal Arms and all departmental and agency logos) may be reproduced free of charge in any format or medium providing 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 regarding this publication should be sent to us at [email protected] You can download this publication from www.cqc.org.uk ISBN: 9780102985641 Printed in the UK for The Stationery Office Limited on behalf of the Controller of Her Majesty’s Stationery Office ID: 2570088 07/13 Printed on paper containing 75% recycled fibre content minimum. Contents CQC at a glance 2 Strategy review 5 Chair’s Foreword 8 Chief Executive’s Review 10 Business review 15 1. Using information and inspection 15 2. Working with our partners 39 3. Building relationships with the public 47 4. Building relationships with those we regulate 55 5. Our responsibilities in mental health and mental capacity 61 6. Building a high-performing organisation 67 Our Board 76 Our Executive Team 78 Management commentary 80 Remuneration report 95 Statement of Accounting Officer’s Responsibilities 102 Governance statement 103 Certificate and Report of the Comptroller and Auditor 130 General to the Houses of Parliament Financial statements 132 Notes to the financial statements 136 Raising standards, Putting people first: CQC at a glance The Care Quality Commission is the independent regulator of health and adult social care in England. Our purpose is to make sure health and social care services provide people with safe, effective, compassionate, high-quality care and to encourage care services to improve. Our role is to monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety, and to publish what we find, including performance ratings to help people choose care. In April 2013 we announced our strategy to transform CQC so that it can fulfil its purpose and carry out its role effectively, focusing on six strategic priorities: 1 2 3 4 5 6 Better Working Building Building Strengthening Building use of better with better relationships how we a high- information our partners relationships with those deliver our performing and in the health with the we regulate responsibilities organisation inspection and social public in terms of care system mental health and mental capacity How we carry out our role ■■ We listen to and act on people’s views and experiences of the care they receive. ■■ We set standards of quality and safety that people have a right to expect whenever they ■■ We challenge all providers, with the worst receive care. performers getting the greatest attention. ■■ We register care services that meet our ■■ We make fair and authoritative judgements, standards. supported by the best information, evidence and data. ■■ We monitor, inspect and regulate care services to make sure that they continue to meet the standards. ■■ We protect the rights of vulnerable people, including those whose rights are restricted under the Mental Health Act. 2 Care Quality Commission Annual report and accounts 2012/13 CQC AT A GLANCE AT CQC CQC AT A GLANCE ■■ We take appropriate action if care services are Funding in 2012/13 failing to meet the standards. £92.7m Annual fee income paid by care ■■ We carry out in-depth investigations to look providers at care across the system. £68.1m Grant-in-aid received from the ■■ We report on the quality of care services, Department of Health publishing clear and comprehensive STRATEGY REVIEW STRATEGY information, including performance ratings to help people choose care. Sectors we regulate* ■■ We involve people who use care services in Registered Registered our work, working with local groups, our providers locations partners in the health and social care system, NHS trusts 256 2,156 and the public to make sure that people’s views and experiences are at the centre of Independent health 1,402 3,033 care what we do. Independent 243 304 CHAIR’S FOREWORD Our principles ambulance Primary dental care 8,057 10,102 ■■ We put people who use services at the centre of our work. Adult social care 12,669 25,275 GP and primary 7,634 8,658 ■■ We are independent, rigorous, fair and medical services** consistent. Total 30,261 49,528 ■■ We have an open and accessible culture. *Figures as at 31 March 2013 CHIEF EXECUTIVE’S REVIEW ■■ We work in partnership across the health and social care system. **From 1 April 2013; includes GP out-of-hours services registered from 1 April 2012. ■■ We are committed to being a high- performing organisation and apply the Key highlights 2012/13 same standards of continuous improvement to 35,371 Total inspections carried out ourselves that we expect of others. 1,408 Inspections that included Experts by ■■ We promote equality, diversity and human Experience (people from outside CQC rights. with experience of receiving care) 8,634 Whistleblowing contacts received REVIEW BUSINESS 910 Warning notices to providers 83% Percentage of warning notices issued within 14 days of identifying one is required 1,090 Visits by Mental Health Act Commissioners 94% Safeguarding calls answered in 30 seconds by National Customer Service FINANCIAL STATEMENTS GOVERNANCE AND GOVERNANCE Centre Care Quality Commission Annual report and accounts 2012/13 3 CQC AT A GLANCE How we fit into the wider health and social CQC care system The Care Quality Commission is a non-departmental public body, overseen by the Department of Health. We were established under the Health and Social Care Act 2008. We are accountable to the Secretary of State for Health for discharging our functions, duties and powers effectively, efficiently and economically. We are one part of a larger health and social care system in England that has seen huge changes in the way it is structured from 1 April 2013. The diagram on the right gives a global overview of the responsibilities under the new system. Facts and figures Structure and workforce Four operational regions: North, Central, South and London National Customer Service Centre in Newcastle, HQ in London Permanent staff 2,148* Of which: 955 frontline inspectors *Average whole-time equivalent staff during the year 4 Care Quality Commission Annual report and accounts 2012/13 STRATEGY REVIEW A GLANCE AT CQC Strategy review In 2012/13 CQC carried out a fundamental REVIEW STRATEGY review of its purpose and role. The review resulted in a new strategy for the organisation. In developing it we looked closely at how we carry out our role, listening to what people who use health and social care services, providers of those services and others told us about what matters to them. We took into account the transformation of As a result, we are making major changes to the health and social care system, which makes what we do and how we do it, and we will CHAIR’S FOREWORD it even more important that existing and new deliver these changes between 2013 and 2016. organisations work together efficiently and In developing our strategy, we engaged and effectively. And we reflected the Secretary of consulted at length with our staff, members of State’s initial response to the landmark Francis the public, people who use services, providers, Report into the failings at Mid Staffordshire NHS stakeholders, and our partners in the health and Foundation Trust, which set out important new social care system. responsibilities for us. CHIEF EXECUTIVE’S REVIEW How we engaged and listened during our strategy review The strategy sets out CQC’s direction for the next three years. It states the changes we intend to make and demonstrates our commitment to make sure people receive safe, effective, compassionate, high-quality care. As the outputs from the consultation were so significant, it was important that we carried out an extensive engagement programme to hear the views and opinions of as many people as we could. We held national and regional events across England for people who use services, providers, commissioners, regulators and other key stakeholders. We ran an extensive programme of briefings and meetings with staff to make sure colleagues across the organisation had the REVIEW BUSINESS opportunity to discuss and contribute to the strategy as it developed. We held events specifically for people who use services, involving Experts by Experience, Local Involvement Network representatives and CQC’s eQuality Voices group. We also targeted seldom heard groups to get a view from diverse communities such as travellers and Jewish women. In addition there were public focus groups, online discussions, and e-bulletins to key audiences as well as submissions online to the consultation questions. Overall we engaged with more than 1,500 people, and used their views and opinions to inform our strategic direction for the next three years. Chris Hopson, Foundation Trust Network’s Chief FINANCIAL STATEMENTS Executive, commented: “We would particularly commend the recent stakeholder engagement AND GOVERNANCE exercise on CQC’s strategy, which was a model of its kind.” Care Quality Commission Annual report and accounts 2012/13 5 STRATEGY REVIEW We are clear that our purpose is to make sure ■■ We will appoint a Chief Inspector of Hospitals, that health and social care services provide a Chief Inspector of Social Care, and a Chief people with safe, effective, compassionate, Inspector of General Practice.