The roles of organisations that regulate and inspect health and social care services

Question 1

Name the organisations that regulate or inspect health and social care services in England

Answer 1

• Care Quality Commission (CQC)
• Ofsted

Question 2

What is the CQC responsible for?

Answer 2

The CQC is responsible for monitoring and inspecting health services and adult social care services in England.

Question 3

What is the CQC’s aim?

Answer 3

It aims to ensure that health and social care services are of a high quality and that they are delivered safely, effectively and compassionately.

Question 4

What does the CQC monitor and inspect?

Answer 4

▸ NHS Trust hospitals and independent hospitals
▸▸ GP provision, including GP practices, walk-in services and out-of-hours provision
▸▸ clinics, including family planning clinics, slimming clinics and clinics run by GPs and
hospitals
▸▸ dentists
▸▸ residential care homes and nursing homes
▸▸ domiciliary or home care services
▸▸ community care provision, including day centres and other community support for people with physical, social or mental health problems, or people who have a
learning disability
▸▸ mental health provision, including provision for people who are detained, for people whose rights are restricted under the Mental Health Act (2007) and for those who voluntarily receive care, either in hospital or in the community
▸▸ accommodation for people requiring treatment for substance misuse

Question 5

What must all providers of services do?

Answer 5

All providers of these services must register with the CQC. A service provider can be an individual, a partnership or an organisation – for example a company, a charity, an NHS Trust, or a local authority.

Question 6

What does OFSTED stand for?

Answer 6

The Office for Standards in Education, Children’s Services and Skills

Question 7

What does OFSTED do?

Answer 7

regulates and inspects services that educate children, young people and adults or care for children through inspection of:
▸ state funded schools and colleges, and some independent providers
▸▸ adult education providers
▸▸ initial teacher education
▸▸ many private agencies who provide training in the workplace, particularly those that
educate and train apprentices
▸▸ education provision in prisons and the armed forces.

Question 8

What does OFSTED also do?

Answer 8

Ofsted also regulates and inspects care provision for children and young people, for
example by inspecting:
▸▸ nurseries, pre-schools and child minders
▸▸ fostering and adoption agencies
▸▸ settings providing residential care for children

Question 9

How do OFSTED Inspectors make judgements about the overall effectiveness of the provider?

Answer 9

Based on their judgements relating to the:
▸ effectiveness of leadership and management
▸▸ quality of teaching, learning and assessment
▸▸ personal development, behaviour and welfare
▸▸ outcomes for children and learners.

Question 10

How is provision graded on OFSTED reports?

Answer 10

Grade 1 – Outstanding
Grade 2 – Good
Grade 3 – Requires Improvement
Grade 4 - Inadequate

Question 11

What other 2 organisations do we look at in England?

Answer 11

The NICE
Public Health England

Question 12

What does the NICE stand for?

Answer 12

The National Institute for Health and Care Excellence

Question 13

What does the NICE do?

Answer 13

NICE is responsible for providing guidance on current best practice in health and social care. It publishes guidance and advice that aims to control and improve health and social care provision.

Question 14

What does the NICE provide?

Answer 14

▸▸ guidance on the most appropriate treatments for people with specific conditions and diseases, such as cancer or diabetes
▸▸ evaluation of whether procedures are sufficiently safe and effective to be used within the health and care services
▸▸ guidance about the use of specific health technologies and procedures, including
the use of new and existing medicines, treatments and procedures
▸▸ assessment of the cost and the effectiveness of treatments
▸▸ recommendations about best practice, based on the most recent research
▸▸ support for health promotion campaigns and healthy living advice.

Question 15

Who uses NICE recommendations?

Answer 15

NHS practitioners, local authorities, charities and any organisations financed by the government who provide HSC services.

Question 16

What does the NICE aim to do?

Answer 16

it aims to provide a smoother transition for service users moving from health services to social care services, and from children’s services to adult social services.

Question 17

Where is the NICE based?

Answer 17

NICE has jurisdiction in England and Wales and its recommendations are national, providing consistent approaches for service users wherever they live.

Question 18

What does PHE stand for?

Answer 18

Public Health England

Question 19

What is Public Health England?

Answer 19

PHE is an executive agency sponsored by the Department of Health that was set up on 1 April 2013, following the implementation of the Health and Social Care Act (2012).

Question 20

What does Public Health England aim to do?

Answer 20

It aims to protect and improve the public health and wellbeing of people in England, and to reduce health inequalities. The focus of all public health organisations is on the protection and improvement of the health of a community or population, in contrast
to the individual support of a service user discussed earlier.

Question 21

Define public health

Answer 21

organised strategies to prevent disease, promote health and prolong life in a population.

Question 22

What measures does PHE use to carry out its responsibilities?

Answer 22

▸▸ setting up health promotion programmes to improve the nation’s health, for
example PHE ran a high-profile campaign ‘Be Clear on Cancer’, with a particular
focus on the prevention of lung, bowel, kidney and liver cancer
▸▸ research projects to improve our knowledge of public health issues and generate
strategies to address problems, for example in 2015 PHE published a report on the
prevalence of breastfeeding at 6–8 weeks after birth
▸▸ taking measures to protect the nation’s health when there is a public health concern,
such as when an epidemic is threatened or a new virus is circulating

Question 23

Give some examples of campaigns supported by Public Health England

Answer 23

Examples of campaigns supported by PHE include, in 2013, helpful advice for people who may be affected by flooding, and in the autumn of 2015 PHE launched their largest flu vaccination programme, ‘Stay well this winter’.

Question 24

What does the CQC in England require?

Answer 24

Service providers to register with them before offering care services.

Question 25

What happens when a service provider applies for registration?

Answer 25

there are checks to ensure that it meets the necessary standards of safety, and has the resources to ensure high standards of care (including an appropriate number of sufficiently experienced and qualified
staff). Once registered, the services are continually monitored. This includes regular
inspection.

Question 26

Describe how inspections of organisations that regulate/inspect health and care services (CQC) take place

Answer 26

• Inspectors are drawn from a range of backgrounds, including experienced health and care professionals, members of other related professions and also care users and their informal carers.
• The inspection teams make judgements supported by robust evidence, on the quality of provision, such as whether the care provision is safe, caring, effective in carrying out its services, well-managed and well led.
• Each of the national regulators publishes National Minimum Standards (NMS) of provision in these areas for the types of settings that they inspect.

Question 27

What are the main sources of evidence used to support their judgements? (Inspections of organisations)

Answer 27

▸▸ feedback from service users, their families and friends, and from staff at the setting
▸▸ written reports of care practice and procedures
▸▸ information from other linked local organisations
▸▸ records of complaints
▸▸ on-site inspection of practical care provision.

Question 28

How might organisations and individuals respond to regulation and inspection?

Answer 28

• Inspection can be a stressful experience
• Managers and staff may feel vulnerable and angry
• Managers and staff may feel they can’t make the improvements needed.

Question 29

How do regulators support care providers?

Answer 29

• The regulators publish clear guidance that outlines what they expect to see.
• Following an inspection, the regulator publishes a report.
• The CQC publishes the outcomes of each inspection and the health and care provision is graded according to the quality of care provided.

Question 30

What happens if practice doesn’t meet the required standards after inspection?

Answer 30

the regulator can enforce change, which may include:
▸▸ requiring or recommending improvements to the provider’s policy and practice in specific respects, for example to share good practice in the provision of care
▸▸ issuing a requirement notice or warning notice, to set out what improvements the care provider must make, and by when
▸▸ making changes to a care provider’s registration to limit the range of care that they are able to provide
▸▸ pursuing a criminal prosecution in extreme cases, such as when there is inadequate safeguarding of service users from abuse and improper treatment.

Question 31

Name organisations that regulate professions in the health and social care services in England

Answer 31

The Nursing and Midwifery Council (NMC)
The Royal College of Nursing (RCN)
The Health and Care Professions Council (HCPC)
The General Medical Council (GMC)

Question 32

When was the NMC set up?

Answer 32

By Parliament in 2002

Question 33

What is the NMC responsible for?

Answer 33

It is responsible for regulating the standard of professional practice of all nurses and midwives in the United Kingdom (England, Scotland, Wales and Northern Ireland) wherever they are working. This applies whether they are in paid employment or working as a volunteer.

Question 34

What does the NMC set high standards for?

Answer 34

▸▸ initial education and training of nurses and midwives
▸▸ continuing professional development
▸▸ standards of professional practice
▸▸ standards of personal conduct, both at work and in leisure time

Question 35

What does the NMC do?

Answer 35

The NMC sets the standards and formal code of practice required of all nurses and
midwives.

Question 36

Describe the NMC and the register

Answer 36

Nurses and midwives have to provide evidence of continuing learning and training in order to remain on the register. All practising nurses and midwives are required to register with the NMC, who investigate any allegations that their members are not meeting the standards set.

Question 37

What does the NMC have the power to do?

Answer 37

The NMC has the power to restrict a nurse’s practice, for example to require that they work under supervision, take specific training or are restricted to working in a limited number of areas, or to remove them from the register. If a nurse or midwife is removed from the register they are no longer permitted to practice.

Question 38

What is the Royal College of Nursing?

Answer 38

It is the world’s largest union and professional body representing the nursing profession. It represents nurses in the public, private and voluntary sectors.

Question 39

What does the RCN aim to do?

Answer 39

The RCN aims to maintain high standards in nursing practice through their education and research activities.

Question 40

When was the Health and Care Professions Council set up?

Answer 40

In 2o12 under the Health and Social Care Act (2012)

Question 41

What does the HCPC promote?

Answer 41

The HCPC promotes good practice and also exists to protect the public, throughout the United Kingdom, from poor standards of care.

Question 42

Who does the HCPC regulate?

Answer 42

The HCPC regulates a wide range of health and care related professionals, sixteen
different professions in all, including physiotherapists, occupational therapists, speech therapists, social workers and paramedics. Members of these professions must register with the HCPC.

Question 43

How does someone register as a HCPC approved practitioner?

Answer 43

individuals must:
▸▸ have achieved the relevant qualifications
▸▸ meet the standards of professional practice and personal behaviour required by the council.

Question 44

What happens if someone complains about a professional registered with the HCPC?

Answer 44

The HCPC will investigate complaints and take the appropriate action. In cases of serious misconduct, this can include suspension or permanent removal from the register.

Question 45

What is the General Medical Council (GMC)?

Answer 45

The GMC is an independent organisation for the registration and regulation of
doctors.

Question 46

What does the GMC do?

Answer 46

▸▸ oversees UK medical education and training
▸▸ decides which doctors are qualified to work in this country
▸▸ sets the standards that doctors must meet in their professional practice
▸▸ takes action to address shortfalls in the standards of treatment that may put
patients’ safety at risk, or brings the medical professions into disrepute.

Question 47

What happens if a serious concern is raised about a doctor’s behaviour or professional practice?

Answer 47

the GMC investigates. If the concern is upheld, the GMC may restrict the doctor’s right to practice. The doctor may be required to work under supervision or to undertake further training or in extreme circumstances they may be removed temporarily or permanently from the register.

Question 48

What is the overall purpose of regulation?

Answer 48

to protect the public by setting standards of education, training, professional conduct and professional practice, to ensure high standards are maintained throughout a health and care professional’s career. Health and care work is a fast changing area, with constant new developments that require new approaches to work. This can be stressful for care workers and requires significant continuing professional development.

Question 49

What do regulators have the power to do?

Answer 49

If an allegation is made that a practitioner is not meeting the standards of education, skill or professional conduct expected, their regulator will investigate that complaint. The regulators have the power to suspend their members, require them to take additional training, restrict the types of work that they can do or, in extreme circumstances, remove them from the professional register.