Risk and CQC Compliance Lead

Job description

Job responsibilities

Organisational Values: The post holder will uphold the vision and core purpose of the Trust, reflecting the Organisational Values in all their interactions with service users, colleagues, partners, stakeholders and the wider community.

Risk Register: You will explore, develop and recommend approaches for risk management, including use of appropriate information technology and software. You will promote and continuously develop a proactive risk management culture across the organisation and fully embed risk systems and processes, ensuring that risk records translate into operational actions and responses in a meaningful way. The work programme will require you to:

• Review and revise the Trusts Risk Management Strategy on an annual basis, including the development of an annual work programme.
• Develop, maintain and operationalise risk systems and supporting processes utilising the Ulysses Risk Register module to record, update and support management of risk.
• Develop and support associated infrastructure required to embed risk management throughout the organisation (across both operational and corporate functions).
• Prepare Risk Reports for sign off via Chief Nursing Officer and for submission to the groups and committees across the Trust, including Trust Board and its sub-committee structure.
• Continuously develop a proactive risk management culture across the organisation to include bespoke training and educational sessions and planned interventions as required.
• Develop and facilitate an internal review programme to provide assurance on the risks to the safe and quality delivery of systems and processes.
• Develop, implement and audit systems to provide assurance to the Trust Board (or its sub-committees) on key risks.

CQC Fundamental Standards: The post holder will support the preparatory requirements of CQC inspections and assessments, including those that are unannounced. Working alongside clinical teams the post holder will support and create systems and processes to assist in demonstrating compliance and will act as a source of advice to all staff, at all levels across the organisation in the articulation of CQC regulatory requirements. The work programme will require you to:

• Be up to date with national policy in respect of all aspects of CQC regulatory activity and provide specialist advice and support as required by the Trust Board and its sub committees, through to managers and staff working at the front line of service delivery.
• Co-ordinate responses to a core service inspection and assessment visit by the CQC (announced and unannounced), being a central hub for the transfer of information and evidence, arranging internal briefing sessions, and supporting the inspection and assessment process.
• Provide oversight and review of the robustness and quality of evidence submitted for the purpose of CQC inspection and assessment providing advice on same to leads across the Trust.
• Lead the development and implementation of systems and processes, which provide assurance to the Trust Board, for the effective delivery of the CQC Fundamental Standards (or any successor model).
• Prepare CQC Inspection and Assessment Activity and Preparation reports for submission to the groups and committees across the Trust, including Trust Board and its sub-committee structure.
• Prepare/facilitate a regular group meeting, Chaired by the Chief Nursing Officer, to support compliance with the CQC Fundamental Standards.
• Prepare/facilitate responses to enquiries received from the CQC in relation to the care and treatment provided to patients or concerns raised by families/carers or other stakeholders.
• Support the production of responses returned to the CQC following inspection and assessment (e.g factual accuracy checks, and Provider Action Statements)
• Maintain a contemporary Statement of Purpose, accurately reflecting the Trusts registration for regulated activity on behalf of the Chief Nursing Officer.
• Leading the preparatory requirements of the regulatory / inspection and assessment programme of work including internal Peer Review visits (or equivalent) and oversight of feedback and subsequent action planning.
• Act as the interface and point of contact between the CQC engagement team assigned to work with the Trust.
• Act as the Interface with the Mental Health Act (MHA) department and leads in relation to MHA activity and related concerns/complaints and enquiries.

Other types of inspection and assessment: The post holder will support the preparatory requirements of other associated inspection activity (for example (His Majestys Police Inspectorate or Special educational needs and disabilities (SEND). Working alongside clinical teams the post holder will support and create systems and processes to assist in demonstrating compliance and will act as a source of advice for inspection.

Policy Monitoring: Working with the Chief Nursing Officer and policy authors across operational and corporate services, the post holder will facilitate the collection and monitoring of key data evidencing compliance with key trust policies. The work programme will require you to:

• Develop a programme of policy monitoring reporting, focussed on key policies that underpin compliance with CQC Fundamental Standards or are associated with the safe and effective delivery of services.
• In conjunction with other leads across the Trust, utilise bespoke software to support policy monitoring activity (e.g supporting the production of Standard Operating Procedures to deliver monitoring activity).
• Prepare Policy Monitoring reports for sign off via Chief Nursing Officer and for submission to the groups and committees across the Trust, including Trust Board and its sub-committee structure.

Quality Account: Working with senior members across operational and corporate services, the post holder will support the review and development of systems and processes to facilitate the annual Trust Quality Account. The work programme will require you to:

• Review and revise the Trusts Quality Account delivery plan on an annual basis, taking into account any nationally derived changes to legislation, content requirements or changes in personnel within the Trust.
• Develop, maintain and operationalise a Quality Account Priorities report and any supporting processes (in conjunction with operational services).
• Prepare Quality Account reports for sign off via Chief Nursing Officer and submission to the groups and committees across the Trust, including Trust Board and its sub-committee structure.
• Facilitate engagement with key external stakeholders, including ICB, Healthwatch and Local Authority representatives to support delivery of Quality Account.
• Prepare the Quality Account for submission externally as a draft document, for the purposes of seeking commentary from key stakeholders.
• Prepare the final Quality Account for submission and approval by Trust Board and for the purpose of reporting nationally (by 30 June of each year).

Person Specification

Qualifications

Essential

• Professional qualification at Degree level or above.
• Additional training and / or equivalent working experience in an area related to risk / safety.

Experience

Essential

• Substantial experience of working within the NHS or similar organisation in a safety / risk role / governance role.
• Experience of investigating incidents / issues / risks quality concerns
• Experience of interpreting complex data / reports / dashboards.
• Experience of writing and producing reports for senior Groups and Committees.
• Experience in designing and delivering education and training programmes to all grades of staff

Other

Essential

• Driving licence / ability to drive and own means of transport in working hours.

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Employer details

Employer name

Coventry and Warwickshire Partnership Trust

Address

Wayside House

Wilsons Lane

Coventry

CV6 6NY

Employer's website

https://www.covwarkpt.nhs.uk/ (Opens in a new tab)