Asking questions

Andrea Sutcliffe, Chief Inspector of Adult Social Care at the Care Quality Commission.

What do you do when a journalist asks you a question? If you’ve had the benefit of media training you might know the answer to that one — it’s the ABC of interview techniques. Acknowledge, Bridge and Communicate. Don’t ignore the question (acknowledge) but don’t lose the golden opportunity to get your message across (bridge and communicate).

That can be a great way to handle a short, live interview when time is precious and you have a point to make, but it goes against the grain of our childhood training to “answer the question”. For me that ingrained instinct comes through, particularly in longer conversations with print journalists or pre-recorded TV and radio interviews. Sometimes this can have unintended consequences, as we saw last week.

Hot topic

First, my interview with The Times. Arranged to focus on the publication of our Sandwich Generation survey, it also covered a review of my first year in post. We discussed a range of issues, as I’d already done with, for example, Community Care. In answer to the question about what other issues I’d had to tackle, I discussed the use of overt and covert surveillance.

Frankly, this wasn’t news — we know it is a very live issue in the sector and was signalled last October in A Fresh Start for the Regulation and Inspection of Adult Social Care, included in our consultation document in April, discussed at a round table in May and debated at our public board meeting in July when our intention to produce information for both providers and the public was explained.

So imagine my surprise when the front page headline read “Green light for relatives to spy on care homes”. While the article itself was reasonably balanced, the inaccurate headline triggered a bit of a reaction. We published a statement clarifying the position but that didn’t stop subsequent news items suggesting that we would be issuing instructions on how to use cameras and we wanted relatives to do our jobs for us, none of which is true of course.

Among the hyperbole, the renewed interest in the topic produced some thoughtful blogs — a couple I would suggest are from Stephen Burke in The Guardian and from Marches Care Ltd, a provider in Oxfordshire.

The CQC board on Wednesday will be discussing this issue. You can read the board papers and watch the meeting on our YouTube channel. Only after this will we be finalising our formal position.

Publication of provider handbooks

The second example came with the launch of the provider handbooks last Thursday, explaining how we will regulate residential and community adult social care services.

This was the culmination of a year-long process of hard work, co-production and testing, and I am very grateful to everyone who has worked with us to shape the new approach. All the details are available on our website, including a handy little video explaining the key elements.

In advance of the launch, BBC Breakfast asked to record an interview with me in a care home. Thank you to the staff and residents of Anchor Norton House for letting us disrupt their day.

In the interview I was asked whether I thought there was too much awful care and I answered, yes there is.

As anyone who has read this blog or heard me speak will know, I am always keen to emphasise the great work that happens in social care services. We know that there are thousands of dedicated and skilled staff providing compassionate, high-quality care, and that when this happens, social care can transform people’s lives for the better. That’s why CQC has been such a supporter of initiatives like National Care Home Open Day to help showcase the great care that happens.

But that is not always the case and I spoke truthfully when I said that there is too much awful care. It’s not everywhere, but it does exist and pretending that it doesn’t won’t help us to tackle the problem. Nor do recognising and addressing failures in care mean that I think all care is bad.

But of course, the “too much awful care” is what grabbed the headlines and I know that has caused concern for many leaders and staff in the sector. It is sad that an essentially positive story for social care was used to highlight concerns. However, the real solution to these concerns lies in our own hands by making sure people always receive high-quality, safe, effective and compassionate care.

Cracks in the Pathway

Today we are publishing our report on the care of people living with dementia as they move between care homes and hospitals. We found some excellent care in various settings but also found widespread variation, meaning too many people are at high risk of experiencing poor care at some stage. This cannot be acceptable, especially as we have a wealth of information from NICE, SCIE and others so we know what we should be doing.

There will be some who will once again worry that shining a spotlight on the problems in hospitals and care homes will detract from the good care that does happen. I hope not. But it is only when we are honest with ourselves about what isn’t working that will we be able to put it right. This film from SCIE about people living with dementia reminds us why it is so important we do.

Answer the question!

Which takes me right back to the beginning — what do you do when someone asks you a question, be they a journalist or even a CQC inspector? I suggest, answer the question and be prepared for the consequences!

Originally published at

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