CQC’s Valentine’s Day message to the adult social care sector

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

Very few people love a regulator — some people think we do too little, others that we do too much. So, perhaps our sub-conscious was at work when we set the deadline for the consultation on CQC’s ‎next phase of inspections as 14 February, Valentine’s Day.

This is an important consultation — since introducing our new, more thorough approach to inspection in 2014 we have completed over ‎30,000 inspections in adult social care alone. Across all the sectors we regulate we have learnt a lot from our experience. We have also had lots of feedback from providers, people who use services, their families and carers and our partners. All this has shaped our proposals to improve our continuous monitoring of providers, streamline our assessment frameworks and ensure we focus on the key aspects of leadership and safety that have been the most challenging areas for providers to date.

We have already had responses — individuals and organisations carefully considering our proposals and offering support, suggestions for change and critical challenge. That’s just as it should be — adult to adult conversations that will enrich and improve our vital work to ensure people receive health and care services that are safe, compassionate, effective and high-quality. We have never suggested that we are perfect; there will always be room for improvement in our methodology, approach and performance. Working with others will help to identify and deliver that improvement.

Not everyone is sending us a Valentine though. Fair enough, Valentine’s Day isn’t everyone’s cup of tea. I won’t be getting one from my husband either — he reckons he doesn’t need to be told when to say “I love you”.

But ‎even in the new world of “alternative facts”, ill-informed commentary that then gets repeated as reality is not going to help. Contrary to what John Burton has written for the Guardian Social Care Network:

  • We do want to hear from people about their experience of care — this helps us to determine the timing and focus of our monitoring and inspection of services. Every week information is passed to and followed up by my inspectors leading to improvements in care for everyone using services. We will also explain how people can take forward their complaints if that is what they want to do too.
  • CQC is a national organisation but our teams are local and have established strong relations with providers, commissioners, public organisations and others. This local intelligence helps to strengthen the monitoring of services and encourages support from others to help improve services.
  • CQC inspections do not just focus on records, policies and procedures — this is an out-of-date view of our inspection methodology. These things are important but their impact on, and the experience of, people using the services are what drive our assessments of care as is evident in the detailed explanation of our inspection methodology in our handbooks available on the website.
  • Our inspections will be driven by the three Rs — within a year of Registration; in response to Ratings (within 6 months if Inadequate, 12 for Requires Improvement and 2 years for Good and Outstanding); and in response to Risk.

He is right about one thing though — we cannot rely on regulation alone to deliver improvement in services. Regulation is an important lever in setting expectations, monitoring, inspecting and rating services and taking enforcement action when it is required. But it takes a collective effort from staff, providers, commissioners and funders as well as other national organisations all listening and responding to the voice of people using services, their families and carers to truly make a sustainable difference to quality.

Depending on the regulator for quality will only ever go so far — everyone stepping up and delivering on their responsibility for quality is where we need to be. That’s the Valentine Day’s message the adult social care sector as a whole needs to send to the people who matter most — those who are using these vital services, their families and carers.