Spotlight on strategy

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

This weekend I went to see the movie Spotlight*, the story of The Boston Globe investigation into child abuse by priests and the decades-long cover up by the Catholic Church.

It is a powerful story told in an understated way that makes it all the more compelling. The hard but important work of investigative journalism must be difficult to translate to the screen but the journalists it depicts have testified to the film’s authenticity and I think that’s one reason it makes such an impact.

Impact

The story itself is the other main reason for that impact. The abuse of children and young people by those in authority is horrifying but that it was allowed to continue, for victims to be silenced and the abusers to be protected for so long, is utterly shameful. As the final reel of the film makes clear, this was not just in Boston but across the world. Nor is it just the Catholic Church. As Dame Janet Smith’s inquiry into the BBC during the Jimmy Savile and Stuart Hall years lays bare, there are too many occasions when the culture and practice of too many institutions allow abuse to go undetected or unpunished.

Adult victims

The focus for Spotlight and Dame Janet Smith was abuse against children and young people, but we know that they are not the only victims. Older people, people living with dementia, people with a learning disability or physical disability — they too can be victims of physical and mental abuse. And when this is carried out by people who we trust and pay to care and support them, the betrayal of that trust is appalling, as some recent examples make plain:

Responsibilities

In highlighting these concerns I am not suggesting that all care services are like this. Indeed, our inspections find the answer to the question “is the service caring?” is consistently a resounding “yes” with staff highly praised by people using the service. Here is just one example from the recently rated Outstanding Steps Ahead Care and Support Limited:

“They are fantastic, number one, they go the extra mile and are always there for me.”

That’s what we want to see and what people using services have every right to expect — to be treated with respect, dignity and kindness. Providers have a responsibility to make sure this is the case by employing staff who really do care; making sure there are enough of them so they have the time to care; providing them with training and support so they are capable and confident in their difficult roles; and ensuring that there is an open and transparent culture that responds well to concerns and deals promptly and effectively with problems. There are responsibilities too for commissioners to fund services appropriately so that this standard of care and support can be achieved and sustained.

CQC strategy spotlight

The focus on getting this right must lie with providers and their staff but at CQC we have an important role in setting clear expectations, monitoring, inspecting, reporting, celebrating good services and taking action when we find poor care. Our new approach to regulation introduced in October 2014 allows us to get under the skin of services more than ever before and as a consequence our proportion of enforcement activity is increasing. But there is more to do. We are in the final two weeks of our 2016 to 2021 strategy consultation and I would like to highlight two specific themes.

The first is improving our use of data and information. In adult social care we are not blessed with the amount of data, nationally and consistently collected as the NHS. There is some, and we need to work hard to develop this further, but our best source of information comes from people who use services, their families and other professionals. The information provided can help to focus our inspection activity, when to inspect and what to look for. It is invaluable and we need to treat it as such. One of the themes of Spotlight was that there were people trying to tell the story of widespread abuse but no one listened. CQC has not always listened or acted as well as we should have done in the past either but it is essential that our new strategy reaffirms our commitment and ensures we have the ability to do so.

The second is having a shared view of quality so that we can rely upon providers delivering quality day in and day out within a nationally agreed framework:

“We would ultimately like to see all national and local oversight bodies (such as NHS Improvement, NHS England, commissioning groups, local authorities and professional regulators), as well as providers themselves, use this framework to understand and report on provider quality. People have welcomed the transparency that CQC’s inspections and reports have brought to understanding the quality of care — the benefits would be even greater if everyone in the system looked at quality in the same way.”

Your turn

There’s much more in our strategy proposals to consider, so please do take the time to read the document and respond to the consultation. You can email us or submit your view online. Either way, please do so by the closing date of noon on 14 March 2016. Thank you.

*I wrote this on Sunday and woke this morning to the news that Spotlight had won Best Film at the Oscars — brilliant!


Originally published at www.cqc.org.uk.