Fresh from a well-received presentation at the Managers Conference, after which Chris had already successfully navigated several tough questions from delegates, he agreed to sit down with CMM to pick apart some of the key themes of his presentation and answer further questions that had been gathered from delegates throughout the conference.
From factual accuracy challenges, provider portals and inspectors’ training to the essence of care, the use of AI by inspectors and consulting those with lived experience of regulation and inspection, Chris spoke honestly and passionately about his priorities as Chief Inspector and ambitions for the framework’s delivery moving forwards.
While there is still work to be done to ensure the new assessment framework accurately reflects the realities of delivering care on the ground, which Chris acknowledged, providers should feel reassured that CQC is listening to and acting upon feedback from across the sector to make regulation more effective and improve providers’ inspection experience.
CMM: How will the new assessment framework be applied consistently and fairly?
Chris Badger: The new assessment framework is designed to be simpler, shorter and, crucially, to clearly define what ‘good’, ‘outstanding’ and ‘requires improvement’ look like.
We really want people to get engaged in that. That helps providers be clear about what they need to do or what they will be judged against. But crucially, it helps with consistency because inspectors have something measurable to compare what they see in a provider against a set of agreed standards.
So that is one way we are keen to get consistency – also making sure we are developing our quality assurance processes and the skills of our teams to do that. Going back into teams that are dedicated to adult social care will also help and that adds to consistency.
CMM: What new training opportunities will be provided to inspectors to enforce the framework?
CB: We have involved them heavily in developing the framework and they continue to be involved. Really importantly, we have done that often in sessions with providers and inspectors working together, asking, ‘Is this any good to inspect against? Is it any good to provide services and be regulated?’ So that is important.
They will get to know the framework, we will test it and we will put in the training around it. We are also looking at different training opportunities where colleagues might need skill development. Technology is evolving, so we need to make sure they are up to speed. We have already done a lot on learning disability and autism services, and we are putting in new training on new policies supporting that.
With regards to dementia, we have got statutory guidance coming and linked to that, we will look at the training we give teams across CQC on dementia – not just adult social care, but that is one example. Wherever colleagues identify gaps in training, we will work to fill them.
CMM: How will inspections prioritise identifying good?
CB: Part of it is about ethos and attitude – you go in with a mindset that you are looking for good, not a deficit model. The framework will be clear on what good looks like, which will help. It is also about skills. Inspectors often do this well already, putting people at ease during the inspection. When people are at ease, they are more likely to open up, hear the feedback and act on it, which is what we are here to do.
We will praise colleagues who manage to do that and, where people need support, we will put that in place. From a provider point of view, the more open and engaging they are with the inspection, the more likely we are to see a good mindset. When there is defensiveness, it can cause worry and risk. It has to be a two-way process.
CMM: Will providers have the opportunity to give feedback on the new framework?
CB: Yes. First of all, there is lots of work to do to finalise and agree it. We are at quite early stages and we really want feedback. We have had a lot already from providers. There are sessions coming up in the Spring where people can come along or submit feedback themselves. We will be piloting and testing it with providers, which should give really rich feedback.
We will keep it under review as we go forward. You are not going to get everything right first time and that is one of the lessons we have learned. We will not stick rigidly to something – we need to listen and adjust. Care is changing, so the framework needs to change too.
CMM: How will the outcomes of factual accuracy challenges acknowledge inspectors’ opinions without being determined by them?
CB: Factual accuracy is about checking the facts. It is not about redoing the inspection or negotiating the outcome. That process can be frustrating and resource heavy. We need to focus on what it is and what it is not. The more evidence-based the inputs, the better. Inspectors use professional judgement, which is exactly what we want.
Where something has been missed or could have been considered, we want to understand that and adjust accordingly. But it is about focusing on what it says on the tin – factual accuracy, nothing more.
CMM: How does the new assessment framework balance ease of application with the complexity required to regulate services effectively?
CB: The framework tries not to be too complicated or try to do too many things. It is not wrong to cover all areas but a lot of it was duplicated. We are not narrowing what we look at – we are just planning to do it more efficiently and rationally.
The key building blocks remain and, for me, safety and personalisation are foundational. That does not change. Regulations we inspect against have not changed – they are broad. This framework is about a more effective, efficient and proportionate way of understanding compliance and quality. It is proportionate without sacrificing the important aspects of care and it will capture the essence of care, which is what I am interested in.
CMM: How has the framework been informed by the voices of people with lived experience?
CB: We have done work with people who have lived experience of regulation and inspection. They have helped make inspections more effective for everyone – service users and providers – because their insights add credibility and knowledge.
We have talked to people about what matters to them – the essence of care – and also what they want to know if they are using an assessment report to choose a service. That feedback has shaped the framework.
CMM: How will CQC leverage AI to support productivity while keeping the framework person-centred?
CB: What is important is the professional judgement of inspectors – what they see and hear is central. AI will assist inspectors by analysing data, identifying patterns and supporting professional judgement and will help inspectors apply that judgement across more settings more efficiently.
AI supports and promotes human intelligence; it does not replace it. Inspectors still make the call, and AI can help articulate their observations. Governance ensures the individual remains at the centre. Providers using AI should do the same – human judgement remains key. Inspectors and providers should mirror one another in their approach.
CMM: How will CQC ensure clarity about what good care looks like? Will there be clear definitions for providers?
CB: We will release what we are calling the ‘ratings characteristics’. These will replace quality statements and outline what good and outstanding look like for each key line of inquiry. It will demystify what we are looking for – helpful for both providers and inspectors.
In the future, we may develop specific sets for homecare, supported living, nursing care and Shared Lives. Adult social care is diverse, and one set of characteristics might not capture all nuances. We will continue to work with providers and people using services to refine them.
CMM: Will new digital technology systems be introduced to support effective regulation? Does this include simplifying the registration process?
CB: Yes, we are looking at significant improvements to technology for providers and CQC colleagues. Implementation will be phased – registration, assessments, enforcement etc. – but the assessment framework will guide technology development, not the other way around. Technology should support the framework, making inspections and registration more efficient without compromising oversight.
Since this interview took place at the Managers Conference, CQC has published four draft sector-specific assessment frameworks, including adult social care, which you can read here. You can also share your feedback on the framework here, until 5.00pm on 12th June.
Henry Thornton is Lead Editor at Care Management Matters (CMM).
Email: [email protected] Linkedin: @Care-Management-Matters-(CMM)