It’s great to be back writing for Inside CQC, this time in my new role of Interim Chief Inspector of Adult Social Care.
I want to start by saying a big thank you to all of you who worked over the festive period to ensure people continued to receive the support and care they rely on and could enjoy a special time with friends and family. It might be part of the job, but it still deserves to be shouted about.
Now onto 2019! With changes to leadership at CQC it’s no surprise that questions have been raised about what this means for our regulation. I want to reassure you that there are no big surprises coming; our focus is on strengthening how we carry out our role and improving the experience providers have of working with us and our interactions with the public. We’re all in this business for the same reason – making a difference to people who use services – and developing strong relationships with CQC is important to us.
With this in mind, I was disappointed to read concerns raised by Neil Grant in the December issue of Care Management Matters that CQC risks losing sight of the basics. The article makes a number of allegations – including that CQC applies arbitrary ratings limiters and does not give due regard to the need for consultation. I do not agree with these claims.
It’s important to say that a breach of the regulations is serious and our enforcement policy reflects this. Where there is a breach, there is a risk to people’s safety and experience and I make no apologies for not compromising on the standards of care people have the right to expect. Our guidance for providers and inspectors does detail the small number of circumstances that are sufficiently serious to apply a ratings limiter; but it also makes clear that inspectors will make proportionate judgments about applying these based on each individual case.
In fact, making proportionate judgments is a key part of an inspector’s role. We know that this happens best when an effective relationship is built between inspectors and services, so we’re committed to supporting inspectors with this.
From 28th January, we will be rolling out improvements to ‘how we report’. This follows work to coproduce and pilot these with providers and inspectors (find full details on this in our next provider newsletter). Reports will be clearer to the reader and a small but important improvement we’re introducing means that, after the registered manager receives the draft report, the inspector will call them to talk through the evidence. In our piloting of this, we’ve found it has helped providers to better understand how we arrived at our judgments and helped clarify issues or concerns or celebrate Outstanding care. As a result, some challenges that might previously have been made have been avoided which has allowed us to publish some reports more quickly – a good thing for providers, CQC and the public.
It’s this type of change that you’ll be seeing from CQC this year – changes that come from us listening to our staff, providers and the public about what works and where we can refine our approach to help us work better together. We remain committed to working in coproduction to make these changes not just because it’s the right thing to do, but because it helps us get these improvements right. We may not always be required to carry out a formal consultation by law, but – in the spirit of the Quality matters commitment we made with the sector in 2017 – we will always engage with our stakeholders to ensure we hear first-hand from you what the impact of any change might be.
Before I sign off for this month, I want to give you an advance update that we’ll be publishing the latest issue of our Learning from safety incidents series soon. These resources – developed with the help of our online community of providers – describe critical safety issues and the steps providers can take to avoid them happening in their services and have proved hugely popular. With the coldest months of winter still to come, the new issue will focus on avoiding risks of people developing hypothermia. I hope you’ll read and share the information within your organisations when it’s available.
Debbie Westhead is Interim Chief Inspector of Adult Social Care at the Care Quality Commission. Share your thoughts and feedback on Debbie’s column in the comments area below.