This column will be my last before I retire from my role as Director for People with a Learning Disability and Autistic People at Care Quality Commission (CQC). In my 26 years as a regulator, I’ve seen many examples of great care to balance some of the unacceptable practice – most recently at Ryver House in Plymouth.
Ryver House is a care home where younger adults with a learning disability and autistic people live. The care provided here was outstanding. During our visit, we found a person-centred, inclusive and empowering culture. People led flourishing lives and were supported to express themselves in the choices they made, such as the work they undertook, sports they followed, the clothes they wore and the music they enjoyed.
It’s clear to me that the care these younger adults were receiving was built around them. Their ambitions, needs and concerns were listened to and acted upon. They were supported to be themselves and to be their best selves.
Being listened to, really heard, is a privilege. I appreciate how important it is to my self-worth and it has added value to my roles throughout my career. I also know that our own preconceptions of people can impact on how we listen to others. We all see life through a different lens, and that lens may cloud or colour our judgement. Challenging our own biases and preconceptions – and supporting our colleagues to do the same – will help us all be heard clearly and truthfully.
Listening to others
The transformation journey that CQC is on will help us reflect on the things that we don’t know. We’ll be checking for gaps in our knowledge and supporting inspectors to get out and about more. By assessing services in ways that help us to spot the signs of developing closed cultures, we can check them out before harm occurs – not afterwards. Listening to all voices, examining all truths and hearing different perspectives can help us all take note and step in before cultures close, before voices fall silent and before the focus on meeting individual needs is lost at the expense of running the service.
One way we’re doing this is by convening an expert advisory group for people with a learning disability and autistic people. This is made up of people with lived experience, organisations that represent them, representatives of provider groups and other strategic stakeholders. We’re working together to help identify where CQC can have the most impact on reducing inequalities for people with a learning disability and autistic people; keeping people well; enabling people to get the best care where they live; and ensuring everyone in health and social care is working to reduce restrictive practice in their services.
We also continue to encourage more people, and their loved ones, to share experiences of care through our Because We All Care campaign. To date it has driven nearly 94,000 people to share experiences of health and social care. Our campaign focus in April 2023 is on people with a learning disability and autistic people because they are more likely to experience poorer care and inequalities. We encourage you to engage with, and share, the social media posts when you see them and we thank you for your ongoing support.
More voices
Saying goodbye will not be easy; however, I know I am leaving the work I have started in good hands. My colleague, Rebecca Bushell-Bauers, will be taking on the Director role and, along with Deputy Director Hayley Moore, the team will continue to champion the need to speak up and be heard.
Rebecca’s passion is to tackle inequalities faced by people with a learning disability and unacceptable practice in health and social care. Rebecca said, ‘People deserve the right to live as citizens and lead their best lives. This is what motivates me.
‘I am excited about my new role, including how we can use our new powers from April 2023 to assess local authorities and integrated care systems to influence and shape commissioning for people with a learning disability and autistic people to ensure the right model of care is accessible to support them to lead their best lives.’
Hayley’s focus is on embedding the positive work undertaken so far around safeguarding and closed cultures to identify and act on early warning signs of poor care or culture. Commenting on the work, Hayley said, ‘I want us to be ambitious in protecting people’s human rights, and in being proactive in how we regulate across health and social care to enable people to live a life free from harm or abuse.’
So, as I leave CQC, I take with me huge gratitude for the privilege of having been heard. Of being able to speak and to be listened to over the years. Keep speaking and, importantly, keep listening.