I joined CQC in the summer of 2023, shortly before the roll-out of the new single assessment framework. It is fair to say that it has been a turbulent couple of years, and the challenges and issues we have faced as an organisation have been very publicly discussed.
Now, as I prepare to hand over the role of Chief Inspector of Adult Social Care and Integrated Care to Chris Badger, I am able to reflect on the progress we have made and impact we have had, despite the challenges.
Our influence
At CQC, we are in a unique position to be able to support the reform of adult social care. There is much going on to drive change in the sector at present – the Casey Commission, Fair Pay Agreement, 10 Year Health Plan, sector-led workforce plans and more – but I have seen a lack of connection across Government and the wider sector. To address that challenge, I have convened an internal group to discuss and lead on adult social care reform.
We are bringing people and topics together to cement our key understanding across the organisation, underpin our planning and enable rapid and positive responses. We are bringing together our regulatory oversight and expertise across key areas including, for example, safeguarding and exploitation of workers. This gathering of expertise will reinforce a solid foundation for when Chris starts in his role.
Our independent voice
I was delighted that we marked Dementia Awareness Week in May this year with the publication of our review of the experiences of people with dementia in England and how health and care services are responding. This work is central to our intention to develop stronger guidance to define what good dementia care looks like, bringing in people’s views. Dementia affects us all. It is the leading cause of death and one of the biggest challenges in social care. Underpinned by people, families and carers, our dementia strategy recognises that dementia deserves a stronger regulatory approach as one of the tools for change.
Spotlighting good practice
I have spent most of my career working in social care in local authorities. The opportunity to work with colleagues in our local authority assessment teams to deliver our new responsibilities under the Health and Care Act 2022 – to assess how well authorities are meeting their Care Act duties – has been a highlight of my time at CQC. We are on track to complete our baselining exercise of assessing all 153 local authorities by the end of March 2026 and are using what we have learned so far to co-design our ongoing approach. ADASS’s 2025 Spring Survey highlighted that many councils had reviewed their data and revised their systems, partly in anticipation of CQC assessment, helping to better manage waiting lists. It is encouraging to see this lever of regulation – anticipation – driving change.
As we enter the autumn, we are going to be formally consulting on the changes we are proposing to make to our assessment framework. We have spent several months engaging with a wide range of stakeholders on how the framework needs to change to better meet the needs of people who use health and social care services and those we regulate. I encourage you to participate in the consultation process. Finally, I am grateful to have been able to see, through our regulatory activity, that there is good and outstanding practice across the sector, enabling people to live rich, full lives. Thank you for the energy and dedication you have shown and continue to show.
What feedback would you give on the changes CQC is proposing to its single assessment framework? Leave a comment on this column or join the conversation to share your thoughts.
James Bullion is the interim Chief Inspector of Adult Social Care and Integrated Care at CQC.
Email: [email protected] X: @CQCProf