Inside CQC
Sue Howard

In this month’s Care Quality Commission (CQC) column, Deputy Chief Inspector of Adult Social Care, Sue Howard discusses CQC’s own workforce and the changes being made to improve inspection.

You can’t talk about adult social care without talking about workforce. There would be no social care without the thousands of dedicated and talented people who work in it: from care workers, to nurses, to chefs, to cleaners to leaders. We’re in a human business so the people who take on these roles are our biggest asset.

The same applies to CQC. Our people are the heart of our organisation. Like any other organisation we need the right people, with the right values, training and support to do what we do.

I started my career as a night care assistant in a home for older people, before moving into management roles in services and at CQC. I’ve been in frontline roles as well as leadership roles so I’ve seen from different perspectives that it’s when an organisation creates that right environment, tools and support for its staff that they do the best job they can. At CQC, we’ve put a lot of thought into how we do this.

The current climate means we are regulating a changing provider landscape with new types of services and social care supporting people with increasingly complex needs. We’re also seeing pockets of deterioration around the country and taking more enforcement action when we find poor care. Our teams must be able to respond to the regulatory demands in their local areas and have the specialist skills to understand what ‘Good’ looks like in different models of care.

To build the required flexibility into our workforce, we have moved to hub working. This means inspection teams working together in regional hubs to:

  • Ensure we have capacity in regions to inspect in response to risk and direct our resources to where they are most needed.
  • Build understanding of provider portfolios and risk across regions and improve how we share this.
  • Develop knowledge of the local population and wider health and social care system.
  • Improve the quality and consistency of our inspections and regulatory actions through collaboration, shared knowledge and constructive challenge in hub areas.

We know that constructive and consistent relationship management between individual service locations and their named inspector is something providers really value. It’s fantastic that 79% of adult social care providers agree or strongly agree that their service has a good relationship with their named CQC contact person (annual provider survey 2018). For this reason, we have maintained the named relationship owner role of inspectors, but services may see different inspectors involved in the regulation of their service where this helps us take the right action at the right time.

Another key change we’ve made, to build our capability to regulate a changing and complex sector, is establishing ‘Area of Interest’ groups. These groups represent the services and activities that we regulate and are designed to help inspectors – who are all members of one group – develop their knowledge and professional development in an area then be equipped to share this with colleagues in their teams and hubs.

There are nine areas of interest:

  • Older people.
  • Nursing.
  • Mental health.
  • Learning disabilities.
  • Children and young people.
  • Drug and alcohol misuse (in adult social care).
  • Care at home and community services.
  • Dementia.
  • Enforcement.

We picked these nine as a starting point to focus our development approach and will see how these may evolve over time. Inspectors are still working across a mix of services, but the interest areas ensure our teams include colleagues who can advise on, support, and lead inspections and enforcement activity where needed. The groups will work in teams, hubs and nationally to learn together and develop new resources we can provide to all inspectors.

As well as helping us to improve how we perform as an organisation, these changes are important to individual wellbeing. Inspectors have a tough job that involves a lot of remote working and pressured decision-making. Building their support networks and creating a dynamic learning culture helps us make sure CQC is a good place to work for them.

I hope this has given you a flavour of the changes we’ve been making and why. We’re not sitting still now we’ve adopted them; they’re designed to be flexible and evolve over time to fit in with our needs and how the sector itself continues to change. If you’ve got any thoughts on the changes and any impacts you’ve seen so far, we’d love to hear them.

Sue Howard is Deputy Chief Inspector of Adult Social Care at the Care Quality Commission. Share your thoughts on Sue’s column and suggest topics for future CQC columns in the comments section below. Not a member? Sign up today .

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