Debbie Ivanova’s blog

How we make change happen.

Care Quality Commission
3 min readSep 30, 2019
A photograph of Debbie Ivanova, Deputy Chief Inspector of Adult Social Care

Debbie Ivanova, Deputy Chief Inspector of Adult Social Care updates on our restraint, seclusion and segregation in hospitals and care services work.

As you’ll know if you’ve been following these blogs, the team started phase two of this review in July. This part mainly involves visits to social care services, some children’s services and low secure and rehabilitation mental health hospitals. My team have been around the country and visiting services in Middlesex, Oxford, Yorkshire, Lancaster, Sussex and Cornwall, to name a few.

To give you an idea of the scale of our work we’ve visited nine mental health services, fourteen social care services, and gathered additional information through a survey from over two hundred social care services.

Over the course of the thematic review we’ve engaged with people from across the health and care sector. In my last blog I spoke about the importance of us increasing the representation of people with lived experience — both direct and family members — at our events. We know we haven’t got this right yet and are committed to increasing this representation through each piece of engagement — whether online or face to face.

The issues span several sectors and often seem too large to be able to solve.

On 13 August we held an event to look at what a #BetterSystem would look like for people with a learning disability and or autism and last Wednesday we had the first Expert Advisory Group (EAG) for the next phase of the review. The event included people who use services and their families, providers, commissioners, charities, NHS England and the Department for Health and Social Care. We’re still gathering views about what a #BetterSystem would look like so if you haven’t contributed yet, please do so before 1 October here. We really want to hear from you.

The key question most people ask at these meetings is — how can we make change happen this time? What’s going to be different?

I don’t have a quick fix answer, and neither does CQC, otherwise we wouldn’t be doing this review. Everyone who has been engaged in this work, and other work around restrictive practices knows that we’ve been trying to solve these issues for some time, for the best part of a decade. The issues span several sectors and often seem too large to be able to solve.

That’s why, at CQC, we remain committed to changing what we have the power to change and encouraging others to step forward and do the same. We will be using the stories of people who use services that we have visited on the review to amplify the calls for change and to influence what recommendations we make. We’ve got two more meetings with our EAG, one on 10 December focused around our final report findings, and on 28 January to gather feedback on recommendations.

We remain committed to changing what we have the power to change and encouraging others to step forward and do the same.

However, when the final report and recommendations come out in March 2020, we need every single person who has a stake in this work, to step forward and be clear about what they are going to do to drive forward these recommendations. This is my early plea to ask you to think about how you can put pressure on the part of the system you are responsible for.

Whether you are a family member, someone who has been in one of these services, work on the frontline, are a provider, a commissioner, an advocate, a voluntary sector representative or just want to advocate for change, I ask you to think about what you can do to make this happen and how we can best use this review to make that change.

If you want to speak to someone about the review, please email RSSthematic@cqc.org.uk. The team will get back to you as soon as possible.

#CQCrestraintreview

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Care Quality Commission
Care Quality Commission

Written by Care Quality Commission

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

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