Andrea Sutcliffe, Chief Inspector of Adult Social Care at the Care Quality Commission.

The four day weekend was a perfect opportunity for me to escape London for the Lake District.

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Blessed with fine weather (once the fog lifted) we took to the hills hiking up Cat Bells on Saturday and then round Buttermere and over the Haystacks on Sunday. With some lovely meals, a great performance of Two at The Theatre by the Lake and a bit of retail therapy (new walking sticks) — we had a wonderful time (if you ignore the Bank Holiday traffic misery!)

However you spent the weekend — celebrating Easter, visiting family, DIY, relaxing, indulging in chocolate or other favourite pastimes, I hope you were able to enjoy yourselves. If you were one of the many thousands of people caring for and supporting people using adult social care services, thank you. Ours is a day in day out service and people who rely upon it have every right to always expect the same levels of high-quality, compassionate care, including high days and holidays. But we shouldn’t forget it takes dedicated, well-supported staff to make that happen and that should be properly appreciated.

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The long weekend included a very significant event for CQC — on Monday 6th April we formally took responsibility for the market oversight of hard to replace providers. The Care Act 2014 established this new role and the regulations set out what we mean by hard to replace — that their size, regional presence or specialist service could cause local authorities difficulties maintaining continuity of care for people if they were to fail.

This is a new area of work for CQC, combining our understanding of the quality of service with oversight of the finances of the providers involved. We have been working over the last year to develop how we will run the scheme with great support and engagement from the sector, including providers, trade associations and commissioners as well as taking into account the views and concerns of people using services, their families and carers. The guidance for providers about how we will operate market oversight has now been published. This week we will write to everyone who will be included and request their first submission of financial data.

Another thank you to everyone who has helped and a special mention for Sally Warren, the Deputy Chief Inspector for London who leads on market oversight and has been instrumental in getting us so well prepared.

It strikes me that preparing for my Easter weekend hikes and our new responsibilities are a bit similar. When hiking you need to be aware of what could go wrong — poor weather, unforeseen obstacles or an accident. In market oversight our worry is that business failure could put services at risk and people might not get the support they need.

We have criteria for both — there are hundreds of walks to choose from but my checklist usually involves a tough climb, good views and I love a bit of a scramble. For market oversight the criteria are size, regional presence or specialism that would make them difficult to replace. Inclusion in the market oversight scheme does not mean that providers are likely fail.

Preparation is vital — the weather forecast, maps, walking notes, the right boots, wet weather gear, water and emergency provisions are key ingredients for a successful hike. For market oversight we will continue to use the quality information about services we already have but in addition will ask providers for regular financial information so that we can assess their sustainability.

Monitoring to identify risks so that the right action can be taken is common to both hiking and market oversight. Keeping a watchful eye on the weather, for example, is critical when out on the steep Cumbrian fells as the mist can descend and make the going tough or unachievable. Getting off the mountain as quickly as possible would be the right action to take in these circumstances!

For market oversight, we will monitor the regular quality and financial information we get and if we have concerns will increase our engagement and ask for additional information. Just as we cannot stop the weather from turning when out walking, the scheme has not been created to prevent business failure, only to identify where risk of failure is likely.

Market oversight will allow the right people to take the right action to ensure people who use services continue to have their care needs met. If we consider that business failure is likely and that the provider is unlikely to be able to continue to provide one or more services we will notify local authorities in the areas likely to be affected. They can then draw up specific contingency plans to support people using those care services to help ensure they continue to receive care. That’s our equivalent of getting off the mountain in one piece!

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Of course, all the plans and preparation in the world aren’t worth anything if we do not carry them out well. That’s what Sally and the team will be concentrating on now. Let’s hope that the market oversight scheme really is like my weekend hikes — well prepared, challenging and rewarding.

Happy Easter!

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Originally published at

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