Scrutiny and the yellow jersey

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

The sporting event of the year for me is the Tour de France — an awe-inspiring three week ordeal that pits man and bike against mile upon mile of impossibly steep mountains, treacherous cobbles, rolling hills and wild crowds of spectators, baking sunshine, wind and rain to secure one of sport’s greatest trophies — the winner’s yellow jersey. All against the backdrop of breath-taking scenery and for me aided and abetted by the peerless coverage provided by ITV4.

And on Sunday, for the third time in 4 years we had a British winner, Chris Froome. A quiet, unassuming man he has yet to command the heroic status awarded to Sir Bradley Wiggins, the first British winner (and inspiration for my Guardian Social Care Network blog in 2012). Froome won me over though in his victory speech in 2013 when he spoke of his dead mother and said he hoped he’d made her proud.

Scrutiny

This time though his speech was a bit more pointed when he said:

“The yellow jersey is very special. I will always respect it and never dishonour it.”

This was in answer to the critics in the press and on the roadside who accused him of doping to gain time over his rivals. He and his team have consistently denied the allegations but the scrutiny remains intense.

That scrutiny from press and cycling officials, though no doubt frustrating for a dedicated sportsman like Froome, is important to restore and sustain public confidence in a sport that has taken a battering over the last 20 years.

CQC scrutiny

This has a parallel with CQC as two important documents were published last week — our Annual Report and Accounts and a review by the National Audit Office (NAO). In 2011 the NAO was one of many voices highlighting that CQC needed to change. This year the NAO has returned to see how we are getting on.

In 2011 Amyas Morse, head of the National Audit Office said:

“Against a backdrop of considerable upheaval, the Care Quality Commission has had an uphill struggle to carry out its work effectively and has experienced serious difficulties”

But in 2015 Amyas Morse reported that:

“The Commission has made substantial progress in the face of sustained criticism, and is developing a more intelligence-driven approach to regulation. Further challenges lie ahead for the Commission to demonstrate, in practice, effectiveness and value for money. It now needs to build an organisational culture that gives its people the confidence, as well as the skills, to apply the regulatory model assertively, fairly and consistently.”

So, good progress made but more needs to be done. I think that’s a fair assessment and one that the senior team and the rest of CQC recognises.

David Behan, Chief Executive welcomed the NAO report. He acknowledged the hard work making progress has involved but also said:

“We know we are not at the end of this journey and that there is more to be done. In particular, recruiting, training and supporting our staff is a key priority of ours, as is a complete overhaul to our registration process for providers to improve its efficiency and overall experience.”

CQC transparency

Scrutiny is an important way to restore confidence, but increased transparency also plays a key role. Chris Froome has recognised this in cycling by calling for more stringent testing schedules and the CQC is committed to working in a transparent and inclusive way. For example, our public board meetings are usually broadcast live and on YouTube with papers, including performance reports, available on our website together with a wealth of information about our activity and we work in co-production with people who use services, providers, commissioners and other national partners exposing the issues we are tackling and seeking creative solutions together.

The Annual Report and Accounts for 2014/15 provides a wealth of information about our progress through the year, what we have achieved and how. But it is also realistic about the further work that needs to be done. In my contribution I have said:

“We have a lot to be proud of in 2014/15. We worked with a vast range of people using services, their carers and families, providers, commissioners and partners to co-produce our new approach. We launched the new, more rigorous inspections of adult social care services, and started to issue ratings. We laid the groundwork for applying the new fundamental standards and using our stronger enforcement powers. And we established the framework to deliver our new responsibilities for the market oversight of difficult-to-replace providers…

We still have a lot to do in the coming year. In 2015/16 we will recruit the full numbers of staff we need, so that inspectors have smaller portfolios and can respond appropriately to any concerns they receive, and registration inspectors have the capacity to deliver a timely and robust service. We are also putting in a lot of work to speed up our report writing. We will be focusing on completing all comprehensive rating inspections by September 2016, as well as implementing our new role overseeing the financial health of difficult-to-replace providers.”

Maybe not yellow…

So to go back to my cycling analogy — I don’t think CQC can claim to have won the yellow jersey yet. We have a lot more to do. But, given the mountains we’ve had to overcome, maybe we have a fair claim to the polka dot jersey for the best climber? Let’s hope so, because this year Chris Froome won both and that’s got to be a good omen!

Originally published at www.cqc.org.uk.