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

Singer Peggy Seeger is 80 next week and is celebrating this milestone by touring with her sons to sell-out crowds across the country.

I was there on Saturday at the Queen Elizabeth Hall and what a wonderful night it was. As feisty as ever, funny and insightful her beautiful voice and chatty interludes had the audience singing along and moved us to laughter and tears.

The wit and wisdom of old age brought so vividly to life by Peggy on Saturday was once universally revered and honoured. But something has happened over the years. As we have striven to extend life with remarkable advances in revolutionary treatments, paradoxically we seem to have relegated the interests and needs of older people.


One impact was seen in the publication last week by the Association of Directors of Adult Social Services of their latest budget survey. They warned of rising demand and complex needs being failed by reducing budgets and as their new President Ray James eloquently put it:

“Short-changing social care is short-sighted and short-term. It must also be short-lived if we are going to avoid further damage to the lives of older and vulnerable people who often will have no-one else but social care to turn to. It is vitally important these care and support services are protected.”

And while it is not the only factor, we know that lack of funding and investment can have a significant impact on the quality of care and the sustainability of good services.


But we know that we can be so much better than this. Like virtually every other viewer, I was blown away by Channel 4’s Dementiaville programme and truly person-centred care shone through ensuring that even in the most difficult of circumstances, people living with dementia were supported to live well. I smiled along with the residents and staff of Poppy Lodge and shed tears for Bob, Les, John and their families. There are two more programmes in the series and I can’t wait.

One of my inspectors, Liz Peim, sent me an email:

“I just want to say how moving and incredibly heartening it was to watch Dementiaville on Channel 4. However, it also left me so saddened about the services that fail to provide such thoughtful, compassionate and effective care for people with dementia.”

I could not have put it better myself — so how do we make sure that it is the experience of Poppy Lodge that is people’s common experience?

Improving care

Last week’s improvement top tips may help but the conference trail last week highlighted two very important factors.

The first was culture. At an event run by Care England and Pulse UK providers and others came together to consider the role of culture in improving care. I have used the quote before that culture eats strategy (and structures) for breakfast and can have such an influence on the way staff behave. The evidence base is clear that a good culture, underpinned by strong values that staff believe in will have a positive impact on the care that people receive.

That is why we ask whether a service is well-led and consider what the culture of the service is like in our ratings. Our experience tells us that a good culture is characterised by a welcoming and vibrant approach; staff who go the extra mile; genuine support and development available for staff; attention to detail; continuous improvement; and a person-centred focus that listens to the voice of people using services, their families and carers.

My second conference of the week was the NHS Confederation Conference where I was flying the social care and CQC flag (integration thoughts from that conference will be the subject for another blog I think). Sadly I had to miss the plenary session by Alison Cameron on Friday morning From patient voice to patient leadership. Alison has been a member of our external co-production group and speaks powerfully about her experiences of ill health, using services and making a difference. You can find Alison’s session to watch here and if you ever need convincing about the importance of listening to and involving people who use services, this will do it!

The reason I had to miss Alison was because I was speaking myself at the Alzheimer’s Show in London. This was a really interesting audience — many health and care professionals but also a lot of people living with dementia themselves, family members and carers. Their insights and passion for good care were an inspiration. As professionals we sometimes fall into the trap of thinking we know best, but we need to have the humility to understand that it is only people who are living with dementia and their loved ones who can say what it is really like and what they need.

This week is Carers Week — another important opportunity for us to remember what really matters. I recommend taking a look at the websites of Carers UK and the Carers Trust for a wealth of information about carer’s issues.


On stage Peggy Seeger joked that you should always be nice to your kids because they choose your nursing home. Let’s hope that by paying attention to the culture of care and listening to people, their families and carers, if Peggy’s family have to make that choice, they can be confident that she will have a great experience not a poor one.

Originally published at

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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