Monday 17 December 2018
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Balancing regulation and standards with quality and improvement

As CQC prepares for a new strategy, Des Kelly OBE contemplates the need for providers to give their views and experiences

Every month CQC holds a meeting with Trade Associations in adult social care. I represented the National Care Forum (NCF) at the meeting held on 9 September which was ably chaired by Sally Warren, Deputy Chief Inspector. The meetings are well attended by a wide range of provider representative bodies and key staff from the CQC demonstrating the high level of commitment on both sides. They are a regular opportunity for a two-way exchange of views, sharing information and feedback from the frontline.

In order to demonstrate transparency, PowerPoint slides are produced from every meeting detailing the items discussed. View the slides from this meeting here. They represent a valuable forum on a number of levels and I believe they reflect a mature and more confident regulator endeavouring to ‘practice what they preach’ by listening, being responsive and honest in the promises made. Please don’t get me wrong – I am not advocating, in any way, a ‘cosy’ relationship between provider representative groups and the regulator. That would be compromising for both parties. NCF has always been clear that the primary responsibility for quality of service rests firmly with care providers. We believe that a professional relationship between providers and the regulator is in the best interest of consumers and the public. Professional relationships matter and mutual respect and appreciation is important to improving anything.

As well as regular updates and a robust exchange of views, particularly about inspection, the fact that the meetings happen regularly means that there is meaningful continuity and follow-up. At the meeting last week: CQC provided the latest data on quality ratings assessments and there was a discussion of the distribution found so far; information was provided on the Provider Portal roll-out to small adult social care providers; plans were shared on the process of developing the new five year strategy for CQC and the process of consultation; exploring the role of quality regulation in a local area to understand what it says about the quality of care in a place. In addition the meeting discussed electronic care plans, Your Care Rating and the complexity of easy read inspection reports.

What was fascinating about the discussion that followed these agenda items was the level of maturity that has been reached through efforts to work co-productively. It touched on the right balance between provider-based regulation and pathway/place-based approaches to regulation as well as the role for CQC in shaping the regulatory model to understand quality of care beyond traditional provider-based boundaries. These have a bearing on the developing role for CQC in continuous quality improvement. Clearly all of these will need to be considered as part of the forthcoming five year strategy for CQC and NCF will be encouraging providers to fully engage with the process. The context within which the regulator now operates needs to reflect the complexities found within the services they inspect as well as the market dynamics that a deepening understanding highlights.

Many adult social care services are changing as demands from consumers and commissioning practices impact. The pace and the scale of such changes will alter provision significantly in time and a growing range of care and support services are likely to emerge. And all of this is occurring as the integration of care and health and housing becomes a policy priority compounded by further concerns about the impact of continuing austerity measures on the stability and sustainability of the market. I am sure that there will be no shortage of opinions for CQC about how these factors should shape what and how they operate in the future!

Des Kelly OBE
Executive Director
National Care Forum