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From YouTube: CQC Board Meeting - November 2015 (with subtitles)
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A
B
A
B
B
B
A
A
C
B
A
Now
I'm
sort
of
mult
only
channeled
today,
because
I've
got
my
board
pad
and
the
papers,
so
the
troll
with
being
omni-channel
is
you're
not
quite
sure
whether
to
go
totally
digital
or
stick
with
a
paper
and
I
said
I'm,
probably
going
to
get
rather
confused
about
what
I'm.
Looking
at
the
looking
my
iPad
or
looking
the
board
pad
on
my
iPad
or
looking
at
the
papers,
but
so
apologies
if
that
causes
any
problems.
A
A
A
Timetabling
change.
We
were
at
ten
o'clock
going
to
go
over
to
the
NCSC
to
listen
in
to
some
calls,
but
various
various
directors
have
commitments
to
catch
early
trains
and
so
we're
going
to
delay
this
to
some
time.
You
know
perhaps
in
the
spring,
because
I'd
lean,
as
I
said
earlier,
pointed
out:
it's
not
just
the
call
simpler,
there's
a
number
of
other
important
functions
and
by
and
that
we
really
need
to
give
justice
to
a
visit
to
a
visit
to
our
new
castle
location.
So
you
know,
perhaps
in
the
spring
we'll
arrange.
B
A
D
Michael
good
morning,
everybody
so
on
I,
don't
intend
to
dwell
on
it
chief
executives
report,
so
much
of
it
is
about
performance
and
the
main
item
this
morning
is
about
performance.
So
I
think
there's
far
more
detail
on
our
progress
and
performance
in
the
performance
report
rather
than
in
my
report.
So
I.
If
you
allow
me
to
gloss
over
that
those
aspects
of
the
report
which
are
about
performance
because
we'll
have
a
more
substantial
discussion
on
the
next
item
and
I'll
just
pull
out
at
two
or
three
things.
D
D
We're
making
increase
in
progress
in
the
rollout
of
the
digital
portal,
with
increasing
amounts
of
business
being
transacted
digitally,
which
an
is
a
more
efficient
as
well
as
a
more
effective
use
of
a
time
both
for
people
that
are
making
applications
and
for
CQC
staff,
so
that
precedes
and
it's
a
cross
CQC
effort
that
term
Andrea's.
Obviously,
in
through
the
registration
program
board
next
item
I'd
go
to
is
just
towards
the
end.
Michael
is
just
to
review
where
we
are
on
publications
and
accountability
through
the
public
accounts
committee.
D
Last
thing
I
just
want
to
mention,
particularly
in
public
forum,
is
that
the
Secretary
of
State
yesterday
early
evening
published
his
letter
to
the
Health
Select
Committee,
announcing
that
Peter
Wyman
was
his
preferred
choice
as
successor
to
David
Pryor
Lord
prior
as
chess
or
I.
Think
that
will
now
go
out
will
be
in
the
public
domain
and
Peter
will
appear
before
the
Health
Select
Committee
I
think
it's
on
the
first
to
December
for
a
confirmation
hearing,
which
is
why
it's
any
announcement
is
subject
to
that
confirmation
hearing
and
is
described
as
a
preferred
choice.
D
B
Starts
one
question
about
it
really
about
inspections,
but
I,
don't
think
necessarily
about
the
performance
aspect.
I
noticed
the
good
news
that
too,
what
would
sell,
but
special
measures.
The
general
practice
has
been
moved
out
of
that
and
the
improvements
are
made
and
I.
Just
wonder
when
that
happens.
B
Do
we
both
on
our
behalf
and
you
need,
on
behalf
of
practices,
that
successfully
turned
itself
around
do
enough
to
communicate?
First,
did
that
happen
because
he
cut
must
be
pretty
dreadful
being
in
special
measures
in
the
general
practices
in
relation
as
far
as
relations
with
the
patients
are
concerned,
and
to
its
use
the
opportunity
from
both
sides
ready
to
demonstrate
how
the
process
is
constructive
and
effective,
rather
than
something
to
be
feared.
C
We
about
fifty
percent
so
far
of
those
who've
been
special
measures
about
her
be
improved
and
one
occasion
due
to
take
over
by
the
local
acute
trusts,
and
we
carefully
put
out
a
press
release
and
talk
about
this,
but
the
press
aren't
as
keen
I
think
to
publish
the
good
news
stories
as
they
are
about
the
problems
and
that's
one
of
our
difficulties
all
the
way
through,
but
we're
trying
to
collate
more
examples
of
this
happening,
and
it's
part
of
our
strategy
is
to
to
try
and
communicate
that
more
effectively.
C
At
the
moment,
we've
only
had
five
or
six
of
these
practices,
so
it's
small
numbers.
There
are
lessons
in
all
of
them
and
what
we
need
to
do
is
get
that
out.
What
we
would
hope
is
that
the
leaders
of
the
GP
bodies,
the
BMA
and
the
college
would
also
help
us
communicate
the
good
news
and
also
share
outstanding
practice
where
we
live
in
hope.
B
The
strike
minute-
it's
not
just
a
matter
of
communicating
with
the
public
and
patient,
although
that
is
extremely
important-
is
also
questions
implied
by
that
of
communication
with
other
practitioners
and
registered
providers,
so
that
the
process
is
understood
because
does
seem
to
me,
particularly
in
relation
to
people.
Who
is
it
that
were
running
their
own
businesses,
that
the
sort
of
process
must
be
potentially
generate.
C
I
could
come
back
and
I
it's
exactly
what
we're
trying
two
days
on
Monday
night
I
was
at
a
big
meeting
of
GPS
talking
just
about
this
sort
of
issue,
and
it
was
hugely
constructive.
The
feedback
from
the
audience
the
contentious
issue
was
about
fees.
It
wasn't
about
the
inspection
and
for
those
we
just
saw
the
big
survey
of
practices
and
it's
overwhelmingly
positive.
Once
they've
been
inspected
and
you're
right,
it's
about
special
measures
be
in
primary
care,
particularly
about
improvement.
C
C
What
we're
hoping
is
that
and
we're
sure
we're
seeing
this
that
it's
not
just
people
in
special
measures
that
improve,
but
we
think
that,
because
we
are
around-
and
they
know
we're
coming
in
to
inspect
the
practices
are
better
than
they
would
have
been
without
us
and
that's
borne
out
based
on
the
fundamental
standards,
the
basic
standards
we
had
during
the
pilot,
we're
not
finding
thirty
percent
of
the
practices
fail
on
the
basic
standards.
Anymore.
C
D
So
I
think
we
just
need
to
think
differently
about
how
we
get
some
of
those
messages
across
around
our
it
impact,
because
I
think
it
is
clear
from
the
state,
scary,
port
and
the
case
of
your
point
out.
Robert,
the
improvements
are
being
made
and
I
think
we
need
to
play
our
part
in
drawing
those
two
people's
attention
as
well.
Otherwise,
what
people
have
is
an
impression
that
things
are
not
satisfactory.
Services
are
inadequate
and
require
improvement,
but
where
that
improvement
is
made,
is
less
awareness
of
that?
D
So
I
think
we
need
to
think
critically
about
what
more
we
can
do
in
the
motion
to
that
I
know.
Chief
inspectors
doing
this
from
platforms
and
conferences
and
in
meetings
ago
too,
but
and
I'm
not
sure
about
penetrates
a
national
media
in
any
way
shape
before
I'm.
Quite
frankly,
hospital
does
a
good
job
regulated
as
a
good
job
is
never
a
new
story.
Obstacle
doesn't
do
a
good
job
regulator
doesn't
do
a
good
job.
D
B
Wonder
whether
it
perhaps
it
is
obviously
has
to
be
some
distance
in
one
sense,
between
us
as
a
regulator
and
those
we
regulate.
But
in
these
circumstances
whether
there
is
some
more
perhaps
joint
programme
of
communication
for
action,
it
could
be
thought
about
between
us
and
the
providers,
because
just
to
show
that
we're
all
in
this
together
in
that
in
that
regard,
in
a
way
which
perhaps
my
penetrates
little
bull,
either
is
only
locally.
Actually
them
had
sons
and.
C
And
the
press
that
matters
if
you're
running
a
small
business
is
the
local
press
and
actually,
as
a
national
regulator,
we
sort
of
miss
that
a
bit
and
if
you
think
about
ofsted
as
an
example,
Ofsted's
ofsted
and
the
local
school
community,
by
putting
banners
outside
the
school,
which
is
really
very
local
and
works
very
well,
we
are
we
are.
We
now
are
good
and
we
were
inadequate.
C
E
I
just
say:
do
we
have
been
doing
some
proactive
work
around
that
in
particular
and
pay
tribute
to
when
Chris's
team
around
this,
because
we
from
an
adult
social
care
point
of
view,
we
had
been
producing
press
releases
around
the
outstandings
and
the
inadequate
and
not
press
releasing
others,
and
we
weren't
getting
exactly.
As
you
say,
Paul
we
weren't
getting
the
response
to
that
and
from
a
local
press
perspective.
E
So
from
the
first
of
April
this
year,
we've
been
producing
the
information
on
a
weekly
basis,
broken
down
by
local
authority
areas,
sending
that
out
from
the
regional
press
contacts
to
the
local
press
and
highlighting
in
that
all
of
the
reports
that
we've
published
in
the
previous
week
and
with
that
just
one
simple
change
of
approach:
the
numbers
of
reports
that
we've
had
and
you
quite
right.
It's
the
local
press
that
do
this.
E
The
numbers
of
reports
that
we've
had
of
the
good
services
that
we've
rated,
not
just
the
outstanding
but
the
good
as
well-
has
massively
increased
and
and
again
we're
also
encouraging
providers
who
are
now
from
the
first
of
April,
expected
to
publish
their
ratings
and
display
them.
In
in
public
areas
and
services
and
to
and
to
make
more
of
that
and
I
think
we
are
seeing
that
in
that
trend.
So
you
know
Chris
I'm
sure
has
been
talking
to
others
and
learning
mother's,
but
that's
just
one
example:
porn.
F
That's
very
helpful
and
rare
I'm
to
give
a
sense
of
how
this
work
there
they're
broadly
four
ways
that
the
wheeler
to
reach
different
constituencies
so
there's
a
whole
set
of
media
involvement
and
engagement
and
Andrews
laid
out
how
that's
developed
over
the
over
the
course
of
time.
Then
there's
the
direct
provider
engagement,
so
behind
the
scenes
there
are
also
is
open
forums
or
newsletters,
where
we
have
ongoing
engagement
with
all
the
different
sectors
that
we
regulate
and
that
allows
them
to
hear
the
messages
unfiltered.
F
If
you
like
it's
worth
saying,
then
we
look
at
our
new
stores,
which
are
both
local
and
national
I'm.
The
significant
majority
of
news
stories
are
positive
and
about
the
work
that
we're
doing,
and
that
doesn't
mean
that
all
of
them
are,
and
that
doesn't
mean
there
isn't
room
for
us
to
improve.
But
it
is
an
important
fact.
Then
there
is
all
the
work
that
we
do
with
parliamentary
stakeholders
or
particular
importance.
Local
and.
F
Representatives
and
ankles
the
local
papers
will
want
to
understand
what
the
mps
perspective
is.
So
we
would
always
let
mp's
know
of
all.
An
inspector
was
particularly
important
issues
like
coming
out
of
special
measures
and
then
one
of
the
other
challenges
of
particular
importance,
because
it's
our
internal
communication,
so
that
our
staff
knows
one
things.
I
don't
resemble
Steve's
us
every
week,
Andrew
as
well.
Lots
of
us
it's
put
out
weekly
messages
about
what
we're
learning
are,
what
we
found.
F
What
the
different
ratings
are
of
people
have
come
out
of
special
measures
so
that
our
inspectors
as
they're
out
and
about,
can
also
be
getting
that
message
across
to
providers
about
the
value
that's
being
added
and
the
encouraging
improvement.
So
there's
quite
a
lot
going
on,
which
isn't
to
say
that
we
can't
know
for
others
as
well.
A
Thank
you
Paul
there
there
I
think
Lewis
has
written
a
note,
but
I,
maybe
I
think
it
was
loose
who
suggested
with
them
in
the
case
of
care
homes,
I
didn't
know
if
he
copied
and
Ray
on
this
email
that
we
should
actually
write
to
each
resident
or
their
relatives
about
the
results
of
inspections.
Now
I
reply
to
nurse
that
this
in
principle
was
a
interesting
idea,
but
an
important
idea,
but
the
problem
is
that
if
we
write
to
a
relative
or
a
patient
setting
their
home
has
been
rated
inadequate.
A
A
E
If
that's
appropriate,
Germany
obviously
depends
on
the
nature
of
the
nature
of
the
service,
and
what
I
wanted
to
do
was
to
follow
up
with
the
team
to
see
how.
How
confident
are
we
that
that
is
actually
happening?
It's
there
and
a
provider
handbook
as
an
expectation
but
I,
don't
know
whether
we've
kind
of
proactively
checked,
and
that
is
happening
across
the
board.
But
it
was
exactly
for
the
reason
and
that
Lewis
identified
that
we
wanted
to
make
people
aware
and
the
the
reason
for
asking
the
providers
do,
because
that
is
indeed
what
ofsted
do.
E
Is
they
ask
the
school
to
send
the
information
out
parents
the
reason
for
asking
the
provider
to
do?
It
is
a
because
they've
got
the
details
and
the
contact
details
to
be
able
to,
and
secondly
because
it
would
then
allow
them
if
it
was
an
inadequate
or
requires
improvement
service
for
them
to
add
information
into
that
communication
about
what
they're
doing
about
it
and
again
you
certainly
when
I've
talked
to
people
about
the
display
of
ratings
and
their
concern
about
displaying
inadequate
or
requires
improvement,
they
put
something
up
next
to
it.
E
C
I
think
that's
the
right
place
to
locate
it.
Isn't
it
because
if
I
received
a
letter
saying
that
my
mum
was
in
a
place,
that
was
an
adequate
form,
CQC
I'd,
write
back
and
say
and
what
you
want
me
to
do,
and
and
whereas,
if
I
receive
it
from
a
provider,
then
I
wrapped
back
and
say.
And
what
are
you
doing
and
so
I
think
it's
it's
locating
the
letter
and
the
communication
in
the
right
place
and
we
have
to.
A
D
Saw
Michael
and
what
some
other
if
I'd
present
the
reports
in
the
high
level
and
I
think
Andrea,
Steve
and
Michael
are
on
standby
to
come
in
on
some
of
the
issues
about
what
we're
doing,
particularly
in
those
areas
for
development.
What
action
they've
got
in
place?
So,
if
I
go
first
and
then
she's
a
kind
of
way
of
saying
I'll
do
the
presentation
and
they
can
answer
all
the
difficult
questions
which
effectively
that's
or
older.
D
Work
so
and
I'd
like
to
do,
and
this
report
is
flag
in
five
areas
for
discussion
and
development
and
I'll
go
through
each
one,
very
briefly
from
there
Michael.
So
on
the
comprehensive
inspections.
I
think
we've
made
good
progress
in
relation
to
this.
We
continue
to
roll
this
out
and
rates
services
and
we
are
seeing
an
increase
in
higher
highest
proportion
of
good
and
outstanding
ratings
in
caring
and
the
highest
proportion
of
requires
improvement
ratings
in
the
safe
area.
D
But
what
we've
not
drawn
attention
to
as
much
previously
coming
on
to
this
issue
about
our
impact
is
in
adult
social
care.
Forty-Four
percent
had
improved
their
rating
on
reinspection.
Twenty-Five
percent
of
hospitals
had
improved
on
reinspection
and
eighty-six
percent
for
primary
medical
services.
So
this
speaks
to
the
points.
I
think
that
Robert
was
flagging,
of
where
we
do
go
back
and
re
inspect.
D
Improvements
are
noticeable
and
evidence
in
the
way
that
we
read
those
services
we
place
under
than
64
locations
into
special
measures
in
the
second
quarter
and
they're
being
tracked
and
we'll
reinspect
those
after
six
months.
In
order
to
chat
that
improvements
are
indeed
being
made
on
our
reporting
and
I
think
this
is
an
issue
that
we
flag
in
a
man
report.
D
That
has
been
said
so
all
examples
of
good
progress
that
are
being
made
areas
for
development,
and
this
is
perhaps
something
that
the
board
might
want
to
discuss
and
my
typical
inspector
colleagues
are
prepared
for
questions
on.
This
is
in
relation,
so
just
where
we
are
in
terms
of
the
inspection
program.
We
considered
this
in
detail
at
the
last
meeting
and
the
actions
are
set
out
that
are
being
taken
in
3.3
of
the
cover
and
reports
and
then
in
the
detail
of
the
performance
report.
D
It
itself
so
I'd
like
to
present
the
comprehensive
inspections
as
good
progress
being
made.
Well
still
further
work
to
be
on
the
tech
and
going
back
to
the
public
accounts
committee.
I
think
the
reinspection
zand
the
improvements
after
a
reinspection
or
some
evidence
of
the
impact
that
we're
making
and
intense
effectiveness
secondary
is
around
that
quality
and
the
completion
of
CRM
I
think
we
continue
to
press
this
issue
within
the
organization
and
I
think
improvements
are
taking
place.
D
A
critical
issue
here
is
that
we
are
dependent
on
data
to
actually
manage
your
organization,
be
able
to
chart
our
performance
and
effectively.
That
means
that
reporting
is
made
in
real
time
into
the
customer
relationship
database,
which
allows
us
to
be
clear
about
what
progress
we
are
making,
and
we
can
do
that
in
a
say
in
real
time.
So
we
continue
to
press
on
that
publication
of
inspection
reports.
D
We
do
continue
to
make
progress
in
relation
to
this,
particularly
in
adult
social
care
and
primary
medical
services,
which
they're
not
easy
reports,
but
they
are
simpler
reports
to
produce
they
still
need
producing
and
to
a
standard,
I
think
in
hospitals.
These
are
much
more
complicated
affairs
with
more
people,
making
a
contribution
and
there's
further
work
to
be
done
in
relation
to
them.
D
Next
area
is
locations
not
meeting
one
or
more
standards,
page
12
in
the
performance
reports
and
again
what
the
report
sets
out
is
some
of
the
actions
which
should
be
in
taken
across
the
three
inspection
directorates
and
and
again
my
country
and
Steve
were
prepared
to
say
more
about
what
word
we're
undertaking
to
drive
improvements
in
that
area.
I've
touched
briefly
on
safeguarding,
but
just
to
the
risk
of
repeating
myself
I
think
there's
been
a
very
effective
piece
of
review
work
carried
out
over
the
past
few
months
and
that's
now
bearing
fruits
with
improved
performance.
D
The
way
that
we
are
responding
to
set
guard
in
both
concerns
and
alerts
and
I
personally
feel
much
more
confident
as
a
consequence
of
that
review.
Work
in
relation
to
that
material.
That
information
that
intelligence
being
processed
both
in
a
timely
manner,
but
also
in
an
appropriate
manner
as
that
works
its
way
through
so
I
think
they're.
The
five
key
areas
that
we've
flagged
in
the
covering
report
Michael.
D
The
report
also
in
its
detail,
touches
on
our
financial
performance
and
you'll,
see
that
we're
projecting
them
to
spend
towards
the
end
of
the
financial
year
just
over
six
million
pounds.
That
is
a
report
at
the
end
of
I.
Think
it's
at
the
end
of
sep
tember
and
we
continue
to
monitor
that
performance
on
Finance
and
then
the
last
item
just
to
mention
is
in
relation
to
the
strategic
risk
register
which
occasionally,
in
our
conversations,
we
focus
heavily
on
our
performance.
D
But
the
risk
register
is
an
important
tool
that
I
know
that
Paul
rue
through
the
audit
and
Risk
Committee
spends
time.
Considering.
It
also
comes
to
the
executive
team
and
we
continue
to
update
that
on
a
on
a
regular
basis
and
that
Flags
some
of
the
risks
but
props
Michael.
If
I
pause
there
and
and
if
colleagues
have
questions,
then
between
myself
and
the
executive
team,
not
just
the
chief
inspectors,
will
endeavor
to
answer
those
questions.
A
Thank
you,
David
I
should
just
say
that
Jennifer
sent
me
an
email
about
the
point.
She
would
like
discussed
that
at
the
board
meeting
and
as
far
as
the
performance
report
was
concerned,
there
were
two
main
areas,
both
of
which
david
has
touched
on.
One
is
the
plans
to
get
closer
to
our
targets
on
inspections
and
the
other
one
which
I
also
felt
was
an
important
point.
It
is
the
number
of
locations
where
there
is
a
still.
A
B
B
H
The
shock
is
not
my
name
is,
and
yes,
certainly
I,
think
in
terms
of
comprehensive
inspections,
barring
problems
are
related
to
winter
pressures
or
anything
that
might
prevent
us
from
doing
inspections
over
the
next
four
months.
We
are
on
track
to
do
all
the
acute
trusts,
with
gin
with
A&E
departments
by
the
end
of
March
and
then
all
the
other
trusts,
including
specialists,
trust,
mental
health
and
who
community
trusts,
and
indeed
the
ambulance
trusts
by
the
end
of
june.
So
I
think
we
will
I
get
to
that
target.
H
C
Speak
up
the
context
behind
this
is
there
are
over
twenty
thousand
locations,
and
the
report
focuses
mainly
on
the
trajectory
for
general
medical
practice,
so
I
think
it's
important
so,
though,
we're
on
schedule
for
our
dental
target,
which
is
temp
scent
of
the
eleven
and
a
half
thousand
dental
inspections
by
April
and
in
order
to
help
meet
the
GP
target,
we
can
profile
the
dentists
to
help
us
focus
inspectors
on
general
practice.
But
of
course
the
two
big
issues
are
recruitment
and
the
quicker
we
get
inspectors
to
be
doing
inspections
and
then
productivity.
C
Of
course,
if
the
financial
situation
changes
and
we
can't
use
bank
inspectors
after
April,
that
will
certainly
cause
a
problem
in
meeting
the
targets.
The
the
rest
of
the
focus
is
on.
How
do
you
improve
the
productivity
by
reducing
the
sort
of
things
that
can
be
removed
from
the
frontline
inspectors?
Job,
and
a
number
of
these
things
include
registration
inquiries,
supporting
getting
better
business
support
to
try
and
help
them
become
more
effective.
So
we
need
a
across
CQC
support
there
and
then
there
are
sort
of
more
medium
to
long-term
things,
including
pre-populated
reports.
C
So
it's
about
productivity,
recruitment
and
well
you
do
that
and
we
get
the
inspections
done,
we're
also
showing
because
we've
introduced
a
new,
smaller
report.
A
shorter
report
to
complete
the
time
to
publication
is
also
improving
and
over
the
last
three
months,
75%
on
the
rolling
three
month
basis
have
met
the
KPI
rather
than
the
forty
odd
percent,
which
is
in
the
monthly
board
report.
So
actually,
we've
seen
the
seeds
of
improvement
on
trajectory
but
they're
not
showing
yet
on
the
figures
in
the
board
report.
E
You
very
much
so
some
of
this
is
repetition
of
what
both
Mike
and
and
Steve
had
said,
because
them
the
issues
affect
all
three
directorates
so
again,
we've
we
had
anticipated
the
level
of
recruitment
in
terms
of
people
able
to
go
out
and
do
inspections
at
the
level
of
productivity
that
we
were
wanting
earlier
than
has
actually
been
the
case
and
I.
E
That
is
a
focus.
The
second
area
is
also
making
sure
that
we're
equipping
and
supporting
our
inspectors
to
do
the
job
as
well
as
they
possibly
can
do,
both
in
terms
of
productivity
of
getting
through
inspections,
but
also
in
terms
of
making
producing
timely
reports.
And
so
we
have
been
looking
at
that,
both
in
terms
of
the
capability
and
performance
of
inspector
inspectors.
Identifying
specific
needs
that
they've
gotten
trying
to
address
those
needs.
So
report.
E
Writing
has
been
one
particular
area
and,
and
we've
seen
some
success
and
positive
progress
in
that
respect,
as
well
looking
at
streamlining
some
of
the
processes.
So
we
have
and
try
to
cut
out
some
of
the
levels
of
checking
that
we've
had
in
our
quality
assurance
process
to
speed
that
side
of
things
up
and
we're
looking
to
make
further
improvements.
That
out
next
year
as
well,
and
the
continuous
improvement
group
led
by
Debbie
Westhead
is
continuing
to
work
with
colleagues
across
MZ
QC.
E
And
there
are
a
small
number
of
bank
inspectors
who
potentially
could
lead
inspections
for
us
and
because
they
they
have
been
our
staff
that
have
been
properly
trained.
But
we're
not
routinely
using
them
to
do
that.
So,
there's
that's.
How
we're
trying
to
increase
the
capacity
as
well
as
their
capability
and
performance.
E
We
continue
to
have
as
a
proportion
of
our
inspection
activity
an
increasing
amount
of
enforcement,
which
is,
as
colleagues
as
said,
is
cut
very
time-consuming.
It's
clearly
absolutely
essential
that
we
do
that,
and-
and
we
will
continue
to
do
that
so
I
can
see
in
terms
of
the
monthly
monitoring
that
we're
doing
that.
Little
by
little.
We
are
kind
of
chlorine
back
on
the
on
the
backlog,
and
we
will
that
will
ramp
up.
E
I
think
that
we
will
be
there
or
there
abouts
around
the
end
of
sep
tember
next
year,
and
it
will
be
incredibly
challenging
to
actually
hit
September,
but
I.
Don't
think
we
will
be
far
off
and
there
will
certainly
be
some
areas
of
the
country
and
that
will
will
complete
and
their
comprehensive
inspection
program
ahead
of
that
schedule.
And
one
of
the
other
things
that
we're
looking
at
is
trying
to
make
sure
and
that
we
can
utilize
them
and
to
add
to
support
colleagues
elsewhere
in
the
country
to
to
to
complete
their
programs
as
well.
E
So
there's
a
raft
of
different
things,
but
it's
I
wouldn't
want
you
to
think
that
it's
all
completely
sorted
and
because
there's
there's
all
sorts
of
things
that
could
happen
between
now
and
time
next
year,
but
we
are
managing
and
monitoring
it
very,
very
carefully
and
there's
huge
commitment
within
the
teams
to
do
it.
I
think
that's
another
thing
to
say
thank.
A
You
very
much
I
mean
this
is
such
an
important
issue,
because,
of
course
anybody
who
listened
in
or
watched
the
public
accounts
committee
that
this
really
was
the
all
those
ostensibly
about
the
nao
report.
It
really
became
a
session
about
our
ability
to
meet
targets.
I
mean
there
was
one
positive,
which
is
one
of
the
committee.
Members
actually
suggests
that
the
CQC
needs
more
resources,
so,
whether
anybody's
going
to
listen
to
that
comments,
as
set
as
a
separate
point,
but
really
there
was
one
particular
member
of
the
committee,
mr.
B
Firstly,
absolutely
clear
that
we
have
a
lot
of
inspectors
to
incredibly
hard
work
and
to
extend.
Perhaps
one
might
actually
express
worry
about
that,
because,
if
you
put
alongside
what
we
see
about
not
meeting
targets
of
page
16
with
what
he
said
about
staff
morale
and
saw
the
two
things
so
are
potentially
linked
and
communication,
and
so
on
so
I'm,
firstly
tribute
to
the
staff-
and
everyone
is
trying
to
to
to
to
do
this
and
I
here
absolutely.
B
What
being
seven
is
encouraging
about
mitigating
this,
but
are
the
figures
telling
it
that
make
them
fit
me
if
I'm
wrong?
But
what
seems
to
be
I'm
being
told
that
page
16
is
that
we
are
getting
further
and
further
away
from
the
target
rather
than
closer
to
it.
Question
1
am
I
wrong
about
that,
and,
secondly,
I
notice
and
I
not
sure
what
the
significance.
So
it
is
that
he
said
that
the
trajectory
blind
has
been
removed
from
this
month's
reporting
and
I'm
not
sure
what
that's
about.
B
So
what
I'm
hearing
is
lots
of
it
really
committees
work
being
done
about
mitigating
this,
but
what
I'm
not
entirely
sure
as
I
parities?
What
is
there
is
there
that
assures
us
that
we
are
actually
going
to
do
what
we've
said
we're
going
to
do
now?
If
we're
not
going
to
be
able
to
do
what
we
said,
we're
going
to
do
well,
I
can
understand.
B
D
So
I
think,
last
month
Robert
I,
we
said
and
I
said
that
there
was
a
risk
that
by
sep
tember
of
next
year,
we'd
undershoot
on
the
trajectory
on
pms
and
adult
social
care
by
seven
and
eight
percent,
and
that
what
we
were
doing
in
this
pics
upon
your
point
about
the
connection
between
morale
work
Lord
and
how
we
get
to
it
possible
claws
again.
I
think
what
staff
have
told
us
loud
and
clear
is
that
any
plan
needs
to
be
credible.
It
needs
to
be
realistic,
undeliverable
and
I.
D
Think
all
three
of
my
colleagues
have
said
what
work
is
being
put
in
place
and
but
there
is
still
a
risk,
I
think,
and
it
will
be
wrong
for
us
to
pretend
that
we're
going
to
get
there
very
clearly
and
overshoot
that
target
I
think
what
we
are
doing
is
working
very
hard
to
get
to
that
target.
We
are
mitigating,
but
the
staff
survey
which
we
published
and
again
we
report
here
and
there's
detail
in
the
performance
report
quite
properly,
is
showing
that
we
have
made
progress
as
an
organization
on
the
staff
survey.
D
There's
a
lot
to
be
very
pleased
about
in
that
staff
survey,
but
Morales,
diminishing
and
I
think
this
issue
between
people's
personal
morale,
which
is
high
in
his
increased
and
organizational
morale
I,
would
reflect
that
the
organizational
morale
is
really
about
work
lords
and
this
issue
about
targets.
So
what
I
think
we're
trying
to
do
as
the
senior
team
is
strike
a
balance
between
motivating
and
inspiring
people
and
not
asking
them
to
do
the
impossible?
D
I
think
we
are
asking
them
to
do
the
difficult,
but
not
the
impossible
and
trying
to
get
to
a
position
where
we
can
deliver
what
we
publicly
set
out
and
committed
to
to
deliver.
So
so
I
don't
think
we're
just
carrying
on
I
think
we'll
continue
to
work
hard
and
I.
Think
Andrea,
Mike
and
Steve
upset
out
what
they're
doing
Paul
and
Eileen's
teams
also
work
to
support
that
all
points
about
championing
the
recruitment
activity.
D
So
I
thought
that
just
gives
an
explanation
of
in
answer
to
your
question.
But
we
are
just
to
come
to
what
I
think
is
your
key
point
Robert
trying
to
strike
a
balance
between
doing
what
we've
set
out
to
do
and
actually
trying
to
support
staff
to
do
it
and
to
do
the
job
that
we're
asking
them
to
do.
I,
don't
want
to
give
false
assurance.
I
think
this
is
going
to
be
very
tight
as
we
go
through
the
remainder
of
this
financial
year
into
the
next
financial
year.
D
What
is
clear,
those
those
new
staff
come
into
the
organization
and
begin
to
go
through
their
induction
and
real
specific
training
begin
to
pick
up
on
secondary
role,
for
that
we
do
have
more
capacity
and
we
can
set
this
work
forward.
I
think
we
probably
add
45
minutes
on
this
yesterday
about
what
are
the
improvements
in
our
systems
and
processes?
How
can
we
improve
the
way
we
produce
and
as
draft
reports,
a
huge
amount
of
time
goes
into
reports,
that's
the
drafting
of
reports,
and
then
it
does
factual
accuracy
test
checks.
D
If
there's
requests
for
ratings
reviews,
that
activity
spends
a
huge
amount
of
time.
So
I
think
what
we
have
become
increasingly
clear
on.
As
a
senior
team
is
focusing
on
that
I'm
making
that
as
efficient
to
process
as
we
can
is
likely
to
free
a
significant
proportion,
the
time
which
will
help
so
I
think
I've
been
focused
on
getting
more
people
into
the
organization
and
then
ensuring
that
they've
got
the
skills
to
do
the
job.
There's
an
awful
lot
of
activity
now
going
on
in
terms
of
efficiency.
I
think
you're
right.
D
I
read
those
figures
in
exactly
the
same
way
as
you
do
they
gap
between
what
we've
done
and
the
numbers
that
we
should
be
doing
is
increased,
and
I
think
this
is
why
it
was
important
that
we
were
able
to
have
more
time
or
Molly.
What
action
is
being
put
in
place
to
of
those
I
would
want
to
say
it
the
next
month,
the
report
that
we
bring,
so
they
won't
be
the
course
for
the
report,
but
a
month
or
report
that
we
have
some
evidence.
That
gap
is
closing
in
the
next.
D
F
So
we
have
changed
the
look
and
feel
of
these
that
the
big
change
we've
tried
to
do
is
firstly,
to
make
sure
that
there's
them
the
picture,
extends
out
all
the
way
to
the
end
of
the
and
the
baseline
in
period
and
and
within
that
to
show
what
the
actual
in
month
position
looks.
Like
few
remembers
of
previous
charts,
it
became
quite
difficult
to
see
what
the
in
motivation
was
always
a
cumulative
target.
F
So
what
page,
16
and
17
are
now
doing
in
those
bars
and
blue
lines,
and
it's
to
show
month
by
month,
as
well
as
they
em
the
productivity
where
we
have
it
in
the
terms
given
in
their
text
at
the
bottom
and
but
just
a
couple
of
things
to
add
to
what
chief
inspectors
have
been
saying
it
does.
It
does
obviously
take
time
as
people
come
on
board
and
the
recruitment
been
so
successful.
We
have
a
lot
of
new
people.
We
have
to
get
them
up
to
speed.
F
Number
of
concerns
doesn't
particularly
change
that
those
additional
inspectors
are
able
to
share
the
load
of
the
inspection
over
and
above
that,
so
that
that
bedrock
of
concerns,
activity,
2i,
think,
colleagues,
inner
tubes
bet,
there's
a
reason.
We
would
expect
to
see
an
increase
in
productivity
coming
as
we
have
would
get
our
new
inspectors
on
board
and
they
become
fully
trained
up
so
Roberts.
Having
sounds
absolutely
the
right
one.
F
B
Dude,
do
we
have
a
understand
the
difficulties
of
full
cast
and
all
that
particularly
about
something
as
I'm
canta
fiable,
as
how
many
concerns
anyone's
got
to
deal
with
in
the
world
compares
overanalyze
things,
but
it
is
it.
Is
there
somewhere
a
sort
of
forward,
look
analysis
which
says
well
actually
the
way
which
we
are
going
to
get
to
where
we
hope
to
get
to
is
by
this
and
that
didn't
do
multiple.
It
actually
works.
B
In
other
words,
we
have
enough
man,
house
will
have
enough
manners
to
actually
achieve
what
we
set
out
to
achieve,
or
if
things
stay
as
they
are
or
are
we
still
in
the
position
of
because
we
got
so
much
immediate
and
urgent
work
to
do
the
inspections
going
back
and
we
just
don't
know
how
that's
going
to
pan
out
which
of
those
two
situations.
William.
G
I
do
because
it
was
in
very
related
point.
Is
that
all
right,
just
on
the
question
of
forecasting,
cuz
I,
think
that's
I,
think
that's
really
important
that
the
really
important
thing.
So
it
seems
to
me
that,
as
a
broad,
there
are
three
things
that
we
need
to
do
in
relation
to
this
kind
of
issue.
One
is
to
agree
with
the
exec.
The
target
will
be
set
at
the
beginning
of
the
year.
G
G
Now
and
there's
a
question.
So
at
what
point
do
we
say
we're
not
going
to
hit
it?
And
there
are
good
reasons
why
we're
not
going
to
hate
it?
And
this
is
how
we're
going
to
address
it.
Sort
of
beyond
the
this
immediate
reporting
period,
because
reputation,
lee
there's
only
one
thing
worse
than
not
hitting
a
target
is
pretending
that
you're
going
to
hit
it
right
to
the
day
before.
It's
sort
of
you
know
you
the
endpoint
and
I.
D
On
so
do
we
have
some
forecasting
work?
Yes,
we
did
and
that
SAT
behind
the
way
that
I
and
colleagues
reported
to
the
board
at
the
last
meeting.
So
it's
you're
both
of
your
points,
I,
think
what
we
were
projection
is
an
eight
percent
in
six
percent
under
performance
at
September
2016,
in
both
adult
social
care
and
primary
medical
services
and
expressed
a
different
way.
D
That
would
mean
instead
of
completing
the
program
at
the
end
of
sep
tember,
the
programs
will
be
completed
between
six
and
eight
weeks
later
sore
the
end
of
mids,
mid-october
and
probably
into
November.
So
that's
what
that
means.
Some
of
the
improvements
that
are
in
these
charts
or
on
page
16
and
onwards,
not
on
the
the
charts
themselves,
but
in
the
tables
underneath
assuring
improvements
in
productivity,
which
I
think
the
two
things
at
both
Andrea
and
and
Steve
spoke
about,
and
that's
the
point
about
systems
improvement.
D
So
I
think
what
we've
been
doing
to
your
point
term
Anna
is,
we
are
saying
there
is
a
risk
to
improve
in
those
targets,
but
we're
11
months
out
from
except
ember
soar
to
say,
with
confidence
really
they're
going
to
hit
it
you're
worried
you're
going
to
miss.
It
is
the
language
I
used
last
month
and
I
use
again
this
month
is
there
is
a
risk
that
we
will
miss
that
target
work
is
underwear,
which
is
why
it
was
important
that
we
spent
some
time
going
through.
What
is
a
mitigating
action?
D
D
We
want
to
do
a
good
job
people
care
about
what
they're
doing
they've
got
pride
in
what
we're
doing
and
they
want
to
do
a
good
job.
So
I
think
the
secret
to
this
is
to
tap
into
that
energy,
which
is
not
about
hitting
a
target.
But
it's
about
doing
a
good
job
in
the
right.
Where
the
other
thing
we
don't
want
to
happen,
is
we
don't
want
the
quality
of
our
reports
to
start
suffering
and
we're
desperate,
not
to
start
avoiding
taking
enforcement
action
because
actually
take
an
enforcement
action
means
more
time.
D
So
the
balance
is
between
morale
and
actually
completing
it,
but
it's
also
doing
it
to
the
standard
that
we
think
this
work
should
be
undertaken
to
and
during
the
enforcement,
because
I
think
the
bigger
hits.
Our
reputation
is
not
whether
we
get
there
by
the
end
of
sep
tember,
the
middle
of
October
quite
frankly,
but
if
the
quality
of
what
we
do
begins
to
suffer
in
anywhere
share
before
or
and
I
think.
This
is
why
I
briefly
touched
on
the
risk
register
in
presenting
the
rapport
that
we
actually
go
into
somewhere.
D
We
think
it's
okay,
we
miss
something
that
is
subsequently
found
to
be
less
than
its
suboptimal
and
then
we're
back
into
this
debate
about
well.
You've
been
in.
You
said
it
was
okay,
you
missed
it
and
there
was
something
that
we
miss,
because
we
were
chasing
a
target
rather
than
doing
the
job
in
the
muscle.
So
I
think
what
we're
doing
very
clearly
and
very
transparently
is
flagging:
a
risk
to
the
completion
in
adult
social
care
and
primary
medical
services
of
that
of
hitting
the
target
by
the
end
of
sep,
tember,
but
I.
D
Think
we're
also
saying
as
an
organization
as
a
leadership
team,
not
just
the
senior
leadership
team,
but
the
wider
leadership
team.
We're
focused
on
working
to
mitigate
the
risks
that
will
miss
that.
But
we're
not
going
to
try
and
do
this
in
a
way
that
actually
allows
the
quality
of
what
we're
doing
to
suffer
or
the
fact
that
we
don't
take
any
pills.
So.
G
Can
I
can
I
just
a
nice
I
completely
agree
with
you
about
cause,
you
I
think
that's
that
that's
hugely
important
and
and
that's
why
I
think
re
forecasting
is
also
important,
because
you
know
there's
a
very
good
reason
for
me
for
casting
the
thing
it
thing
about.
We
forecasting
and
financial
context
is
usually
you.
There
is
a
there
is
a
kind
of
pattern
for
reef
or
casting
formal
pattern
which
which
organizations
adopt
so
I
guess.
G
D
And
I'm
quite
happy
to
take
a
steer
from
the
board
in
relation
to
this
and
so
ever
discussion
about
it.
But
we
are
looking
at
what
our
plans
and
priorities
are
for
next
year
we
were
in
a
business
planning
process,
so
the
logical
time
to
do
that,
for
me,
is
as
part
of
that
business
planning
process.
So
the
next
couple
of
months
will
bring
to
the
board
the
plans
and
priorities
for
next
year.
D
So
I
think
we'll
give
a
clear
and
unambiguous
statement
of
what
we
think
we're
going
to
do
by
September
in
the
business
plan
which
will
publish
in
April,
so
this
next
few
months,
we'll
see
as
review
there's
some
really
I
think
very,
very
good
staff
who
have
done
some
quite
excellent
work
in
polls
team
in
relation
to
forecasting
that
have
allowed
us
to
bring
these
reports
and
their
work
continues
to
different
and
center
and
relation
to
monitor
this
and
tracking
this
we
receive
as
an
executive
team.
A
weekly
report.
D
I
was
overheating
Andrea
speaking
to
my
concede
yesterday
about
just
how
the
quality
of
that
debt
has
transformed
the
ability
to
have
a
conversation
about
where
we're
up
to,
because
we've
now
got
this
in
real
time
down
to
team
level.
So
it
allows
a
management
conversation
to
take
place
about
performance
which
has
not
been
possible
hitherto.
D
Now
that's
been
available
for
three
four
months
in
the
quality
that
it's
been
coming
through,
so
I
feel
we're
in
a
much
stronger
players,
but
I
really
don't
want
to
be
a
hostage
to
fortune
of
saying
we're
going
to
hit
it
or
we're
not
going
to
hit
it
when
there
is
a
risk
that
we're
not
going
to
eat
it.
I
think
we
should
be
clear
about
that
mitigate
the
risk,
but
also
be
realistic
with
you,
because
we
are
trying
to
balance
morale
and
delivery.
D
The
key
point
in
this
is
we're
not
going
to
not
investigate
areas
were
that
we're
concerned
about,
and
that's
the
issue
about,
would
being
responded
to
concerns
and
said
garden
alerts
have
come
through,
which
is
why
I
made
the
points
about
that
review.
We've
done
upset
garden
earlier
in
the
year
being
hugely
important
and
actually
get
into
those
concerns
that
come
through,
and
we
none
of
us
in
the
executive
team,
wanted
to
hear
I.
Think
we
just
clear
about
this.
I
I,
certainly
don't
want
to
be
here.
D
I'd
much
rather
be
having
a
conversation
with
you
about
we're
achieving
what
we've
set
out
to
do,
but
the
reality
is
we're
not
there
and
the
organization
is
working
incredibly
incredibly
hard
in
the
staff
survey.
We
put
great
reliance
on
it
when
Mike
goes
into
hospitals,
great
reliance
on
the
staff
survey
and
I
think
we've
got
to
give
equal
reliance
on
our
own
staff
survey
and
what
I'll
stop
it
selling
us
through
the
snap
survey.
D
C
But
it's
probably
just
the
time
code
to
be
outlined
is
probably
just
about
right,
so
I
think
it
sort
of
in
March
or
April
being
able
to
be
more
definitive
would
be
the
right
sort
of
time
and
and
what?
What
we're
balancing
is?
Your
point,
a
crucial
point
about
staff,
morale
and
also
public
reputation,
and
the
earlier
we
can
say
is
better
for
staff
this.
So
it's
better
for
public
reputation
because
then
you're
preparing
what
we
know
what
we're
doing.
E
Make
a
comment
about
the
use
of
the
word
reputation
and
because
it
sort
of
worries
me
slightly,
because
I
think
that
the
key
thing
and
David
I
think
emphasized
this.
The
key
thing
is
the
confidence
that
people
could
have
a
nose
and
the
job
that
we're
doing,
because
we
need
to
be
doing
the
job
well,
so
it's
sort
of
reputation
sometimes
sounds
and
I'm
sure
this
was
not
meant
by
members
around
the
table
sounds
a
bit
self-serving,
but
actually
it's
not
about
that.
E
It's
actually
about
making
sure
that
people
continue
to
have
confidence
and
that
confidence
can
grow
in
our
ability
to
do
what
we
say
that
we're
going
to
do,
but
to
do
it
in
a
way
that
absolutely
protects
the
public
in
circumstances
where
they
need
that
protection
and
I,
just
I
just
think,
there's
a
balance
in
terms
of
the
way
that
we
talk
about
it.
So.
G
I
use
that
word
and
I
use
it
and
absolutely
in
a
sense
that
you
mean
because,
like
what
I
think
is
really
important,
is
that
if
people
want
to
throw
brickbats
at
the
organization
for
failing
to
target,
we
can
be
very
clear
that
we
that
we
knew
that
was
happening,
that
we
took
what
action
we
could,
but
not
action.
That
was
inappropriate,
and
so
people
can
continue
to
have
confidence
in
this.
A
A
A
What
are
they
spending?
How
much
of
the
time
is
actually
spent
on
writing
reports
and
reacting
factual
accuracy
comments
by
providers?
What
what's
really
good,
I
think
a
better
sense
of
the
activity
of
our
inspect
inspectors,
I
think
would
be
very
helpful
for,
or
certainly
for
the
non-executive
is
probably
quite
helpful
for
the
whole
board.
A
E
Thank
you,
and
so
again,
then
I'll
probably
kind
of
steel,
certainly
some
of
them
Steve's
thunder
and
maybe
some
of
Mike's
as
well,
because
some
of
the
issues
that
I
reflected
in
these
charts
are
are
common
to
us.
And
one
of
the
issues
is
that
we
do.
We
do
have
some
concerns
about
what
the
data
is
actually
telling
us.
So
there
are
some
difficulties
with
the
we're
measuring
two
things
here.
E
What
we
said
was
non-compliant
under
our
old
methodology
and
now
we're
obviously
going
back
and
saying
that
services
are
good
outstanding,
requires
improvement
or
inadequate
and
there's
a
a
quark
which
I'm,
frankly,
don't
quite
understand
and
but
there's
a
quark
that,
if
we've
rated
services
as
good,
it
doesn't
take
the
non-compliance
out
of
the
system
and
we're
going
back
into
that
and
to
and
to
see
how
we
can
correct
that.
But
it
has
to
be
done
manually
and
teams
in
an
impulse.
E
So
we've
been
going
through
a
process
of
work
of
identifying
and
whether
those
services
which
we've
kind
of
quote-unquote
sand
called
dormant
really
are
have
ceased
to
exist
and
we
should
be
and
d
registering
and
taken
them
off
or
whether
they
are
expecting
to
be
active
and
actually
sort
of
getting
them
back
in
back
into
the
system.
So
so
there's
a
lot
of
work
going
on
to
kind
of
really
get
us
to
focus
on
those
areas.
E
Particular
area
and
we've
gone
back
and
they
have
addressed
that
that
compliance
problem,
but
they've
ended
up
with
a
non-compliant
area
elsewhere,
and
this
I
think
is
one
of
the
benefits
of
our
new
system
of
saying
it
requires
improvement
or
inadequate,
as
opposed
to
the
individual
regulatory
compliance
or
non-compliance,
because
we're
taking
a
look
at
the
service
as
a
whole
and
and
actually
the
fact
that
people
bump
between
different
regulations
in
not
being
compliant
is
indicative
of
a
service.
Overall.
E
Good
leadership
should
be
looking
at
the
picture
across
the
board
and
actually
addressing
those
problems
so
kind
of
taking
those
to
sort
of
contextual
and
factors
into
account.
What,
then,
are
we
doing?
We
are
particularly
in
adult
social
care,
because
we've
got
so
many
services
that
we've
got
to
get
through
in
the
comprehensive
program
and
going
back
to
them
to
check
on
their
at
non-compliance.
A
The
page
12
numbers
about
whether
providers
improve
are
so
important
to
us
for
the
for
exactly
the
confidence
issues
that
Andrea
raised.
Just
now
that,
without
wanting
to
have
more
data
alert
and
I've
suggested,
we
understand
productivity,
a
bit
more
I
think
with
page
12,
we
also
probably
to
perhaps
rethink
I
mean,
as
well
as
clearing
up
the
data
cleansing.
The
data
Zambia
said
rethinking
how
we
present
this,
because
I.
A
Well,
given
that
they
have
they've
been
in
breach
for
12
months,
this
actually
means
it
could
be
up
to
two
years
that
this
I
think
it
means
it
could
be
up
to
two
years
that
the
non-compliance
has
existed
for
depending
on
know
when
over
the
next
12
months,
they're
inspected,
but
I
think
the
first
step
is
to
get
a
sort
of
more
granular
understanding
of
this
data,
because
I
think
it
is
very
important
for
the
sport
and
for
the
public
to
understand.
And
this
after
all,
is
that
the
the
title
of
page
12.
F
Clarify
one
of
the
points
you
may
will
absolutely
take
that
away
and
to
confirm
this
is
any
breach
of
any
regulations.
Often
it
will
be
a
an
individual
and
fundamental
seller
that
continues
to
be
breached,
but
we
have
done
quite
a
lot
of
analysis
and
it
showed
in
all
the
different
sectors.
It
is
usually
significantly
more
than
one
standard
that
has
been
breached
in
that
time
scale.
F
There's
a
certain
amount
of
one
is
put
rights
and
other
comes
up,
as
has
been
said,
and
the
point
about
their
inspections
that
are
planned
over
the
next
month
is
to
be
clear
about
it.
It's
577
where
and
inspection
schedules
and
improvements,
as
well
as
it's
been
inspected
in
the
last
12
months,
there's
as
it
says,
if
there's
another
714
where
it
is
scheduled
in
the
next
12
months,
another
478
where
something
has
been
inspected
in
the
last
12
months.
F
There
are
certainly
I
believe
I'm
137,
where
we
currently
don't
have
an
inspection
planned
and
haven't
inspected
them
in
the
last
I
haven't
had
a
recent
inspection.
So
some
of
this
is
try
to
put
a
lot
on
a
single
page
and
we
definitely
will
keep
iterating
and
improving
forward
supporters
and
those
are
the
basic
facts.
Yes,.
A
A
I
think
that's
right,
although
I
think
the
early
chart
said
that
forty-four
percent
of
reinspection
'he's
a
result
in
improve
rating.
I
mean,
of
course
you
know.
If
one
looks
at
this
from
the
other
direction,
it
means
you
know
over.
Fifty
percent
of
Inspector
providers
have
not
improved
since
the
inspections
say,
I
think
andruw's
pointers
in
a
is
is
a
very
good
one,
but
both
sides
of
this
number
are
important
to
understand,
understand
Steve,
so.
C
We
take
this
particularly
seriously
if
you
look
at
the
numbers,
the
numbers
on
the
chart
for
primary
care,
so
the
graph
looks
as
though
it's
going
up
dramatically,
but
if
you
look
at
adult
social
care
where
there
are
25,000
locations
and
the
figure
is
nineteen
hundred
and
six,
if
you
look
at
our
graph,
it's
actually
163
out
of
20,000.
So
when
you
look
I'm
into
pictures,
so
if
you
look
at
pictures,
it
looks
as
though
this
is
worsening
and
it's
a
big
chart,
but
actually,
as
a
percentage
of
20,000
locations.
C
It's
tiny
but
they're,
very
important
and
I
can
tell
you
about
every
single
one
of
those
174
as
of
yesterday,
because
I
get
a
weekly
update
on
it.
So,
as
of
yesterday,
we
had
174
on
that
chart
and
it
just
for
future
reference.
If
you
look
at
the
yellow
on
the
chart,
those
numbers
are
increasing
because
of
special
measures.
Those
are
the
ones
between
six
and
nine
months
and
because
we're
focusing
on
GP
and,
as
I
said
earlier
on
today,
primary
medical
services
here
includes
dental
inspections.
C
We
only
do
ten
percent
of
dentists
each
year
and
that's
one
of
my
concerns
about
data
and
risk,
and
we
have
to
keep
on
top
of
that,
but
it
also
includes
a
number
of
independent
doctors
on
this
list
so
of
our
174.
As
of
yesterday
morning,
we've
only
really
got
a
hundred
because,
as
Andrea
said,
there
are
issues
about
how
the
data
is
recorded
and
when
ten
of
those
extra
ones
are
deregistered
or
clothes,
but
they
still
show
up
on
the
system.
C
There
are
anomalies
in
the
system
which
I
Swire
support,
Michael
your
quest
for
granularity
I,
don't
know
how
you
do
that
over
thousands.
Sixty
are
because
I
find
it
difficult
over
170,
odd
60
are
compliant,
but
actually,
as
they're
recorded
in
the
crm
database,
it
doesn't
come
out
that
he
sort
of
mean.
So
we
know
exactly
what's
happening.
C
44
have
plans
inspections
on
crm,
but
all
of
the
others
are
in
our
risk
management
that
are
covered
on
our
regional
meetings,
so
we
know
exactly
what's
happening
with
them
all,
and
there
is
a
process
in
place
in
order
to
to
tackle
these
and
with
the
special
measures
regime
that
focuses
things
in
a
slightly
different
way
as
well,
so
I
think
we're
on
top
of
it.
If
you
go
back
in
the
board
papers
to
18
months
ago,
our
chart
was
in
the
opposite
direction,
but
showed
much
larger
numbers
as
it
came
down.
H
So
let
me,
let
me
tell
you
about
hospitals-
are:
are
the
320
again
we
take
this
extremely
seriously,
but
what
I
think
we
need
to
do
is
to
have
a
better
sub
classification.
The
clapton,
the
granularity
you're
asking
for
whether
the
same
granularity
will
work
across
directorates.
I
think
is
something
that
we
need
to
discuss
and
to
discuss
with
Paul.
H
Certainly
in
terms
of
my
Directorate,
what
I
have
been
asking
the
director
manager
and
through
repair
to
the
heads
of
inspection
is
to
classify
these
as
have
weary
inspected,
and
the
original
non-compliance
persists,
but
secondly,
have
weary
inspected,
but
it's
something
new.
Thirdly,
we
haven't
reinspect
it,
but
we
know
we're
going
to
within
the
next
that
say
three
months
or
we've
not
yet
got
it
on
a
schedule
or
is
it
something
else
and
which
is
actually
the
deregistration
point?
H
But
Andrea
we've
got
a
handful
in
in
that
category,
and
we've
already
got
a
sample
using
this
classification
that
I've
literally
got
through
this
morning
and
the
the
majority
are
that
they
are
still
non-compliant
or
that
there
is
a
new
non-compliance.
But
there
are
some
where
we
know
what's
going
on
in
that
trust.
You
know
we
have
done
an
inspection.
We
haven't
had
the
capacity
yet
to
go
back,
but
in
many
of
these
that
the
non-compliance
is
not
of
the
greatest
worry
to
us.
F
Paul
yeah
I'm
there's
a
lot
detail
under
this.
This
is
always
the
way.
Isn't
you
have
to
work
out?
What
you
want
to
show
in
a
board
report
will
see
nothing.
Pretty
workout
wants
Shana,
monthly
or
quarterly
when
we
want
to
deep
dive
into
each
and
every
one
of
the
thing
that
comes
out.
Kaylee
I
hope
is
free
to
the
chief
inspectors
and
thought
under
myself
this
and
David.
This
is
a
big
deal
and
we're
trying
to
keep
on
top
of
it
I'm
very
happy
to
bring
more
granularity
as
we
needed
to
the
board.
I.
B
Just
point
which
may
be
my
understanding
but
I
think
Mike
just
touched
on
it,
which
potentially
dissolve
elephant
in
the
room.
The
percentages
as
I
understand
it
are
given
here
are
the
percentages
of
obsession
on
his
chart
as
against
the
number
of
registered
providers.
What
I
wonder
whether
that
doesn't
reflect,
therefore,
is
bearing
in
mind
the
other
child
about
what
we've
inspected
and
what
we
haven't
is
actually
what
we're
talking
about
here,
who
should
be
surely,
as
a
percentage
of
those
we
have
inspected
and
know
about
they're?
B
B
Concerning
ago,
some
of
this
might
be,
at
least,
we
know
what
we
know,
but
we
also
here
to
factory
what
we
there's
a
look
out
there,
that
we
don't
there
and
then
so
that
we
don't
need.
We
need
to
have
a
balance
between
dealing
with
what
we
know,
because
we
can
evaluate
then
and
actually
getting
on
with
what
we
don't
finding,
how
what
we
don't
know
and
I.
Just
wonder.
Therefore,
you
know
the
percent,
but
equally
the
percentage
give
you
chance
that
translate
these
red
figures
into
a
percentage
of
those
places
which
should
be
inspected.
F
We
are,
though,
look
at
the
non-compliance
of
breaches.
Don't
just
relate
to
our
new
approach,
inspections,
many
of
them
date
back
to
our
our
old
approach
as
well.
But
the
point
is
absolutely
right
that
we
have
particular
concerns
that
we
haven't
been
in
under
our
new
approach.
So
there
may
well
be
things
that
we
are.
We
will
uncover
as
we
do,
that.
C
C
C
We
need
to
be
part
of
that
something
out,
because
we
know
if
they
can
form
themselves
in
such
a
way
as
not
work
with
us,
and
that
would
be
really
unfortunate
or
they
could
form
themselves
in
such
a
way
as
to
be
an
integral
part
of
meeting
this
risk.
So
I
think
in
the
new
year,
I
think
it'd
be
very
good
to
have
a
board
book
I'll.
D
Set
that
forward
Michael
if
it's
any
consolation,
Paul
without
early
conversations
with
the
new
chief
executive
mark
and
I,
were
just
talking
about
it
again
this
morning
and
I've
had
two
or
three
meetings
without
Smythe's
in
a
chair
were
this
issue
about
the
nature
of
our
relationship
and
our
we
work
together,
it's
critical
so
much
so
these
are
dance
personal
relationships
and
with
David
and
David
for
having
moved
on
and
those
changes
taking
place.
We've
got
new
personal
relationships
to
establish,
but
some
there
will
be
changes
in
NHS
improvement.
D
They'll,
bring
forward
the
new
structure
by
the
end
of
this
calendar
year,
so
they've
got
changes
to
make
to
create
a
single
organization
from
those
two
organizations.
So
there's
going
to
be
further
people.
Developments
are
thinking
that
organization
that
will
need
to
do
so
on.
If
we
take
that
away
and
I'll
make
the
suggestion
to
both
the
gym,
untied,
Smith
and
I'm
sure
it
will
be
happy
to
do
them.
Mike
also.
A
A
I
think,
if
you
just
give
us
a
sense
of
how
far
we
are,
how
close
we
are
to
meeting
you
know,
we've
talked
earlier
about
being
the
actual
inspection
target
itself.
But
how
close
we
are
to
meeting
me?
What
we
especially
is
we're
going
to
be
discussing
the
business,
the
new
business
plan
later
just
generally,
how
we,
however,
forming
against
this
year's
plan,
yeah
happy
to.
F
See
y
si
Alli
the
overall
picture
against
each
of
the
commitments
in
the
business
plan
and
the
four
sections
of
it
on
page
26
and
then
for
the
particular
high-priority
change
projects.
There's
a
bit
of
commentary
on
on
page
27
and
on
specific
de
liberals
that
are
amber,
read
further
commentary
on
page
28,
so
I
won't
try
and
go
through
all
that
detail
of
seeing
the
board
meeting
in
the
summary,
and
is
that
it
is
a
it's
quite
a
spread
from
ones
that
are
actually
looking
pretty
green
at
the
moment.
F
For
example,
revising
our
policies
on
safeguarding,
as
David
mentioned,
all
the
way
through
to
ones
that
have
a
good
degree
of
red
in
them.
I,
don't
think
we
have
any
that
are
hard
Reds,
but
there
are
a
number
that
are
amber
red
and
that's
why
we
break
out
in
the
subsequent
pages,
what
they're
and
the
details
of
those
are-
and
it's
probably
worth
doing,
two
more
things
as
a
sort
of
summary.
The
first
is
to
say
that
the
four
are
components
of
the
current
business
planters
that
reminder
ball.
There's
two
that
are
particularly
outward
facing.
F
You
sure
we
can
show
the
difference
that
we're
making
I'm
a
reason
to
highlight.
That
is
that
the
performers
are
slightly
different
across
those
four
so
and
in
terms
of
delivering
a
new
approach
to
regulation,
and
we
had
the
discussion
about
the
inspection
trajectories.
But
broadly,
we
are
happy
about
the
way
in
which
we
are
embedding
that
new
approach.
F
I
think
the
overall
point
here
so
there
are
a
number
of
things
are
going
well
that
our
way
in
which
we're
embedding
the
values
are,
for
example,
and
and
we've
made
a
lot
of
progress
around
the
way
in
which
we
monitor
services.
We're
moving
from
are
the
focus
on
quantitative
data
and
intelligent
monitoring
having
a
more
encompasses
comprehensive
surveillance
that
we
call
CQC
insight
which
we're
rolling
out
for
the
new
financial
year
and
I.
F
Think
we've
always
said
that,
as
we
spend
the
last
two
and
a
half
years
of
of
transforming
the
organization,
we
put
a
particular
emphasis
on
getting
going
starting
the
ratings
program.
Getting
this
assessment
frameworks
and
the
methodologies
right,
I'm,
I,
think
that
was
right,
but
there
is
the
corollary
to
that,
is
that
it's
relied
a
lot
on
individuals
to
to
work
hard.
Do
that.
The
right
thing
is
not
always
with
the
support,
the
processes
and
systems,
so
we
are
playing
catch
up
on
that
and
that
is
reflected
in
the
staff
survey.
F
That's
why
again
we
rated
number
of
these
things
as
and
bread,
for
example,
my
work
on
the
am
knowledge
information
strategy
and
on
the
operating
model,
but
we
have
a
big
program
of
work
underway
and
would
hope
to
be
shown
those
coming
through
a
greener
over
time.
The
fire
was
just
on
experts
by
experience.
We
we
had
some
conversation
about
whether
this
is
amber
red
around
but
green,
because
at
the
time
when
we
were
putting
this
together,
we
didn't
quite
have
the
sign-off.
We
were
looking
for
from
the
Department
of
Health.