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From YouTube: CQC board meeting – January 2017
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A
Right
good
morning,
everybody
and
welcome
to
the
January
meeting
of
the
Care
Quality
Commission
before
I
go
into
the
businesses
on
the
agenda.
I
just
would
like
to
start
by
offering
the
board's
very
public
congratulation
to
you.
David
on
your
knighthood.
Hugely
well
deserved,
not
just
for
the
work
you've
done
at
the
CTC,
but
for
a
lifetime
of
public
service,
and
we
were
all
absolutely
thrilled.
So
congratulations.
A
We
have
apologies
from
Eileen
Milner
from
Michael,
Marr
and
forum,
Lewis,
Appleby,
otherwise
I
think
were
present
incorrect
minutes
of
the
meeting
of
the
December
meeting.
Are
they
a
true
and
accurate
record
of
what
we
discussed?
Thank
you.
There
is
nothing
on
the
action
log.
Is
there
anything
that
anybody
thinks
is
arising
from
those
minutes?
It's
not
otherwise.
On
the
agenda.
B
B
Cement
progress,
picking
up
on
a
theme
which
was
in
the
state
of
care
report.
We
provided
some
updated
numbers
in
relation
to
services
which
have
improved
their
overall
rating
on
re-inspection
and
they're,
pretty
similar
to
the
ones
that
we
set
out
in
some
detail
in
the
state
care
report.
Last
October
enforcement
activity
is
running
a
high
level
where
we've
taken
12
months
today,
just
over
1600
enforcement
actions
with
a
further
just
over
a
thousand
in
progress.
There's
no
specific
updates
from
any
of
the
three
inspection
directorates
but
attached.
B
The
rest
of
the
report
is
an
updated
paragraph.
5
I
just
updates
on
winter
pressures.
The
Secretary
of
State
for
Health
gave
a
statement
in
the
House
of
Commons
on
the
9th
of
January,
reflecting
on
the
pressure
that
the
NHS
had
been
o
of
under
during
that
first
week
in
January,
and
particularly
in
particular,
and
we've
been
asked
as
a
consequence
of
that
announcement
to
look
at
whether
we
could
undertake
some
rapid
rear
inspections
of
services
were
as
a
result
of
our
inspections.
B
We
had
some
concerns
about
the
safety
and
quality
of
those
services
and
and
therefore
there
were
some
restrictions
on
either
admissions
or
in
the
way
that
those
services
were
being
used
locally.
We
think
there
are
three
reasons
why
the
restrictions
it
could
be
because
of
what
CQC
has
done.
It
could
be
what
local
commissioners
have
done:
local
authorities,
the
CCGs,
or
indeed
the
providers
themselves,
deciding
that
they're
going
to
exit
the
market.
B
B
It's
about
550
beds,
which
have
been
affected
by
what
we
do,
which
are
on
the
arithmetic
that
the
team
have
carried
out
is
about
more
point,
one
percent,
so
the
intelligence
that
we
hold
at
the
present
time
is
this
isn't
a
big
number,
but
it
is
a
number
and
therefore
we'll
continue
to
do
that.
Work
and
do
the
analysis
and
look
at
this.
B
We
need
to
look
at
where,
as
a
consequence
of
inspections,
providers
decide
did
not
prepare
to
continue
ie
their
voluntary
exit.
The
market
as
well
in
relation
to
this
I
suspect.
As
we
begin
to
this
and
better
understand,
this
theater
will
be
as
many
implications
for
the
way
that
commissioners,
Commission
services
and
the
quality
and
price
of
their
Commission
to
is.
There
is
about
the
action
that
we
take,
but
because
there
was
a
public
statement
by
the
Secretary
of
State
at
the
beginning
of
January.
B
Next
item
I
cover
is
a
staff
survey
we're
going
to
touch
on
this
in
some
detail
later
this
morning,
but
we'll
bring
the
report
to
the
public
board
meeting
on
the
to
the
February
meeting
tomorrow.
In
actual
fact,
a
senior
leadership
team,
which
is
the
executive
team,
plus
all
their
direct
reports,
they're
going
to
spend
a
part
at
some
time
that
we've
got
together
tomorrow,
going
through
the
actions
that
are
being
discussed
in
workgroups.
B
Our
view
is
that
positive
progress
is
being
made
by
the
providers
by
r
employ,
in
particular
in
relation
to
managing
the
contract.
As
these,
what
appears
to
be
now
a
tradition,
I
think
board
members
would
have
received
an
email
at
the
beginning
of
this
week
from
a
group
that
contained
their
view
that
there
was
still
problems
with
this
contract,
and
my
view
is
that
there
are
and
continues
to
be
issues
with
the
contract
that
the
contract
is
performing
at
the
contract
level
and
so
I'm
not
going
to
go
through
each
and
every
item.
B
So
I
think
that
the
spirit
will
go
back
to
people
if
they're
still
outstanding
issues,
then
we're
quite
happy
to
set
up
an
opportunity
to
door
to
the
discuss
with
the
people
that
are
raising
the
concerns.
We'll
continue
to
monitor
the
conflict
and,
as
they
I
think,
the
figures
are
beginning
to
are
demonstrating
that
a
contract
conditions
are
being
met.
Our
employee,
in
terms
of
Phyllis
and
November,
deter,
which
was
the
last
performance
report,
sure
that
performance
is
being
maintained
in
paragraph
8
such
again.
It
was
a
busy
week.
We,
the
Parliament,
came
back.
B
The
prime
minister
gave
a
speech
in
relation
to,
amongst
other
things,
mental
health
services
and
made
a
commitment
which
confirmed
what
we'd
been
asked
to
undertake,
which
is
a
thematic
review
or
child.
Another
lesson:
mental
health
services,
so
that
work
and
the
detail
of
that
work
is
being
scoped
and
the
timetable
is
being
developed
and
over
the
next
few
weeks
and
that
will
be
brought
to
a
future
board
meeting
before
we
start.
B
We
just
want
to
make
sure
that
some
of
the
detail,
I
think
they've
been
that
many
reports
on
Child
and
Adolescent
Mental
Health,
which
say
it's
not
very
good.
We
need
to
be
really
clear
what
it
is
that
we're
going
to
add
to
those
debates,
rather
than
just
amplify
and
repeat
what
many
people
have
said
over
to
my
calculation.
B
20
years,
quite
frankly
so,
and
we're
working
hard
at
doing
that,
all
bring
that
back
to
the
board
and
then
finally,
colleagues
aren't
just
flagging
up
the
consultation
documents
that
are
currently
out
there,
close
on
the
14th
of
February,
I,
think
and
hugely
important
that
we
get
a
feedback
on
changes
to
the
assessment
framework
and
the
particular
changes
to
the
way
that
we're
going
to
do
the
NHS
one.
But
that's
a
report.
Peter,
as
I
said
a
majority.
B
C
Thank
you
just
two
comments,
one
on
the
winter
pressures
and
one
on
cam
and
I
went
off
to
ask
my
colleagues
here
winter
pressures.
You
know
what
are
we
hearing
about
it
and
it's
not
it's
not
she's
sort
of
rolling
in
through
our
doors
whether
people
are
just
so
busy
suffering
from
winter
pressures.
They're.
Not
thinking
I
must
tell
my
HealthWatch
about
this,
but
what
we
are
hearing
about
is
particular
about
any
and
that's
more
on
the
area
of
people
almost
holding
the
back
from
from
you.
C
They
recognize
the
pressures
and
they
don't
want
to
go
into
any
nests.
They
have
to,
and
we've
got
one
one
gentleman
who
thought
all
I
won't
go
skating,
I'll
go
to
a
walk-in
Center
and
the
walk-in
Center
then
said:
no,
no,
you
need
to
go
to
A&E
and
he
had
something
in
his
eye.
So
maybe
we
can't
try
Makeba
car
here,
so
they
took
him
over
to
A&E.
The
nursing
A&E
said
no,
no,
you
didn't
need
to
come
here
at
all
I'll.
C
Just
she,
just
whatever
it
wasn't
as
I
took
you've
got
it
sorted
very,
was
left
at
A&E
without
a
car,
and
they
want
to
get
him
home
and
said
it's
absolutely
we're
hearing
about
so
I
think
there's
something
about
assigned
postings
for
us
inside
with
Rovers,
but
also
outside
the
service.
But
people
are
generally
trying
to
use
that
is
as
best
they
can.
The
other
point
with
Matt
cams
echo
what
David
says
entirely.
C
D
B
B
E
F
Every
bit
volunteering
right
Andrea
yourself
and
that
that's
not
kind
of
figures
that
we
would
have
for
the
whole
of
the
country.
We
do
have
some
understanding
of
occupancy
levels
and
the
services
that
sit
within
the
market
oversight
scheme-
and
you
know
they
are
very
high
percentage
occupancy
in
terms
of
that.
But
that's
not
data
that
we
routinely
collect.
F
You
know
on
their
local
patches
where
that
capacity
is,
if
that
capacity
has
been
restrictive
for
any
reason,
and
frankly,
we
only
restrict
their
capacity.
If
we
have
very
serious
concerns.
A
big
and
and
the
service
needs
to
have
ability
to
improve-
and
you
know
again,
if
we're
taking
action
which
takes
capacity
out
of
the
system.
We're
doing
that,
because
there
are
serious
concerns
and
unfair
for
people's
well-being
and
safety.
F
G
That's
right
and
really
what
we
do
know
is
the
total
number
of
beds
in
in
England,
and
that
number
has
been
fairly
constant
over
the
last
six
years
or
so
one
of
the
indications
I.
Think
of
that
is
that
partly
and
more
people
are
being
treated
at
home
rather
than
in
an
accountant
which
is
the
right
development.
But
it
also
raises
a
question
to
what
extent
capacity
is
keeping
up
with
demand,
because
we
know
that
over
at
the
same
time,
more
people
are
in
need
of
care.
That's
not
an
answer.
We
can
as
a
question.
D
Why
we
do
it?
We
don't
close
bench,
because
we
were
close,
eventually
close
beds,
because
these
are
not
beds
that
we
are
saying.
Patients
should
be
using
so
I
think
that
I
just
think
with
something
odd.
Where
we're
being
asked
to
look
at
550
beds.
I
suspect
there
are
a
couple
of
thousand
that
are
not
being
used,
because
the
adult
social
care
market
doesn't
provide
the
money
to
use
those
beds.
D
But
the
NHS
could
step
in
and
use
that
as
Bentham
and
so
I
think
that
precisely
the
way
which
you
were
talking
about
it,
which
is
local,
NHS
local
care
providers,
as
well
as
local
care
commissioners
getting
together
and
saying
how
over
the
winter,
can
we
utilize
this
capacity,
which
won't
necessarily
be
there
needed
in
the
summer
by
the
NHS?
But
is
there
I
think
it
is,
is
what's
needed
and
we
are
small
partner
and.
F
But
I
forget
what
the
statistic
is,
but
there's
a
very
significant
proportion
of
people
who
do
get
discharged
from
hospital
into
a
care
home
who
never
go
home,
because
the
expectation
is
that
they
will
continue
on
and
that
not
be
the
right
thing
for
them,
but
to
actually
have
a
period
of
rehabilitation,
support
and
confidence
building.
All
of
those
kind
of
things
would
be
with
the
skills
that
people
in
adult
social
care
services
have
to
do
that.
That
could
be
a
much
better
outcome
for
individuals
and
also
help
the
system
and
more
broadly.
A
H
Different
area
the
appendix
which
I
printed
out
so
I
actually
read
it
this
time
and
not
that
I
necessarily
understand
but
I.
Just
a
question
about
little
table
on
the
page
period
of
the
fit
and
proper
person
to
the
DQ,
candor
and
I.
Think
I
understand
the
columns,
and
forgive
me
if
we
all
have
this
explained
to
us
before,
but
I,
don't
quite
understand
the
relationship
between
the
percentage
of
enforcement
and
the
number
of
management
reviews
and
their
date.
They
don't
sort
of
add
up.
I
How
did
he
talk
to
you?
Okay,
the
Biggers
vary
from
section.
I
can
certainly
give
a
view
from
hospitals.
Yeah
I
am
aware
where
we
have
a
panel
meeting,
which
is
would
be
one
meeting
where
we
may
be
discussing
at
several
different
individuals
in
terms
of
directors
in
terms
of
fit
and
proper
person.
I,
don't
know
if
that
helps
or
doesn't,
but
that's
what
happens.
H
F
H
I
F
There
is,
there
is
work,
that's
being
done
on
from
an
enforcement
point
of
view
around
how
a
would
collect
this
information
and
be
how
we
can
present
it
to
the
board
in
animal
meaningful
way,
and
that's
one
of
the
reasons
why
the
data
is
is
a
bit
out
of
date
in
the
table
that
you've
got
at
the
moment.
Could.
H
I,
just
ask
for
clarification,
agree
that
it
when
it
took
when
they
were
the
columns
when
there
is
enforcement
which
would
register
this
column.
What
are
the
sort
of
things
that
that
includes?
Is
that
a
notice
is
that
an
informal
requests?
That's
a
tough
market
se8,
something
better
or
correct
a
youtube
candor
issue,
or
is
it
more
formal
than
that.
F
A
I
mean
this
is
general
point
of
Laurel
that
if
we
have
so
much
data
and
trying
to
present
it
in
a
way
which
is
manageable
for
us
as
a
board,
but
if
we're
missing
something
or
we've
got
something
that
it
doesn't
meet
your
or
any
other
board
members
needs,
and
let's
have
that
not
now.
Well,
let's
have
that
risk.
Obviously,.
H
We
have
this
discussion.
Every
time
can
I
have
this
piece
of
information.
Then
someone
change
their
mind
about
it
is
that
obviously
in
performance
tells
the
number
of
management
reviews
we
having
it
important,
but
actually
be
outcome
of
that.
What
is
important
is
what
the
demand
for
the
service
is
in
the
sense
and
how
many
people
are
there
sufficient
concerns
raised
or
incidence
in
relation
to
gives.
We
can
do
that
actually
require
us
to
take
pay
attention.
Yeah.
A
I
absolutely
get
city
I'll,
just
kind
of
just
broaden
it.
So
if
there
are
other
issues
that
you
are
in
a
lab
or
member
thinks
we
were
not
capturing
the
most
useful
way
at
the
risk
of
reinventing
wheel
every
every
every
time.
Let's,
let's
look
at
it
anything
else.
Anybody
wants
to
raise
on
on
data
to
report.
A
J
J
J
Morning,
I
am
cyan
Ervin
and
I
patient
safety
campaigner
and
happy
new
year
board
fingers
crossed
27
things.
17
things
improved
somewhat
and
I
have
a
thank
you.
A
question
and
clarification
for
service
I'd
like
to
thank
you
to
Andrea
and
her
team
for
the
elderly
land.
We
had
to
make
a
report
or
I
had
to
make
a
report
which
isn't
in
police
over
finding
an
old
man
at
mysteries
and
Andrews
team
have
been
grace.
We
have
failed
men
having
seriously
abused
when
we
get
there
in
the
end,
and
this
is
a
question
for
Mike.
I
Like
should
I
say
that
I
can
I
can
certainly
tell
you
the
approach
that
we
take
to
assessing
well
led.
Okay,
there
are
a
number
of
different
components
within
that.
The
first
is
that
we
assess
the
capability
and
capacity
of
that,
the
range
of
leaders
in
an
organization
and
in
a
hospital
that
would
include
the
board,
that
is,
the
chief
executive,
medical
director,
director
of
nursing,
etc.
I
We
then
look
to
see
whether
they
have
a
vision
and
their
strategy
and
whether
that
vision
and
strategy
is
actually
being
implemented.
We
look
at
their
governance
arrangements.
In
other
words,
would
they
know
where
their
problems
are
and
as
to
what
extent
that
actually
matches
what
we
find
on
inspection?
Or
do
we
find
a
whole
lot
of
things
that
they
don't
know
about?
I
Very
importantly,
we
look
at
the
culture
of
an
organization
that
we
have
engagement
of
staff,
because
we
think
that
is
so
critical
that
how
an
organization
performs
clearly
the
staff
survey
is
an
important
element
of
that.
But
it's
also
the
focus
groups
that
we
hear
and
the
conversations
we
have
with
staff
around
a
hospital.
But
we
look
at
degree
of
patient
engagement.
I
We
look
at
degree
of
external
engagement
with
other
people
in
the
health
economy,
health
and
care
economy,
and
we
also
look
at
what
innovations
are
within
the
trust
and
what
they
are
doing
to
make
improvements.
And
what
is
their
approach
to
doing
that.
So
all
of
those
things
aren't
individual
components
of
our.
I
I
J
I
J
So
when
you're
writing
the
review
for
West,
London
and
I
know
I
was
interviewed
in
Google
as
November
I
think
when
they
do
this.
Anybody
sees
that
November
when
West
London
were
reviewed,
I
think
so.
Yeah
and
I
was
interviewed
and
I
give
some
information
about
rubber
bases
breaches
of
the
most
public
mental
health
act
as
clinical
director,
so
I'm
just
seeing
to
be.
J
But
it's
not
being
that's,
not
really
been
taken
into
account
in
the
way
they
understood
service
wanted
to
understand
with
the
world
legs
ping
it
so
I
know
if
it's
happening
with
one
or
two
patients
is
definitely
happening
with
more
and
it
seems
to
be
a.
It
certainly
seems
to
be
reported
with
them
at
their
group
meetings,
and
so
maybe
just
have
a
look
at
that.
It's
just
one
more
thing
and
then
I'm
going
to
give
everybody
else
a
chance.
Is
there
any
clarification
around
xx?
J
Thank
you
for
the
ticket
by
the
way
for
the
20th,
but
it's
a
clarification
around
the
20th,
but
if
it
seems
the
the
group
of
whistleblowers
only
being
allowed
go
in
the
afternoon,
but
the
meeting
is
in
the
morning.
So
not
really
quite
clear
how
that's
working
anybody
have
any
ideas,
that's
exactly
the
master
guards
and
others
exactly.
Thank.
A
B
B
J
F
J
K
Am
I
running
from
Harper
healthwatch
two
big
questions
if
I
may
run
in
relation
to
all
the
permits
phase
of
the
regulatory
approach
and
one
in
relation
to
communications
as
I
come
from
an
education
background?
I
am
aware
of
how
much
dialogue
there
is
in
a
school
inspection
between
inspectors
and
pupils
and
between
inspectors
and
parents.
I
Should
I
take
that
one
to
start
with
I
think
the
key
things
say
is
there
is
a
lot
of
conversation
with
patients
and
relatives
already,
and
we
want
to
extend
that
and
find
the
best
ways
of
engaging
with
them.
So
we
started
and
with
listening
events,
and
they
were
variably
attended
to
be
honest
and-
and
we
tended
to
get
very
polarized
views
with
both
people
who
are
hugely
supportive
of
a
trust
and
those
who
were
not
so
I
would
attend.
I
But
really
the
numbers
were
quite
small
in
comparison
with
the
numbers
of
going
to
a
trust
so,
and
we
are
now
been
looking
at
different
ways
and,
for
instance,
just
having
a
stool
at
the
front
of
the
hospital
and
letting
people
who
are
coming
through
and
there
are
thousands
getting
to
a
hospital
in
any
one
day.
And
we
found
that,
for
example,
to
be
a
much
more
successful
way.
And
when,
when
we're
on
the
wards,
we
talk
to
patients,
we
listen
to
patients,
and-
and
so
we
are
doing
a
lot
of
that
already.
K
Absolutely
some
time
ago,
I
did
ask
a
question
at
the
board
in
relation
to
at
the
planning
of
a
television
documentary
along
the
lines
of
a
day
in
the
life
of
CQC
inspector.
As
this
might
balance,
some
of
the
media
coverage
in
the
Daily
Mail
or
times
and
I
wondered
whether
there
is
progress
on
such
a
TV
documentary
I.
A
B
Chris
day,
our
director
of
engagement
continues
to
reflect
on
this
and
I
think
he.
It
is
something
that
we're
open
to,
but
we've
not
made
anything
happen.
It
is
that
sent
we're
alive,
we're
alive
to
the
opportunities
that
might
be
presented
by
them,
but
there's
no
firm
time
for
the
present
time.
It's
a
straight
answer.