►
Description
Hear from Kate Terroni, Chief Inspector of Adult Social Care as she discusses our transitional regulatory approach and the latest on our emerging strategy for 2021 and what this means for those working in the adult social care services.
B
Hi
and
good
afternoon,
everyone
and
a
very
warm
welcome
to
our
cqc
webinar,
my
name's
kate
turoni
and
I'm
the
chief
inspector
of
adult
social
care,
and
I
am
going
to
be
talking
to
you
over
the
next
hour
for
any
of
you
who
have
done
these
teen
live
events,
they're
very
odd,
as
in
you
only
see
a
couple
of
your
colleagues
in
the
bottom
of
the
screen,
and
you
have
no
sense
of
who
else
is
out
there,
who's
listening,
how
what
you're
saying
is
being
received
or
is
landing
because
you
don't
have
the
kind
of
cues
of
looking
at
an
audience.
B
So
I
would
really
invite
you
and
encourage
you
to
just
keep
a
chat
going
with
me.
I've
got
the
chat
box
open.
So
if
you
wanted
to
say
hi
and
where
you're
from
or
if
you
want
to
react
to
things
as
I
go
or
ask
questions
or
put
your
comments
in,
I
will
keep
them
open
and
I
will
endeavor
to
do
the
double
act
of
talking
sticking
as
best
as
I
can
to
the
slides.
I've
got
in
front
of
me,
but
also
seeing
what
you're
saying
on
the
chat
function.
B
So
please
say
hello.
Let
me
know
you're
there
and
chat
away
as
we
go
so
really
pleased
to
have
you
join
us.
The
purpose
of
this
webinar
for
the
next
hour
is
to
talk
about
us
at
cqc.
What
we've
been
doing
recently,
what
we're
going
to
be
doing
next
and
what
we're
going
to
be
doing
in
the
future
and
that's
going
to
kind
of
cover
two
strands.
B
One
is
about
how
we
are
transforming
the
way
we
work
operationally
so
different
ways
of
delivering
our
business
and
then,
alongside
that,
how
we
are
transforming
for
our
future
strategy.
So
that's
that's
what
I
plan
to
cover
today,
I'm
just
gonna,
let
you
know
who's
on
the
call.
So
if
we
can
go
to
the
next
slide,
please
steph
when
you're
ready.
B
Now
I
can't
yet
see
any
chat
on
the
calls.
So,
oh
there
we
go.
Oh
hello,
a
few
people
saying
hello,
lovely,
okay,
that's
good
to
see
great
dorset
northeast
orchard
trust,
portsmouth,
fabulous!
Okay!
So
so
I'm
kate
I've
got
I'm
debbie
vanova
who's.
My
deputy
achieving
specter
on
the
call
who
will
be
helping
me
answer
some
questions
and
then
we've
got
sarah
sam
and
steph,
I'm
looking
at
your
comments
and
they
will
be
driving
the
slide
deck.
B
So
that's
who
who's
on
the
call
today
so
and
what
we're
going
to
cover
is
we're
going
to
I'm
going
to
briefly
remind
you
of
our
role
and
purpose,
going
to
talk
a
bit
about
the
timeline
and
what
we've
been
doing
so
far
in
adult
social
care,
going
to
focus
on
infection
prevention,
control,
winter
care
at
home,
and
our
pilot
that
we're
doing
and
talk
a
bit
about
our
transitional
approach
and
then
we're
going
to
have
a
a
break
to
have
some
questions
and
then
we're
going
to
get
on
to
the
strategy.
B
So
that's
a
that's
the
plan
of
the
hour
awesome
nice.
Thank
you,
claire,
nice.
To
see
you
too
all
lots
of
lovely
comments.
So
I'm
not
talking
to
myself,
wonderful,
okay,
so
before
we
get
into
our
purpose
and
what
we're
going
to
cover
today.
I
just
wanted
to
start
off
by
acknowledging
where
we
are
at
this
moment
in
time.
So
I
think,
for
many
many
people,
2020
has
been
one
of
the
most
toughest
years
and
I
think
for
people
in
social
care
for
people
personally
for
people
with
their
families.
B
It's
been
really
really
grotty
with
you
know,
bereavements,
with
working
in
a
scenario
you
never
probably
envisioned
you'd
be
working
in,
and
then
we
got
the
news
on
saturday
night
that
we
all
knew
was
coming,
but
still
doesn't
make
it
any
easier
to
hear.
B
So
I
just
wanted
to
start
off
by
saying
I
don't
know
how
you
felt
when
you
woke
up
this
morning,
but
you're,
probably
not
on
your
own,
if
it
felt
a
little
bit
harder
to
get
out
of
bed
a
bit
darker
a
bit
tougher
as
we
think
about
the
next
four
six,
eight
eight
weeks
and
as
we
kind
of
cling
on
to
spring
and
brighter
days,
the
other
side
of
christmas.
B
So
I
just
wanted
to
share
with
you
that
you're
you're
not
on
your
own
if
this
morning
felt
a
bit
tough
getting
out
of
bed.
It
might
felt
like
that
quite
a
lot
over
the
last
eight
months
and
just
to
say,
you
know
hats
off
to
you
out
there
doing
doing
what
you
do
and
you
know
keeping
people
safe
and
delivering
high
quality
care,
so
just
just
an
acknowledgement
that
it's
really
tough
and
thank
you
very
much
for
all
that.
B
B
Are
your
stuff
still
going
out
and
about-
and
we
absolutely
will
be
so
I
will
cover
during
this
slot
a
bit
about
how
we
did
things
differently
during
the
first
wave,
but
how
our
intention
is
absolutely
to
keep
on
crossing
the
threshold
during
wave
two,
and
also
I'm
going
to
talk
to
you
a
bit
about
what
we
said
already
around
visiting,
because
it's
as
important
as
it's
as
it's
been
to
ensure
that
you
all
are
doing
that
really
tough
job
of
weighing
up
keeping
keeping
people
safe
while
supporting
people
to
see
their
loved
ones.
B
So
just
wanted
to
do
that
as
a
bit
of
preamble
and
one
other
thing
before
I
get
into
the
slides.
Is
we've
done
one
of
these
webinars
before
we
did
one
about
two
weeks
ago,
and
I
asked
for
feedback
at
the
end
about?
Was
it
a
good
use
of
an
hour
of
your
time?
B
B
So
if
you're
not
in
the
care
home
business,
I
just
want
to
give
you
a
warning
that
that
might
be
your
experience
and
I
just
want
to
explain
why
we
are
still
going
to
be
talking
about
care
homes
at
the
start
of
this
presentation,
and
that
is
predominantly
to
do
with
where
we
have
found
the
greatest
risk
around
covid.
B
That
said,
you
talked
a
bit
too
much
about
care
homes
and
I
just
want
to
acknowledge
I'm
going
to
do
that
again,
because
that
has
been
where
the
risk
and
some
of
quite
a
lot
of
our
focus
has
been
over
the
last
eight
months,
but
that's
not
to
say,
you're
a
supportive
living
provider
shared
lives,
extra
care,
housing,
home
care.
Hopefully,
we've
got
something
that's
of
use
to
you
as
well
as
we
go
okay,
let's
dive
on
please
steph.
B
So
I
won't
hammer
this
point
because
you
will
know
it
well
well
and
good.
So
we
are
cqc
we're
the
independent
regulator
of
health
and
social
care
in
england,
and
our
job
is
to
make
sure
that
people
are
getting
high
quality,
effective,
person-centered
care.
So
that's
what
we
do
that's
great
to
see:
we've
got.
We've
got
some
staff
nurses
on
the
call,
as
well
wonderful,
great
and
we're
doing
better.
This
time
we
have
some
people
who
we
think
were
meant
for
the
hospital's
webinar
join
us,
but
you're.
B
Looking
at
your
all
social
care,
which
is
fab.
So
our
purpose
as
the
regulator
is,
is
not
changing,
but
we
need
to
change
the
way
we
do
business
so
that
we
can
make
sure
we
remain
relevant
to
all
the
all
the
the
people
out
there
who
use
cqc
as
a
as
an
indicator
about
what
the
quality
is
of
people
out
of
services
that
are
being
provided.
B
So
we
need
to
ensure
that
we
can
continue
to
pay
all
the
attention
we
need
to
the
voices
of
people
who
access
services
about
their
experiences
of
safety
and
quality.
We
want
to
do
better
at
giving
providers
real-time
information
about
how
they're
doing
and
the
public.
B
So,
if
you're
looking
for
what
cqc
says
about
social
care
providers
in
your
area,
we
want
to
give
a
much
more
up-to-date
view
of
that,
and
we
want
to
give
information
to
providers
where
you
can
look
and
see
that
you
know
one
of
your
one
of
the
social
care
providers
down.
The
road
has
just
got
an
outstanding
rating
or
has
just
got
a
good.
What?
What
is
it
that
they're
doing
that
you
want
to?
B
You
want
to
learn
from
as
well,
and
we
want
to
continue
to
focus
even
more
so
around
improvement,
how
we
can
work
together
to
improve
the
quality
of
services.
So
that's
that's
what
we're
all
about
and
then
I'm
going
to
just
give
you
a
bit
of
a
timeline.
So
we
started
thinking
about
what
our
new
strategy
should
be
a
little
over
a
year
ago,
so
our
currency
current
strategy
finishes
in
april
may
of
2021.
B
So
next
year
and
almost
over
a
year
ago,
we
started
thinking
about
what
our
direction
of
travel
should
be,
and
actually
what's
happened
is
our
thinking
about
how
we
can
provide
much
more
real-time
information
for
people
about
the
quality
of
care,
how
we
can
do
more
place
more
emphasis
on
improvement,
how
we
can
have
a
more
flexible
way
of
working.
B
Actually,
what
ended
up
happening
through
the
pandemic
is
our
plans
for
the
new
strategy
and
the
way
of
working
ended
up
being
brought
forward
and
we
ended
up
implementing
a
whole
host
of
things
in
keeping
with
where
we
think
we're
going
as
an
organization,
but
a
lot
quicker
than
any
of
us
probably
thought
we
could
do
prior
to
the
pandemic.
So
we
rolled
out
our
emergency
support
framework
in
may.
We
are
implementing
a
new
transitional
approach
to
regulation
that
we're
doing
now.
B
We've
developed
an
approach
around
affection
prevention
control
as
we
speak,
and
we
are
testing
out
our
strategic
theme.
So
that's
what
we're
doing
here
today
and
then
looking
forward.
We
are
going
to
carry
this
conversation
on
for
the
next
month
or
so,
and
then
we'll
have
a
formal
consultation
in
the
new
year
in
january,
ready
for
it
to
go,
live
in
may
2021.
So
that's
where
we
are
in
terms
of
timeline.
B
Okay,
so
many
people
saying
hello,
I'm
I
must
not
get
myself
distracted,
so
I've
got
skills
to
care
here.
Okay,
so
so
quick
recap
about
the
emergency
support
framework.
So
you
will
all
remember
that
at
the
very
start
of
the
pandemic,
we
made
the
decision
to
pause,
routine
inspections,
and
that
was
at
the
time
when
none
of
us
really
knew
what
we
were
dealing
with
in
terms
of
the
disease.
B
We
were
very
conscious
that
it
needed
to
be
all
hands
on
deck
from
provider
perspective,
and
actually
the
only
thing
we
wanted
to
do
in
those
early
weeks
and
months
of
the
pandemic
was
to
support
you
in
coping
with
something
that
none
of
us
have
had
to
cope
with
before
so
we
said
we
were
going
to
pause
routine
inspections,
but
that
we
were
always
going
to
go
out
and
cross
the
threshold
where
we
needed
to
in
person,
and
then
we
basically
set
about
having
lots
of
phone
conversations
with
many
providers,
but
we
also
developed
this
emergency
support
framework,
which
is
a
set
of
questions,
and
I'd
be
interested
to
hear
from
you
how
you
found
them.
B
We
we
introduced
a
set
of
questions
where
our
inspectors
could
talk
to
you
with
an
emphasis
about
a
supportive
discussion
enabling
us
to
get
support
to
you.
So
we
were
able
to
escalate
issues
for
government
and
locally
to
things
like
local
resilience
forums
when
in
those
early
days,
you
were
telling
us
loudly
and
clearly
about
issues
around
access
to
ppe,
access
to
testing
and
challenges
with
staff
isolating
at
home
because
it
wasn't
known
whether
they
had
covered
or
not.
So
we
developed
our
esf.
B
We
had
structured,
supportive
conversations
with
you
and
we
used
it
to
hopefully
get
you
the
support
that
you
needed
when
that
was
being
flagged
up
to
us,
and
then
we
used
all
of
that
knowledge.
We
learned
from
our
emergency
support
framework
into
this
new
transitional
regulatory
approach,
which
again
is
a
kind
of
structured
way
of
having
a
monitoring
conversation
with
you
all.
But
it's
a
bit
broader
ess
started
off
very
narrow,
and
our
transitional
regulatory
approach
is
a
bit
broader
in
what
we
cover.
B
So,
let's
move
on
steph,
okay,
just
a
few
numbers
and
let
you
know
what
we've
been
up
to
so
we
have
done
esf
emergency
support
framework
on
over
17
000
locations
and
that
equates
to
about
70
of
active
social
care
locations
have
had
some
sort
of
regulatory
intervention
and
that's
either
an
emergency
support
framework
or
that's
a
an
infection.
Prevention,
control,
inspection
and
you'll
see
in
the
bar
chart
the
number
of
physical
inspections
we've
done,
increasing,
notably
since
about
july
time.
B
So
we've
done
a
total
of
just
under
1
500
inspections
that
will
probably
be
slightly
higher
because
these
figures
are
a
few
days
out
of
date.
Now.
So
that's
what
we've
done
so
far
if
you
want
to
move
on
okay,
so
so,
where
we
are
now
is
we're
evolving.
Our
approach.
We've
developed
a
new
approach
to
infection
prevention.
Control
that
I
want
to
talk
to
you
about.
We've
got
our
transitional
regulatory
approach
that
develops
all
the
stuff.
We
learned
around
esf
and
all
of
this
learning
is
going
into
our
future
strategy.
B
So
let's
move
on
and
talk
a
bit
about
ipc
infection
prevention
control.
So
in
august
we
developed
a
we've,
always
looked
at
ipc,
but
we
developed
a
new
methodology
that
was
just
infection,
prevention,
control
focus
and
we
had
a
couple
of
main
drivers
for
this
one.
We
all
know
that
ipc
good
ipc
was
one
of
our
main
defenses
against
keeping
people
safe
from
from
coving.
B
So
we
and
we
were
really
keen
to
not
just
go
out
to
risky
services
to
look
at
ipc,
but
we
wanted
to
see
what
best
practice
was
as
well.
So
we
undertook
a
little
over
400
ipc
inspections
in
the
late
summer,
about
300
to
301
of
those
were
going
out
to
good
services
to
look
at
what
they
were
doing
well
across
eight
areas
of
assurance.
So
around
things
like
ppe
policies,
approach
to
enabling
safe
visiting
to
happen,
etc,
and
our
plans
are
to
continue
to
do
ipc
inspections.
B
So
we've
committed
to
do
500
from
about
a
week
ago
through
to
the
end
of
november,
and
those
are
again
going
out
to
good
services
going
out
to
services
where
we've
had
concerns
from
members
of
the
public.
People
who
use
services
or
staff
about
ipc
practice
and
regardless
of
the
type
of
service
it
is,
if
we're
getting
concerns
about
ipc
because
of
the
level
of
risk.
B
At
the
moment,
we
are
likely
to
send
an
inspector
out
to
go
and
have
a
look
at
what's
going
on,
but
also
we
are
working
with
the
government
around
implementing
their
winter
plan.
So
you
might
have
seen
some
of
these
announcements
or
you
might
be
contributing
to
this.
But
in
following
the
work
of
the
task
force
over
the
summer
in
the
government's
winter
plan,
they
talked
about
supporting
people
who
have
a
cova-positive
test
at
the
point.
B
They
need
to
be
discharged
from
hospital,
not
moving
back
into
a
care
home
directly,
but
actually
going
to
a
designated
care
home
where
we
it's
been
identified
as
such,
and
we
have
gone
out
and
undertaken
a
ipc
inspection
with
an
increased
focus
on
whether
that
care
home
can
safely
cohort
or
zone
those
residents
with
positive
covert
test
results
so
that
they
don't
pass
a
covert
on
to
other
residents
as
well.
B
So
our
ipc
focus
will
absolutely
continue,
particularly
in
the
next
few
weeks
and
months,
but
that
will
continue
on,
I
suspect,
for
you
know
through
to
through
spring
and
we're
doing
some
particular
work
around
the
government's
designation
scheme
that
I
can
talk
a
bit
more
about
if
that's
of
interest
to
those
of
you
on
the
call.
B
And
finally,
we
will
share
our
examples
of
best
practice
in
our
november
insights
report.
So
we've
been
publishing
some
monthly
reports
about
what
we've
been
seeing
as
the
impact
of
covert
across
health
and
social
care,
and
we
will
be
having
a
focus
on
what
we've
seen
around
good
ipc
in
in
november,
with
the
hope
that
we
can
share
best
practice
and
everyone
has
the
ability
to
provide
that
high
high
quality
ipc.
B
So
if
we
just
move
on,
I'm
just
going
to
show
you
what
our
ipc
looks
like
so
we'll
go
out,
we'll
do
an
ipc
inspection.
It
will
be
written
up,
but
to
make
things
even
easier
for
members
of
the
public.
We've
produced
a
bit
of
a
dashboard
that
you
can
see
in
front
of
you.
B
So
there
are
eight
areas
we
look
at
when
we
go
out
and
do
ipc
inspections,
and
we
look
at
whether
we're
assured
somewhat
assured
or
not
assured,
on
our
inspection
visit,
somewhat
assured
often
means
that
there's
a
relatively
small
tweak
that
a
provider
needs
to
make
to
get
that
into
the
assured
space.
B
If
we're
not
sure,
depending
on
how
concerned
we
are,
we
might
go
back
and
do
a
fuller
inspection
as
well,
but
our
eight
ticks
of
of
ibc
assurance
is
what
you
and
the
public
will
be
looking
for,
and
this
is
what
we'll
we'll
be
continuing
to
do
when
we
go
out
and
do
ipc
inspections.
B
So
this
is
what
we've
seen
on
our
ipc
inspections
so
far,
you'll
note
that
the
areas
that
nee
that
need
the
most
amount
of
focus
is
about
ensuring
that
people
have
good,
up-to-date,
ipc
policies.
So
I'm
I'm
sure
you
have.
But
if
you
haven't
this
would
be
a
prompt
to
have
a
look
at
that
now
and
also
effective
ppe.
So
we've
noticed
a
bit
of
a
bit
of
a
deterioration
in
the
consistent,
effective
use
of
ppe
and
all
services.
B
So
just
plug
what
you
already
know,
but
that's
what
we've
seen
when
we've
gone
out
on
our
ipc
inspections.
So
let's
let's
move
on
so
I
just
want
to
take
this
opportunity.
I
said
it
at
the
beginning,
but
I'm
reading
your
feedback
as
we
go
as
well.
B
I'm
not
doing
it
quite
just
this,
but
I
will
have
a
proper
read
at
the
end
also,
but
you
know
it's
really
tough
at
the
moment
and
I
I
hope
you
feel
that
we're
all
in
this
together
and
we
will
do
our
best
to
support
you
and
to
encourage
you,
encourage
you
to
share
your
best
practice
with
others
as
well
and
just
a
massive
thank
you
to
all
of
you
and
your
staff,
who
you
know
when
the
country
was
shutting
down
and
is
shutting
down
again,
will
continue
to
leave
their
house
houses
and
go
into
people's
homes,
delivering
home
care
and
into
supported
living
services
and
into
care
homes.
B
So
just
a
massive
thank
you
and
from
me
if
we
can
move
on
please
steph,
so
just
a
couple
of
other
bits
and
bobs
in
the
beginning
of
lockdown,
when
we
weren't
crossing
the
threshold.
Quite
so
frequently,
it
became
even
more
important
for
us
to
hear
directly
from
people
who
are
using
services
about
the
quality
of
that
care.
So
we,
along
with
healthwatch
england
and
about
10
other
partner
organizations,
launched
a
campaign
in
the
summer
called
because
we
all
care-
and
we
did
this
because
we
did.
B
There-
was
some
research
that
showed
that,
since
the
pandemic,
more
people
were
wanting
to
improve
the
quality
of
their
local
health
and
social
care
through
giving
feedback.
So
we
wanted
to
really
move
it
away
for
feedback
being
something
you
do
when
you're
unhappy
or
you've
had
a
particularly
good
or
bad
experience
to
feedback
being
something.
That's
much
more
part
of
you
visit
your
gp
or
your
dentist,
and
you
give
cqc
feedback
on
your
experiences.
Be
that
mixed,
good
or
bad.
B
So
we
lost
this
big
campaign,
absolutely
delighted
with
the
response
in
terms
of
the
amount
of
feedback
we
have
received
and
just
to
let
you
all
know
that
about.
I
don't
have
the
most
up-to-date
figure
in
front
of
me,
but
something
like
50
of
our
physical
inspections
that
we've
done
so
far
have
been
informed
by
feedback.
We've
had
from
people
who
use
services
their
families
or
members
of
spell
so
this.
When
people
take
the
time
to
feedback,
it
doesn't
just
go
into
a
black
hole.
B
B
If
we
can
move
on
please
so
to
talk
about
something
other
than
care
homes.
Thank
you
so
much
for
being
patient.
If
you're,
not
a
care
home
provider
on
this
call,
we
have
also
used
this.
As
I'm
sure
you
have
in
your
business
as
an
opportunity
to
try
different
ways
of
working,
and
we
we're
really
reflecting
on
how
much
intelligence
we
could
get
about
the
quality
of
care
being
provided
without
physically
visiting
a
service.
So
you
know
when
we
weren't
crossing
the
threshold
and
visiting
as
frequently
you
know.
B
How
are
we
using
local
health
watch
information?
How
were
we
using
information
from
advocacy
organizations,
information
from
local
authorities,
clinical
commissioning
groups,
etc?
To
help
us
have
the
most
up-to-date
view
of
quality
and
of
and
of
risk,
and
it
got
us
thinking
about
home
care
and
we
had
some
conversations
with
uk
hca,
so
jane
townsend
and
colin
about
whether
we
wanted
to
pilot
a
different
way
of
inspecting
home
care
providers
and
I've
been
out
on
home
care
inspections.
B
Where
we
visit
a
service,
we
often
sit
in
a
relatively
small
office
in
some
business
park.
We
speak
to
a
couple
of
members
of
staff,
often
in
a
very
small
space,
and
actually
there
is
this
pilot
is
about
exploring
what
would
it
look
like
if
we
didn't
spend
that
time
traveling
to
a
registered
office?
B
But
actually
we
spent
more
of
that
time,
speaking
over
zoom
over
skype,
over
teams
with
people
who
use
services
with
staff
who
maybe
aren't
on
site
they're,
maybe
at
home
or
in
in
another
environment,
to
gather
that
intelligence
about
the
quality
of
care?
So
that's
the
thing
we're
testing
is:
can
we
get
enough
information
about
the
quality
of
the
service
to
undertake
a
home
care
inspection
without
physically
physically
going
to
visit
the
service
in
person?
So
that
was
what
we
were
testing
and
we're
in
the
middle
of
it
at
the
moment.
B
So
we
were
delighted
when
180
home
care
providers
expressed
an
interest
in
being
part
of
it.
It
was
always
going
to
be
voluntary
because
we're
trying
out
a
new
way
of
doing
things.
It
involves
60
providers
that
are
good
or
outstanding
dotted
across
the
country,
and
things
are
underway
now.
So
we
have
inspections
that
are
happening
as
we
speak,
the
pilot
will
run
till
the
end
of
november
and
we
will
evaluate
that
and
then
we'll
make
a
decision
about
what
happens
next.
B
But
if
you
have
a
view
on
it,
if
you
want
to
share
your
experiences
if
you've
been
involved,
love
to
see
some
comments
from
you
in
the
chat
on
that
as
well.
So
that's
a
little
bit
about
our
home
care
pilot.
If
we
could
move
on,
that
would
be
great
okay.
B
So
how
will
you
regulate
during
the
pandemic,
so
we
are
going
to
continue
monitoring
as
I've
said,
and
our
monitoring
will
continue
to
be
based
on
our
chloe's
on
our
key
lines
of
inquiry
when
we
go
out
and
physically
visit
you
when
we
cross
the
threshold
and
come
and
visit
your
home
care
service,
your
shared
life
service,
extra
care,
residential
nursing
homes,
etc.
Your
experience
will
be,
I
hope,
of
us
being
much
more
focused
and
targeted
in
our
inspection
and
as
a
result.
B
B
So,
as
I
said,
our
esf,
our
message,
support
framework
is
based
on
our
key
lines
of
inquiry.
We're
got
a
strong
focus
around
safety
and
areas
such
as
ipc
as
I've
said,
we're
using
all
these
different
information
to
inform
how
we
should
work
going
forward.
B
So
our
piloting
around
home
care
we're
doing
some
provider
collaboration
reviews
where
we've
gone
out
originally
to
11
parts
of
the
country
to
interview
providers
about
what
worked
well
and
how
they
came
together
during
the
first
wave
of
the
pandemic,
to
prioritize
collectively
to
move
resources
around
etcetera
to
respond
to
risk
and
what
were
the
barriers?
B
And
we
published
our
findings
on
that.
We
will
continue
to
place
a
strong
emphasis
on
support.
So
again
really
welcome
your
comments.
I
know
in
the
beginning,
I
heard
really
strongly
from
providers
that
they
welcome
the
increased
emphasis
on
it
feeling,
like
a
supportive
relationship
with
their
inspector,
really
keen
to
hear
whether
that's
what
is
still
your
experience
now
so
emphasis
on
support
and
obviously
using
risk
to
help
us
make
decisions
about
when
we
go
out
to
cross
across
the
threshold.
B
So
that's
how
we're
continuing
to
develop
our
approach,
let's
move
on
and
risk
is
our
main
driver
as
you'd
expect
risk
and
then
and
then
a
component
of
looking
at
best
practice
as
well.
So,
whereas
before
the
pandemic,
our
frequency
of
going
out
and
inspect
was
largely
driven
by
what
our
providers
previous
rating
was.
We
have
moved
away
from
that
moved
away
from
our
fixed
timetable
of
inspection
and
moved
away
from
the
previous
rating
driving
our
our
frequency.
B
We
want
to
move
much
towards.
This
was
our
original
thinking
about
our
new
strategy,
how
incoming
intelligence,
how
what
we
hear
from
people
who
use
care?
What
we
hear
from
other
organizations
on
a
daily
basis
helps
inform
our
view
of
risk
and
therefore,
when
we
go
out
and
visit
a
service
inspections,
inspections
in
person
will
continue
to
be
an
invaluable
tool
as
we
go
forward,
and
we
know
that's
something
that
really
matters
some
members
of
the
public
as
well.
B
You
want
to
leave
us
on
and
then
with
regard
to
ratings,
so
and
because
we're
not
going
out
and
doing
full
comprehensive
inspections,
because
the
way
we're
working
is
very
different
and
responding
to
risk.
We
will
be
really
focused
when,
when
we
interact
with
you
either
be
that
through
a
monitoring
call
be
that
through
an
ipc
inspection
or
through
a
targeted
or
focus
inspection,
we
can.
B
We
have
the
ability
to
look
at
all
of
our
key
lines
of
inquiry
on
inspection
and
we
have
the
ability
to
re-rate,
but
that
is
not
our
main
driver.
At
the
moment,
our
main
driver
is
responding,
responding
to
risk,
so
re-rating
is
still
something
that
we
can
do,
but
that
is
not
that's,
not
our
main
purpose
for
going
out
and
visiting
a
service.
B
Let's
move
on
seth,
okay,
so
I'm
gonna,
I'm
gonna
pause
for
a
minute
and
then
sam
and
then
see
debbie's
been
busily
trying
to
respond
to
some
of
your
questions.
Sam
is
going
to
just
give
me
some
a
summary
of
some
of
the
things
that
you've
been
talking
about
in
the
chat
and
debbie's
gonna
endeavor
to
respond
to
some
of
those.
So
I'll
pause
for
a
minute
and
hand
over
to
you,
please,
sam.
A
Thanks,
kate
and
thanks
everyone
for
your
question
so
far,
there's
some
really
interesting
ones
in
the
chat.
We've
had
quite
quite
a
few
around
the
topic
of
testing
coming
in
and
there's
a
few
key
themes
that
it
might
be
interesting
to
pick
up.
So
one
of
them
is
about
what
support
we
can
offer
to
make
the
case
for
more
testing
to
be
available
for
home
care
or
domiciliary
care
services
and
the
staff
who
work
there
and
then
there's
just
there's.
A
C
Okay,
so
we
we've
been
involved
in
the
testing
discussions
right
from
the
beginning
and
have
continued
to
put
forward
the
need
for
all
care
staff
working
both
in
supported
living
in
extra
care,
housing
and
eventually
moving
into
also
domiciliary
care
that
that
testing
would
be
useful.
It
is
an
interesting
situation
because
we
actually
don't
have
testing
of
of
hospital
staff
on
a
routine
basis,
so
adult
social
care
has
been
dealt
with
quite
differently
through
this
period,
but
we're
already
beginning
to
see
what
a
difference
that
can
make.
C
So,
yes,
we
have
regular
conversations
with
the
department
about
this
and
we
and
I
understand
that
the
plans
as
we
go
forward
will
be
to
gradually
extend
to
all
parts
of
the
sector,
and
that
also
includes
the
the
the
visiting
professionals
we
clearly
at
the
moment.
Don't
meet
the
criteria
as
our
inspectors
for
testing,
because
we
don't
have
that
regular
contact
and
and
the
personal
care
element.
So
we
don't
fall
into
it
at
the
moment.
A
Thanks
debbie
we've
also
got
quite
a
few
questions
about
our
approach
to
inspecting
and
rating
during
the
transitional
period.
I
think
just
first
off
just
asking
for
a
bit
of
clarity
about
what
our
approach
will
be
during
the
recently
announced
lockdown
period,
but
also
having
some
concerns
around
where
some
providers
might
benefit
from
a
rating,
but
because
we
don't
have
immediate
concerns,
may
not
get
an
inspection
and
have
the
ability
to
be
re-rated.
C
Yes,
this
is
a
tricky
one,
and
I
saw
there
were
lots
and
lots
of
questions
around
this.
There
will
be
occasions
when
a
rating
may
change
on
one
of
our
inspections,
because
I
I
also
saw,
I
think,
a
question
there
about.
If
we
found
some
problems,
what
would
we
do
so
we
we?
We
could
extend
an
ipc
inspection
to
become
a
focused
inspection
which
has
got
the
ability
to
change
a
rating.
C
What
we're
also
looking
at
is
you
know
if
there
is
a
real
if
there
is
a
real
need
in
an
area
of
the
country,
and
we
think
that
we've
seen
some
really
good
evidence
that
a
service,
perhaps
that's
inadequate,
has
improved.
We
may
be
able
to
go
out
and
have
a
look
at
that
service
and
see
if
we
can
change
the
rating.
So
it's
not
a
there
will
not
be
changes
in
rating,
but
what
we
have
to
be
really
clear
about
is
that
isn't
our
focus?
C
Our
focus
has
to
be
on
looking
at
what
the
situation
is
within
the
service
at
this
time,
particularly
where
there
are
risks,
or
particularly
around
infection,
prevention
and
control.
I
know
that's
hard
and
I
know
it
means
that
the
chances
are
that
nobody
is
going
to
be
getting
an
outstanding
rating
over
the
next
few
months,
and-
and
some
of
you
have
worked
incredibly
hard
to
get
yourselves
into
a
position
where
you
are
ready
for
that
and
yeah
we're.
C
Sorry
too,
because
we
love
going
out
and
having
a
really
good
look
at
services
that
have
done
so
much
to
make
a
great
life
for
people
living
in
it.
But
really
we
have
to
think
about
how
we
use
our
resources
and
how
we
support
in
the
best
way.
We
can
the
sector
to
get
through
this
next
period
of
time,
and
that
does
have
to
be
at
the
moment.
Looking
at
risk
and
looking
at
infection
prevention
control.
A
Thanks
debbie
we've
got
a
question
here
about
our
ipc
inspections
and
whether
they'll
apply
to
domiciliary
care
services.
C
You
know
at
the
moment
they
don't.
It
is
just
about
care
homes,
but
one
of
the
things
that
I've
been
talking
to
to
people
about
is
you
know.
Actually,
these
are.
C
These
are
really
good
inspections
and
I
think
they're
really
helpful
for
people
what's
difficult
about
them
being
for
domiciliary
care
is
because
they're
very
much
observation
of
how
care
what
how
people
are
using
infection
prevention
and
control
in
a
care
home
now,
that's
obviously
very
different
in
someone's
own
home,
but
there
are
situations
where
I
can
imagine
it
could
be
really
helpful.
For
example,
if
we've
got
a
setting,
that's
being
used
as
set
step
down
beds
from
hospital,
say
people
are
getting
personal
care
delivery
through
into
that
setting.
C
It
may
be
that's
appropriate
to
look
at
it
at
the
moment,
though,
because
we've
got
plenty
to
do
with
with
just
the
the
the
home
care
care
with
care
homes
we're
not
looking
to
extend
it.
C
The
methodology
that's
on
our
website,
though,
could
be
an
an
interesting
and
useful
thing
for
people
to
have
a
look
at
to
see
the
kind
of
things
that
we're
looking
at,
because
that
may
help
improve
practice
and
also
just
to
say
that
we're
about
to
release
a
new
independent
voice
product
over
over
the
next.
I
think
it's
the
middle
of
next
month,
which
will
put
all
the
findings
from
our
infection
prevention
and
control
inspections
together,
and
that
tells
some
amazing
stories
and
I've
had
some
great
conversations
with
people.
C
Who've
been
able
to
talk
about
some
of
the
really
innovative
practice
that
they've
that
they've
done
in
their
care
homes
about
the
the
ways
they've
worked
with
families
and
the
way
they've
kept.
Everybody
really
involved
with
with
what's
happening.
So
there's
some
great
stuff
out
there
that
people
can
use
the
learning
across
into
different
settings.
A
Okay,
thanks
debbie
we've
also
got
a
question
reflecting
on
the
winter
plan
and
the
question
of
staff
moving
across
services
and
working
in
different
services
and
just
asking
for
a
bit
more
what
our
position
is
on
on
that.
C
Okay,
this
is
a
tricky
one,
because
we
haven't
got
yet
got
the
regulation,
so
we
don't
know
exactly
what
it's
going
to
be
saying
and
therefore
I
can't
tell
you
exactly
what
we're
going
to
be
doing
with
it.
But
I
suppose
what
I'd
like
to
reassure
you
about
is
this
is
all
based
on
how
important
it
is
that
we
have
staff
not
in
work
when
they're
unwell
when
they're
isolating
we.
C
We
all
know
that
everyone,
except
expect
everyone,
accepts
that
it's
also
about
how
important
it
is
that
staff
aren't
going
from
one
place
to
another
because
of
the
difficulties
with
with
asymptomatic
staff
and
not
not
always
being
clear
when
they
they
have
have
this
disease.
So
what
we
will
probably
have
to
be
taking
is
a
very
pragmatic
approach
to
this.
C
So
if
we
understand
there
are
people
who
are
not
following
those
rules
who
are
not
keeping
people
off
start
off
off
when
they're
sick
or
not
paying
staff
to
be
off
when
they're,
sick
or
people
who
are
not
actually
who
are
moving
between
services,
because
the
provider
has
not
taken
the
right
actions
to
make
sure
that
they
have
other
plans
in
place
because
they
haven't
really
thought
through
what
is
going
to
happen
over
the
next
few
months
and
they
haven't
used
their
haven't,
used
the
resources
that
are
available
to
them
in
the
right
way.
C
Then,
of
course,
we'll
need
to
look
at
that
and
see
whether
somebody
has
has
broken
the
regulation,
but
we
know
how
difficult
it
is.
We
know
how
hard
it
is
for
our
staff,
and
we
also
know
how
many
of
our
staff
are
are
dependent
on
having
more
than
one
job,
to
be
able
to
actually
kind
of
keep
keep
the
the
food
on
the
table
and
keep
their
families
together.
So
there
has
to
be
a
real
effort
from
all
of
us
to
think
about
how
best
do
we
make
sure
that
people
are
protected?
A
Great
thanks,
debbie.
I
think
we
maybe
got
time
for
one
more
question
and
then
we'll
try
to
pick
up
the
rest
in
the
next
q
a
session.
So
there's
just
a
question
about
the
length
of
our
transitional
approach,
whether
it's
it's
going
to
be
last
into
to
april
next
year
or
potentially
longer.
C
B
Debbie,
so
I
start
talking
oh
yeah
there
you
go,
you
got
me
so.
Certainly
the
intention
is
that
everything
we
do
kind
of
builds
on
what
we've
developed
so
far
and
again,
like
you,
no
doubt
all
the
different
ways
of
working
that
you've
tested
out
during
covert.
B
There
is
a
real
commitment
that
we
want
to
keep
what
works
going
forward
as
well,
so
the
the
the
ability
we
have
tech
wise
around
capturing
some
of
these
regulatory
monitoring
conversations
are
learning
from
our
home
care
pilot
and
I've
seen
some
of
your
your
comments
about
what
you
also
think
can
be
achieved
virtually
rather
than
in
person.
B
All
of
that
will
need
to
be
bundled
up
into
how
we
work
going
forward,
so
that
does
flow
on
to
what
I'm
going
to
talk
about
now,
which
is
the
four
pillars
the
four
proposed
pillars
of
our
our
new
strategy.
B
So
this
is
where
you
have
a
real
chance
to
influence,
so
we
are
in
the
conversation
stage
of
a
strategy
that
we'll
be
consulting
on
formally
in
january,
but
there
are
some
key
questions.
I've
got
for
you
as
we
go
that
your
feedback
would
absolutely.
This
is
the
window
to
do
some
real
influencing
as
well.
So
I'm
going
to
talk
about
people
smart,
safe
and
improved.
B
So
if
we
go
to
the
first
one,
so
we
know
that
people's
experiences
of
of
people's
outcomes
are
very
much
influenced
by
the
way
that
health
and
social
care
providers
work
together
to
ensure
that
they
get
good,
joined
up
care.
And
we
also
know
people's
experiences
and
outcomes
are
very
much
influenced
by
their
ability
to
access
the
right
care
in
the
right
place
at
the
right
time,
with
the
right,
professional
and
supporting
them.
So
we
want
to
increasingly
regulate
providers
through
the
the
lens
of
the
person
receiving
health
and
social
care.
B
So
we
want
to
focus
on
whether
people
feel
listened
to
whether
that
people
have
access
to
the
information
they
need
at
the
right
time
to
help
them
make
decisions,
and
we
want
to
play
an
increasing
role
in
talking
about
health
inequalities
and
and
not
just
looking
at
what
people's
experiences
are
when
they
access
services
and
the
quality
of
those
services,
but
also
what
their
experience
is.
B
In
in
getting
access
to
the
right
care
at
the
right
time,
so
when
I
think
about
this
one,
I
think
about,
I
think
local
act
personals,
making
it
real.
B
I
statements
where
there's
a
set
of
statements
written
by
people
who
use
services
who
talk
about
their
expectations,
about
how
care
should
be
wrapped
around
them,
where
people
should
have
a
really
good
understanding
of
what
their
needs
are,
and
it
should
be
coordinated
well,
and
this
is
where
we
would
like
to
regulate
much
more
through
the
lens
of
what
it's
like
to
experience,
accessing
health
and
social
care.
B
So
we've
been
talking
about
that
a
bit
so
far,
so
things
such
as
our
new
ipc
tool,
things
such
as
our
the
functionality
we
have
around
having
these
structured
monitoring
conversations
with
you
all
our
ability
to
go
out
and
do
focused
and
targeted
inspections
that
are
narrower,
but
still
enable
us
to
look
across
the
five
key
lines
of
inquiry.
B
We
want
to
build
on
that.
So
we
want
to
make
sure
that
we
collect
information,
digitally
that
we
don't.
You
know
we're
not
another
organization.
Ask
you
to
share
the
same
information
you've
already
given
your
local
authority
or
your
your
clinical
commissioning
group.
We
want
to
make
sure
we
collect
the
information
once
and
that
we
make
it
available
so
that
people
can
use
it.
B
We
want
to
move
away
from
inspections
that
are
based
on
previous
ratings
to
much
more
flexible
inspections
that
happen
when
the
risk
or
the
need
warrants
it.
We
want
to
make
sure
that
we're
proportionate
when
we
go
out
so
we
want.
We
want
to
ensure
that
when
we
do
go
out
and
visit
a
service
we're
doing
what
we
absolutely
need
to
do
in
person
and
everything
else.
B
We
do
prior
to
visiting
or
or
after,
and
we
want
to
be
really
focused
when
we
come
out
and
spend
time
with
you
in
your
service
and
we
want
to
be
flexible
and
responsive.
So
we
want
to
be
able
to
respond
to
intelligence
when
it
comes
in
and
and
go
out
and
and
respond
in
a
way,
that's
proportionate.
B
That's
what
we're
thinking
about
smart
if
we
move
on
to
safe,
so
safety
safety
is
a
language
I
think
that
gets
used,
maybe
a
bit
more
in
health
than
it
does
in
social
care,
so
they
as
their
own
health.
They
often
talk
about
a
zero
zero
tolerance
around
safe,
never
events,
etc.
Zero
avoidable
harm
when
I
think
about
safety
in
in
social
care.
So
forgive
me
if
you've
heard
me
say
this
before,
but
in
health
services.
B
They
have
a
national
reporting
mechanism
when
it
comes
to
reporting
medication
errors
and
on
average,
about
237
million
med
areas
are
reported
each
year
in
health
services.
We
don't
have
an
equivalent
mechanism
in
social
care,
but
we
do
until
covered.
We
had
our
pir
our
provider,
information
return
and
when
we
look
at
the
last
few
years
on
our
provider,
information
returns,
approximately
50
percent
of
providers,
social
care
providers
say
that
they've
had
no
medication
errors
and
the
reason
why
I
mentioned
that
is
there's
something
for
me
about
recognizing.
B
When
an
error
has
occurred,
naming
it
having
a
reporting
mechanism
to
capture
it
and
then,
most
importantly,
learning
what
were
what
were
the
components
that
contributed
to
it?
How
do
we
take
that
learning
so
that
it
doesn't
happen
again
within
the
service,
but
also
much
much
wider?
So
this
is
about
how
we
can
absolutely
move
the
dial
more
on
safety,
but
also
when
we
talk
about
safety
and
I
think
about
safety
and
social
care.
For
me,
it's
really
important
that
it
isn't
a
paternalistic
conversation.
B
It
isn't,
you
know
professional,
knows
best
person
receiving
care,
but
it's
much
more.
How
we
have
a
partnership
conversation
about
safety
and
risk
so
that
people
who
receive
services
also
have
ownership
about
what
what
risk-based
decision
decisions
they
want
to
take
as
well,
depending
on
their
capacity.
So
there's
a
bit
about
safety
and
then,
if
we
move
on
to
improve,
so
this
is
one
where
I
would
particularly
welcome
your
comments
and
questions
so,
and
this
is
one
where
people
are
quite
split
on
our
opinion
on
this.
B
So
my
my
opinion
on
this
is
that
everyone
in
the
country
should
have
access
to
good
or
outstanding
social
care,
and
if
you
happen
to
be
a
provider
in
an
area
where
you've
got
a
fabulous
local
authority,
quality
monitoring,
team
or
you've
got
a
great
community
health
offer
from
your
local
health
provider
or
you're
part
of
a
massive
organization
that
has
its
own
quality
monitoring
function
or
internal
audit.
B
There
may
be
many
places
for
you
to
go
to
get
support
to
improve,
but
I
remember
back
to
meeting
a
a
new
registered
manager
of
a
service
that
was
requires
improvement
and
she
said
to
me
I
am
where,
where
do
I
go?
B
Where
do
I
go
to
improve,
and
I
would
really
like
to
be
in
a
scenario
where,
regardless
of
where
you
are
in
the
country,
regardless
of
what
your
local
authority
or
ccg
offer
is,
regardless
of
whether
you're
a
big
provider
or
a
teeny
home
care
organization,
supporting
you,
know,
20
people
that
you
will
have
access
to
the
right
quality
improvement
support,
and
if
that
is
something
that
you
recognize.
B
So,
firstly,
is
that
something
that
you
recognize
that
there
isn't
that
consistent
improvement
offer
on
social
care,
then
my
question
to
you
is:
might
the
regulator
have
a
role
in
being
the
convener
of
that
improvement
offer?
So
what
I
mean
by
that
is
because
we
have
that
visibility
of
all
social
care
providers
registered
social
care
providers
in
the
country
and
because
we
also
in
a
very
small
number
of
circumstances.
B
So
I
think
most
providers
want
to
improve,
and
would
you
know
would
snap
the
chance
up
to
have
a
support
in
that
area
for
most
providers?
I
think
inspectors
could
play
more
of
a
coaching
role,
so
I
think
inspectors
could
do
more
of
sitting
alongside
a
registered
manager,
signposting
coaching
supporting
encouraging
their
improvement.
B
I
think
in
a
in
a
small
number
of
scenarios,
where
the
provider
is
unable
or
unwilling
to
engage,
we
might
need
to
have
more
of
our
traditional
regulator,
approach
and
style,
but
I'm
interested
in
the
role
of
inspectors
coach,
but
also
as
cqc
moving
into
a
convener
role.
Where
we
map
out
the
improvement
offer
around
the
country,
we
call
out
where
their
gaps
are,
but
also
maybe
we
help
bring
together
a
kind
of
package
of
support
for
those
providers
that
don't
sit
within
that
infrastructure
of
help
for
them.
So
that
that's
my
thinking
on
it.
C
B
I
know
many
people
don't
think
that's
you
know.
Many
people
have
a
different
opinion
on
that.
So
what
do
you
think?
What
do
you
think
of
the
the
idea
that
inspectors
should
be
more
have
more
of
a
coaching
style?
Do
you
think
that's
a
complete
blurring
of
the
role
and
you
should
leave
well
alone
and
you
should
have
a
very
formal
regulatory
role
with
your
inspector
and
it
shouldn't
be
anymore.
So
that's
my
first
question
and
then
my
second
one
is:
do
you
think
the
regulator
is
the
right?
B
Do
you
think
there
is
a
gap
when
it
comes
to
a
coordinated
improvement,
offer
for
social
care
providers,
and
if
so,
what
role
do
you
think
the
regulator
should
have
in
addressing
that,
so
I'm
going
to
quickly
scroll
down
and
see
what
hopefully
you're
starting
to
respond
to
them?
Some
of
those
questions
and
we'll
come
back
to
that
in
a
minute.
B
While
I
just
saw
my
last
couple
of
slides
so
and
so
what
we're
going
to
do
next
is
we're
going
to
carry
on
rolling
out
our
transitional
approach,
we're
going
to
formally
consult
on
our
strategy
in
january
and
we're
going
to
take
all
our
learning
from
the
summer
and
before
into
our
way
of
working
going
forward
and
next
one
please
seth
and
then
following
the
consultation,
we
will
implement
our
new
strategy
from
may,
but
there
will
be
many
more
occasions
for
you
to
contribute
and
get
involved.
B
So
the
next
slide
just
reminds
you
what
you
probably
already
know.
Oh
if
we
go
on
one
more
slide
seth.
So
there
are
many
ways
for
you
to
get
involved.
We've
got
our
digital
platform
called
citizens
lab
where
you
can
have
a
read
of
our
strategy,
a
discussion
document.
Hopefully
many
of
you
get
our
provider
bulletins
and
blogs,
and
you
can
follow
me
or
the
ckc
twitter
account
as
well
for
information
and
we've
recently
started
putting
out
podcasts
as
well
so
many
ways
for
you
to
get
involved.
B
So
I'm
gonna
pause
and
scoot
my
eyes
over
some
of
your
comments
and
hand
over
to
sam
and
to
see
whether
there
are
any
reactions
to
what
I
said
around
a
potential
new
strategy
for
cqc.
A
Thanks,
kate,
yes,
we've
got
some
got
some
really
interesting
comments
on
those
strategy.
Themes
on
the
some
of
the
improvement
questions
you
posed
so
we've
got.
We've
got
a
bit
of
a
general
question
about
whether
we've
given
any
thought
to
how
we'll
link
him
with
some
of
the
existing
organizations
that
already
work
in
the
improvement
space
and
also
a
bit
of
a
suggestion
that
we
could
do
more
work,
publishing
best
practice
and
guides
to
how
to
deliver
best
practice
and
a
bit
of
a
reference
to
ofsted.
A
Who
some
people
think
do
this
quite
well.
B
Okay,
interesting
so
I've
had
a
couple
of
conversations
about
this
idea
before
and
I
always
think
you
know
when
you
try
and
co-produce
something
in
a
genuine
way.
It
means
you
often
have
quite
a
blank
piece
of
paper
when
you
start
talking
to
people
about
it.
So
the
great
thing
is:
there's
a
chance
to
shape
it
together.
The
flip
side
is,
there
are
a
whole
load
of
questions.
You
don't
have
the
answers
to
so
so
let
me
be
really
clear
that
this
isn't
a
this.
B
We
haven't
landed
in
a
place
on
this,
and
this
is
why
hearing
what
you
think
about
this
is
really
important,
so
so
important
questions
like
yeah
there's
a
lot
of
support
available
out
there
already
don't
duplicate,
and
how
would
you
dovetail
into
it?
I
I
don't
know
I
don't
know
the
answer
to
that,
but
I
would
be
really
keen
to
hear
your
your
thoughts
as
well.
I'm
looking
some
there's
quite
a
lot
of
positive
responses
to
the
the
idea
of
inspectors
having
more
of
a
coaching
style.
B
B
Yeah-
and
I
know
earlier
katie
commented
earlier
that
her
her
inspector
changed,
she
wasn't
informed
about
it
and
she's
got
someone
new
and
there
I
think,
there's
a
there's,
a
balance.
B
We
need
to
strike
where
there's
something
for
me
about
the
inspector
having
a
relationship
with
the
registered
manager,
understanding
the
context
of
your
service,
the
model
of
care
so
that
when
they
come
in
they're
not
coming
in
cold,
and
you
don't
have
to
explain
from
scratch
why
you
know
a
supported
living
service
looks
like
this
rather
than
than
that,
but
then
there's
also
the
balance
of.
B
I
do
think
there
needs
to
be
some
degree
of
rotation
so
that
it
it
keeps
quite
fresh,
but
I
I
would
I
would
definitely
like
to
see
a
longer
period
of
time
for
inspectors
and
providers
to
establish
those
relationships,
and
I
think
we
do.
I
think
it's
working
really
well
in
some
parts
for
some
people
and
that's
not
the
same
experience
for
other
providers.
So
again,
if
you
know
how
how
long
you
know
do
you
think
you
should
know
your
inspector,
you
know
pick
up
the
phone
have
those
regular
conversations
with
them.
B
How
often
do
you
think
they
should
change
and,
and
refresh
do
you
have
a
view
on
that
as
well?
That
would
be.
That
would
be
great.
A
Thanks
kate,
we've
gone
looking
at
one
of
the
other
strategy
themes.
We've
also
got
quite
a
few
questions
about
anything.
We've
done
about
our
change
to
how
we
inspect
and
rate
services
in
the
future.
So
questions
about
our
inspection
frequency,
whether
that
will
change
whether
our
key
questions
will
change
or
whether
we'll
look
to
rate
services
in
a
different
way,
maybe
not
relying
on
inspections
but
rely
on
other
types
of
activity.
B
Great,
so
again,
absolutely
all
up
for
discussion.
I
think
what
I
would
acknowledge
is
the
ratings
are
like
a
currency
that
makes
sense
to
the
population.
I
think
I
think,
we've
I
think,
they're
really
established,
and
I
think
people
know
what
they
mean
and
there's
like
a
real
helpful
simplicity
to
it.
So
I
think
there
is
a
value
in
the
current
currency
of
ratings.
B
However,
I
think
many
of
you
would
say
to
me
if
this
was
a
two-way
conversation
that
thing
so
I've
heard
many
providers
say
you're,
good,
you're,
good
rating,
so
a
provider
who
you
know
arguably
just
gets
into
the
goods
end
of
the
category
to
the
provider.
B
That's
you
know
not
quite
hit
outstanding,
but
is
absolutely
you
know
delivering
really
strongly
against
each
of
the
key
lines
of
inquiry,
so
I
certainly
have
providers
say
that
would
would
it
make
sense
to
break
out
some
of
these
ratings
is
one
thing,
other
things
that
you
might
want
to
think
about.
So
none
of
this
I
I'm
not
giving
any
sort
of
inside
scoop.
This
is
all
things
that
are
up
for
discussions.
B
So
what
would
it?
How
do
you
make
your
ratings
more
responsive
to
changes
in
intelligence
coming
in?
Could
you
re-rate
a
service
without
physically
going
out
there?
Could
you
re-write
a
service
based
on
a
collection
of
intelligence
from
git
feedback
on
care?
How
much
emphasis
should
we
place
on
local
authority,
quality
monitoring
visits?
You
know
and
the
product
of
that?
How
much
should
we
place
on
intelligence
that
comes
from
other
sources?
B
What
would
it
what
would
it
look
like
if
a
rating
wasn't
linked
to
an
inspection?
It's
an
a
question.
B
What
would
it
look
like
if
you
kept
the
four
ratings,
but
maybe
there
was
a
scale
from
one
to
100
where
one
to
25
was
inadequate,
you
know,
26.50
was
requires
improvement,
etcetera
and
what,
if
you
could
move
up
and
down
within
those
ratings,
depending
on
intelligence
and
what,
if
that
was
mainly
more
information
for
you
as
a
kind
of
benchmarking
improvement
tool,
so,
instead
of
maybe
confusing
something
that
works
for
the
public,
but
maybe
if
you've
got
you
know,
you've
got
a
good
rating
to
the
public,
but
actually
you
know
that
your
good
rating
is
72
and
you're.
B
B
I
just
think
the
challenge
to
us
is:
how
do
we
keep
the
ratings
as
live
as
possible,
and
one
way
of
doing
that
might
be
that
your
rating
could
change
without
an
inspection.
I
don't
know
what
I
I
don't
know
what
I
think
about
that
would
love
to
know
your
thoughts
and
then
the
other
is.
How
can
you
use
ratings
to
drive
improvement
by
maybe
giving
more
of
a
breakdown
of
you
know
if
you're,
if
you're,
if
I'm
a
registered
manager
of
a
good
service?
Well,
how?
How
good
am
I
and
how?
B
How
do
I
get
myself
up?
You
know:
how
do
I
improve
the
quality
of
care
by
looking
at
other
providers?
That
are,
you
know,
maybe
slightly
ahead
or
doing
something
different
or
better.
So
I'm
definitely
all
up
for
discussion
as
well,
and
now
is
the
time
for
you
to
gosh.
I
wish
I
could
read
the
483
comments
that
are
saying
in
the
chat
and
we
will
look
at
them
all
as
well,
but
yeah
really
up
for
hearing
your
thoughts
about
ratings.
A
There's
also
been
some
questions
about
collecting
information
from
providers.
So
a
bit
of
reflection
that
there's
often
loads
of
requests
from
different
people
for
information
that
aren't
always
joined
up
and
also
our
own
information
collection
mechanisms,
aren't
always
the
easiest
for
providers
to
use.
And
I
wonder
if
we
want
to
say
something
about
that
aspect
of
the
strategy.
A
B
So,
and
so
we
we
want
to
do
this
a
lot
better.
We
want
to
do
this
a
lot
better
to
ease
the
pressure
on
you
with
needing
to
complete.
You
know
multiple
information
returns,
and
we
were
particularly
attuned
into
that
at
the
beginning
of
the
pandemic,
where
you
know
you
have
to
provide
a
lot
of
information
anyway,
but
you
know
put
us
in
the
middle
of
a
pandemic
and
the
risk
of
those
information
requests.
The
frequency
and
the
detail
was
was
significant.
B
We
obviously
forced
the
provider
information
return
at
the
start
of
the
pandemic,
while
we
introduced
our
home
care
tracker
and
and
the
capacity
tracker
was
launched
within
the
nhs
we
are.
There
are
active
conversations
at
the
moment
that
some
of
your
trade
associations
and
us
are
involved
with
with
the
department
as
well
about
what
is
the
best
mechanism
for
bringing
all
that
information
together.
Who
should
have
access
to
it?
How
does
it
drive
action?
That's
needed
on
the
back
of
it.
B
So,
there's
a
whole
lot
of
intelligence,
saying
that
there's
a
problem
in
this
part
of
the
country
or
there's
an
issue
with
testing
or
there's
an
issue
with
this
sort
of
this
bit
of
ppe.
How
how
do
all
those
different
sources
come
together
in
one
place?
B
I
think
I
think
there
have
been
some
improvements
on
that,
but
I
I
think
we
all
would
like
to
do
better
on
that,
and
there
are
ambitions
and
conversations
that
are
underway
that
I
probably
would
need
to
come
back
to
you
all
on
about
in
you
know
in
the
nearest
future
to
update
you
on,
including
what
our
thinking
is
around
pir,
so
I'll
provide
information
return.
B
So
there
is
definitely
some
information
that
we're
not
capturing
because
we're
not
getting
those
back,
and
we
have
been
talking
a
lot
in
cqc
prior
to
the
pandemic,
enduring
about
closed
cultures
and
about
risks
for
people
in
services
where
close
cultures
can
develop
and
actually
our
provider
information
return
is,
is
a
really
important
source
for
us
about
giving
us
information
about
self
turnover,
resident
manager,
all
that
sort
of
stuff.
B
A
B
Okay,
so
let
me
do
that
last
one
first,
so
I
think
that
there
are-
and
I
know
there
are
some
on
this
call
very
strong
trade
associations
who
do
a
really
good
job,
advocating
on
behalf
of
social
care.
I
think
we
absolutely
have
a
role
in
terms
of
using
the
intelligence
we
have
about
what's
happening
in
health
and
social
care,
to
call
for
things
when
we
see
them
as
that
kind
of
independent
voice
as
well.
But
I
think
there
are
some
already
some
really
fantastic
advocating
organization
organizations
that
do
advocating
really.
B
Well,
I
think
sometimes
our
challenge
in
social
care
is
to
be
as
consistent
as
we
possibly
can
with
some
of
the
key
things
we're
calling
for
so
in
our
state
of
care
report
that
we
published
about
two
weeks
ago.
We,
along
with
many
of
you
on
many
of
occasions,
call
for
that
long-term,
sustainable
funding,
solution
for
social
care
and
a
new
deal
for
our
social
care
workforce,
and
I
think
the
challenge
to
us
is
a
very
dispersed
sector
without
a
single
kind
of
figurehead,
which
I
think
is
the
right
thing
for
us.
B
It's
how
we
collectively
use
every
opportunity
we
have
to
bang
the
same
drum
about
the
same
messages
if
we
have
agreement
on
them.
So
that's
one
thing
regulating
systems.
So,
yes,
I
think
they're.
Definitely
in
our
new
strategy
there
will
be.
B
We
will
continue
to
hold
individual
providers
to
account
for
the
safety
and
quality
of
their
services,
but
though
I
strongly
suspect
there'll
be
a
stronger
emphasis
on
how
well
do
you,
as
a
provider
work
with
your
system,
your
other
providers
in
the
system
to
ensure
that
people
get
high
quality
joined
up
care.
So,
for
example,
if
you
are
a
big
acute
hospital,
can
you
be
good
or
outstanding?
B
If,
when
you
look
outside
your
doors
or
your
social
care
providers,
are
falling
over
and
are
poorly
rated,
so
so
something
that
that
places
an
increasing
emphasis
on
providers
owning
their
bit
really
well,
but
also
thinking
about
how,
as
a
home
care
provider
you're
working
with
the
gp
you're
working
with
you
know,
with
with
the
hospital
etc,
to
ensure
that
the
people
you
support,
get
could
join
up
care,
and
I
know
often
it's
particularly
hard
for
social
care
providers
to
do
that
because
there's
so
many
of
you
and
often
the
scale
isn't
there,
but
if
we
also
place
an
increa,
an
equal
emphasis
on
a
big,
acute
hospital
trust
or
a
gp
practice
or
a
dentist
to
say
you
know:
okay,
dentist
you're
serving
the
patients
that
come
into
your
surgery
really
well.
B
B
So
yes,
yes,
I
think
there'll
be
a
lot
more
on
systems
and,
finally
on
commissioning,
I
would
say,
because
I
I
believe
it
as
well
so
jane
townsend
from
uk
hta
says
often-
and
one
of
you
has
put
it
in
the
chat
that
I've
seen,
that
we
judge
home
care
providers
on
the
quality
of
the
service
they're,
providing
but
home
care
providers
in
particular
say
that
their
ability
to
deliver
high
quality
care
is
impacted
by
how
they
are
commissioned,
whether
it's
time
and
task,
whether
they've
got
travel
covered
etcetera.
B
So
I
absolutely
believe,
commissioning
plays
how
services
are
designed
and
purchased
absolutely
plays
a
key
role
in
the
quality
that's
being
provided.
We
don't
have
the
regulatory
power
to
do
that.
Currently,
I
don't
know
whether
there's
an
appetite
for
that
to
change.
You
all
are
a
loud,
strong
audience
that
might
have
a
view
and
might
want
to
talk
collectively
about
that
as
well,
but
certainly
through
our
work
with
systems.
B
When
we
did
our
system
reviews
a
couple
of
years
ago,
we
were
able
to
talk,
because
we
had
special
powers
issued
to
us
for
that
about
the
impact
of
commissioning
on
people's
experiences
of
how
health
and
social
care
was
delivered.
It's
two
o'clock
and
I've
probably
talked
far
too
fast
anyway,
for
the
last
hour,
I'm
going
to
draw
it
to
a
close
now
and
say
massive.
Thank
you.
I
can't
get
over
how
many
comments
you've
put.
There
would
be
really
keen
to
hear
how
you
found
the
chats
the
hour.
B
Was
it
a
good
use
of
your
time?
What
could
we
do
better?
Next
time?
You
might
tell
me
to
speak
slower,
which
is
a
challenge.
I'd
probably
struggle
with,
but
happy
to
hear
that
feedback
as
well
and
keep
telling
talking
to
us
about
our
strategy.
There
is
a
real
window
to
influence
how
we
are
changing,
because
we're
changing
rapidly,
just
like
you
are
so
tell
us,
tell
us
about
inspectors.
As
coaches
tell
us
about
ratings,
tell
us
about
commissioning,
get
involved
and
tell
us
what
you
think
should
be
in
that
strategy.
B
Massive!
Thank
you
to
you
and
your
staff,
and
I
hope
the
next
few
weeks
and
months
are,
as
you
know,
as
as
bearable
as
they
can
be
and
keep
doing
the
the
fab
job
you
all
are
out
there.
Many
thanks
and
we'll
finish
there.
Thank.