►
Description
Hear from Kate Terroni, Chief Inspector of Adult Social Care and Mary Cridge, Deputy Chief Inspector of Adult Social Care at CQC as they discuss our transitional regulatory approach and the latest on our emerging strategy for 2021 and what this means for the adult social care sector.
A
A
Right
good
afternoon,
everyone
very
warm
welcome
to
our
cqc
session
on
now
next
and
future.
My
name's
kate
tarone,
I'm
the
chief
inspector
of
adult
social
care
and
I'm
going
to
be
taking
us
through
this
presentation.
Today
we
have
an
hour
together,
so
the
plan
is
that
I'm
gonna
cover
some
slides.
We're
then
gonna
have
an
opportunity
to
have
some
questions
and
then
gonna
do
another
set
of
slides
and
then
we're
gonna
have
some
questions
at
the
end.
So
because
this
is
a
team's
live
event.
A
We
can't
because
of
the
number
of
you
that
are
on
this
webinar.
We
can't
have
an
interactive
session
in
terms
of
you
talking,
but
I've
got
my
chat
box
open
and
it
would
be
fab
as
I
talk
for
you
to
be
writing
comments
and
questions
as
we
go,
so
I
will
endeavor
to
multitask
in
terms
of
talking
and
keeping
an
eye
on
what
you're
saying
in
the
chat
box
so
say
hello,
and
let
me
know
what
you're
thinking
in
response
to
what
I'm
saying.
A
So,
if
we
could
have
the
next
slide,
please
deaf,
okay,
so
who's
on
the
calls
I've
introduced
myself.
I'm
really
pleased
to
be
joined
by
mary
quidd
who's.
One
of
my
three
deputy
chief
inspectors,
mary
covers
central
region,
and
then
we
have
the
team
of
colleagues
who
makes
this
event
happen.
So
we've
got
jen,
abigail
and
steph.
Who
will
be
keeping
an
eye
on
your
your
chat,
but
also
driving
the
slide
deck
for
me
and
capturing
the
themes
of
what
we
discussed.
A
Today,
thank
you
so
so
what
we're
going
to
cover
today?
So
I'm
going
to
very
briefly
remind
you
of
our
role
and
purpose
here
in
cqc.
I'm
going
to
talk
to
you
about
our
timeline
about
how
we
are
changing
and
where
we
are
with
that.
I'm
going
to
do
a
super
quick
recap
of
what
we've
done
so
far
in
adult
social
care.
A
Since
the
start
of
the
pandemic
going
to
talk
a
bit
about
where
we
are
now
with
regard
to
infection
prevention
control
winter,
some
piloting
we're
doing
around
how
we
might
regulate
home
care
a
bit
differently
and
then
I'm
going
to
talk
about
our
transitional
approach
to
regulation.
So
that's
the
first
half
of
the
session
and
then
we're
going
to
have
questions
and
then
we're
going
to
move
on
and
talk
about.
A
A
Okay,
so
if
you're
on
this
call,
I'm
guessing,
you
have
a
pretty
good
idea
of
what
we
do
already,
but
just
to
remind
you
that
we
at
cqc
are
the
independent
regulator
of
health
and
social
care
in
england,
and
our
job
is
to
make
sure
that
people
receive
effective,
high
quality,
compassionate
and
care.
So
our
role
and
purpose
is
not
changing.
A
A
A
A
You
want
to
move
us
on
stuff,
okay,
so
we've
got
a
timeline
slide.
That's
all
that's
magically
appearing
before
my
eyes,
so
so
this
is
our
timeline
around
transformation
and
there's
a
few
things
that
get
that's
going
on.
So
our
our
current
strategy
is
due
to
end
in
april
may
next
year.
So
before
the
pandemic,
we
have
started
thinking
about
what
should
be
our
future
direction
of
travel
as
a
regulator.
How
do
we
remain
relevant?
A
A
So
we
started
scoping
and
thinking
about
our
strategy
back
in
2019
in
at
the
start
of
this
year,
our
strategic
priorities
were
developed
following
a
series
of
engagement
and
then
coupled
with
that,
as
we
went
into
april
may
time,
we
I
developed
our
emergency
support
framework,
which
you'll
probably
be
familiar
with,
where
we
are
now
in
autumn
is
that
we
are
progressing
our
emergency
support
framework
and
moving
into
a
transitional
phase.
And
I'm
going
to
talk
to
you
a
bit
about
our
new
transitional
regulatory
approach.
A
We
have
got
a
really
real
sharp
focus
around
infection
prevention
control
and
then
on
our
strategic
side
of
things.
We
are
testing
out
our
strategic
themes
with
people
in
this
kind
of
informal
run-up
to
our
our
consultation
launching
in
the
new
calendar
year.
So
we
are
having
an
early
conversation
with
you
all,
and
it
is
a
conversation
because
many
of
these
things
haven't
been
finalized
or
landed.
A
Yet,
as
you
would
have
expected
at
this
point
and
we'll
talk
about
that
a
bit
later
on
in
the
hour
as
well,
our
intention
is
to
go
out
and
consult
formally
on
our
new
strategy
in
springtime
and
that
we
launch
our
new
strategy
in
in
may
of
next
year.
So
we're
doing
the
dual
piece
of
thinking
about
how
we
need
to
transform
as
an
organization
and
what
our
strategic
direction
is.
While
we
transform
the
way
we
we
regulate
in
response
to
what
covert
has
presented.
A
So
those
were
the
early
themes
that
we
heard
in
our
conversations
with
with
the
sector,
we
then
developed
a
structured
way
of
having
monitoring
conversations
with
our
providers,
which
is
this
emergency
support
framework,
and
the
purpose
of
that
was
absolutely
about
support
and
when
I've
done,
these
calls
before
I've
generally
heard
positive
feedback
from
providers
about
how
they
experience
working
with
us
with
the
emergency
support
framework.
But
I
am
keen,
as
ever,
to
hear
what
your
experiences
are.
A
So
as
I'm
talking,
you
want
to
be
busily
typing
away
in
the
chat
box
about
how
you
found
that
and
any
feedback
on
how
we
work
together
in
the
early
days
of
the
pandemic.
That's
really
useful
learning
for
us
as
well.
So
please,
please
share,
but
the
plan
for
the
emergency
support
framework
was
supportive
conversations
with
registered
managers.
It
was
an
opportunity
for
us
to
identify
what
the
emerging
issues
were
for
those
providers
and
to
help
them
get
targeted
support.
A
So
in
those
early
days
there
was
a
lot
of
conversation
about
getting
access
to
ppe
us
having
conversation
with
local
resilience
forums
in
some
instances
supporting
providers
to
share
personal
protective
equipment
with
amongst
themselves,
but
we
were
also
escalating
those
issues
up
nationally.
So
we
did
our
first
insights
publication
in
may
time,
which
was
pretty
heavily
adult
social
care
focused,
and
it
talked
about
those
main
issues
that
were
coming
out
from
our
regulatory
conversations
with
providers
around
ppe,
testing
and
and
staffing.
A
So
if
we
can
just
move
on
to
the
next
slide:
steph.
Okay,
so
they've
been
almost
17
and
a
half
thousand
locations
who
have
had
an
emergency
support
framework
assessment
and
we're
calling
these
regulatory
actions.
So
so
they
are
an
intervention,
a
an
exchange
that
we've
had
with
a
provider
to
give
assurance
and
provide
support
about,
what's
happening
out
there.
What
you'll
see
as
well
is
it's
slightly
pale,
but
hopefully
you
can
see
the
bar
chart
on
the
right
of
the
slide.
A
That
says
that
actually
we
endeavored,
through
the
start
of
the
pandemic,
to
get
as
much
information
as
we
could
without
needing
to
go
and
physically
visit
services
in
person,
because
at
that
time
it
was
about
supporting
providers
to
get
on
and
do
what
they
they
needed
to
do.
But
we
always
said
that
we
would
go
out
and
physically
visit
a
service
when
the
risk
required
us
to
do
so.
A
So
we
have
undertaken
1,
200
inspections
in
adult
social
care
since
the
beginning
of
the
financial
year
since
april,
and
the
number
for
october
is
significantly
increased,
since
this
bar
charts
being
produced
as
well.
So
emergency
support
framework
was
our
main
way
of
having
visibility
and
providing
support
to
the
sector,
and
we
continued
to
go
out
across
the
threshold
when
we
were
concerned
about
risk
and
we
needed
to
have
a
look
at
what's
going
on
out
there.
Should
we
move
on.
A
A
Let's
move
on
steph,
okay,
so
infection
prevention
control,
something
that
was
has
always
been
important
but
is
under
the
most
critical
spotlight
and
now
so
earlier
on.
In
the
summer
we
developed
a
new
methodology
focused
around
infection
prevention
control.
We
developed
it,
we
shared
it
with
providers,
it's
on
our
website.
So
if
you
want
to
have
a
look,
it
shows
the
eight
areas
of
assurance
that
we
plan
to
cover,
or
we
do
cover
during
infection
prevention
control
inspections.
A
It
says
that
the
it
shows
providers
what
we
expect
to
see
under
each
of
those.
As
for
what
is
best
practice,
we
have
undertaken
in
excess
of
400
infection
prevention
control
inspections,
since
we
launched
this
new
methodology
and
we've
gone
about
it
in
two
ways,
so
one
we
obviously
need
to
respond
to
risk
when
it
comes
to
infection
prevention,
control
and
when
we
have
concerns
brought
to
our
attention
around
maybe
from
whistleblowers
or
for
people
who
receive
care
of
their
families,
highlighting
possibly
a
provider
struggling
around
good
infection
prevention
control.
A
We
go
out
and
have
a
look
in
person,
so
we
go
out
across
the
threshold
where
we
have
concerns
about
the
risk
around
infection
prevention
control,
but
also
we
were
really
keen
to
do
a
bespoke
piece
of
work
to
say
what
does
best
practice.
Look
like.
We
want
to
see
where
providers
are.
You
know
absolutely
fantastic
job
around
implementing
good
infection
prevention
control,
so
we
did
300
inspections
over
the
summer
where
we
went
out
to
good
services,
and
we
were
assured
in
90
of
the
the
cases
about
what
we
were
seeing
around
ipc
practice.
A
So
we've
done
that.
Our
intention
is
to
do
about
500,
more
infection
prevention
control
inspections
in
the
next
few
weeks,
running
up
to
the
end
of
november.
Again,
with
that
dual
focus,
one
is
going
out
and
responding
to
risk
where
we
have
some
concerns
and
the
other
is
seeking
best
practice
so
that
we
can.
We
can
publish
it
in
terms
of
individual
providers
reports,
but
also
we
can
bring
that
together
and
talk
about
it
in
in
a
national
report.
A
And
this
is
what
it
looks
like
on
our
website.
So
when
we
go
out
and
do
an
ipc
inspection,
we
publish
a
short
report,
but
also
to
support
making
this
as
accessible
as
possible,
for
maybe
a
member
of
the
public
who's
looking
at
what
their
local
care
home
may
be.
Providing
on
this
front,
we've
developed
developed
a
a
graphic
that
you
can
see
in
front
of
you.
A
That
shows
the
headline
of
what
we've
seen
when
we've
gone
out
and
looked
across
the
eight
areas
of
assurance,
and
what
we
are
doing
is
where
we're
assured
you're
getting
the
great
tick,
and
the
word
assured
when
we
are
partially
or
somewhat
assured
that
can
often
be
a
small
amendment
that
a
provider
might
need
to
make
in
terms
of
a
policy
or
making
a
small
change
for
us
to
then
be
assured.
And
then,
when
we're
not
assured
their
actions
agreed
to
ensure
that
that
is
addressed.
A
So
this
is
just
a
breakdown
of
what
we
found
across
those
eight
areas
of
of
assurance,
so
there
are
many
things
that
are
working
really
well
out
there.
So
we
we've
been
really
pleased
by
what
we've
seen
in
terms
of
providers
approach
around
things,
such
as
safe
emission,
good
infection
prevention,
control
to
support
visitors
coming
in,
and
people
going
out
of
the
service
and
coming
back
in
access
to
testing,
etc.
A
And
then
the
the
areas
that
have
found
we
found
more
areas
of
concern
and
improvement
is
around
still
being
as
vigilant
as
ever
about
the
use
of
good
personal
protective
equipment.
So
we're
all
weary.
You
know
it's
been
an
incredibly
long,
eight
months
with
a
kind
of
turmoil
that
no
one
could
have
ever
have
imagined,
and
many
of
you
that
are
on
this.
Webinar
would
have
experienced
this
more
than
than
you
know.
A
Other
people
out
there,
but
that
message
around
being
absolutely
vigilant
when
it
comes
to
ppe,
is
critical
and
it's
critical
that
we
don't
stop
talking
about
it
and
then
the
final
area,
which
is
something
that
I
would
implore
you
if
you've
not
done
already,
is
to
make
sure
that
your
ipc
policy
is
up
to
date
and
is
reflective
of
the
current
times.
We're
in.
So
that's
what
we've
seen
and
when
we've
gone
out
to
that
relatively
small
number
of
homes.
A
Ipc
will
continue
to
be
a
focus,
so
we've
got
a
plan
for
500
in
the
next
kind
of
four
or
five
weeks.
Ipc
is
a
focus
of
our
regulatory
conversations
with
you
monitoring
conversations
with
you
over
the
phone,
but
also
I
anticipate
the
ipc
focus
continuing
well
into
spring.
So
obviously,
this
is
not
going
away
because
it's
such
a
critical
issue
and
we,
as
the
regulator,
will
continue
to
play
our
role
in
providing
assurance
to
the
public
on.
A
That,
if
you
can
move
us
on
stef,
so
I'd
like
to
say
just
a
couple
of
other
things
around
ipc
before
I
move
on
one,
because
I
don't
get
this
opportunity
very
often.
I
want
to
say
an
absolute
heartfelt
thank
you
to
you
as
frontline
workers,
as
managers
as
people
running
care
services,
for
what
you've
done
today.
A
A
couple
of
other
kind
of
hot
topics
around
this
infection
prevention
control
agenda
that
I
just
want
to
flag
with
you
that
I've
talked
a
bit
about
in
the
last
couple
of
weeks,
but
just
in
case
you've
missed
it
myself
and
ted
baker,
who's,
the
chief
inspector
of
hospitals
and
rosie
bennyworth
who's.
The
chief
inspector
of
primary
medical
services
put
out
a
position,
maybe
about
two
weeks
ago
about
our
expectations
around
discharge
planning.
A
I
talked
about
my
absolute
support
for
care
providers
to
not
accept
someone
unless
they
know
their
theirs
their
covert
status,
and
they
can
absolutely
be
assured
that
they
can
provide
good
quality.
Ipc
and
rosie
talked
about
the
importance
of
that
community.
Health
offer
so
that
social
care
providers
are
not
left
in
isolation,
managing
people
with
very
complex
needs,
so
we
put
our
kind
of
collective
position
on
this
and
want
to
really
encourage
you
to
give
us
feedback
on
how
it
is
feeling
up
feeling
like
out
there.
A
But
I
am
really
hopeful
that
you
have
heard
from
me
that
you
have
my
back
in
are
backing
as
a
regulator
that
you
need
to
be
absolutely
assured
that
you
can
safely
manage
someone
before
and
you
move
them
into
their
service.
I
know
it's
obvious.
I
know
that's
what
you
do
anyway.
I
am
just
very
aware
of
the
pressure
in
the
system
pressure
from
hospitals,
pressure
from
maybe
commissioners
etc.
A
A
So
you
know,
I
often
think
if
this,
if
I
was
a
resident
of
a
care
home-
and
this
is
my
last
12
months
on
on
the
planet-
how
how
am
I,
how
might
I
want
to
be
supported
and
that
incredibly
tricky
balance,
that
social
care
providers
juggle
every
day
about
safety
and
keeping
people
physically
safe,
weighing
up
with
keeping
them
mentally
well
and
supporting
them
to
have
that
kind
of
family
life
piece?
So
I
just
wanted
to
flag
you
as
well.
We've
also
made
our
you
know
our
position
on
visiting.
A
I
know
lots
of
you
were
talking
about
kind
of
clear
as
well.
I
hope,
okay
shall
we
move
on.
Please
jen
a
couple
of
other
bits
before
I
pause
for
questions
so
as
we
weren't
crossing
the
threshold
as
much
I'm
during
the
start
of
the
pandemic,
our
need
to
hear
directly
from
people
about
the
experience
of
receiving
care
was
more
important
than
ever.
So
we,
along
with
healthwatch
england
and
about
10
partner
organizations,
launched
our
because
we
all
care
campaign
in.
A
A
We
have
been
delighted
to
see
a
significant
increase
in
the
number
of
people
who
have
given
us
feedback
on
care
and
actually
a
large
number
of
occasions
when
we
actually
go
out
and
cross.
The
threshold
is
as
a
result
of
that
intelligence.
That's
provided
to
us
through
a
forum
such
as
give
feedback
on
care,
so
this
this
feedback
absolutely
counts
to
us,
having
as
up-to-date
of
you
as
possible
about
the
quality
and
risk
that's
out
there
in
the.
A
That's
not
to
say
we
won't
carry
on
crossing
the
threshold
because
it's
still
a
really
important
part
of
how
how
we
work,
but
it
did
get
us
thinking
about
home
care
providers
and
uk
hca,
jane
and
colin,
and
I
had
an
early
conversation
to
say
actually,
with
a
home
care
inspection,
my
inspectors
will
go
out.
They'll
go
to
the
registered
office.
A
A
So
we
are
doing
a
pilot
at
the
moment.
We
were
delighted
we
put
the
offer
out
there
to
home
care
providers
saying
do
you
want
to
try
a
new
way
of
inspecting
180
organizations
come
forward
and
we
are
doing
a
pilot
with
60
of
those
at
the
moment
spread
across
the
country,
and
this
pilot
is
to
look
at
if
we're
not
spending
time
traveling
to
an
office
location.
How
might
we
increase
our
amount
of
activity
in
talking
to
staff,
maybe
when
they're
away
from
the
office?
So
might
that
aid?
A
If
this
works
and
we
evaluate
it
and
there's
full,
you
know,
there's
good
support
for
it.
Might
we
say
that
we
don't
automatically
go
and
visit
our
home
care
office
when
we
need
to
inspect
that?
Actually,
in
the
majority
of
cases,
we
can
achieve
what
we
need
through
this
route,
but
we
will
always
keep
the
ability
to
to
go
out
and
visit
a
place
in
person.
If
that's
what's
required.
A
However,
when
we
are
out
and
inspecting
be
that
targeted
or
focused
it,
it's
not
going
to
be
it's
not
the
full
comprehensive.
So
it's
not
going
to
be
the
long
reports
that
you
are
used
to
receiving
it's
going
to
be
much
more
targeted
in
what
we
are
looking
at
and
we
are
only
going
to
be
doing
the
activity
with
you
as
a
provider
in
person
that
is
essential.
Everything
else
that
can
be
gathered
without
being
there
in
person
would
be
the
way
that
we
would
look
to
do
it
going
forward
and,
let's
move
on
steph.
A
A
We
need
to
go
across
the
threshold
when,
when
the
risk
requires
that
us
to
do
so,
but
in
the
near
future
we
will
not
be
looking
at
a
return
to
the
previous
rating
being
the
driver
for
when
we
cross
the
threshold.
We
want
to
our
aspiration
and
our
strategy
is
very
much
about
how
how
does
an
always-on
view
of
what's
happening
in
a
service
help
us
constantly
re-prioritize
when
we
need
to
be
going
out
and
looking
at
a
service
in
person
and
the
final
slide.
A
I
think-
and
I
I
know
the
question
of
ratings
has
cropped
up.
I've
certainly
heard
from
a
number
of
trade
associations
and
providers
questions
about
rating.
I
think
there
is
a
an
absolute
acknowledgement
that
our
collective
focus
needs
to
be
on
risk
and
managing
risk
at
the
moment.
But
I
know
that
for
some
parts
of
the
country
there
are
some
providers
who
are
sitting
there
as
it
requires
improvement,
absolutely
confident
that
they're
delivering
good
care.
A
And
if
we
came
back
out
again,
that's
what
we'd
see
in
parts
of
the
country
where
maybe
commissioners
don't
commission
services
from
requires
improvement
providers
and
therefore
that
has
an
impact
on
the
capacity
in
the
area.
And
you
could
argue,
impacts
on
things
like
people
being
supported
to
leave
hospital
in
a
timely
way.
A
So
we
are,
we
are
thinking
about
where
we
might
be
able
to
go
out
and
do
some
re-ratings
in
those
sorts
of
instances
where
it
might
by
a
re-rating
where
it
might
lead
to
an
increase
in
capacity
in
the
system,
but
also
when
we
go
out
and
do
a
focus
and
targeted
inspection.
When
we
have
the
need
to
look
across
the
the
key
lines
of
inquiry.
That
would
that
that
could
lead
to
a
change
of
rating.
A
But
that's
not
our
main
driver
at
the
moment
and
then
I
think
we're
on
to
question
time
now
steph.
So
I
absolutely
haven't
been
able
to
read
all
your
fabulous
comments
as
I've
been
talking,
I
can
see
that
there's
lots
going
on
quite
a
lot.
Anonymous
it'd
be
fab
if
you
wanted
to
put
who
you
were
as
well
just
so
first
glance
it
gives
you
gives
us
a
glimmer
of
who's,
asking
the
questions.
How
do
we?
How
do
I
say
so?
We've
got
some
questions
for
you.
A
C
Thank
you.
Thank
you.
I
couldn't
tell
yes,
there's
been
lots
of
questions,
so
there
have
been
some
questions
around
the
ipc
inspection,
some
detail
about
that
which
I'm
in
the
process
of
answering.
So
one
of
the
recent
questions
was
whether
they're
announced
or
not,
and
if
they're
risk-based
they'll
be
announced
from
the
car
park.
So
quite
a
quite
a
short
notice
announcement.
If
not
risk-based,
then
there'll
be
a
bit
more
notice.
C
There
have
been
some
positive
in
the
majority
sort
of
positive
reflections
about
how
relationships
with
inspectors
have
improved,
but
that
hasn't
been
universal
experience
and
there
are
some
colleagues
on
from
primary
medical
care
who
didn't
who
didn't
have
the
same
positive
experience
in
the
early
days
of
esf
lots
of
questions
about
the
future.
So
some
responses,
I've,
given
her,
have
been
about
waiting
for
the
the
strategy
information,
that's
coming,
but
definitely
the
messages
we
are
learning
from
esf
and
yes,
we
want.
C
A
A
The
only
other
thing
I
didn't
mention
that
might
be
of
relevance,
but
mainly
to
care
home
providers
is
you'll,
be
aware,
probably
about
an
active
discussion
going
on
at
the
moment,
as
the
government
talks
to
local
government
about
implementing
designation
areas
for
people
who
have
a
cover,
positive
test
result
who
are
being
discharged
from
hospital.
So
we
are.
A
We
are
here
and
involved
with
that
work
and
our
role
is
when
local
authorities,
in
partnership
with
their
other
system
leaders,
identify
where
a
designated
space
might
be.
We
will
go
out
in
response
to
that
and
undertake
an
ipc
inspection
which
would
be
our
normal
methodology,
but
there'll
be
an
increased
focus
on
the
ability
for
that
provider
or
that
service
to
zone
and
cohort
those
people
that
would
be
coming
in
with
a
known
coded
status.
So
just
to
let
you
know
we're
involved
with
that
piece
of
work.
A
That's
those
places
are
being
identified
as
we
speak
and
local
authorities
are
getting
in
touch
with
us
as
well.
One
just
one
comment
I
saw,
which
I
know
is
a
bit
of
a
hot
topic-
I'm
just
going
to
cover
off
and
then
we'll
move
on
with
the
slide
testing
of
inspectors.
I
I
I
hear
from
my
inspectors
and
I
hear
from
you
these
questions,
often
about
inspectors
getting
tested.
So
a
couple
of
things
one.
A
We
have
asked
the
department
of
health
and
social
care
for
this
to
happen,
and
their
view
is
that
our
inspectors,
along
with
other
visiting
health
and
social
care
professionals,
don't
meet
the
criteria
for
getting
tested
because
we're
not
delivering
hands-on
care,
but
the
department's
keeping
that
under
review
and
then.
Secondly,
I
just
want
to
reassure
you
all
the
robust
way
that
we
go
about
supporting
our
inspectors.
So
they've
all
had
training
around
affection
prevention
and
control.
They've
all
got
the
right
kit.
They
undertake
individual
risk
assessments
for
inspections
that
they're
undertaking.
A
Okay,
shall
we
move
on
steph
with
the
next
slide,
so
I'm
going
to
talk
a
bit
about
strategy,
so
all
of
that,
that's
all
the
busy
activity
we've
been
collectively
doing
to
transform
during
covid.
How
does
that
now
translate
to
the
type
of
regulator
we
we
want
to
be
in?
I
I
would
suggest
and
happy
to
hear
what
you
think
in
terms
of
how
aligned
it
is.
It
certainly
feels
for
me,
like
we
are
motoring
in
the
direction
that
feels
in
keeping
with
our
ambition
about
what
we
want
to
do.
A
But
let
me
walk
you
through.
We've
got
kind
of
four
pillars
of
our
strategy
that
we're
having
a
conversation
about
this
autumn,
and
I'm
just
going
to
give
you
the
headlines
of
each
of
these
and
would
love
to
hear
your
thoughts.
So
if
we
go
to
the
next
slide,
okay,
so
we
can
talk
about
the
first
pillar,
which
is
people,
and
those
of
you
who
may
know
me
will
know
that
I'm
a
really
big
fan
of
think
local
act,
personals,
making
it
real.
A
I
statements
and
the
eye
statements
have
been
compiled
with
a
large
number
of
voices
of
people
who
experience
using
services
and
they
talk
about
people's
expectations
about
what
services
should
look
like.
So
I
think
the
I
statements
are
a
fantastic
source
of
you
know
whenever
you
need
somewhere
to
go.
I
think
a
starting
point
of
the
I
statements
is
critical
and
what
we
want
to
do
as
a
regulator
is
we
want
to.
We
want
to
regulate
services
through
the
lens
of
people
who
receive
them.
A
So
we
know
that
the
outcomes
people
get
from
health
and
social
care
are
significantly
impacted
by
their
ability
to
access
them
in
a
timely
way,
but
also
for
the
ability
for
those
health
and
social
care
services
to
join
up
in
a
kind
of
holistic
way
around
the
person.
So
so
our
ambition
is
to
regulate
in
the
way
that
matters
to
people
and
from
their
their
perspectives
looking
at
access
and
how
they
move
between
services.
A
We
want
the
information
we
make
available
to
empower
people
to
make
decisions
about
their
care,
but
also
more
than
maybe
we've
done
before.
So
we
have
our
ability
to
publish
reports
called
our
independent
voice,
so
we
publish
state
of
care
on
friday
and
we
published
it
annually
and
that's
our
annual
report
about
the
state
of
health
and
social
care
in
the
country.
A
But
we
think
in
our
new
strategy
we
should
have
a
greater
role
in
calling
out
inequalities.
So
in
our
state
of
care
report
this
year
we
talked
about
how
covid
has
just
magnified
those
inequalities
that
existed
prior
to
the
pandemic
and
things
such
as
different
people's
experiences
of
accessing
care.
Things
such
as
the
fantastic
digital
transformation
that
has
happened
across
health
and
social
care,
yeah,
that's
great
for
a
lot
of
people,
but
actually
for
some
groups
of
people
that
that
won't
work
for
them.
A
So
we
think
we've
got
a
role
about
calling
out
inequalities
and
shining
a
spotlight
where
that
needs
to
be
addressed.
So
that's
a
bit
about
people.
Let's
move
on
steph
to
smart,
so
we
want
to
be.
We
want
to
be
a
really
proportionate
regulator
and
we
want
to
every
time
I
say
this
expression.
It
makes
me
kind
of
cringe,
but
I
can't
think
of
a
better
way
of
saying
it.
A
A
A
So
this
is
about
being
flexible,
smart
and
proportionate
in
how
we
regulate
services
and,
let's
move
on
to
safe,
so
safety
across
health
and
social
care
is
often
the
poorest
area
of
performance
and
ted.
My
colleague
in
hospitals
will
say
that
there
hasn't
been
a
significant
shift
on
the
safety
area
for
at
least
20
years
in
in
from
a
health
perspective.
A
So
we
want
to
see
we
want
to
see
things
significantly
shift
on
the
safety
front.
We
want
to
see
a
stronger
focus
on
safety
culture
in
adult
central
care.
It's
a
figure,
that's
stuck
in
my
head
from
a
little
while
ago,
but
I
I
think
it
shows
this.
It
gives
this
example
quite
well,
so
in
in
health
services,
there
are
approximately
237
million
medication
errors
reported
a
year,
so
237
million
in
social
care
land
when
prior
to
covered.
A
When
you
used
to
complete
your
provider,
information
returns,
50
of
those
provided
information
returns.
Ish
shows
that
there
was
no
medication
errors
that
happened
now.
That
gets
me
thinking
about.
Are
we
consistent
in
spotting
when
an
error
has
happened,
recognizing
it
recording
it
and
then
squeezing
all
the
learning
we
need
out
from
it,
so
that
it
doesn't
happen
again?
A
So
so
this
strand
is
about
how
we,
as
a
regulator,
can
really
really
move
the
dial
on
safety
and
then
my
contribution
when
we
were
having
these
discussions
about
this
component
as
well,
is,
I
feel,
like
safety,
can
sometimes
feel
a
bit
paternalistic
and
in
social
care.
I
think
we're
all
about
equality
and
working
on
an
equal
footing
with
people
who
receive
services.
A
So
that's
a
bit
about
safety
and
then,
if
we
move
on
to
the
last
one
which
is
about
improve
so
when
we
think
about
improvement
and
we
think
about
the
improvement
offer
across
health
and
social
care,
it
is
very
mixed
and
I
think
that
adult
social
care
has
the
least
on
offer
when
it
comes
to
improvement
depending
on
the
type
of
organization
you
sit
in
and
the
part
of
the
country
you're
in.
So
if
you're
part
of
a
large
organization,
you
may
have
your
own
audit
and
quality
team.
A
A
I
don't
think
there's
a
consistent
offer
for
social
care
providers
when
it
comes
to
improvement,
and
I
think
we
need
to
change
that
because
I
think
everyone,
everyone
accessing
social
care
deserves
to
get
good
and
outstanding
care,
and
I
don't
think
our
job
as
a
regulator
is
to
just
sit
back
and
comment
on
the
fact
that
a
number
of
people
are
receiving
care.
That
is
less
than
good.
I
think
we
should
have
a
more
proactive
role
in
helping
that
be
addressed.
A
So
this
is
a
perfect
example
of
the
strategy
where
our
thoughts
are
not
fully
formed
yet,
and
we
really
want
to
know
what
you
think
this
could
look
like.
So
if
I
just
give
you
my
thinking
on
it
and
then
we'd
love
to
hear
your
thoughts,
so
I
think
some
inspectors
have
a
kind
of
supportive
before
covid.
I
think
there's
a
lot
more
since
covid,
but
before
code
I
think
some
inspectors
have
that
sitting
alongside
a
provider
kind
of
vibe.
You
know
we're
in
this
together.
Show
me
what
you're
doing
well.
A
There's
there's
a
different
way
of
needing
to
work,
but
for
most
providers
most
providers
are
eager
to
do
the
best.
You
know
deliver
the
best
quality
care
for
the
people
they
support,
so
I'm
interested
in
what
it
might
look
like
if
inspectors
had
more
of
a
coaching
style,
I'm
interested
in
what
it
might
look
like
if
ctc
were
the
convener
of
the
improvement
offer.
A
A
My
ambition
is
that
there
is
a
consistent
improvement
offer
to
every
social
care
provider
in
the
country,
but
I
know
that's
quite
a
big
ambition
and
you
might
think
that's
not
our
role,
so
I
would
love
to
hear
your
thoughts
in
the
chat
or
when
you
formally,
when
you
give
us
feedback
on
our
strategy,
engagement
document,
to
say
what
would
be
of
most
value
to
you
when
it
comes
to
improvement,
is
there
a
gap?
Is
it
the
regulator's
job?
Do
you
think
it's
a
blur
blowing
the
line?
A
If
I
say
my
inspector
should
be,
I
should
have
a
coaching
style.
Would
it
be
welcomed?
I
just
would
really
love
to
hear
what
you
think
about
those
ideas,
because
this
out
of
all
the
pillars
of
the
strategy,
this
is
the
one
that
I
think
is
most
up
for
kind
of
debate
and
negotiation,
because
I
don't
think
there
is
a
consensus
about
what
this
should
look
like
bob.
A
We've
got
our
home
care
pilot
and
we're
currently
engaging
on
this
strategy
now
so
get
involved.
Give
us
your
thoughts,
we'll
formally
consult
on
it
and
in
january,
but
now
is
now,
is
a
really
good
window
to
also
let
us
know
what
you
think
is
missing,
or
are
we
heading
in
the
right
direction
to
give
you
the
support?
You
need
to
do
the
the
great
job
you're
out
there
they're
doing
so.
That's
next
and
then
the
next
side
of
the
future.
A
So
we'll
have
our
consultation
and
then,
where
we'll
publish
our
strategy
and
this
new
strategy
will
go,
live
in
may
2021
and
and
get
involved
and
we've
got
our
online
platform.
We've
got
many
ways
for
you
to
hopefully
engage
and
talk
to
us
on
it.
So
so
please
please
get
involved
and
then
the
final
slide
steph
okay,
so
I'm
gonna
have
a
sip
of
water
and
I'm
gonna
throw
the
red
box
back
over
to
mary.
C
It
would
help
if
I
took
myself
off
mute,
wouldn't
it
apologies
people,
so
a
range
of
topics
coming
through
in
the
questions,
108
questions
so
far,
there's
a
sense
that
dom
care
are
feeling
forgotten
about
that.
Our
focus
is
very
much
at
the
moment
on
residential
care
and
a
sense
of
does
the
guidance
that
we're
giving
for
residential
settings.
How
does
that
fit
with
dom
care
so
that
there's
a
quite
a
swell
of
questions
and
views
around
don
care?
There's
some
questions
about
ratings?
C
Some
enthusiasm
for
the
idea
of
an
inspector
who's
also
a
coach,
but
also
some
questions.
I
think
that
go
to
sometimes
a
feeling
about
trust
or
not.
So
there
was
a
question
which
I've
answered
about
whether
providers
would
be
secretly
penalized
if
they
said
no
to
accepting
somebody
in
their
service.
I've
answered
no,
that
we
support
providers
to
make
decisions
about
admissions
to
their
service
and
there
will
be
no
punishment
from
us,
secret
or
otherwise.
A
Yeah
great
okay
fab.
Thank
you,
mary.
Thank
you
for
your
comments,
we'll
busily
digest
all
of
them
really
great
challenge
about
home
care
and
our
focus,
and
I
think
I
think
that
will
be
a
specific
action
and
jen
who's
on
the
call,
I
think,
will
take
a
specific
action
away
about
infection,
prevention,
control
and
home
care.
Much
of
the
guidance
and
the
tool,
I
think,
would
be
relevant
for
home
care,
but
I
think
that's
a
really
helpful,
healthy
challenge
to
say
actually
that's
available
for
care
homes.
You
could
argue
you
know.
A
Our
focus
has
been
on
camps
during
this
pandemic
for
for
this
ipc
because
of
the
risk
about
large
numbers
of
people
living
together
in
a
communal
space.
But
yes,
if
I
can,
if
I
can
agree
to
take
away
that
as
a
specific
action
and
we'll
probably
look
at,
maybe
issuing
something
in
one
of
my
blogs
jen
on
that
with
regard
to
keep
the
ratings.
What
do
you
think?
I
think
I
I
think
what
I've
heard
is
that
ratings
are
really
important
and
it's
a
kind
of
currency
that
the
public
understands
now.
A
What
would
it
look
like
if
ratings
were
decoupled
from
the
act
of
inspection,
and
you
know
what,
if
you
know,
the
intelligence
that
came
in
what
if
there
were
a
number
of
virtual
calls,
what
if
there
were
conversations
with
stakeholders
and
focus
groups
that
were
held,
but
are
there
other
ways
that
that
the
regulator
could
be
given
enough
assurance
that
a
rating
could
change
without
a
physical
inspection?
Is
a
is
a
question?
A
I
think
it
might
be
worth
being
interested
in
exploring
how
much
can
we,
as
the
regulator,
rely
on
other
people's
judgments
on
bits
of
bit?
So,
for
example,
there
are
some
really
fantastically
resourced
and
you
know
fantastic
quality
monitoring
teams
out
there
that
sit
in
local
authorities
and
ccgs.
Now
how?
How
should
some
of
that
play
into
the
way
that
we
judge
a
service?
A
I
don't
know,
but
I
think
that
I
think
I
would
suggest
that
the
ratings
outstanding
good
requires
improvement
and
inadequate
are
probably
a
currency
that
is
worth
retaining,
because
it
makes
so
much
that
you
know
the
public.
It
makes
sense
to
the
public,
but
as
to
how
our
rating
is
changed,
I
think
it
could
be
interesting
to
explore
what
that
might
look
like
and
yeah.
Your
point
of
the
point
about
requires
improvements,
working
really
hard
to
improve
and
just
their
frustration
about
inspections.
A
As
I
said
we
need
to.
We
absolutely
need
to
prioritize
our
efforts
on
where
the
greatest
risk
is.
If
you
happen
to
be
an
ri
service,
that
is,
you
know
really
confident
that
you
get
good
on
a
re-rating
and
you
happen
to
be
in
a
part
of
the
country
where
there
are
capacity
issues
you
might
want
to
have
a
conversation
with
us
about
about
that.
But,
as
I
say,
the
priority
will
always
be
going
out
at
the
moment
is
going
out
to
those
those
most
at-risk
services.
A
B
Wanted
to
highlight
some
very
helpfully
and
highlighted
about
home
care
there,
but
just
to
say
that
we
do
have
some
providers
on
the
call
from
shared
lives
and
supported
living
as
well.
Who've
also
highlighted
that
the
ipc
work
and
that
guidance
would
be
useful
for
those
groups
as
well,
and
so
I
just
wanted
to
pick
that
out
of
the
chat.
There's
one
particular
comment:
that's
got
a
few
likes
there.
How
will
share
live
services
be
inspected
as
we
do
not
fall
neatly
under
the
current
guidance,
yeah?
B
Okay
as
well
yeah,
and
just
one
around
the
ipc
that
I
just
wanted
to
pick
up,
because
it
seemed
that
there's
a
bit
of
anxiety
there
and
we
appreciate
your
support
providers,
do
not
accept
residents
with
a
covert
positive
test.
Does
this
mean
providers
will
secretly
be
penalized
for
not
accepting
covert
positive
because
we
are
not
deemed
to
be
following
safe
ipc
measures.
A
So
I
I'm
I'm
hoping
that
that
of
what
I've
said,
will
support
providers,
I'm
hoping
that
you
know
I.
I
can
only
imagine
the
pressure
that
providers
have
come
under
in
the
last
eight
months
and
I'm
hoping
that
you
know
providers
are
regulated
by
us
and
we,
as
the
regulator
are
saying
we
back
you.
We
back
you
to
say
who
you
can
and
can't
take
you
know
it's
your.
A
It's
always
been
your
final
call,
but
there
has
been
such
pressure
and
there
probably
will
be
the
pressure's
probably
seriously
starting
to
notch
up
where,
where
you
are
as
well
around
the
country.
Obviously
we
all
want
to
work
together.
We
want
to
collaborate,
we
want
to
support
people
leaving
hospital
in
a
timely
way
or
coming
into
a
service
if
their
situation
is
breaking
down,
for
example
at
home.
A
But
you
know
it's
the
regulator
that
comes
in
and
and
judges
whether
what
you're
doing
is
is
safe,
and
I
just
want
you
to
know
you've
got
our
you've
got
our
backing
when
it
comes
to
you
know,
making
that
making
that
call
recognizing
all
the
other
pressures
that's
in
in
that
is
and
will
be
in
the
system
as
well.
For
you,
you
know
if
you
happen
to
be
a
caring
provider
with
a
couple
of
empty
beds.
A
You
know,
I
know
I
know
the
the
pressure
will
be
there,
but
we
have
to
keep
on
coming
back
to
yeah
your
ability
to
keep
people
safe
with
the
with
the
people
that
you
take
into
your
care.
As
I
say,
it's
always
been
the
way,
but
I
I
just
I
felt
it
might
have
been
yeah
the
right
time
to
just
make
that
restate
that
really
clearly
as
well
anything
else
jen.
A
B
A
A
I'd
love
you
to
say
that
I'm
saying
it,
but
it
would
be
far
more
powerful
if
a
host
of
our
providers
came
back,
saying
yeah,
nice
idea
about
strategy,
but
wouldn't
it
make
sense
if
it
was
judged
against
kind
of
quality
matters
and
making
it
realize
statements.
So
I'm
a
I'm
a
massive
advocate
as
well,
but
yeah
tell
us
that
if
that's
what
you
think
that
would
be
that'd
be
great
anything
else.
Jen!
A
A
And
just
so
many
so
many
really
helpful
comments,
so
I'm
gonna,
I'm
gonna,
start
to
draw
this
to
a
close,
as
I
say,
if
possible,
so
you
may
or
may
not
have
seen
our
state
of
care
publication
on
friday
kind
of
three
headline
messages.
If
I
may
one
is
that
there
are
now
84
85
of
social
care
providers
are
good
or
outstanding,
which
is
remarkable
because
of
the
two
big
challenges
we've
got
in
the
sector.
A
That
was
just
absolutely
magnified
by
by
the
pandemic,
and
they
are
that
we
need
a
long
set
long-term,
sustainable
funding
solution
for
social
care.
It's
great
having
all
this
short-term
investment,
but
it
doesn't
enable
commissioners
and
providers
to
do
that
long-term
planning
about
what
their
service
should
look
like
in
five
10
15
years
time,
and
then
the
third
message.
So
it's
remarkable
that
good
and
outstanding
providers
are
continuing
to
increase
up
to
85.
A
We
need
long-term,
sustainable
funding
and
we
need
a
new
deal
for
the
social
care
workforce.
So
I've
been
saying
a
lot
over
the
last
couple
of
weeks.
Never
before
we
talked
about
social
care
as
much
as
we're
talking
about
it.
Now,
the
first
10
weeks
of
the
pandemic,
everyone
stood
on
their
doorsteps
and
clapped
for
care
workers
that
now
needs
to
translate
to
the
right
terms,
conditions,
career
progression,
value
training
that
we
need
to
enable
this
this
profession
to
be
recognized
for
what
it
is,
which
is,
you
know,
good
social
care.
A
We've
got
provider
bulletins
that
we
will
get
some
messaging
out
to
you
all
about
home
care,
shared
lives
and
ipc,
and
then
you
know,
we've
got
our
twitter
account
and
I'm
also
on
twitter
as
well.
If
you
want
to
follow
us-
and
I
think
that
is
it
we're
doing
a
few
of
these,
so
we
would
really
value.
This
is
the
first
survivor,
maybe
about
10,
of
these
across
the
the
health
and
social
care
across
the
different
sectors,
really
love
to
hear
your
thoughts
about.
A
Did
this
work,
was
it
the
right
pace?
How
did
you
find
the
ability
to
put
comments
in
and
get
a
response,
etc?
So,
please,
let
us
know
in
the
chat
whether
this
was
a
good
use
of
an
hour's
hour
of
your
time
and
from
our
perspective,
can
I
just
say
a
massive
thank
you
for
joining
us
and
thank
you
for
all
your
your
contributions
and
your
your
comments.
We
will
take
them
away
and
digest
them
to
see.
A
A
Everything
is
gearing
back
up
again
and
we're
you
know
feeling
like
we're
in
the
throes
of
it
all
over
again,
admittedly,
a
whole
lot
more
prepared
than
we
were
collectively
the
first
time
around,
but
just
a
massive
thank
you
to
you
and
all
your
teams
for
the
work
you
do
every
day
and
take
care
of
yourself.
Thank
you
all
cheerio.