Britain’s first Chief Inspector of Adult Social Care is preparing to recruit an army of ordinary people with personal experience of the care system to help conduct inspections.
Speaking exclusively to The Independent, Andrea Sutcliffe says these new “experts by experience” – including relatives of people in homes – would take a central role in her radical overhaul of the regulation of care homes and other services.
On Tuesday the Care Quality Commission (CQC) will announce a package of intended changes to the way the watchdog keeps care providers under scrutiny. Homes will be given a ranking from poor to excellent which will be easily accessible for the public online.
Ms Sutcliffe, who started in her job last week, is one of three chief inspectors appointed by the CQC as part of a new regime at the watchdog. The other two have responsibility for hospitals and general practice.
One of her first moves will be to make sure her inspectors only work in adult social care.
“We’ve got experienced inspectors but what they’ve been doing is working to a generic model, so they might be going into a hospital and looking at an intensive-care unit and then going into a domiciliary-care service the next,” she says. “What I want to make sure is that we’re identifying those people within our inspection team who actually have the skills and experience and the understanding of adult social care that means they’re our experts and they can make a professional judgement.”
Alongside these inspectors will be members of the public, whom Ms Sutcliffe hopes will help get to the truth about the quality of care.
She says: “These are people who’ve had an experience of care, either because they might be a mental-health service user themselves, or they might have cared for someone who’s been in a residential home with dementia.”
These “experts by experience” would be trained and paid for their time and expenses. She believes there will be no shortage of volunteers: “We know that an awful lot of those folk are keen to share their experience and share their insight and we know also that when they are involved in inspections they give us a tremendous way of finding out from people who are currently using the service – and the staff – what it’s like, because they’re having a very empathetic conversation.”
As well as the CQC inspector and a member of the public, some inspections will have a third expert with specific knowledge. Ms Sutcliffe says these “specialist advisers” would go into places such as a hospices, where particular experience was needed.
She says: “If the information was suggesting that we had a particular problem, such as with medication, then we’d suggest that a pharmacist go along. It’s about us having greater insight into how we conduct the inspection so that the time we spend doing it is much more focused.”
Care providers will be given rankings, and rated according to how caring, effective, responsive, safe and well-led they are. Those which are failing may be inspected more frequently.
The 49-year-old’s previous job as head of the Social Care Institute for Excellence was focused on finding examples of the very best care, but in her latest role, she will witness some of the worst. Over the summer the CQC’s reputation could scarcely have been lower. After its failure to publish the names of those involved in a cover-up of a bungled investigation into deaths at Furness General Hospital in Cumbria, its own chairman, David Prior, admitted the organisation had not been “fit for purpose”.
Ms Sutcliffe says: “The organisation has been taking a long, hard look at itself and there’s been a lot we can draw from that. We have got to improve and I think there’s a real spirit here about wanting to improve.”
She says she wants to take stronger enforcement action when care organisations fail to comply, saying this was an area the CQC had “fallen down” on in the past.
“For example, with registered managers, which is a basic requirement of registration – registered homes should have one. As of June 2013 we had nearly 4,000 homes that didn’t have one and about a quarter of those hadn’t had one for more than two years.
“What’s interesting is there is a greater correlation between homes that don’t have a registered manager with rates of non-compliance. So we know how important it is and we have the ability to issue fixed-penalty notices.”
On Twitter, she describes herself as “passionate about making a difference”, as well as about Sunderland Football Club, the Tour de France and – judging from the photographs she posts – cats.
For a public figure, she is disarmingly open on the site, something she says she is unconcerned about.
“I do think I’m a human being too,” she says, “and I don’t want to be setting myself up in an ivory tower that says I’m the font of all wisdom on adult social care, because, frankly, I’m not.”
Humanity – how human beings experience care homes – is central to how she wants her inspectors to work.
“It’s about people’s whole lives, so we do need to be making it human, making it personal,” she says. “I think of it in my head as ‘the mum test’. Is this good enough for my mum? Or any relevant member of my family? And if it is, that’s fantastic, but if it’s not then it’s not good enough for anybody’s mum and we need to do something about it.”
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