CQC Board Meeting 23rd March 2022 - Wednesday, 23rd March 2022 at 11:00am - Care Quality Commission

CQC Board Meeting 23rd March 2022
Wednesday, 23rd March 2022 at 11:00am 

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Start of webcast
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  1. Mr Peter Wyman
Apologies and Declaration of Interests
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  1. Mr Peter Wyman
Minutes of the Public Meeting held on 23 February 2022
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Matters Arising and Action Log
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Executive Team’s Report
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  1. Mr Ian Trenholm
  2. Ms. Kate Terroni
  3. Sir Robert Francis QC
  4. Ms. Kate Terroni
  5. Mr Peter Wyman
  6. Ms. Kate Terroni
  7. Mr Peter Wyman
  8. Ms. Kate Terroni
  9. Mr Peter Wyman
  10. Mr Mark Chambers
  11. Ms. Kate Terroni
  12. Chris Day
  13. Ms. Kate Terroni
  14. Mr Peter Wyman
  15. Mr Peter Wyman
  16. Ms. Rosie Benneyworth
  17. Mr Peter Wyman
  18. Mr Peter Wyman
  19. Mr Peter Wyman
  20. Chris Usher
  21. Mr Peter Wyman
  22. Chris Usher
  23. Mr Peter Wyman
  24. Sir Robert Francis QC
  25. Ms. Kate Terroni
  26. Mr Peter Wyman
  27. Mr Mark Sutton
  28. Mr Peter Wyman
  29. Chris Day
  30. Mr Peter Wyman
  31. Ms. Kirsty Shaw
CQC (Care Quality Commission) Business Plan 2020-23 Refresh
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  1. Mr Peter Wyman
  2. Mr Mark Chambers
  3. Mr Peter Wyman
  4. Mr Peter Wyman
Workforce Disability Equality Standard & Workforce Race Equality Standard Update
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  1. Mr Peter Wyman
  2. Chris Day
  3. Mr Peter Wyman
  4. Mr Peter Wyman
  5. Mr Mark Sutton
  6. Mr Stephen Marston
  7. Mr Mark Saxton
  8. Mr Ian Trenholm
  9. Mr Peter Wyman
  10. Mr Mark Chambers
  11. Mr Peter Wyman
  12. Sir Robert Francis QC
  13. Mr Peter Wyman
  14. Mr Ian Trenholm
  15. Mr Mark Chambers
Any other business
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  1. Mr Peter Wyman
  2. Mr Mark Chambers
  3. Mr Peter Wyman
  4. Mr Mark Chambers
  5. Mr Peter Wyman
  6. Sir Robert Francis QC
  7. Mr Peter Wyman
  8. Sir Robert Francis QC
  9. Mr Peter Wyman
  10. Mr Peter Wyman
  11. Mr Peter Wyman
  12. Ms. Kate Terroni
  13. Mr Peter Wyman
  14. Mr Peter Wyman
  15. Webcast Finished

Apologies and Declaration of Interests

Mr Peter Wyman - 0:00:38
OK, let’s get started if we can, please. Sorry, we are a couple of minutes late, but welcome to the March Board meeting for the CQC. We don’t have any apologies for absence, but we do have a couple of colleagues joining us on the screen.
They are very welcome. I also would welcome Becca Appleby-Dean from our LGBT+ Network. You are extremely welcome and do feel free to raise your hand, shout at me or whatever if you if you want to come in. I want to just advise both the
Mr Peter Wyman - 0:01:22
Board and anybody who is watching this that we are going to be supporting the national day of reflection, as we have done previously, so that means we will have a one-minute silence at midday. If obviously anybody is watching this other than in real time,
it will look a bit odd, but that is what we will be doing at midday, just to explain. I don’t think there any other introductory comments that I need to make, in which case can I just ask the Board if there are any declarations

Minutes of the Public Meeting held on 23 February 2022

of interest anybody needs to make? That’s OK. That takes us to the minutes of the 23rd February meeting, are they a true and accurate record of all we discussed? Very good, those are approved. There is one item on the action log, but that is…

Matters Arising and Action Log

it is due today, I was going to say that it is not due until next month, but it is due today. So we will come onto that later, Chris, I imagine. Then, I think unless there is anything else arising, we can go straight into

Executive Team’s Report

the Executive Team Report. Ian. Thanks very much Peter and good morning everybody. I want to say…, a few things I just wanted to bring to the Board’s attention. The first thing is a couple of confirmation
Mr Ian Trenholm - 0:02:50
of two appointments. As you know, we have been
talking about a new Chair and a new Chief Inspector of Hospitals over the last couple of meetings. I am pleased to formally confirm now that Ian Dilks is our new Chair and Ian will be joining us from the 1st of April when Peter’s term
expires. Also, I can also confirm formally that Dr Sean O’Kelly will be our new Chief Inspector of Hospitals. Sean, we hope will be with us towards the end of June. We hope his first Board meeting will be the June board meeting, and in the
meantime I will of course work with Rosie - Dr. Rosie Benneyworth is our senior medic on the Board, as well as the Deputy Chief Inspector - colleagues, to cover the Chief Inspector position in the interim position, but we look forward to welcoming Sean, as
I say, at the end of June. I just want again, just update the Board on the publication of our equality objectives. We published those, as you recall, back in July 2021 - the paper says 22 it should read 2021. We have done a 6-month
update. I think we have made good progress across all of our equality objectives and they are of course on our website in more details. Just a couple of comments on recent engagement. I have met Sir Gordon Messenger and Dame Linda Pollard who are carrying
out a review of leadership within Health and Social Care. I know a number of other senior colleagues have had a number of very detailed conversations with Sir Gordon and Linda and of course the other members of their team. I think what we are trying
to do is move to a position where we can blend the recommendations that the Messenger review will be making into our methodology to make sure that those things are complementary. As we have talked about in the past with the Board, we are in the
process of creating a single assessment framework and we will be launching that later on in this calendar year. If we possibly can, we would like to blend the Messenger review recommendations into that framework as it evolves. I also just want to flag that we
have… Rosie Benneyworth and I have had a number of visits with ICS system leaders. I think they have been very productive conversations. I think we have talked a lot and I think a lot of partners have talked a lot about the importance of integrated
care systems and the opportunity that they add to add real value to individual places right across health and social care. I think we have had some positive conversations, but I think that the point really here is just to re-emphasise the point that, as we
develop our new methodology, we want to do that as far as we can in partnership with those people who are going to be regulated. I would hope that by the time we get to going live with this methodology this time next year, we will
be in a position where those being regulated will have had a good opportunity to contribute, will have got a really good sense of some of the real challenges that are out there. And our regulation will be both proportionate and effective and make a real
difference to support the standing up of these new and important constructs within the health and social care landscape. So, Peter that is all I had for now and I am happy to hand over to Kate, unless we have got colleagues with questions. Thank you.
No, OK, Kate. Lovely. Good morning all. I am going to start by talking
Ms. Kate Terroni - 0:06:28
about visiting, a regular conversation we have had at Board and a significant area of focus for our inspectors when they go out and inspect our care homes in particular. So since we wrote this
paper, the government has updated their guidance on visiting - the most up-to-date publication was released yesterday. In that it reminds the sector that there are no government directives about visiting, bar it should be happening, and it should be happening in a safe way. So
it talks about good Infection Prevention control, etc. The guidance continues to talk about instances where visiting may look different which is where care homes are in outbreak, so that is circumstances where two or more people have COVID. And in those circumstances, the government guidance
continues to be really clear, that even in an outbreak when people are receiving end-of-life care, they should have access to see their loved ones. And even in outbreak, at all residents should have access to their essential caregivers. So as we have talked about at
this Board, it is a key area of focus on all our inspections. What I would say is inspections we have done looking at this area since December in particular, so we have done 2024 care home inspections where we have looked at Infection Prevention Control
and visiting. In 97% of cases we were assured of visiting and in 3% we needed to do a little bit more work to get that assurance. We continue to respond to concerns raised with us by people who receive care, their families, where visiting is
not happening along with government guidance and in every instance we are taking action. So, just to give a number to bring that to life for Board. We have had 226 concerns about visiting since 1st December, of which 98 were concerns about blanket bans. Every
one of those 226 have been looked at, 61 inspections have happened or are in train and in 19 instances we have taken a degree of regulatory action, and in 1 of those 19 instances the providers’ approach to visiting has formed part of our notice
of proposal to close the service. So this is an issue we take very seriously because we recognise the impact it has on residents’ wellbeing and their family wellbeing. So I just wanted to update Board on our actions around visiting, is that OK? Sorry, do
you want me to pause and take a question there, Peter? Thank you. I’m
Sir Robert Francis QC - 0:08:59
glad to see that the government as it were has lifted things which, essentially, should mean that visiting goes back to the practices that were in existence before, no doubt with some
extra precautions because of COVID. About that I wanted to ask, the infection control measures obviously are expected to include protection around COVID which in many places, as I would understand it, involves wearing, sometimes wearing gloves, aprons, masks and so on. All of which are
the antithesis of the normal visiting many vulnerable elderly people would want or benefit from. And I just wonder whether you are aware of what, if any, is the evidence base behind the effect of some of these, which have now become quite habitual precautions, and
whether anyone is reviewing those? Because it does seem to me that if they are not actually necessary, there should be a greater degree of
Ms. Kate Terroni - 0:10:00
flexibility about them. So I would say that we are not the best experts in this, so we point providers in
the direction of government guidance and advice that they may get from their local health protection teams, local directors of public health etc. And it is obviously bespoke to each individual home, each different service, but the things that you would expect providers to do, things
such as good Infection Prevention Control, some providers are still asking families to book ahead of time so that they can manage the numbers of people coming in and out of the services. So I would suggest that the government produces a guide that is based
on scientific evidence is where our best place to answer that question. Our job is to hold providers to account for making sure that they are following the most up-to-date guidance, based on scientific evidence. So, OK. Thanks Kate. I mean we know this is as a
really important subject. Thanks to you and your team for all you have
Mr Peter Wyman - 0:11:00
been doing to make sure that people are able to access their loved ones as much as possible. So, thank you. OK. Two other bits from me.
Ms. Kate Terroni - 0:11:08
So, since we last met as
a Board, the end has come to vaccination as a condition of deployment for people who work in care homes. You will remember this was a new power, new requirement for us to judge against that came into force in November. The decision was made to
reverse that in light of the most up-to-date scientific evidence and we are no longer holding care home providers to account for this element. We are taking a case-by-case approach to cases where we had identified an issue prior to this condition no longer being in
place, and we will make individual decisions about what we do about those cases. But from 15th March going forward, we are no longer holding providers to account for this requirement. Then, the final thing for me is an ongoing focus we have been bringing to
Board on workforce and our focus is kind of twofold. One is what impact are the workforce challenges having on the quality of care and the continuity of care being received by people? And then the second is, what impact are workforce challenges having on the
stability of the social care market? So these are figures that you are familiar with, but this is just bringing you up to date with the most recent data. Which is that we continue to see a very high vacancy rate in care homes, however that
does appear to have stabilised over the last two months. So, I don’t think this is a cause for us to no longer be concerned, but it is positive that it is at least plateauing at still a very notably high rate. Turnover rates continue to
be high for colleagues working in this sector. You may recall we introduced exit interviews for social care providers leaving the market. So, quite early days into doing this, but what is coming out as one of the main drivers for social care providers exiting the
market is the recruitment and retention of workforce. So for those reasons we will continue to focus on workforce and the impact it has on quality and stability as a sector. Kate, I was with a care home
Mr Peter Wyman - 0:13:09
provider the other day and I was asking
about their turnover and whether people were leaving the sector altogether, or just moving between providers? And the answer - it was obviously just one provider - it was about half and half. Is that what you might think is a reasonable national situation? So I
Ms. Kate Terroni - 0:13:35
say, it has varied over time. So I think during the pandemic – I am thinking of last summer in particular - there appeared to be quite a flow out of the care sector full stop and into tourism, where we saw that real boom happening.
Often you just see a kind of churn of colleagues moving from provider to provider. So I am thinking about the Adult Social Care White Paper that was published before Christmas and the government’s ambitions about workforce and moving to a place where people, care workers
have much more passportable qualifications that means that they are not starting from scratch when they move between providers. There is a kind of nationally-recognised standard when it comes to training and qualifications that enables, as I say, quite a fluid workforce to move, but to
move with recognised kind of accreditations as well, rather than each time starting back at scratch. But it tends to flow, Peter, as to the percentage that leave versus the percentage that just rotate between providers. It just seems to me that it is something that
Mr Peter Wyman - 0:14:35
we should be watching quite carefully because there is a huge difference, as you’ve just said, between having to recruit people who come already with experience of working in the sector and recruiting people who previously were doing some completely different job and need much more
training. So when you come to the quality of care that people are receiving, I think there is quite a big difference between the two. So it will just be really interesting to try and watch where the trends are. Thank you. Mark. Thank you Chairman and Kate, thanks for the people data from
Adult Social Care. I mean these stats are really important to show the
Mr Mark Chambers - 0:15:16
pressure that the system is under. Equally important are the steps that the sector is taking to reduce turnover through learning, training, development, trying to reduce these pay squeeze at that level of
the market and how to attract people into the sector. Last meeting we were signposted to the Skills for Care Report and part of our strategy is to drive improvements. So should we and could we not promote innovation and success stories in this area to
encourage transfer of best practice? I wonder whether it’s fair to ask you that question, or whether I should have addressed it to Chris? But it seems to me that is an opportunity for us to help the sector. Thank you Mark. If I start and
then see if Chris wants to come in. So, if you cast your minds back -
Ms. Kate Terroni - 0:16:15
I think 2 Boards ago and 3 Boards ago - we had an annex to the Chief Execs Report which brought to life the workforce detail in Social Care. It
was a bit more fuller and it talked about things like events that stop a service. But also in that annex, we drew out some examples we had where providers had been successful around recruitment and retention. It had things such as, you know, refer a
friend and get a bonus, it had things such as, you know, financial bonuses for retention. We know that staff having access to training and being able to see a career progression, a career pathway, is kind of really key as well to retaining staff. So,
we have done it before. I anticipate it will feature in our State of Care Report, but that’s still a little while off now. But I absolutely take on board the challenge that says, as well as continuing to call out our concerns around recruitment and
retention, it would be great to match that with where providers are still - despite all these challenges - managing to be successful in in recruitment and retention. And we have done it somewhat, but we can certainly continue to think about how we do that.
Chris, do you want to come in? Yes, just to build on that, but Kate is absolutely right. We have done some work to look at how organisations
Chris Day - 0:17:26
are being inhibited in HR practices. There is a wider piece of work as well, which we began
last year, which was about enabling innovation in health and care which has a number of strands to it. One of which is a relationship between the use of technology and people and how both can complement each other in how services adapt and change. I
think a combination of highlighting innovation in the use of technology and people together, and also the innovation we have seen in terms of the people practices in organisations, I think can be supportive of innovation and change in system areas. Could I ask, is there
any new news on the government’s follow up to their White Paper that you mentioned from December? Because if I am remembering rightly, something like 500 million pounds promised for investment in the workforce. So alongside all the things we can do in terms of, sort
of, disseminating good things that providers themselves are doing, that investment in building the supply of the workforce is fairly critical. Is there kind of any new news on when that flows? There is ongoing work about taking the vision - I think we were all
Ms. Kate Terroni - 0:18:45
enthused by in the White Paper - and translating that into a kind of plan, with milestones that the sector can know what to expect by when, and we are really keen to see that as well. So, you know, we have talked about welcoming the
additional money and being very keen to see that rapidly flowing through to front line. We have really welcomed the focus on a care certificate that is passportable, as I mentioned earlier. You may recall there was a small reference in the White Paper to exploration
around what might it look like if the workforce was registered. Again, we really welcomed that but said we would want to see that explored with people who use services, the workforce, etc. So there is lots of work and a way, Stephen, that we are
plugged into. We are we are really keen that that can be shared so that people who work in the sector and people who receive care can know when they could start seeing the benefits of, as I say, a vision that I think we could
Mr Peter Wyman - 0:19:49
all get behind. Great Kate. Thank you very much indeed. Ted, you have been waiting patiently, over to you. Well, thank you Peter. This is my final report to the Board and I have to say I am really disappointed not to be there in person
to deliver it in person, so my apologies for that to colleagues. In this report I am going to highlight three areas that are actually pretty recurrent themes from our reports over the last five years. We are making progress, I think, in all these areas
but there is a long way to go. First of all I want to highlight the recurrent issues around the delays in the urgent and emergency care pathways across the whole country. They are continuing to cause serious concern for me, and for the clinicians who
are providing their services. We hear regular reports that delays are affecting the safety of patients, but also their ability to access timely and effective care when they need it. We have continued our programme of integrated inspections of urgent and emergency care pathways which we
have described to the Board before. We have published a report on the North-East London system at the beginning of this month. Last week we published a report on the urgent and emergency care system in Gloucestershire. We will be publishing further reports in due course,
over the next few months. While these inspections have shown much good practice, and it is important to emphasise we do see good practice in all systems. Both systems, both systems we reported on so far are still not fully integrating services, and patients are still
not able to access the care they need, without attending accident and emergency services. Both systems saw delays in discharging patients who were fit to leave hospital causing acute pressures at the front door of hospitals and in ambulance services. It is those delays at the
front door and in ambulance services that are causing us most concern. My colleagues will be holding a National Workshop in May to highlight these issues that have been emerging from our inspections, but also to work with services in identifying the action they can take
to keep people safe while they are working under these pressures. As we have said before, we need immediate action to keep people safe, but equally we need systems to look at the models of care, urgent and emergency care to produce pathways that can maintain
the flow of patients more effectively. But also make sure patients are getting care they need at the right time, in the right place rather than having to resort to going to the accident and emergency department where that is unnecessary and creates enormous pressure on
hospitals. I would just like to move on to maternity services. We are holding a National Workshop on maternity services for representatives from NHS Maternity Services to discuss the challenges they face. These are the challenges we have identified in our inspections of course, but also
I expect these to be made very clear in the report of the Ockenden Inquiry should be coming out next weeks’ time. There are real, there is a real consensus around the need for change in maternity services to drive forward safety. I think that consensus
is really important. We have been working hard with other national bodies, with stakeholders and with public groups to make sure that we have a real focus on safety going forward. The Round Table that we are planning later in the year will be an opportunity
to take forward some of the actions that are necessary to deliver on that commitment. I am really looking forward to seeing what comes out of that in terms of our ability to drive change. It does need concerted action by the services themselves, but also
(unintelligible) and national bodies, including the CQC, but other regulators and other national bodies as well to make sure we drive consistent improvements in maternity services going forward. Finally I would like to highlight the work that we have underway at the moment in our acute
hospital inspections to review the care of people with learning disabilities and autism in acute hospitals. We expect a report on that work later on in the summer. It is currently incorporated into our acute hospital inspection programme. Thank you Peter. That is all I wanted
to say at the moment. Thank you Ted. Anybody want to add anything or
Mr Peter Wyman - 0:24:14
ask anything? That’s great report though, thanks Ted. Rosie, over to you. Thank you very much and I just want to update the Board on two areas, one that is not in
Ms. Rosie Benneyworth - 0:24:22
the report, just to follow on from what Ian said about ICS work and regulation. Just to let the board know we have started our series of co-production events and we are very keen to co-produce our methodology with a very broad range of stakeholders. So
on Monday we held the first co-production event. We had over 100 stakeholders attend from a whole range of different organisations from ICSs, local authorities, CCGs, voluntary and community sector organisations and experts by experience, as well as the Department of Health and Social Care and
NHS England. We have got lots of rich data from that. We are continuing with further co-production events, both around the Local Authority Assurance and the ICS work and we will bring back some information regarding the themes from that work as we go along. The
second area I just want to talk about is the ongoing work we are doing around clinical searches in GP practice inspections. As we have talked about at the Board before, over the last couple of years we have been really developing our approach to try
and get a much better picture as a regulator of the outcomes for people who are using services, and particularly in general practice around the clinical outcomes. General practice uses clinical systems that enables us to get a really rich picture of the quality of care
by interrogating those systems. We have for the last couple of years been working on approaches where we have been running a set of searches within a clinical system to really look at things like: are people on high risk drugs being monitored effectively, are people
who are having blood tests diagnosing diabetes, are they being appropriately diagnosed with diabetes, are people getting the correct treatment for their needs. So we can get a lot of rich information from these searches. What we have been wanting to do is make those searches
open and transparent for practices because we think that that will drive the improvement, long before we ever go near a practice. We think if practices can see the types of things we are looking at, it will drive that improvement to happen without us without
as there. I am really pleased that we are going to be starting a pilot to look at actually how firstly this validation of our searches just to check we have looked at all of the areas we need to think about, which we think we
have but we want to just validate that. But secondly, the company that we are going to be working with will put those searches, enable those to be visible for all people to import into their clinical systems. So that actually, practices can look at those
areas and find out how they are doing in those areas, so driving that improvement. So that’s my update. Thank you Peter. I think that is a
Mr Peter Wyman - 0:27:23
really, really exciting development. Our objective is to see good care and anything that encourages that, with or without
our intervention, is good. So, thank you Rosie. Excellent. Tyson. Thank you Peter. I think my written update covers most of what I wanted to say. Performance in February has been stronger than January, particularly in Adult Social Care and in the National Direct Monitoring Approach
Team. As expected, it has taken some time to rebook the inspections in Primary Medical Services and hospitals that were stood down over the Christmas and New Year period. But that is starting to pick up and will continue as we maintain our more normal operational
tempo. I am expecting overall there to be fewer inspections in March. That is mainly because in Adult Social Care we have moved away from the quicker Infection Protection Control inspections to much more complex risk inspections which were very much what our plans were, going
Mr Peter Wyman - 0:28:25
ahead. I will update the Board at our next meeting. Tyson, I mean COVID is on the increase as we speak, so presumably that is going to affect some of our inspection numbers, just because our own staff are going to be off or isolating. Absolutely
and we will, I mean we will keep a careful watch on that and we will keep a careful eye out for the latest scientific advice if we need to change our posture at all. But we have regular management information about who is in work,
who is not in work and we will be able to adapt our priorities
Mr Peter Wyman - 0:29:02
accordingly. Yes. So, I wasn’t looking for a change of guidance, just recognising that people are rightly not at work because they are ill, and in large numbers, probably, or larger numbers
so that is going to have an impact next month. OK, thank you. All right are we happy to move on? Chris. Thanks Peter. So this is our
Chris Usher - 0:29:31
January performance update. Just a few areas to pull out for the Board. So in the business plan
of the course of the year, we have been tracking the regulatory activities we undertake through our inspection and direct monitoring activity, which as indicated in the paper is 24…, 21.4% for the year to date. Alongside the inspection and DMA activities, we also publish public
statements, as we have mentioned previously. We also receive information of concern through safeguard and whistle-blowing and complaints which means that the true picture of regulatory contact across the year is far higher when you factor these in, moving away from as it is prescribed in
our business plan shows we have actually had regulatory contact with 75% of services across the year. We will be reporting on a new business plan in the coming financial year which hopefully will revise this wording On registration, we have been trying to bring down
the timescales for a simple normal and complex average days of completion. We are seeing that normal applications reduced by 4.2% for the year, complex 1.3%. We have actually seen an increase in simple 6.2%. The performance across the year has been variable which, in part,
comes from the demand-led service that we are working with. In February, however, we can see a surge in improving performance which will obviously update on next time round. But we can see that is really markedly improving and the team have also processed just over
30,000 registration applications in this financial year. Mentioned previously about Give Feedback on Care and the increasing volumes on that. We have had 50% higher responses than the same period last year. As previously mentioned, Primary Medical Services sector is where we seem to be getting
most of our responses. Obviously this update is to the end of January, but we have seen in February the volumes at the highest rate for two years. So, we are just reviewing these findings and we will bring that back to Board as we start
to close out the year, the findings of the year. We will also be able to provide…, we have got our annual provider survey and stakeholder survey now close to being analysed. So, this is key for building in some quality feedback in addition to the
performance data and metrics that we track and so we will bring that back. Finally for me just in terms of financial position, underspent by 30 million year to date, this is forecast to reduce to 30, sorry, 11.7 by the year end. And on our
capital budget, 2.6 million underspent and that is forecast to reduce to 0.4 million by the end of the year. Chris, while you have the
Mr Peter Wyman - 0:32:26
floor, can I go back to the action log, I was misreading it earlier. So I think you have now adjusted
the metric so we can close the item. You can close the item. You’ll
Chris Usher - 0:32:40
see that as part of the next quarterly update we will provide the dashboard, but the narrative is slightly incorrect in there and the associated risk rates. So that has been acted
on and you will see that as part of the next quarterly update. So, do you want to keep the action open till the next quarterly update or close it down? I just need… You can close it down. Close it down?
Mr Peter Wyman - 0:33:01
Everybody agree? Yes, good. Robert doesn’t… I had a question,
Sir Robert Francis QC - 0:33:10
that was all. I agree fervently with you all the time. My question was about the response to risk inspections where the good news is that 57% - good or bad news – 57% were “require improvement” or “inadequate” which is good in the sense that
it justifies the inspection, the risk to which we were responding was a real risk. Therefore that is good in that sense. I assume that the rest would have been rated as good, at least, and I just wonder what reflection we have or ought to
have on, is it where the specificity – I don’t know if it’s that - or the sensitivity of our response rate, in other words are we looking at the right things for risk? Do we have a measure of how we do that? Shall I
make a start, and then Rosie or Tyson might want to come in as well?
Ms. Kate Terroni - 0:34:12
So, as you say, Robert, I am heartened that our data and intelligence, and what we know about services, including the invaluable information we get from the public, are pointing us
to go out and cross the threshold and visit services where we need to. In Adult Social Care it is 52% of our risk-based inspections are informed by information we get from Give Feedback on Care. So we are going out to these services, we are
finding areas of concern and we are either done, reducing a rating, or we are finding breaches in regulation and taking actions. It is signposting us to the right places. Some of the inspection activity that isn’t triggered by risk might be a previous rating that
is “requires improvement” with a breach or an “inadequate” rating where we might go out and actually find some improvement, so we might see that service go up as well. As you know, we have committed to date to ensure a smaller number of our inspections
are still going out and finding that improvement, so we might go out to a “good” and find a “good” or we might go out to a “good” and occasionally find an “outstanding” at the moment. We are looking to shift our focus and Tyson will
talk about our priorities going forward, where we want to continue to do risk, that will always be our number-one priority, but to see an increasing number of kind of improvement inspections as well. I think the data is showing us what we would want to
see, which is our intelligence or information from the public are sending us to services where we should be going because we are finding poor practice and taking action. But we also are going out and inspecting services where the quality of care was not where
we expected to be and in some circumstances we are finding improvement and that is being reflected in some ratings that are going upwards as well. Thank you Peter. Kate is absolutely right. The only thing I would add is that I also think that as
well as inspecting risk - and the figures here show that we are finding some risk. I think from the wellbeing point of view of our teams, also continuing to inspect “good” or where we’re looking for improvement is good. I think if our teams are
constantly looking at areas that are not performing well, I think that will have an impact upon them. So I am keen for us to keep to a balanced portfolio going forward. So, I mean there are other reasons
Mr Peter Wyman - 0:36:18
for doing that as well. So, I
think this is really, really good news and we have spent… It has been an ambition of ours for a very long time to get ourselves into this position, so it’s great. But it is also important that we go back to services periodically where there
isn’t any reason to be concerned. So I think there are two reasons for going back to “good” and indeed “outstanding” practices. OK, right. So where does that take us? Mark, I think to you. Thank you Peter. So
Mr Mark Sutton - 0:36:55
there are no significant cyber or information
security issues to report this month. As per previous updates, we continue to monitor guidance from the National Cybersecurity Centre and take any action as necessary. We are saying that we are continually reviewing our cybersecurity position and taking continuous improvement action, such as recently we
have launched our Cybersecurity Education and Awareness Programme for
Mr Peter Wyman - 0:37:29
this year which is well underway. Thank you. Good. OK. Then lastly in this section to the other Chris. Just three things to highlight from
Chris Day - 0:37:37
this month’s report. On the 9th of March Ian, the Chief Inspectors
and myself led an event in Parliament to discuss our transformation work, with a particular focus on our approach to assessing both providers and local systems. Parliamentarians were interested in how we would still capture the voice of people using services in our approach, and also
the part that data information would play in in that insight moving forward. We were able to be clear that we will continue to focus on the voice of people using services through data insight that we gather, through direct contract and crossing the threshold, through
Give Feedback on Care and through our use of experts by experience. I think this really does give us a much richer picture of people’s experience in more real time, just as Kate was talking about the use of Give Feedback on Care to drive responsive
inspections. In terms of the Bill, the third reading of the Health and Care Bill in the House of Lords is taking place today. We don’t expect any significant discussions on CQC. The purpose at this stage of the Bill is effectively to tidy up the
Bill and to make sure it is effective and workable. So, we are not expecting any further amendments. The one sort of exception to this I guess is the Baroness Hollins’ amendment which the government has accepted. The amendment creates a duty on the Secretary of
State to issue a Code of Practice on Learning Disabilities and Autism Training and amends our existing regulation in line with that. We are working with the HSE on how that will be implemented. Finally just two things. This Friday will see the launch of the
Out of Sight Follow-Up Report which will track the progress on the Out of Sight Review that we did with the Secretary of State back in December 2020. The Report will give full details of the progress that has been made and further action that needs
to be taken. And then, very finally, today we will be at the JCHR later, which I think Kate will be acting as the main witness. That is
Mr Peter Wyman - 0:39:47
it. Good. Thank you Chris. Are we happy to move on? Right, Mr. Usher back to you I
think. Right OK, Kirsty, do you know I get this wrong every time? Normally I say “Kirsty” and you say, “No, no, it’s Chris”. I have done it the other way around.
Ms. Kirsty Shaw - 0:40:06
Thank you. So, just an update on our Business Plan Refresh. As we have said previously, we will update our business plan every six months to reflect the fact that we are

CQC (Care Quality Commission) Business Plan 2020-23 Refresh

in a state of flux through transformation. We want to make sure that the measures that we are using to monitor our performance keep constant with the pace of change that is going on in CQC at the moment. So this refreshed plan sets out what
we are going to do between now and September. It focuses on our ability to deliver against our regulatory obligations, ensures strong alignment to our strategic ambitions and ensures our transformation activities are prioritised and aligned to delivering our interim operating state too which our phase,
the phase second phase of our transformation. We have rolled over the majority of our objectives from the previous plan as we felt those was still current. We have updated the transformation section to reflect the new priorities to deliver on the next phase of transformation.
Our budget. Our revenue budget for the year has been set at 237.4 million which also includes a reduction of 5% in our GIA allocation which is in line with our spending review settlement. So the plan is there and I am happy to take any
Mr Peter Wyman - 0:41:31
questions if anyone has any. Questions? Gosh, getting away with this lightly today. Oh, Mark, sorry, beg your pardon. Thank you Chairman.
Mr Mark Chambers - 0:41:42
Not so much a question, but just a comment that I am really pleased to see under the managing our people and resources the
section about improving the differential experience of our colleagues, as reported in Pulse Survey. Really pleased to see that and, of course, it links really well to our People Plan and it links particularly to presentations we are going to get later. So, thanks very much
Mr Peter Wyman - 0:42:12
for that. Thanks Mark. Sally. Thank you Peter. I just wanted you to endorse what Mark said about improvements to the Business Plan this time round. As you will know, there has been quite a comprehensive review through the Audit and Governance Committee and a strengthening
of some of the measures which I think is really important. They are quantitative and qualitative measures and we will come back to deliver those. I suppose I just wanted to reiterate what Kirsty said about our budget and the fact that there is, you know,
as part of our need for all organisations to generate savings, a plan to be able to do that. But also a slight risk as we rejig, particularly as we look forward to think about our pilot work on integrated care systems. But this is a
good Business Plan which we should note and endorse and come back in 6
Mr Peter Wyman - 0:43:12
months. Thank you. Thanks Sally. Anybody else? So, Board are we happy to agree the refreshed Business Plan? Perfect. Well done. Thank you Kirsty, thank you Chris. So, we then move on to

Workforce Disability Equality Standard & Workforce Race Equality Standard Update

the Workforce Disability Equality Standard and the Workforce Race Equality Standard update. Gill is not joining us, but Rachel Mackay is. I hope. Yes, she is. We are a few minutes ahead of time so… Yes, that doesn’t often happen, exactly. So we will just wait
for a second. Chris while we are waiting…, on the Bill, it’s third
Mr Peter Wyman - 0:44:16
reading in the Lords today. Do you happen to know when
Chris Day - 0:44:24
(unintelligible) is planned? So, they have indicated it will be towards the end of next month, so we have got a, sort
of a rough gap…, certainly from my perspective there was still a little bit of gardening to do to make sure that the Bill was workable in final form before that. So, I think we are looking at…, but obviously before, there was an issue about,
obviously, getting the final change through, particularly what I just discussed in the earlier meeting into a workable format. It came quite late. I think it makes sense, but there needs to be some…, it needs to workable from not just our perspective, but from the
DHSC’s perspective. So I will probably be able to provide an update to colleagues in the weekly update that we give to Board if that is OK?
Mr Peter Wyman - 0:45:17
Yes. I think that would be good. I am kind of expecting it now to be after the Easter
recess, but… Yes. And I think end of next month is probably the most likely time period. Great, thank you very much indeed. Rachel you are doubly welcome. Thank you very much for stepping into the breach. however I think the Board should know you have actually
done all the work on anyway on this, so… As Gill would have been the first to admit if she had been here. So could I just happily hand over to you please. You need your microphone on, sorry. I will just pass on that thanks
to my team as well, who have done a huge amount of work into this. So, obviously, I am here to talk about the 2021 WDES and WRES reports. As you know, these are kind of our key measures and drivers for our overall ambition to
be a truly inclusive workforce, workplace - sorry - and to realise our ambition for a place where everyone can kind of fulfil their potential and flourish when they come to work. As you also know, this isn’t our only source of insight but does form
a key part of how we monitor our diversity and inclusion strategy, and more broadly our People Plan. So, I just wanted to draw out a couple of key elements and then I will kind of pause for kind of wider reflections. So I think I
would note that there are some really great improvements that we have seen, so across the organisation we are seeing increases of representation for black and minority ethnic colleagues and for disabled colleagues. I think I would highlight there that what that also does is support
us in in kind of some of our follow-on priorities in increasing representation at senior levels, so really thinking about the talent pool that we are building across the organisation and how we might utilise that and grow that in the future. We are seeing improvements
in appointments from shortlisting for disabled colleagues, which is fantastic. We have also seen improvements in the number of, well kind of reduction in the number of black and minority ethnic colleagues and disabled colleagues experiencing bullying and harassment. Although I would just put a slight
caution around that, in that for disabled colleagues that still does remain higher than for non-disabled colleagues, albeit actually still better than some of our NHS Trust competitors. So, a kind of positive but also more that we need to do in that space. I would
also just highlight again, so kind of not being too complacent, but so celebrating the positives but focusing on some other bits. We have also seen an increase in discrimination for disabled colleagues – sorry - black and minority ethnic colleagues. So we want to continue
to focus on that over the next year. We have also seen some fantastic improvements in the number of disabled colleagues believing they have access to the right reasonable adjustments to enable them to do their work, as well as a reduction in people feeling that
they are pressured to return to work before they are ready to do. So, some great improvements but equally some areas that we want to continue to focus on. I think you will have seen from our paper that what we want to do for 2022
is prioritise some of the actions. So, there is kind of a huge amount of work that we are thinking about and we are considering and this isn’t to stop any of the focus on all of the metrics. But I think in our conversations with
the WDES Group and with the Action for Race Equality Group, we wanted to focus on three priority areas each so that we could really maximise our impact on the activity. So, both groups have highlighted that they want to focus on improving the experience of
people believing that we offer equal opportunities for career progression and promotion. I think I would just draw out there that, the fact that there is kind of commonality of ambition there is something we want to maximise and bring together the weight of those groups
in sharing some of their experience and their thinking and their activity. Then there’s some other areas that we want to focus on. So, continuing to focus on the numbers being appointed from shortlisting for black and minority ethnic colleagues, as I have already mentioned, increasing
the representation at senior grades. And making sure that adjustments continue to be made for colleagues with an additional strand around accessibility to ensure that as our baseline expectation for everyone within CQC. So the final thing I would just note is that following our People
Committee conversation, we are also thinking about how we have more regular check-ins on this data. So, as well as having our kind of annual cycle of looking at the data from the last year, we have kind of quarterly reviews that we were able to,
in the moment, to adapt and learn from what we are doing. Then obviously we will continue to track progress through our People Plan overall. So I will pause there, thank you. Thank you very much. Mark.
Mr Peter Wyman - 0:50:27
Could I just add a little bit to that? And
Mr Mark Sutton - 0:50:32
thanks to Rachel. I think on the workforce disability equality standards, which I am the Exec Sponsor for, I think you know this is our first year of running with this. And I think it has proven to be a really, really helpful framework for us
to understand and measure ourselves against. Whilst we have seen some good improvements against the benchmark we took, it provides us with a real springboard for our action plan for the next year. So, I think it has been a really valuable exercise. One of the
things I’ve have really enjoyed while working on this is working with the Disability Equality Network. They are a real…, really at the heart of helping us understand and drive forward these improvements. I think we have got a lot to thank for, for the Disability
Equality Network as well. That is really good. Thank you Mark. Stephen. Rachel, thank you. A brilliant report, actually two brilliant report and lots and lots of
Mr Stephen Marston - 0:51:31
good progress to celebrate. I was interested firstly in the issues about reporting. Because within the Disability Report – am I getting this the right way
round - there is a metric about did you report abuse and harassment and that is sitting at 50.9% did. I’m not sure the same metric is in the BME Ethnicity Report. So, I am kind of interested in the organisation’s approach to reporting and how
far you think you have gained the confidence of colleagues that it is worth reporting? Because 50.9%, and there’s also a figure of 40.5 isn’t as high as is it might be. So sort of confidence in reporting, do people believe that if they bother to
report it will be followed up? Do they feel safe in reporting? All of that that stuff about reporting. Interested in your views, thanks. OK. Just on that point, so absolutely recognise the kind of lower scores around reporting, and actually that is one of the
priority areas. So, as well as focusing on reducing the amount of people experiencing bullying and harassment, the WDES Project Group have prioritised looking at how we encourage people to report that more frequently. So I think as a kind of overall point, absolutely recognise your
kind of reflections there. We are thinking about how we work with the networks to encourage people to kind of report and how we respond to that. I think in terms of the difference of metrics, that is kind of slightly outside of our control because
that is a pre-determined set of metrics. But I think one of the things we are trying to do is bring some of the insight between the two together, so that we can learn from what the WDES is doing in this space and how that
might apply with the WREN network, for example. So maybe not necessarily within the parameters of the WRES report, but more broadly how we respond to in our diversity and inclusion work. Great. Ian. Oh, sorry. Mark. Rachel, I think this is a great bit of
Mr Mark Saxton - 0:53:52
work. I think
there is a vast amount of useful information in here, and a lot to be encouraged by. In that if we decide something is important, we focus on it, we measure it, we use recognised frameworks to tell us how we are doing, you know, you
can drive improvement and make this a better place to be. So I think that is enormously encouraging. I do think it hopes…, provides another helpful triangulation point on bullying and harassment. You know, we discussed at the last, or raised at the last meeting disappointment
with our scores on how satisfied people are that, particularly our internal experiences of that have been resolved to their satisfaction. This gives us another insight into that and I think as we discussed last time, I hope we are going to try and do things
some things differently and experiment with different ways of reassuring people that we are listening and acting appropriately in responding to concerns that people raise. But I think it is a great
Mr Ian Trenholm - 0:55:12
piece of work, thank you. Thanks Peter. Thanks Rachel. I echo the comments of other people in
terms of the quality of the work. I think it is just worth just linking a few things together as well here. I think one of them is we are relatively blessed with a relatively low turnover as an organisation. So, therefore, whilst we have done
a lot of work in the background in terms of recruitment and expressions of interest, and how people move around the organisation, the levels of movement in the organisation have been relatively modest in the last couple of years. Having put that scaffolding in place though,
I then link that to our transformation programme and the work we do on transformation. We are moving to a position where we are expecting there to be a fair amount of movement in the organisation. People that have been joining us on temporary contracts, we
are going to be looking at the making people permanent and advertising new jobs, and so forth. So there will be a degree of movement in the organisation. I am hoping that, if you like, the preparatory work we have done, which this report in part
reflects, will mean that disabled colleagues and people from black, Asian or minority ethnic backgrounds will be significantly better-represented right the way through the organisation, as we go through that recruitment process. So, hopefully the work, the preparatory work will pay dividends over the coming year.
And what you will see in a year’s time, is something which is quite different in shape in terms of the organisation that it is today. One final point, I think possibly, sort of talking a little bit to Stephen’s point is, we have done a
lot of work, particularly over the last couple of years, on having conversations - open and honest and some kind of quite difficult conversations - around some of these issues around disability and ethnicity. But I do think the organisation, you know for me one of
the things which is quite difficult to write down as a number, but just a general willingness to have those difficult conversations that maybe we were less good at a couple of years ago. So, again, I think that will pay dividends. It will enable and
embolden people to call things out when they are not working. It will stop people from just thinking something is quite trivial and then you know sweeping it under the carpet. I am hoping hope we can have those more open conversations and we have created
an environment for those open conversations to happen. As Rachel quite rightly said, there is always room for improvement but I think, you know as a senior team, I think we are very committed to creating that space for the right conversations to take place. Thanks
Peter. It is 12 o’clock, so can we just have one minute’s silence and then we will continue. Right. Thank you very much indeed and I think
Mr Peter Wyman - 0:58:46
that is a poignant moment of reflection, so thank you. Right back to the Board meeting. Mark. Thank you
Chairman, and Rachel thanks very much. Excellent report and
Mr Mark Chambers - 0:58:57
presentation and, as my colleagues have said, I echo all of their comments. So, you know, some good and which we should be really proud of and some things that we need to work on. Very interested
on the inclusive leadership pathway and also glad to see some innovation around e-learning for anti-bias training. So we will follow those with interest. I also feel that we have done a lot of work, or you have done a lot of work, on adverse impact
around shortlisting. I think the more we cite that and cite the improvement in that, it will give us encouragement in terms of these reports. Just in terms of the reports, when we reported the last time I said that really all those metrics in the
WDES and the WRES - I mean they are sort of straight out of Best People Management Handbook. You can’t disagree with them, so, in turn, they impact on our processes on leadership and management training and our culture. And so the report, which is great
to see, is full of actions and full of actions that are linked to our People Plan. So I think your point about more regular reviews is very well-taken and I would like to see that also. But, you know, overall please just continue this good
work and I look forward to seeing more improvements. Thank you. Thanks
Mr Peter Wyman - 1:00:32
Mark. Oh, Robert. I would like to echo everyone’s comments on how
Sir Robert Francis QC - 1:00:37
informative and great these reports are. Clear language, clear tables and easy even someone like me to understand. So, thank you. Thank
you for the direction of travel that all this is going in. I just had one comment and one question. One was that obviously these reports about our approach to disabled people and black and minority ethnic colleagues, but the figures frankly don’t look too great
in some parts for white people either or the staff as a whole. Even though in most cases they are better, much better than those frankly shocking figures for the NHS as a whole. But I absolutely understand where we are going and we don’t feel
complacency about this. The question I had was, that it is quite specific, I think it’s Page 75 of our bundle . I don’t know what page it is of your WRES Report. There is a reference there to an action to reduce stigma, and I
just wonder whether that is what is meant. “We will continue to highlight our black and minority ethnic colleagues lived experiences to reduce the stigma”. I am just wondering slightly what that means and whether you mean it? If it is what I think it means,
then we shouldn’t be reducing it we should be eliminating it. I just wonder whether… I mean it is just a comment and I am sure that it is meant in the best possible way. But if you are saying there is stigma attached to colleagues
from particular ethnic groups, that is quite shocking to me and I don’t think that is what we mean. No, absolutely. And absolutely take that point and will take it away just to make sure that we word that in a kind of truer sense. I
think really it is about how we make sure that we are hearing people’s lived experiences and the impact that it has on them in the workplace, and I guess how they then experience different processes and interactions. So, I will take that comment away .
So, it is an experience of something that feels like stigma?
Mr Peter Wyman - 1:02:57
Yes. Absolutely. Thank you. OK, so could we turn some microphones off? Sorry, thank you very much indeed, otherwise the whole system breaks. Rachel, I think that is a really good piece of work, thank you
very much indeed. And you have heard lots of complementary comments from colleagues. So, can I just ask the Board to agree the reports, possibly with some very minor editorial tweak on that last point that Sir Robert raised on stigma? Are we all agreed? Perfect.
Good, thank you very much indeed. So, unless there is other business…?
Mr Ian Trenholm - 1:03:37
Oh, Ian. Yes. Thanks Peter. I couldn’t let you finish the meeting without acknowledging that this is in fact your last meeting and it is also Ted Baker’s last meeting. I think on behalf
of all of us, and I know Mark wants to say a couple of words as well, but I think we are sadly saying goodbye today to two members of the Board who have made really vital contributions to patient safety and quality over frankly a
number of years. In Ted, in Ted Baker, we have someone who has given 50 years of service to the NHS, who has saved countless lives directly as a practising clinician, as well as being a Medical Director and in the last few years here at
CQC. And as Chair, Peter has guided us, guided CQC to the place where we are today, evolving how we work so that we can regulate well in this complex health and social care landscape that we have spent so much time today talking about. I
think Peter and Ted, I think you have both exemplified in integrity and real belief in the absolute importance of patient safety. I think you will both leave a substantial legacy and I think it is an impact which will endure. So, thank you for your
work both of you. Thank you for your contribution and also your friendship for all of us around this table. So, before I finish, I am just going to hand over to Mark who I know wants to say a few words as well. Mark. Thank
Mr Mark Chambers - 1:05:17
you Ian. Well, good and Ted has appeared on the screen so I can talk to him directly. So after many years of service within the system and ultimately CQC, I wanted to thank Ted and Peter on behalf of and from the perspective of the
non-executive directors. Ted, I’m so sorry you can’t be here, and I hope you recover fully and speedily. Working with you for the past four years has been a pleasure. I want briefly to highlight three areas where you have made an impressive difference and helped
us at CQC to deliver our core purpose. Firstly, as a member of the Executive Team, you have consistently placed the patient experience at the heart of your reports, both verbal and written. At no time has this been more so than during the pandemic and

Any other business

now with the COVID recovery programme. At the very heart of putting patient first has been your razor-like focus on learning and improvement, which is at the heart of our strategy. Secondly, you have always promoted collaboration with other ALBs and royal colleges in order to
advance safety, and particularly a safety culture within the system. You have been relentless in the pursuit of this objective and patients have benefited from your leadership in this area. Thirdly, you have always supported our own staff networks within the CQC and as Chief Inspector
of Hospitals, you have recognised the contributions that all staff groups within the hospital sector have made and continue to make to patient experience and safety. You have highlighted the importance of support, training and development for healthcare workers within our well-led framework. So, thank you
so much Ted and we will miss you. Peter, you too will be greatly
Mr Peter Wyman - 1:07:22
missed. Thank you for all you have done whilst chairing the CQC. Similarly I will highlight three areas where your leadership has been instrumental in placing CQC at the level it is
Mr Mark Chambers - 1:07:36
at today. Firstly, your focus on efficiency and effectiveness whilst not losing sight of our responsibility to the wider system and system users. You have led the way by building a strong Executive Team and kept us true to this task despite constant financial pressures. Secondly,
your strategic leadership enabling us in your time as Chairman to go through a full strategic cycle and setting us up to focus our energies on successfully completing our second cycle, again with its emphasis on people and communities, smarter regulation, safety through learning and accelerating
improvement. Finally, your leadership throughout the last two years, which has skilfully blended the needs of the system with supporting the welfare of our employees whilst keeping a rigour around patient safety. Your leadership enabled us to be agile in our processes and responsive to all
of our stakeholders when the country went into lockdown and providers were under so much pressure. And on a personal note, I think all of us who have reached out to you for advice had never ceased to be amazed
Mr Peter Wyman - 1:09:01
at how accessible you have been,
Mr Mark Chambers - 1:09:07
how the advice received has been valuable and consistently helpful. We have all felt supported by you as we do our work. So thank you, and actually I want to hand over to Robert who is also going to say a
Mr Peter Wyman - 1:09:26
couple of words. This could be getting out of hand, but anyway… Don’t you worry Mr. Chair. But
Sir Robert Francis QC - 1:09:31
having been on the Board for quite some time and in fact throughout the time both Ted and Peter have been in your current posts, I am happy to offer a final 360-degree appraisal to send you both on your way. Ted, I am going to
talk in the third person because I am going to watch you blush, I hope. Ted is a most remarkable person and it has been a great privilege to be able to work with him. His quiet and considered manner conceals a character which is absolutely
committed to the welfare of patients, and in particular their safety. He has consistently brought all his values and skills as a doctor, well perhaps not the physical surgical skills, or at least I hope not, to the role of Chief Inspector. He has been fearless
in speaking truth to power and in not giving an inch on demanding high standards for us all. One of my fondest memories of Ted was the day I was privileged to accompany him to a day at the BA Pilot Training Centre to participate in
the course they ran on patient safety. And he is smiling now. The boyish enthusiasm with which he took to playing with their very expensive toys was a joy to behold. However, I wouldn’t necessarily trust you with actually flying the aircraft, but that was great
fun. Peter, talking of 360-degree appraisals, I have just completed one for you, so you are leaving in the nick of time. I suppose one of the reasons I am on this Board is because I reported in some detail on one place’s experience of Board
leadership, which was - putting it politely - not that satisfactory. So, it has been highly instructive to see Board leadership as provided by you, which is the polar opposite of that. From the moment you were appointed until today, you have been absolutely committed to
CQC’s role of protecting patients and the service in keeping both safe. You have brought to bear your experience of chairing an NHS Trust, which has given you great credibility I believe. You worked
Mr Peter Wyman - 1:11:42
assiduously as an ambassador of us to those we regulate, the government
and the public. Many jokes are made about your former career but none of them fit you. Under a jovial exterior, you really care about this organisation’s work and about the people who do it, and you fiercely
Sir Robert Francis QC - 1:12:00
protected it when it has been necessary. But
you also have that talent, which is absolutely essential for leaders - and not all of them have it I have to say - which is of listening to colleagues. In my case, with commendable if undeserved patience. And that other essential talent you have, which
is having listened to people, you take their views into account and you then move on to achieve consensus with apparently little effort, but if I may say so real skill. So on behalf of everyone here, I would like to wish you both every good
luck and success in what you do next, and I’m sure you both will be doing things next. I am sure that from a little more distance, you will be keeping a close eye on our behaviour and what we do in future. But thank you
Mr Peter Wyman - 1:12:49
to both of you, for everything you have done for us, but also more importantly for the patients and service users of this country. Thank you. Ted, do you want to say anything? Yes. Could I just say a few things? And, first of all, thank you to colleagues for
those kind words. They are very gratefully received. But I just want to say more generally, thank you to members of the Board, both past and present, for their constant support and encouragement. These roles are high-pressure roles and you do need the support of colleagues
on a daily basis to make sure that you are doing the right thing and focusing on the right areas. But I want to extend that to the whole CQC. They are marvellous colleagues I have been working with over the last eight years at CQC
and the last 5 as Chief Inspector, particularly the team within the Hospitals Directorate. Their constant focus on the care and safety of patients never ceases to amaze me. I think they are a wonderful team and I want to give them my biggest thanks. Just
finally, I just wish the organisation well. The services we regulate in health and care are going through unprecedented times and facing enormous challenges. It would be be nice if our standing down was at a time when the challenges, if you like, had melted away
but they haven’t. The pandemic has brought them to the fore and I don’t think the CQC’s role has ever been more important than it is today. So, I wish you well and you have my full support going forward. Thank you very much. So, I
could say a lot but I am not going to because this really could get
Mr Peter Wyman - 1:14:41
completely out of hand. But I just want to say thank you to the three of you for those very kind comments. Ted I want to wish you happiness and success
in the next stage of your life and career. It has been great fun working with you. It has been great fun actually working with everybody. You know, as you said Ted, this is all slightly high pressure at times, but what actually gets you through
any pressure periods is the sort of friendship and support of colleagues, so thank you for that. Then the only final thing I would say is that in Dilks you have a superb new Chair. I guarantee within a few weeks you will forgotten that I
was ever here. And you will be very happy working with Ian which is how it should be. So thank you all very much indeed. So that closes the formal Board meeting. We have a couple of questions from Robin Pike. Robin, you started your questions
because, obviously, you submit them in advance, by thanking me for allowing you to give the questions. Can I return the compliment and
Mr Peter Wyman - 1:15:49
thank you for the questions over many Board meetings? So the first question is it CQC’s expectation that NHS and Care Home staff
wear ID badges when on duty, as is the case for staff working in schools? And so, Ted, just as you thought you had actually finished, I think you might want to start the answer to that one. Well, can I thank Robin Pike again for the questions he
has asked? He always is asking about pertinent points and this is a very good example of that. There isn’t a regulatory requirement that people wear ID badges, but there is a very clear expectation from us in our assessment of services that they should wear
ID badges and they should introduce themselves. I think we do observe care very carefully and if staff are not introducing themselves, that is something we will comment on in our inspection. And it will affect our assessment of those services. I am very pleased to
say we were a very strong champion for the “Hello, my name is” initiative that came from the work of Kate Granger which, I think has, been very influential in influencing the way staff behave at the frontline across the services. I should say that caring
- the key question that would cover this - is one of the areas that scores most highly in our inspection reports. But having said that, there is always room for improvement and we will be constantly vigilant in driving that going forward. Thanks Ted. Kate,
do you want to add anything? The only little thing I would add is, I
Ms. Kate Terroni - 1:17:16
think it is really important we continue to focus on outcomes. So we look at, is the member of staff who is supporting the individual doing so, and a person sent
away, do they know their own care needs, etc.? So you might on a 50-bedded nursing home supporting people with dementia expect all colleagues to have badges. If you think about three adults with a learning disability in a supported living setting - their own home
- supported by staff, people who know them very well, you may not in that circumstance. So I think it is really important that our focus continues to be, can we see a well-established relationship with staff providing person-centred support and that it may not… You
know, we wouldn’t necessarily want to say a blanket statement that says all health and social care workers should wear badges because if I am a care worker supporting a person with learning disabilities to get to the library or the café, I may not want
it to be, massively overt that I am a member of staff. Great. Thank you. Rosie? No. I think that answers that question very
Mr Peter Wyman - 1:18:10
fully. The second question from Robin is when does CQC expect to allow members of the public to attend the public Board meetings in person, as
was the case pre-COVID? Well, actually, Ian and I did discuss whether it might be possible for this meeting to allow members of the public to come. But the really quite high level of number of cases of COVID really made us say that it was
it was not sensible, either from the point of view of just physically accommodating people in the room. You may or may not be able to see this, Robin, from the screen, but we are still sort of fairly socially-distanced in this room. But secondly, also
recognising that some of our colleagues round this table do then go
Mr Peter Wyman - 1:18:55
and visit clinical settings and other places. So, I think the answer to your question is that we will get back to that when COVID levels are really substantially lower than they are now,
and assuming nothing else has hit us that makes it unsafe. So, I can’t give you a date but that is the plan. So, that is it and as Ted and I finally finish, in the immortal words of The Two Ronnies, it’s goodbye from me
and it’s goodbye from him