Staying ahead

Changes from CQC have felt demanding. Let’s see inspections as an opportunity, says Jay Stewart.

Read the full article in DDN Magazine

Jay Stewart - director of public health and substance misuse at Turning Point
Jay Stewart is director of public health and substance misuse at Turning Point

Last year, the Care Quality Commission (CQC) began rating substance misuse services publicly. The sector is no stranger to inspections, but publishing results means there’s greater transparency of services delivered. The good news is that the sector is performing relatively well so far, with many receiving good or outstanding ratings.

Inspections have been the norm for quite a long time now, but years ago our experience of them was inconsistent in terms of their depth, breadth and quality standards.

Over recent years we’ve seen CQC changing. It’s very welcome that there’s now a framework guiding what ‘good’ looks like, and there are specialist advisers and experts by experience taking part in the inspection process. Equally, we’ve seen an increase in knowledge and experience among inspectors as they have examined services across the country.

I appreciate that this is not a view shared by everyone in the sector. As with any human system, you can have variations in judgements and in application of the regulations, but one cannot deny that the robustness and transparency of the inspection process is improving.

I’ve been involved in the health and social care sector for more than 30 years, so I know that it’s not easy to receive an inspection that points out inadequacies in a service. Indeed, it can be a painful blow for the staff and peer mentors who give their all to help support people through recovery. However, we exist to deliver quality services and I know that we all strive to ensure that they are the best they can be.

CQC Inspection
We’ve seen an increase in knowledge and experience among inspectors as they have examined services across the country.

At Turning Point we’ve spent years investing in our clinical expertise, governance processes and support systems, as well as in our leadership team. All of this is essential to ensuring that quality services are delivered and that learning processes are embedded into the fabric of our systems.

I know that the CQC can be minimised by some who do not want to accept that the services they are responsible for need to improve. In addition, I’ve no doubt that there may be occasions when the CQC gets it wrong. But we would do better to focus on what we can learn from inspections and what we can improve.

For me, one of the hallmark principles of good clinical governance and practice is being open to learning and continuous improvement. CQC inspections are much more than meeting basic regulations. Anyone who has experienced a comprehensive inspection will appreciate the depth of inquiry that happens in many inspection scenarios. As such, I think the sector has much to gain from each other through CQC inspections if we maintain an open approach to learning.

There are still many more services to inspect and no doubt areas for improvement. However, the sector should be proud of the results so far, which are quite remarkable given the fiscal pressure that we’ve been under. I think it stands as a testament to the value we place on quality within services.

I’d agree with those who say that quality does come with a cost. But I would also say that not providing quality services would come with an even greater cost – to a council’s reputation, to real sustainable outcomes and, more importantly, to the individuals who we all seek to support in their recovery.

The new published reports give an opportunity to ensure that quality standards and investment are maintained. We should continue to challenge the imperfections in the system and do as we have always done – to strive to improve, learn and be the best we can be.


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