“We are at the starting of a journey to excellence, not the finish,” says David Behan, twenty months into a task that some regarded as impossible, and several thought career poison as chief executive of the Care Good quality Commission (CQC).
Behan, together with CQC chair David Prior, who arrived six months soon after him, are extensively credited with getting stabilised the crisis-prone overall health and care inspectorate, reeling as it was from damning criticism in excess of its roles in the Winterbourne See and Morecambe Bay hospitals scandals.
Behan himself admits it is the toughest issue he has ever completed. “We have attained a lot, people have worked extremely challenging, but there is a long way to go,” he says. Earlier this yr, the Commons well being select committee concluded that the commission had “a renewed sense of objective” and had moved decisively on from a position exactly where it had been “a case study in how not to run a regulator”.
Central to this modify has been the CQC’s new technique that set out to move inspection away from tick-box compliance towards a concentrate on suspected chance that foreshadowed the abandonment of generic inspection teams in favour of specialists and that promised a new technique of ratings for all care providers. Last week, inspectors had been reorganised into specialist teams and the commission is these days publishing a series of handbooks for consultation that set out how it proposes to carry out the new-type inspections and to decide ratings for each support from hospitals to care residences and dental practices.
“We’re going to be altering the way we examine at most likely the most tough time for health and care solutions in terms of demographics, public expectations and engineering – and all of that in a context exactly where cash is going to be as tight as it has even been in my occupation,” says Behan.
Austerity notwithstanding, the commission will be taking on 500 additional inspectors this year and investing £10m on coaching and advancement of its 2,000-plus personnel, as effectively as “experts by knowledge” (users of providers) and other folks from outside the organisation who now join its expanded inspection teams.
One factor of the CQC that is seldom appreciated is that most of its workers function from house when they are not out on inspections. This presents particular challenges.”We’ve lost that variety of social glue they had when they had been practising nurses or social employees. Now they communicate by phone or e mail”, says Behan, himself a social worker by background.
He believes firmly in the need to have to bring workers together at occasions this kind of as a managers’ meeting final week, which was held at the Emirates stadium of Arsenal football club and addressed by wellness secretary Jeremy Hunt. “I will get hit on how significantly it price, I suppose, but if we can not eyeball every single other and have a conversation across CQC, then I am not performing my job.”
When he asked 340 senior managers at the event how several of them had been familiar with the organisation’s stated values, just one particular individual raised their hand. It left him in no doubt that the commission demands a fresh set of principles that employees can determine with. And final results of the most recent staff survey, carried out in February, show that there continue to be troubling issues of organisational culture and particularly of bullying and harassment – the topic of an independent report commissioned by Behan soon after his arrival. Even though 77% of staff both strongly agree or agree that they feel proud to work for the CQC (a striking rise of twenty percentage factors on the preceding survey last summertime) only 35% think morale is great (up from 24%) 47% say they truly feel recognised and valued (up from 37%) and 20% say they have witnessed bullying or harassment at perform in the past 6 months, with 10% claiming to have been bullied or harassed themselves.
Behan admits that the bullying figures appear nevertheless worryingly high and is ordering a lot more function on it, employing outside experience. His belief in opening up the commission to external influence extends to bringing in critics and whistleblowers: James Titcombe, the father of a child who died at a Morecambe Bay NHS foundation trust hospital has been operating for the CQC as security adviser and Dr Kim Holt, the paediatrician who tried to increase the alarm about failings at the north London clinic the place Baby P, Peter Connolly, was treated shortly ahead of his death, has joined on secondment to advise on the new inspection regime and react to personnel who increase issues.
“James asks me questions that make me truly feel truly uncomfortable, like: ‘While you are making up your mind [about the safety of a hospital unit], would you be happy for your child to go in there?’”, says Behan. “I feel we are much better for that sort of challenge within the organisation.”
Challenge is presented, also, by the CQC’s restructured governing board, which still contains Kay Sheldon, who fell out spectacularly with the previous leadership and obtained £60,000 compensation in return for withdrawing an employment tribunal declare. She was subsequently reappointed to the board by Hunt.
With a wholly revamped executive group all around him, plus the 3 new chief inspectors of hospitals, grownup social care and basic practice, Behan says he is for the initial time ready to look forward rather than back. He accepts that CQC processes are still too bureaucratic, having recently sat with a registration assessor – doing work from her house – and counted some 50 clicks of her mouse as she carried out the basic job of shifting the title of the registered manager of a dental practice. “I think that is about 48 too numerous,” he says. “And I consider that’s what staff imply when they say programs and processes never always aid them to do the work.”
The commission carried out a record 39,000 inspections in 2013-14, with warning notices issued in 1,588 situations – a rise of a third on 2012-13. In a crackdown on care residences working with no a registered manager, 228 residences have paid a fixed penalty of up to £4,000. The cash goes direct to the Treasury. But Behan is pleased with the commission’s price range settlement for 2014-15, a complete £223m including a £120m grant from the Department of Health up from £80m.
Whilst Behan insists his task is “brilliant”, and he is paid effectively (£185,000 a year) for performing it, he fails to answer right when asked if he would get the submit now knowing how challenging it has been. Coming from modest roots – his dad and mom worked in the Lancashire textile market – he professes to be relatively bewildered at how far he has risen and to be unpleasant speaking about himself. He says: “I cringe doing this kind of factor, to be trustworthy. This isn’t me,” he says. “If I never ever had to do one more Newsnight interview or go on the These days programme again in my daily life, that would be just fine.”
Age 58.
Lives Kent.
Loved ones Married, two sons.
Training St Mary’s School Roman Catholic grammar school, Blackburn University of Bradford (BA utilized social research and CQSW).
Profession 2012-current: chief executive, Care Top quality Commission 2006-twelve: director basic for social care, Department of Wellness 2003-06: chief inspector, Commission for Social Care Inspection 1996-2003: director of social providers, Greenwich council 1996: director of social providers, Middlesbrough council 1994-96: director of social companies, Cleveland county council 1989-94: assistant and then deputy director of social providers, Cleveland county council 1984-89: venture leader (kids and households) and location manager for north Bristol, Avon county council 1978-84: social work manager/social worker, Wakefield council.
Public life CBE for companies to social care, 2003. (2002-03: president, Association of Directors of Social Companies)
Interests Cycling, foods, family members, travel, Blackburn Rovers FC.
David Behan: a reluctant rescuer of crisis-hit care regulator | David Brindle
