Profile: 'I am not sure the public really knows who we are' says CQC chief David Behan

In an exclusive interview with carehome.co.uk, David Behan who took over as chief executive of the last year, revealed that one of the problems facing the organisation is that the public don’t “really know who we are”.

“We asked Age UK to get together a group of older people. I went up there and not a single one of the 12 present had heard of us. Nine out of 10 older people use some form of health and social care services and yet many of them don’t know that we regulate these services.

“We need to do more to get our message out about what we do,” he says.

This is a surprise as after the barrage of criticism the CQC has received over the last two years for failing to identify poor care, you would think it would be foremost in people’s minds.

The CQC came under the spotlight last year when BBC Panorama revealed that a whistleblower had gone to the CQC over abuse at Winterbourne View care home, but had been ignored.

A recent report by the Health Select Committee on the regulator said the CQC still has a lot to do to win back public confidence. Stephen Dorrell, the Conservative chairman of the Health Select Committee, said the Care Quality Commission (CQC) had come from a “long way behind” but must do more to ensure patients have full confidence in its care home and hospital inspections.

However he added “I’m confident that it’s changing. It is an organisation that has come from a long way behind and it has got a long way to travel.”

With all this to contend with, it seems remarkable when Mr Behan says: “Being the chief executive of the CQC is a brilliant job. I worked hard at writing the application for this job as I really wanted to do it. It is a hugely important job and so far I have had a good time doing it but it is hard work.”

When Cynthia Bower stepped down as chief executive last year, there was a lot of speculation over who would take her place with many in the care sector calling the post a “poisoned chalice”.

However Mr Behan goes as far as to say: “I feel I have almost got the perfect job.”

He does realise he has a challenging task ahead and says: “My job is to lead and inspire the people who work here and the people who regulate care homes and hospitals. I have no fairy dust to sprinkle on everything.

“It is also a job where you are very exposed to the public and the media and you would have to be naïve not to realise that.”

In terms of winning the public’s confidence back, he says: “It is too early to tell whether we have succeeded in that. People are beginning to see the changes and developments we are making at the CQC but there is still a long way to go.

“The public don’t seem to have trust and confidence in public services and political institutions anymore and this has been triggered by scandals such as the BBC Jimmy Saville case and Winterbourne View.”

Mr Behan is passionate about social justice and essential dignity and after doing voluntary work at school, decided he would do his bit to help the world by becoming a social worker.

His progress through the ranks in the social care sector has been astonishing.

As well as working at the Department of Health, he has also served as president of the Association of Directors of Adult Social Services (ADASS) and as director of social services for Greenwich, Middlesbrough and Cleveland councils. Before joining the Department of Health, he was the first chief inspector of the Commission for Social Care Inspection.

He is proud of his achievements and says: “I think my grandfather would be quite amazed if he could see where I am today coming from the job of a social worker to this.

“I have been lucky in terms of the jobs I have had and I still feel I am making a contribution to ensuring people have essential dignity.”

In 2010, the CQC scrapped its star ratings system with care homes given stars according to quality. Since then both care homes and the general public have called for its return so there is an independent system that is easy for the public to understand. Since it was scrapped, councils and independent companies have brought in their own ratings systems which have left the public confused.

The think tank, the Nuffield Trust is currently carrying out a review into an ‘Ofsted-style’ ratings system for hospitals and care homes that has been proposed by Health Secretary Jeremy Hunt.

When asked for his opinion on it, Mr Behan says: “In terms of ratings, let’s see what the Nuffield Trust has to say. The Trust has been to the CQC and spoken to staff about its experience of the ratings system that we ran and looked at how it worked. It is carrying out a very broad based consultation. One of the issues they are grappling with is how you apply a rating to large teaching hospitals as well as care homes.

“It is not about taking back and using previous approaches. We need to think more deeply about it and what will be safe and effective and look after people properly. I think the Nuffield Trust is going about it in a very good way and at the end of the day it is up to the Secretary of State to decide. We do realise that people need to know whether the service they want to use is of a high quality.”

Mr Behan is a “glass half-full” person and is optimistic about the future of the care sector. “The care sector has responded to all the changes that have taken place over recent years remarkably well. I think we forget how far we have come and how much services have improved and residential care has become much more personalised. Up till now age-related issues have not been at the top of the political agenda but this is changing with the Prime Minister’s Dementia Challenge.”

He says that the care sector does face challenges with how it offers services to people with dementia and the funding environment is of course very difficult and adds: “There has been no period in our history where we have seen the level of population growth not keeping pace with economic growth in the way it is now.”

This year, the CQC will be putting “a much greater focus on leadership and culture in homes and hospitals when we are carrying out our inspections. We want to get the input of people who use the services, who are ‘experts through experience’”.

Since the CQC was created, there have been concerns over its generic inspection model where staff inspect all different types of services rather than having specialist areas.

This looks like it is all about to change this year as Mr Behan revealed that in terms of specialist inspectors, “we will be taking this forward this year as there is a huge appetite at the CQC for inspectors dealing with specific areas. This is part of our strategy over the next 12 months”.

This is very timely as the CQC regulates an ever increasing range of services and is due to take on 8,500 GP practices in April this year, so it does seem as if Mr Behan has injected some realism into the organisation.

What will be interesting to see is whether he succeeds in the Herculean task of winning back the confidence of the public!

Interesting facts

First job: social worker

Favourite book: ‘Bring up the Bodies’ and ‘Wolf Hall’ by Hilary Mantel. They are brilliantly written and hugely engaging

Favourite film: The Deer Hunter

Favourite piece of music: Samba Pa Ti by Santana

What is the best present you have received: My wife bought me a watch for my 40th birthday

Last holiday: Brittany with my family