In this episode Michael Dillon, Expert by Experience with Choice Support interviews Amanda Stride, Care Quality Commission’s (CQC) Deputy Director for the local authority assessment programme. They discuss CQC’s new role in assessing how local authorities fulfil their duties Under the Health and Social Care Act 2008 (as amended by the Health and Care Act 2022). It also focuses on what local authority assessment means for people who use services and experts by experience.

CQC Connect

Local authority assessment - An update and why it matters

Mangrove Chapter 2 ‘After’

Kin – a quaint enigma, like “kayak” or “kudo,” one of those rare words that start with a K.

Kin – not as in “kind” or as in “kinetic” (though a kind, kinetic kin is obviously appealing).

Kin – as in young birds helping their parents in rearing their own siblings or in nest building, even when they themselves are capable of breeding.

Kin – yes, as in “next of kin”. It’s an expression mostly associated with dread as it concerns planning for the transfer of belongings or debt after one’s passing. “Next of kin” also presents the question: who will take care of me when my body or mind starts failing? In many contemporary human cultures, the notion of kinship emerges at the crossroad of the nuclear family, legal obligations, and estate planning. These practices stand at a far remove from those birds that defend the parental nest, or the worker bee who foregoes breeding so that the queen’s offspring can thrive.

In zoology, kin selection (or kinship) is explained through genetics, which boils down to basic cost-benefit reasoning. A web search pulls up this quote: The gene that favors altruism spreads when participants are related and the cost to the individuals is low as compared to the benefit to the recipient. Therefore, altruism is promoted by kin selection and close genetic kinship.

The human animal, however, has applied this selective logic in a contradictory way. On the one hand, it has developed methods to subordinate and exploit other species as well as its environment to promote unsustainable population growth. On the other, it has created deep inner division within its own kin so that certain humans feel legitimized to exploit and subordinate other members of their own species. It’s the prime example of altruism meeting – and ultimately getting trumped by – selfishness.

We live in a time when traditional structures of division and belonging have become so deeply entrenched that the human genome has become too weak to bring about collective purpose. The pendulum has gotten stuck on the individualist end of the spectrum rather than on the genome-at-large end. In other words: a few humans experience economic, financial and maybe familial growth for an indeterminate, yet certainly finite, time, whereas all other human and non human animals, along with the environment, gradually go to hell.

So then what? In a time when genetic manipulation is rife, the altruistic gene + group fitness mechanisms seem outdated and insufficient to create a new, sustainable connection. Yet, I wonder: what if there’s a way to reverse-engineer kinship? That is, by activating radical altruism, could we experience that primordial sense of being in the same boat? I’m thinking about practices of giving and caring that would supersede logics of paternalism, pity and anthropocentrism and instead build connections: between humans, as well as between humans and non-humans – at times ephemeral, at times lasting til death do us part.

Now that’s kind, kinetic kinship.

Entry III Kinship

Entry II Porosity

The mouth, like a port, is an opening. A place of first contact with the outside. It regulates two ways of traffic: import (often oxygen, food) and export (often language, carbon dioxide). Whilst the opening and closing of the mouth can be deliberately controlled, the stomach knows what the mouth does not. The mouth pays lip service to representation. The stomach diligently works substance, prepping it to be radically transformed. In this, the stomach is a model of production, in continuous interaction with the exterior.

The stomach can be thought of as the port to the gut, a site where the outside environment comes to dock. Here, organic chemistry, social ritual and roles, as well as economic power truly interact, before valuable content is clearly separated from waste: it is a primary site of active, yet paced transition. A stomach can’t ignore so-called foreignness and needs to engage with it, either by prepping it to transition into the body cells, or by slowly deciding to send it back to the mouth.

The stomach, like the heart, is a muscle. It is the place where what we ingest becomes part of our bodies: substances are slowly transformed by muscular mechanics and chemistry. When our bodies are distressed our stomachs act up: their chemical balance directly corresponds to our emotional balance. Yet, inversely, who hasn’t felt butterflies in their belly when feeling elated? The stomach is the locus of true physical feeling and of metaphoric mood.

Liverpool’s port embodies intensified circulation and necessary interaction: as the world´s first commercial wet dock, it stands for the movement of physical goods, the transport and separation of bodies, protection, control and connection, as well as for incessant exchange of information and knowledges. There is production, invention, and resistance despite imposition and restriction.

Through the stomach, we zoom into the back-and-forths of that production: the minute muscular movements that develop – such as rhythm, gesture, and mobile forms of knowledge – despite the mandate to separate, dominate, standardise and streamline.

Entry I The Stomach

In this podcast, Natalie Valios, Senior content editor at Community Care Inform, leads a question and answer session with Mary Cridge, Director of adult social care at the CQC, and Amanda Stride, Deputy director for delivery of local authority assessments. In this podcast, Mary and Amanda talk about local authority assessment testing, our longer term approach, how we’re talking to frontline staff and much more.

This podcast is hosted by Community Care Inform which is a subscription website providing in-depth practice guidance, legal information and learning tools for people working in social care. The questions are their own, however, the answers reflect CQC’s latest updates around local authority assessment.

Find out more about Community Care Inform https://adults.ccinform.co.uk/

Local Authority Assessments: Community Care Inform interview CQC

Audio Description Introduction - Unmute Dance Theatre and guests present: 'uMoya'

Audio Description of 'uMoya' - Unmute Dance Theatre

In this episode, we reflect on our recent reports into oral health in care homes. We published 'Smiling matters: oral health care in care homes' in 2019, and followed up with a progress report in 2023. Reflecting on the findings of the reports, our guests discuss the importance of oral health; explore ways to improve the experience for people living in care homes; and talk through ways of creating better connections between dental professionals, commissioners, and care homes.

Dr David Shiers, a guest in this episode, is an expert advisor to the NICE centre for guidelines and views expressed are personal and not those of NICE.


Resources mentioned during the episode:

The original smiling matters report: https://www.cqc.org.uk/publications/major-report/smiling-matters-oral-health-care-care-homes

The smiling matters progress report: https://www.cqc.org.uk/publications/smiling-matters-oral-health-care-homes-progress-report

Right to Smile statement: bit.ly/3nZCYeD 

CQC Dental mythbuster 40 - Caring for people with dementia in a dental practice: https://www.cqc.org.uk/guidance-providers/dentists/dental-mythbuster-40-caring-people-dementia

CQC Dental mythbuster 24 - Medical resuscitation equipment for domiciliary dental care: https://www.cqc.org.uk/guidance-providers/dentists/dental-mythbuster-24-medical-resuscitation-equipment-domiciliary-dental

Share your thoughts in our CitizenLab project: https://cqc.citizenlab.co/en-GB/projects/smiling-matters

Smiling matters: oral health in care homes

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We will be sharing podcasts and other audio content through this channel.

Website: https://www.cqc.org.uk/
Twitter: For providers & professionals - https://twitter.com/CQCProf & for public - https://twitter.com/CareQualityComm

All of our podcasts are available with subtitles on our YouTube page: https://www.youtube.com/playlist?list=PLEwLzOd_XW-Ln4XXrojFDRHdpwIQI3dFm

Local authority assessment - An update and why it matters

Care Quality Commission

Related tracks