The Care Quality Commission’s announcement of improvement plans for 2026 will be read with interest across the sector. From Care Campaign for the Vulnerable’s (CCFTV) perspective, any credible reform of regulation is welcome. Providers deserve a regulator that is consistent, timely and fair. Families deserve a system that can identify risk quickly, act proportionately, and restore trust when things go wrong.
Yet the most important question is simple: will these plans translate into safer, more transparent care for the people who live in services day after day?
Because improvement cannot be measured only by internal milestones, updated processes or the number of assessments published. It must be measured in outcomes that matter to residents and those who care about them: fewer unexplained injuries, fewer unresolved concerns, quicker responses to deterioration, better learning when harm occurs, and a culture where openness is normal rather than exceptional.
The reality behind “confidence in regulation”
In recent years, CCFTV has supported families who felt they were navigating the care system without a reliable safety net. At the same time, we work with many high-quality providers who want the same thing: a regulator that provides clarity, consistency and confidence, rather than delays and uncertainty.
That is why the ambition to strengthen regulation is important. A regulator must be capable of doing two things at once: recognising and supporting good care, and identifying poor care early enough to prevent harm.
But there is an uncomfortable truth that families repeatedly encounter. When complex situations arise, particularly around risk, deterioration or disputes, external routes can be limited. CQC is not designed to step into every individual placement issue, and safeguarding is vital but not a catch-all pathway for every serious dispute. For families, this can feel like a gap in the system, especially when decisions have profound consequences for a vulnerable person.
When “process” becomes a safety issue
This gap becomes most visible when high-impact decisions are made quickly, with limited transparency, and the person living in care experiences distress as a result.
Those working in dementia care will recognise that distress does not always look like “challenging behaviour”. It can present quietly: withdrawal, refusing care, refusing meals and fluids, sleeping excessively, losing engagement, or rapidly deteriorating. When that happens, the situation is no longer simply “administration” or “contract management”. It becomes a patient safety issue.
A modern regulatory system should have the confidence to recognise that some decisions sit at the intersection of care delivery, clinical risk and safeguarding and that a “tick-box” approach to process will never be enough.
Independent, choice-led safety monitoring must be part of the future
If the sector is serious about transparency and trust, we also need to embrace innovation that supports both residents and care teams.
CCFTV continues to champion independent, choice-led safety monitoring, implemented with clear consent, robust governance and strict privacy safeguards, as part of a modern approach to care safety and accountability.
It’s not about “spying” on staff. It is about supporting a culture of openness, protecting residents and protecting carers. When used ethically, independent safety monitoring can:
- provide reassurance to families and residents
- reduce false allegations and misunderstandings by establishing clear evidence
- support training and learning by identifying patterns and risks
- strengthen safeguarding by improving clarity around incidents
- reinforce the message that excellent care is something to be proud of, not hidden
Most importantly, it is choice-led. Not every resident or family will want it, and not every circumstance will warrant it. But for many people, particularly where families are worried about unexplained injuries, recurring incidents, or communication breakdown, it can be a proportionate, protective measure.
As CQC reforms its approach, it should consider how it recognises and evaluates services that adopt ethical, consent-based safety monitoring, and how such approaches can support safer outcomes. Regulation should not sit behind the pace of change; it should help guide it.
What reform needs to deliver in practice
From CCFTV’s perspective, effective reform must lead to practical improvements that both providers and families can feel:
Timely oversight
Providers need timely assessments and clear feedback. Families need ratings and outcomes they can trust to reflect reality, not history.
Consistency and credibility
Regulation must be consistent across regions and inspection teams, backed by appropriate expertise and clear evidence.
A stronger bridge between regulation and real-world risk
Where distress, deterioration, or repeated incidents are evident, there must be clearer pathways to action and accountability — not simply a shift into “process mode”.
Recognition of transparency and innovation
Services that adopt meaningful transparency measures, including independent, choice-led safety monitoring, should have that recognised as part of an overall commitment to safety and culture.
Moving beyond reassurance to real confidence
Care is delivered in real time, every hour of every day. Families don’t experience regulation as a framework. They experience it as reassurance – or the absence of it – when something goes wrong.
CQC’s plans for 2026 may be a genuine step forward. But reform will only rebuild trust if it results in the outcomes that matter most: safer care, quicker recognition of risk, transparent accountability, and a stronger culture of openness across the sector.
CCFTV is ready to engage constructively with providers, commissioners and regulators on solutions that are realistic, ethical and rooted in day-to-day care, including the role of independent, choice-led safety monitoring as part of a modern, transparent care system.
