Andrea Sutcliffe: My brother's suicide spurs me on to end the care crisis Miss Sutcliffe is talking about her brother, Adrian, who killed himself after a long struggle with clinical depression. In the years leading up to his death, she found herself on the other side of the bureaucratic fence, witnessing at first hand how things can go wrong, how people fall through the gaps. "Adrian was living independently and was being supported by a variety of agencies," she says, "and, frankly, they kept him alive for 11 years after his first [suicide] attempt. But in the final analysis, my observation would be that it fell to poor communication between different agencies. "It" was his death in 2006, which Miss Sutcliffe says was heralded by a number of warning signs that went unheeded by those meant to protect him. "No one in health, housing or social care shared that information in a meaningful way," she says. My brother's experience and the impact on my family underpin my approach to what I do, and serve as a constant reminder of some important lessons. Adrian Sutcliffe began life as an apparently happy boy but became more withdrawn as he grew older, developing a tendency towards sudden, occasional rages. His first attempt to commit suicide happened in his late teens and resulted in his being admitted to hospital where, according to Miss Sutcliffe, his treatment was "less than sympathetic." There were some good times during his twenties but, after moving to the South of England, he made another attempt to take his own life, resulting in a diagnosis of clinical depression, a condition exacerbated by alcohol. Things again seemed to improve as Adrian moved into his mid-thirties - he had a job and a girlfriend - but indications of trouble ahead were not picked up. When he stopped taking his medication, his local pharmacy took time to inform his GP, who then failed to contact his psychiatrist. His finances began to deteriorate and the social services day centre that might have provided support closed down. Three days before he was due to appear in court for non-payment of rent to a housing association, Adrian Sutcliffe killed himself. Her brother's ordeal informs Miss Sutcliffe's view of her new role. "This is about people and their lives," she says. We have got to take that into consideration when we are inspecting and regulating, and must never forget it. The reason I use my family is because it is the natural thing to do - this is about somebody's mother or brother. Even more importantly, it is about people who do not have someone looking out for them, particularly people with mental health problems who may not have contact with their families. Over the next two years, Miss Sutcliffe is charged with instituting a grading system for the country's 25,000 care homes, similar to that used for schools. There are some 400,000 people in Britain's care homes, many of whom, according to Mr Hunt, are just "parked there," deprived of attention by family, or lacking family altogether. The Health Secretary wants Britain to rediscover its compassion towards the elderly, citing the greater respect accorded to senior citizens in Asian cultures. "There is some fantastic care out there in this country and we should be celebrating that, because we want good people to work in the sector and don't want to put them off," says Miss Sutcliffe. But we also need to be making sure that we are bringing up standards. We have to ask if these services are well led. Most importantly, we need to be confident about what is happening when we are not there. The CQC, once a homogenous body, has been reformed into three directorates, specialising in adult social care, primary care and hospitals. Miss Sutcliffe, whose sector is the biggest of the three, is expecting to take command of at least half of the CQC's thousand or so inspectors, as well as recruiting more. The split is intended to allow inspectors to specialise. All homes are expected to receive a rating by March 2016 - but how often will they be visited? Those that are poor and need improvement - we will be going back between six months and a year, and between 18 months and two years for the better institutions. But a lot can happen in a year. We have to ask what are the trigger factors that would make us say: 'We shouldn't leave it that long. So, has a home had a change of owner - would that make us go back in? Have there been safeguarding alerts from the local authority or has there been a spike in concerns being raised by relatives? We are doing a lot of work on improving how we collect that information. Also, we will randomly select a percentage of places to go back to sooner than expected. One of the things I really do not want to happen is that homes get 'outstanding" and think: 'That's fine, we don't have to worry." Actually, yes you do, because we might be coming back at any time. The incentive for organisations to maintain 'outstanding" is the publicity they would attract in losing it." Clandestine means will also be used, including hidden cameras and volunteer inspectors posing as relatives. The scope and detail of such tactics has yet to be worked out. But will any of this make Britain a more compassionate country when it comes to the treatment of its elderly? "I'm in no position to comment on whether this is a more selfish country or not," she says. But I think we are a more disparate country - we live in different places from our parents, we are not around. There is an issue about how we address the fact. Miss Sutcliffe and her siblings are more fortunate than many. Let's go back to my mum and dad. They live in a wee village in North Yorkshire, and I absolutely know that if anything went wrong, the whole village would help. Everybody would rally round. When my parents celebrated their 50th wedding anniversary party in the local pub, there were two toasts, one to my mum and dad and the other to the village, because that is the reason I can live in London and my brother and sister can live on the other side of the world - because we know there are people around them. Some 800,000 elderly people are said to suffer from chronic loneliness, and some five million cite television as their main company. In the end, one cannot legislate for kindness.