Lack of trust has emerged as a significant issue during this process. As trust is a critical factor in developing strong relationships and better partnership working, there is an urgent need to rebuild trust between providers and ECC.  This, in part, will be achieved by both sides being more honest and respectful of one another and also by discussing important issues sooner rather than later, particularly those regarding quality, safeguarding and finance.  There is a need for ECC to be more upfront about the future direction and emerging thinking about the challenges ahead for the care market.  ECC also needs to champion care providers much more as a valued part of the health and social care system.

A specific issue that is undermining trust is that some officers do not fully understand the challenges of running care businesses. As a whole, ECC has become too officious and remote from care providers. In the worst cases it is imposing too many solutions, on parts of the market, which are often unrealistic and impractical in the current environment.  ECC needs to listen and engage with providers about what is achievable within the current available resources, looking to find the best collective answers to meeting service users' outcomes as well the organisational and business needs of both parties.

For their part, providers need to engage more in understanding the financial, statutory and legal environment in which ECC has to operate.  It needs to be understood that ECC has to balance a range of priorities, as determined by a wide and diverse community, and that the current care crisis is not one of its own making. In essence, the nature of the conversation has to change fundamentally - it needs to genuinely recognise the realities for both providers and ECC; accept the challenges that lie ahead; and to find a way to work together to achieve the best possible solutions that put service users' needs at the centre of any future partnership working.

In addition to more open communication, real engagement, collaboration and timely information sharing,  it must also be understood that rebuilding trust has to start with the individual. This trust needs to exist on a one-to-one basis as well as between groups and, ultimately, between ECC and the majority of providers. Trust is determined by how people act and behave and not by what they say.  Trust, therefore, needs to start with each individual believing that people have the best intentions and that they are working in the interests of all parties. All other trust-building behaviours flow from this.  As a starting point Appendix G sets out a step by step guide to building trust for officers and providers to consider and adopt.