Our recent achievements and on-going joint working

I wanted to write about what we’ve been busy doing in the past year and reflect on all the hard work we’ve done as Inspection Wales.

Where were we a year ago?

A year ago, we published a stocktake of our progress, which showcased our progress in meeting four key themes over the previous 18 months or so.

These themes include being able to identify areas of collaborative working; support different approaches of working together to respond to legislation and policy change in Wales; coordinate the development of a forward programme; and continue to promote the work of Inspection Wales and increase public knowledge of what we do.

Some of the joint working projects showcased in the stocktake were:

  • Care Inspectorate Wales (CIW) and Healthcare Inspectorate Wales (HIW) worked together to monitor and review mental health services;
  • CIW and HIW worked together on learning disability services; and
  • Estyn and the Wales Audit Office worked together on the inspection of regional consortia for school improvement.

Our work during the past 12 months

Our collaborative project work continues in many areas.   child iconServices for children and young people:

  • The Wales Audit Office, CIW and Estyn have worked together on a joint local Safeguarding Children Review at Monmouthshire County Council.
  • Estyn and CIW are to work jointly to inspect early years’ settings that provide both care and education. Further information on the joint childcare and play framework is available on CIW’s website.
  • Joint teams of Estyn and WAO staff deliver Estyn’s local government education services inspections, which report on outcomes for learners, quality of services and leadership, including how well local authorities use their resources to deliver their strategic priorities.
  • Estyn and CIW routinely work together to inspect secure children’s homes and schools and colleges that have residential provision. During 2018-2019, Estyn will work with CIW to explore how to develop joint inspection activity for independent schools and residential special schools.
  • All Inspection Wales partners are currently completing various pieces of work on the theme of support for young people. Each organisation has a different role and remit in relation to the topic of youth and are working together to deliver a series of reports and other outputs. Estyn’s report on Youth Support Services In Wales was published first on 27 July and the WAO is due to report next, with a planned publication date of November 2018.

Heart icon

Health and social care services for adults:

  • CIW and HIW jointly reviewed Community Mental Health Teams across Wales. A national overview report will be published before the end of 2018, and all individual inspection reports have been published.
  • CIW and HIW have recently (July 2018) published a joint thematic review of substance misuse services in Wales.
  • The Wales Audit Office collaborated with CIW in its inspection of Adult Social Services in Powys County Council and the report was published in May 2018.
  • CIW and HIW jointly reviewed the healthcare support provided to older people living in care homes in north Wales. A report of this work will be published shortly.

On reflection

These examples of collaborative work show that Inspection Wales partners are working together across a broad range of services, but particularly in the areas of healthcare and education. Our joint work is often about using audit, inspection and regulation as a way to improve services for the most vulnerable. For example, children detained in secure settings, individuals experiencing mental health and substance misuse problems and those using children and adult social services.

What next?

We will continue to prioritise joint work which can improve services for vulnerable people. For instance, CIW and Estyn, together with Her Majesties Inspectorates of Probation and Constabulary, are in the early stages of planning a review of safeguarding children in Wales, with fieldwork to begin in the latter part of 2019. There will also be a continued focus on joint work to improve health and social care.

The NHS celebrated its 70th birthday on the 5 July 2018, and the next day the Welsh Government published its long term plan for health and social care in Wales – Healthier Wales. Under the plan, the Welsh Government will ask two of Inspection Wales’ partners, HIW and CIW, to jointly review the effectiveness of Regional Partnership Boards and the progress of the Welsh public services in delivering integrated health and social care services. (Regional Partnership Boards are tasked with driving the strategic regional delivery of social care services in collaboration with health bodies.)

In upcoming blogs, I will report more on the joint safeguarding work and the joint response of HIW and CIW to Healthier Wales.

About the author

Emma Giles, Inspection Wales Programme Board ManagerDr Emma Giles took over as Inspection Wales Programme Manager in March 2017. Prior to this, Emma was a performance audit lead with the Wales Audit Office.
Emma is an outdoor enthusiast who likes mountain biking and walking.

Her PhD in Criminology looked at how offenders and criminal justice staff understood fairness, and what these differing perceptions of fairness meant for relationships between staff and offenders.

Office workers sat around a desk with a laptop

The challenges of running a joint review…

One of the inspections I’m working on at the moment is around mental health. It’s a joint project between the Care and Social Services Inspectorate Wales (CSSIW), who I work for, and Healthcare Inspectorate Wales (HIW).

We’re looking into how Community Health Teams provide care, support and treatment to adults with mental health problems. As part of this review, we’re carrying out inspection visits at one Community Mental Health Team in each of the 7 health board areas in Wales. We’re carrying out interviews with senior officers at health boards and local authorities. And, we’re also consulting a wide range of stakeholders, including service users and their carers/families to hear their views about the services they receive.

If you’re interested, you can also get involved with the review (opens in new window).

So far, we’ve scoped, planned and completed four inspections visits and our joint working has been fairly harmonious so far, albeit challenging at times.

Our Inspection methodology consists of a blend of HIW and CSSIW routine methods. We’ve faced some challenges – such as whether to conduct announced or unannounced visits; reaching agreement on the use of language, i.e. “patient” versus “service user”; and how to capture evidence from inspections.

However, we’ve achieved an approach, including the design and production of assessment tools, which enable us to make a holistic evaluation of the quality of care, support and treatment, as well as its compliance with both mental health and social care legislation.

Inspection teams are led by HIW and comprise an equal number of HIW and CSSIW reviewers. This has created some challenges and highlighted differences in the way we work. For example, home visits to service users/carers versus office visits; the way we manage immediate concerns; and the level of detail included in preliminary verbal feedback.

However, we have agreed a joint approach and created mixed inspection teams. This has helped to achieve a good balance of evidence, through lively debate about the cases reviewed and the staff, service users and carers we’ve interviewed.  There is also the very positive spin-off that professionally we have learned a great deal from each other.

Although early days – we haven’t fully completed an inspection report yet – from my personal experience of participating in two of the inspection visits, I think, our joint approach is already producing an overarching evaluation of services that is “greater than the sum of its parts”. I am very confident that this will eventually be reflected in our overarching joint national report to be published next year.

About the author

Bobbi JonesBobbie Jones has worked as a local authority inspector for CSSIW since 2013. Prior to this, Bobbie worked as an inspector for HMI Probation after having spent a career of over 20 years in the National Probation Service.

Bobbie qualified as social worker in 1991 and has subsequently completed a Masters degree at Cambridge University in Criminology, Penology & Management.

Bobbie enjoys gardening, relaxing with a good book and playing with her grandchildren.

A teacher in a school

Inspection Wales Programme makes good progress

It’s sometimes said that external reviewers are like buses; they all turn up at the same time. And the challenge to the Inspection Wales partners, as the four principal external review bodies in Wales, is to demonstrably work together effectively to plan and deliver our work.  Such collaboration is essential to make the most of our respective, limited, resources, and to add most value to public bodies being reviewed and the people of Wales.

Front cover of the stocktake paperWe’ve now published a review of the progress [opens in new window] we’ve made in delivering our programme, an initiative to improve cooperation and collaboration between the four external review bodies in Wales.

The examples and case studies described within the paper demonstrate the extent to which the four review bodies are already planning and delivering work jointly, and show how, to again paraphrase another commonly used phrase, four heads are better than one.

The paper identifies long standing arrangements for collaboration, such as healthcare summits and quarterly meetings between the Heads of Inspection. It also outlines a recent new initiative from Estyn [opens in new window] and refinements to existing practices by CSSIW [opens in new window] which further demonstrate the commitment to information sharing by Inspection Wales partners. It provides details of joint working, particularly, but not exclusively, in the areas of education and health. For example, joint reviews by Estyn and the Wales Audit Office [opens in new window] of the four regional consortia for education improvement and joint reviews by HIW [opens in new window] and CSSIW of learning disabilities and Deprivation of Liberty safeguards.

Next steps for Inspection Wales

Over the next 18 months, Inspection Wales will further progress its first joint national thematic review on the topic of services for young people. Working across their respective remits in this way will enable Inspection Wales partners to take a more comprehensive look at the services provided to young people by different public bodies and report more holistically on young people’s experiences of services.

There will be a further blog in the near future about the joint work Inspection Wales partners are doing on youth services in Wales. There will also be a further blog about the forthcoming joint HIW and Wales Audit Office review of governance at Betsi Cadwalder University Health Board.

Inspection Wales partners will also continue to engage with the Welsh Government as it develops its plans for local government reform, as set out in the January 2017 White Paper on local government reform.

About the author

Emma Giles, Inspection Wales Programme Board ManagerDr Emma Giles took over as Inspection Wales Programme Manager in March 2017. Prior to this, Emma was a performance audit lead with the Wales Audit Office.
Emma is an outdoor enthusiast who likes mountain biking and walking.

Her PhD in Criminology looked at how offenders and criminal justice staff understood fairness, and what these differing perceptions of fairness meant for relationships between staff and offenders.



Collaboration in Action – Working Together on Health Governance

We talk about collaboration a lot on this blog, and that’s because it important to make sure our partners work adds value to public services. It would be a waste of resources if we all looked at the same things in the same way. It’s important for other reasons too, if we looked at services through the same lens we might miss important issues.

Talking about it is one thing, but we thought it would be nice to show you how collaboration actually works for health services in Wales. Two of our partners both have roles in the external review of health service governance. Now you might think governance is somewhat dry subject for a blog, I would beg to differ!

Governance in it true sense is an enabler for effective organisations, it determines the big, important questions, like how do we do things around here? Is it acceptable to do this? How is an organisation structured? How do the leaders know if we are doing the right things? In health- are our patients safe?


Healthcare Inspectorate Wales and the Auditor General for Wales both have specific remits which include governance of health services in Wales. Our partners could both just go out and review governance independently of each other, and report through their channels. But they decided that working collaboratively was better [opens in new window]. The paper [opens in new window]accompanying this blog explains how they do this in a clear way, but my summary is that we made a strategic decision to come at governance from two directions.

HIW approaches it from frontline services in individual wards and service areas, whereas WAO approaches it from the organisational top-down perspective. This means that our work complements each other. That is not enough on its own to get maximum value from our work, so we also work collaboratively in many ways, we use various formal and informal liaison mechanisms to make sure we make connections from what our work is telling us, and are able to spot many problems and draw attention to them before something awful happens.

We do this through our Healthcare Summit process, regular meetings between senior and operational staff from both partners, and engagement with Welsh Government through the NHS Escalation and Intervention process [opens in new window].

So what?

We have evolved our collaborative working since devolution, this is not something new, and this has helped us to produce a number of joint pieces of work from CAMS, to the Betsi Joint review of governance in 2013.

This is a good example of collaboration in action, and I hope you will read our partners paper.

A female carer helping a lady make cupcake cakes

Choice and voice: a joint approach

The collaborative approach to a joint inspection between Healthcare Inspectorate Wales (HIW) and Care and Social Services Inspectorate Wales (CSSIW) led to a successful report launch involving service users and carers, and a big push on social media on launch day.

Publishing our findings in June, we – the two inspectorates – challenged local authorities and health boards to improve the planning and delivery of services for people with learning disabilities.

Together we delivered a lengthy national inspection programme in six local authorities and local health boards, to see how services were planned and delivered for people in those areas.

We met with advocacy and involvement groups, including All Wales People First [opens in new window] and the All Wales Forum of Parents and Carers [opens in new window], and we produced an all-Wales report, which we launched at an event at iSmooth [open in new window], a Mencap Cymru [opens in new window] social enterprise in Ammanford.

This was thoroughly appropriate for this particular report, and gave the report more meaning than if it was a generic conference venue.

Many members of staff at iSmooth have learning disabilities and it was important that the venue was relevant to the types of issues discussed in the report, about the support available for people with learning disabilities.

Kevin Barker, inspector and CSSIW lead on the inspection said the process demonstrated a commitment to do what we expect others to do: work together to achieve a better result.

“Actions will always speak louder than words,” he said.

Online reaction

Words spoke loudly on the day of the report launch, with tweets between 28-29 June on the English-language @CSSIW Twitter channel [opens in new window] reaching more than 8,000 people.

Of those people who saw the tweets, 2.2% of them either clicked on them, clicked on links in them or expanded the images.

The most popular tweet from the launch which was seen by more than 2,240 people was the video of Wayne Crocker, Director at Mencap Cymru. It was retweeted 7 times and had 7 likes, by partners such as Mencap Cymru.

Meanwhile, tweets on CSSIW’s Welsh-language @Arolygu_gofal Twitter channel [opens in new window] reached 2,000 people over the two days. Of those people the tweets reached , 0.8% of them either clicked on the them or clicked on the link.

For the @HIW_Wales Twitter channel [opens in new window], which retweeted CSSIW’s tweets across the two days, their tweets reached 283 people, of which on average 0.4% of them engaged with them.

Valuable learning experience

Working together on such an important inspection programme has been a valuable learning experience for both organisations, commented Alun Jones, director of inspection, regulation and investigation for HIW [opens in new window].

“The resulting national inspection report and the individual local authority/health board reports are richer and more powerful for having input from both inspectorates,” he said.

“Our work has allowed us to shine a light on the way in which organisations work together to plan and deliver learning disability services.

“We have made a number of important recommendations which call for more effective joint working for the benefit of people with learning disabilities and their carers.”

Digging deeper

Richer more powerful reports were made possible by digging deeper with our inspection approach, explained HIW review manager, Emma Philander.

“From my point of view I feel that the highest quality care and support for adults with learning disabilities ensures that it meets the holistic needs of the person,” she said.

“By HIW and CSSIW working jointly it meant that we could better assess whether services were meeting people’s holistic needs, both from a health and social care perspective.

“Working together meant we could unpick the complexities of how health staff and social care staff were working together and the impact this had on people with learning disabilities.

“It meant we could dig deeper with our inspection approach and hold both the local authority and health boards to account to improve services for people with learning disabilities.

“I feel that both organisations learned from each other’s approaches and we look forward to building on this and collaborating more in the future.”

Policy and legislation manager for HIW, Nia Roberts, agreed.

“One of the other good things about this work was that we looked at health boards and local authorities at different levels,” she explained.

“We saw how colleagues from health and social services worked together on the front line to provide care and support to individuals with learning disabilities.

“We also asked senior representatives from health boards and local authorities to explain how they plan and commission to meet the needs of all people with a learning disability in their area. This involved scrutiny by both CSSIW and HIW.

“Given the provisions of the Social Services and Well-being (Wales) Act, this was important work, which was enriched by having both inspectorates involved.”

CSSIW project lead Kevin Barker concurred.

“There were many benefits from the joint work between CSSIW and HIW in this inspection, not least the range and quality of the evidence that it delivered,” he said.

“People with learning disabilities and their family carers often need help and support from both health and social services. They expect a joined up approach from the people and agencies involved and so do the inspectorates.”

You can read the joint inspection report on the CSSIW website [opens in new window].

Inspection Wales progress report cover on a white desk

Is joint working working? Collaboration between audit and inspection bodies in Wales … the story so far.

Four years ago, the heads of the 4 main audit and inspection bodies in Wales signed an agreement to formalise joint working between the bodies.

It was a logical move by the Wales Audit Office (led by the Auditor General for Wales), the Care and Social Services Inspectorate Wales (CSSIW), Her Majesty’s Chief Inspector for Education and Training in Wales (Estyn) and Healthcare Inspectorate Wales (HIW).

The agreement strengthened links between the 4 organisations and provided a solid foundation for better collaboration, knowledge sharing and business planning. The key objective? To improve outcomes for the people of Wales.

But have we achieved what we set out to achieve?

Well, when I took up my new role as Inspection Wales Programme Manager in February 2015, it was the first thing I wanted to find out.

So have we?

Yes, I believe we have. But, (until now) we haven’t told many people about it.

We’ve produced a report on our progress so far, which provides some detailed findings if you’re interested in reading more. But, I will summarise here.


They’re hard to measure, but I can testify that relationships between our four organisations are strong and exist at many levels across the businesses. There needs to be a level of trust to work together outside organisational comfort zones, and we do have this. I’m not saying that everything is perfect, and in some areas these relationships are still developing, but we have strong foundations in place.

Building blocks

We needed to agree how we do things together. That was not as easy as it could be because we all work to different laws and reporting arrangements. We’ve already published our remit paper, which explains all this in detail. Hence, we needed to work through basic processes like sharing information, and how we handle serious concerns about an organisation.

Joint working

We have done a lot of things together, but, we haven’t always told everyone that we did it together! Our stocktake report contains many examples, and some of these will be familiar pieces of work to you, but you might not have known they were joint.

We know we need to get better at sharing and our joint working achievements. That’s partly why we’ve set up this blog site. I’ll be writing more posts in the coming weeks and months, but you will also find posts from other people who are equally passionate about working together.

We look forward to sharing more with you about our audit and inspection missions to let the people in Wales know whether they are getting what they need and deserve.

About the author

Mandy Townsend on holiday sat in a boat

Mandy Townsend started work as the Inspection Wales Programme Manager in February 2015 and is seconded to the part-time role for two years.

Mandy, who is based in North Wales, spends the rest of her week in her original role as a Health Performance Auditor at the Wales Audit Office.

Macbook displaying the information sharing guidance

To share or not to share? How we’re using our collective knowledge for effective collaboration

One of the key building blocks of collaboration between the Inspection Wales partners’ is the sharing of information. And, tapping into the collective knowledge and expertise of our organisations has already started to improve the strength and scope of our work.

Our most recent report on regional education consortia in Wales is a great example of this. As detailed by Estyn’s Mark Campion in a previous post, the sharing of our collective data and research was a great way for us to add value.

By establishing a framework that allows us to share information before we started this joint piece of work, we were able to work together to reap the benefits and produce two reports, for Welsh Government and the National Assembly for Wales, without wasting resources and duplicating effort.

It is, however, important that we get it right when it comes to sensitive information and over the last few years we’ve operated a working group across our partners to make sure that what we do share is appropriate and proportionate.

This group explored:

  • what information we all had
  • how we store it
  • what we should share, and
  • explored how we should do this safely and legally.

You can imagine, given the breadth and depth of partner responsibilities, how complex this is. Ultimately, what our staff needed was a framework to share information, and perhaps most importantly, permission from the Heads – the Auditor General for Wales, the Chief Inspector of Care and Social Services, the Chief Inspector of Estyn and the Chief Executive of Healthcare Inspectorate Wales – to do so when our work requires it.

Sharing information is vital for the success of any collaboration and having the framework in place means that we don’t get caught in the trap of hoarding expertise. It also means we can work together towards our shared goal – to support better outcomes for the people of Wales.

Read our overview to find out how we share information.

About the author

Mandy Townsend on holiday sat in a boatMandy Townsend started work as the Inspection Wales Programme Manager in February 2015 and is seconded to the part-time role for two years.

Mandy, who is based in North Wales, spends the rest of her week in her original role as a Health Performance Auditor at the Wales Audit Office.

Collaboration in action

A joint report on the independence of older people released today provides a great example of how the Inspection Wales Programme is developing approaches to collaborative working.

This study was conducted by the Wales Audit Office and the Care and Social Services Inspectorate, who are part of Inspection Wales, along with the Older People’s Commissioner for Wales.

In this blog post, representatives from all three organisations outline the advantages of working together on this report and how collaboration is helping them deliver better outcomes.  

Huw Vaughan Thomas, Auditor General for Wales

HVt generic twitter

Working together. Everyone talks about it and the benefits it brings. You know the picture. Better use of resources, wider knowledge to draw on, specialist expertise, greater experience to broaden understanding and practically, more hands make light work of the difficult task. As an idea it is difficult to argue against but can still be very difficult to do. Different working styles, different expectations and different objectives all have to be balanced if it is to be successful. It also helps if you get on and like each other.

Thinking of the pluses and minuses of working together, I am pleased to say that the Wales Audit Office study on the independence of older people, which was published on October 15th 2015, is built on an effective working together experience. Colleagues in the Care and Social Services Inspectorate in Wales and the Office of the Older Peoples Commissioner in Wales positively assisted the Auditor General to deliver this study.

The support provided, advice given, help in shaping the methodology, delivering fieldwork, distributing surveys, promoting the work and reviewing findings has led to a comprehensive review which produced a detailed picture of how councils support the independence of older people.

Without the enthusiasm and willingness of CSSIW and the Commissioner to support this work the study would not have been as a comprehensive in its coverage or made the impact it has. One thing is for sure, the benefits of joint working is plain for all to see and is something we need to continue to build on and is something we can and need to do more of.
Imelda Richardson, Chief Inspector of Care and Social Services Inspectorate Wales

Imelda Richardson image for twitter and facebook

We work closely with Wales’ other inspectorates and we’re proud to champion a joint working approach, as demonstrated by working with Estyn to create a joint inspection framework for early years services. We have a number of agreements in place on how we work with other regulators, inspectorates, and local authorities involved in improving the quality of social care and social services in Wales.

For this report we were able to share knowledge from our inspection activity in all 22 Welsh local authorities, and collaborate with partners to better focus on the wellbeing of our older population. We were happy to play a supporting role for this report and share our knowledge and experience about the needs of older people.

Our work is an important part of Wales’ social care sector, and joint working allows us to be a stronger voice for improving care for people in Wales than if we operated in isolation.

Taking on board ideas around best practice and taking a cross-cutting view across social care allows us to improve our own practice and share ideas more widely across other organisations, and can only have a positive impact on the people of Wales who rely on or help support social care in this country.

I look forward to further collaborative work with partner organisations in the coming years.

Sarah Rochira, Older People’s Commissioner for Wales

Sarah Rochira

As Older People’s Commissioner, I have welcomed the opportunity to work with the Wales Audit Office (WAO) and other partners to produce this report. The report follows on from my participation in the WAO Shared Learning Seminars in July 2015, and I am pleased that this work has strengthened links with the Auditor General and colleagues. Collaboration across the public sector in Wales is needed more than ever, and I am pleased that the WAO and others reinforce my key statements and recognise the importance of maintaining the independence of older people.

Given the challenging financial outlook, service providers in Wales must now work together to provide high-quality services that reflect the needs of older people. Older people’s needs are not confined to health and social care services, and providers based in transport, education, housing and leisure sectors, for example, must deliver cost-effective services that help to maintain the independence of older people.

A collaborative, joined-up and long-term approach, based on the integration and prevention agendas, is now urgently required to remove key barriers and maintain the health and wellbeing of older people. Joint working is crucial in addressing both the national wellbeing goals within the Wellbeing of Future Generations Act and also the aims within the Ageing Well in Wales Programme.

I look forward to working further with the WAO and other partners to make clear the importance of taking a preventative approach and to ensure that public service providers can better utilise older people’s wealth of knowledge and experience, increase their contribution to communities across Wales and help older people across Wales to maintain their health and independence.

If you would like to find out more about the report ‘Supporting the Independence of Older People: Are Councils Doing Enough?’ the report can be downloaded from the Wales Audit Office website.

The power of working together: Why audit and inspection bodies in Wales need to connect more

Mandy Townsend

Hi. I’m Mandy Townsend and I’ve got an exciting new job I want to tell you about.

Working as the new Inspection Wales Programme Manager doesn’t sound very stimulating does it? But, believe me, it’s a really great role which is designed to help people in Wales.

How do I do that?

I bring together the main bodies in Wales that exist to help make sure public services are delivering what they should be. I help them work together, share information and coordinate their work as efficiently and effectively as possible. This work is called the ‘Inspection Wales Programme.’

The 4 audit and inspection bodies I’m talking about are the Wales Audit Office (led by the Auditor General for Wales), the Care and Social Services Inspectorate Wales (CSSIW), Estyn (Her Majesty’s Inspectorate for Education and Training in Wales) and Healthcare Inspectorate Wales (HIW).

Most of our work is very separate because each body has different purposes and different laws which govern what they have to do. But some of our work can have a common focus. For instance, we all have a role to play in checking particular public services; and there are other areas where 2 or 3 of us share responsibility in various combinations for scrutinising aspects of services.

While we know how our work relates to each other, most people don’t. So, we’ve written a short paper to explain it.

Personally, I like this visual summary:

Graphic showing the 4 inspection bodies linked together

You can see the linkages between the work of the 4 audit and inspection bodies and it means that joint working helps us all be more efficient.


There are many reasons for this – avoiding duplication of effort is one of them. It’s not just public bodies that don’t want us examining the same thing twice, importantly we don’t want to either, it is a waste of our time and energy. We could be using our limited resources to do something else.

But, the main reason, for me at least, is that when we work together we are more powerful. If we all contribute to the same thing and report (good or bad) on it, people take notice, and things change.

That’s why we want to work together as well as we can. After all, the reason we all come to work is to improve services for the people of Wales – to make things better.  If the Inspection Wales Programme can help our partners do this more efficiently, then it’s a success.

And that is why my job is exciting.

About the Author:
Mandy Townsend on holiday sat in a boatMandy Townsend started work as the Inspection Wales Programme Manager in February 2015 and is seconded to the part-time role for two years.
Mandy, who is based in North Wales, spends the rest of her week in her original role as a Health Performance Auditor at the Wales Audit Office.