Free article: CQC inspection reports

Published: Monday, 02 July 2018

Martin Hodgson talks about the new CQC report highlighting improvements in adult social care.

Summary

  • The CQC has published a new report containing case studies of adult social care providers that have achieved significant improvements in their ratings from ‘inadequate’ to ‘good’.
  • The CQC found that most providers said that a CQC inspection report highlighting their failings helps them to identify why they have been struggling and points out where they can improve.
  • In most of the case studies a new manager had come into the service to deliver the improvements and they did this by engaging with staff and with people who use services and their families.
  • Involving staff is identified as one of the best ways to drive improvement. The report states that failing organisations often tend to have cultures in which staff are either afraid to speak out or do not feel they have a voice.

The Care Quality Commission (CQC) has published a new report containing case studies of adult social care providers that have achieved significant improvements in their ratings.
Driving improvement: Case studies from nine adult social care services, has been written to inspire others that improvement is possible and to highlight the sort of actions that service providers can take to achieve similar progression.

In preparing the report the CQC say that they spoke to a range of people at each service. This included people who used the services and their families, registered managers, providers and owners, care staff, administrative and other staff, commissioners and social workers. All of the services in question - two nursing homes, five care homes and two domiciliary care services - had moved from “inadequate” ratings to “good” ratings. One service had been subject to enforcement action.

The case studies were chosen to reflect a cross-section of the adult social care sector and a mix of people involved.

The CQC asked questions such as:

  • What was your reaction to the service being rated as inadequate?
  • How did you approach improvement?
  • What support did you ask for and what support did you receive?
  • What were the obstacles to improvement? How did you overcome them?
  • Did the inspection report help you improve your service and outcomes for people?
  • How did you involve staff and support them further in their work?
  • How did you involve people, their families and carers and volunteers, who use the service?

Providers were also asked to list the top five actions they took that helped their services improve.

Driving improvement sets out the key themes emerging from the case studies. These include the following:

  • Most providers react to a report highlighting the failures of their service with “shock, surprise and disappointment.” However, when they stand back and have time to reflect they understand the failings. For some the CQC state that the report comes as a relief, helping them to identify why they have been struggling and pointing out where they can improve. For others a negative inspection is a “wake-up” call.
  • The CQC state that the value of a good leader in driving improvement cannot be underestimated. In most of the case studies a new manager had come into the service to deliver the improvements and they did this by engaging with staff and with people who use services and their families. Effective leaders were reported to be “open to suggestions” but “took tough decisions” where necessary.
  • Involving staff is identified as one of the best ways to drive improvement. The report states that failing organisations often tend to have cultures in which staff are either afraid to speak out or do not feel they have a voice.
  • Typically, when a new manager took up the reins, the CQC noted that they wanted to see care plans and in most cases identified that plans were lacking in detail and did not show that the care being provided was person-centred. The CQC point out that it is not possible to provide good care if care staff do not understand the needs of the person being cared for.
  • Most of the services featured received support to help them improve, such as from the corporate provider, if there was one, or from commissioning bodies.

The CQC urges all service providers to read the case studies report and use the examples to inspire their staff and drive their own improvements.

Speaking about report, Tony Hunter, chief executive of the Social Care Institute for Excellence, said:

“Knowing what good looks like is valuable – but knowing how to improve is critical. The value of this new report is that it highlights practical steps that owners, managers and staff can take to move on from that initial shock of getting an inadequate rating. It is a real wake-up call and the most progressive organisations recognise this.”

Further information

Driving improvement: Case studies from nine adult social care services can be downloaded from the CQC website at https://tinyurl.com/yaqpyr9h

About the author

Martin Hodgson RMN, BSc, MSc, PGCEA, is a community psychiatric nurse and a psychology graduate by background, Martin has had a long career working as a senior manager in various health agencies, initially to do with mental health and latterly to do with primary and community care.

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