Friday 14 December 2018
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CQC outstanding it aint what you do its the way that you do it

What would it take I wonder to make every social care service ‘outstanding’? I’ve been thinking about this a lot recently as it seems to be becoming something of an elite group. The adult social care sector still has less than 1% of care services rated at the highest level – can this really be accurate? 
NCF is fully in support of celebrating the achievements of those care providers judged to be delivering the very best care and learning from what they do so well. However, there are now some 65% of services assessed as ‘good’ and presumably some of these are just missing out on the outstanding accolade. All the care providers I meet aspire to be as good as they can. I can honestly say that I don’t know any that would want to be thought of as being ‘no worse than anyone else’ (a phrase so powerfully used in a paper by George Julian this week). So, I was interested to chair the TLAP Quality Forum last week (21 April 2016) which included an illuminating presentation by Steve Holmes, Quality and Risk Assurance Manager with CQC, which drew on analysis of the results of some 100 care services rated as outstanding. The presentation highlighted just what makes the difference for the very best providers. And guess what? It’s not rocket science! Steve summed it up in just four words:


These headings were used to illustrate what can be learnt by studying what inspectors said in their reports. I have made reference to this in several previous blogs – the best care providers are constantly vigilant to the learning opportunities of other providers.
Using examples as a way of evidencing a person-centred approach for example and telling a story about the services offered as well as how they are provided makes it meaningful. What does “treating everyone as an individual” actually look like? In what ways do staff show that they truly understand person-centred care? Are staff able to talk about the purpose of care planning and why it is important in simple ways? Of course an overriding factor in successful services is the evidence of effective leadership and the quality of management. We have always known this to be true. Inspiring staff through leading by example so that there is clear evidence of a shared understanding of purpose will say a lot about the commitment to supporting people well. Steve’s presentation stimulated considerable discussion at the Quality Forum. Members wanted to know more about the finding that smaller services seem to do best and the seeming predominance of ‘outstanding’ ratings amongst services in the self-pay market. Perhaps we need to have all services rated before we draw out such trends conclusively and there is still a way to go until the first round of assessments/ ratings are complete. 
I left the meeting with a tune in my head: ‘It ain’t what you do it’s the way that you do it… that’s what gets results” – but then I do come from Coventry and I’m old enough to remember Fun Boy Three’s 1982 hit with Bananarama. You might know it reached No 4 in the UK singles chart but I bet you didn’t know it was first recorded in 1939!

Des Kelly OBE | Executive Director | National Care Forum