How best do we achieve good governance (CQC Regulation 17) in home care (Domiciliary Care)?

Answered by Sheila Scott

Dear C,

Thank you for your question.

This would be my basic description of good governance for an Adult Social Care Service.

“Establishment of policies, procedures and forms and continuous monitoring of proper implementation, by the Registered Manager and the Responsible Person to ensure the delivery and continual improvement of a quality service. This needs to include the mechanisms required to ensure that the service is meeting these five questions:

Is it Safe?

Is it Effective?

Is it Caring?

Is it Responsive?

Is it Well-Led?”

The important thing as far as I am concerned is that you will have policies, procedures and forms in place for your service.

It is not enough just to have the paperwork in place. The policies and procedures that you have must be the key part of the way you provide the service to people living in their own homes.

So as a small example, it is not enough to say that a carer will visit at a particular time, you have to ensure that that commitment is being met. This is part of your audit and good governance will ensure that you not only have a system in place to track punctuality but that you audit that system to ensure that the policy is being met as far as possible and that, where it cannot be met, the service user is informed as soon as possible that there will be a delay. If this is an ongoing problem then you must demonstrate the steps you have taken to improve the service.

I presume that you have audits in place and these are what will demonstrate the quality of the service being delivered.

Important areas that need to be continually monitored are care plans and staff files to ensure that they are up to date and the subject of regular reviews.

If you don’t have the appropriate systems in place there are systems that you can purchase such as the Quality Compliance Systems (QCS) which you can find out about at www.qcs.co.uk

You should base your systems for auditing around the Key Lines of Enquiry (KLOEs) http://www.cqc.org.uk/sites/default/files/20150327_asc_community_provider_handbook_appendices_march_15_update_01.pdf

I hope this is helpful.

With best wishes,

Sheila