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07th April 2020

What makes for a well-led care home?

Demonstrating to a CQC inspector that a service is Well-led is one of the most challenging domain key questions for providers. Ed Watkinson, a former inspector who consults for Quality Compliance Systems (QCS), reveals the secrets to achieving an Outstanding rating. 

EW) “Outstanding providers are those with an extremely positive culture deeply embedded in their DNA. These services are managed by inspirational leaders, who lead by example. They set the vision and culture by seeing their staff as a precious resource, which if nurtured and guided in the right way, can provide service users with outstanding person centred care.

Indeed, in the best services, culture is key. Managers instil it by working closely with the carers - mentoring them, providing them with constructive feedback and rewarding them when they show improvement.

Finally, a Well-led service with a strong organisational culture tends to have a horizontal structure rather than a vertical one. This creates an atmosphere where carers feel empowered to share ideas for improvement, or, in the worst case scenario, raise concerns. Most importantly, they know that they’ll be listened to by managers.”

CHM) Engagement (W3) and Partnership (W5) are two KLOEs that providers often score poorly in. What does Outstanding Well-led care look like in both?

EW) “When a service lacks culture and vision, it often struggles to excel in the ‘Engagement and Partnership’ KLOEs. Outstanding engagement means no bottle-necks and no silos. Instead it is about leaders in a care home taking their staff on a journey of improvement and treating them as equal partners. That could be engaging with staff around business planning or when working on future strategies.

Well-led services have good partnership networks and adopt a co-productive outlook. But there are varying degrees of excellence. Services that have secured a Good rating will have forged links with the CQC and Local Authority safeguarding teams. Outstanding providers, however, will not only have this standard network in place, but will also be closely connected with local cultural, religious, sporting, community and other organisations that have connections and can contribute to the improvement of the lives of people that use the service Outstanding services see themselves as a sponge who can suck up and integrate best practice, knowledge and resources.

Finally, both the Partnership and Engagement KLOEs require providers to ask tough questions. For example, do they meet the needs of local people who are service users or might become clients in the future? And what resources can they tap into locally that could transform the lives of residents? Sometimes providers will fall short. However, the best ones learn from their mistakes and improve their service offering.”

(CHM) How can QCS, which provides bespoke policies and management toolkits for the care sector, help to drive improvement in this important area?

“QCS helps providers in a number of ways. Take the Governance KLOE for example which tests if legal requirements have been met. Registered Managers using QCS’s compliance tools enjoy peace of mind because each of QCS’s 250-plus policies are constantly being updated and conform to CQC standards

Secondly, another key theme which spans each of the five KLOEs, is the ability to incorporate innovation and new thinking into a service. With all QCS’s policies and procedures following best practice, Registered Managers can gather fresh insight and a range of different perspectives from a raft of industry bodies, think-tanks and key influencers. By integrating these insights into policy and procedure they can demonstrate to an inspector that their service is committed to improvement and the steps that have been taken are in line with industry best practice.

Finally, in a time of pandemic, QCS’s app contains the latest COVID-19 infection prevention and control policies. Not only does this mean that Registered Managers can provide the right policy at the right time to care workers in a home, it also enables them to digitally distribute best practice to a remote workforce quickly and efficiently. For those working on the front lines, if policy and procedures are applied correctly, this can raise infection control standards.”

*All information is correct at the time of publishing. Use of this material is subject to your acceptance of our terms and conditions.

Ed Watkinson

QCS Director of Care Quality

Ed serves as part of the Senior Management team at QCS. He is lead on the development of new quality assurance, compliance and care management policies and procedures. Read more

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