Last month, I wrote about the multitude of challenges faced by supported living services – a subject that I am very passionate about. This week, I’d like focus on supported living once again. But in this column I want to zero in on the important role that best practice and accreditation can play in transforming supported living services.
Best practice is particularly key, but it is often overlooked. Having worked with adults with complex needs in residential services and supported living for many years, I was always very surprised to see this happen. Today, when I work as a consultant for Quality Compliance Systems (QCS), the leading provider of content for the social care sector, on creating new policies for the supported living sector, it is obvious to me that best practice is still being misunderstood. What’s more in a sector embracing so many different specialist areas, it is often grossly undervalued.
If used correctly, it can be a force for good. But too often, managers and staff are overly focused on meeting Care Quality Commission (CQC) regulations. In competing to attain that elusive outstanding rating, they forget what is really important. It all points to the fact that simply following CQC regulations is not enough. Supported living services should ensure that staff embrace a values-based person-centred culture of best practice learning. This culture should shine through in organisational policies, procedures and support plans. Ultimately, it should lay the foundations for an evidence-based portfolio of best practice which delivers positive outcomes of the individuals they support. QCS has spent time updating its suite of best-practice tools and resources to ensure this is the case.
Accreditation and best practice are inextricably linked
But allied to best practice is accreditation. In fact, the two are not just closely related but are inextricably linked. Why? Well, in most cases to be considered outstanding in specific areas of best practice requires specialist knowledge that often can only be acquired from an outside body.
In the sector, the number of people, and services for that matter, that fall under the banner of supported living is both vast and varied. For supported living services to flourish, the people that are being supported need to feel that they, in the words of REACH Standards for supported living, are “supported to live the life they choose – with the same choices, rights and responsibilities as other citizens”.
That requires an almost unique understanding of the people being supported. It means understanding the needs of those living with learning disabilities, autism and also those with rare genetic conditions such as Fragile X syndrome, or additional needs including physical disabilities, Epilepsy or conditions that affect communication.
The CQC, commissioning bodies, and most importantly individuals and their loved ones, need to have confidence in a service before they agree to a placement. They want to be reassured that a supported living service, not only conforms to CQC regulation, but also to any specialist best practice requirements and benchmarks. They want to know (where it applies) that the service meets the requirements of the Real Tenancy Test and understands the challenges that people with learning disabilities face every day.
Accreditation provides reassurance
Accreditation, with defined and recognised training paths, which enables providers to demonstrate that they are going over and above the required standards, is the solution. Take supported living services, for instance, that are supporting people with autism, learning disabilities, or with complex needs. The National Autistic Society runs an Autism Accreditation scheme, which is the only autism-specific quality assurance programme in the UK for those providing services to autistic people.
For those who apply for accreditation, there are a myriad of benefits. The National Autistic Society says that accreditation provides “a more autism-focused service” and “a more personalised service”. However, those who are successfully accredited also see an “increase in referrals” to their services, “a decrease in vacancies”, are able to provide best practice “evidence for commissioning bodies”.
Providing such evidence will also go down well with the CQC, especially given the changes to the way it will assess providers in the future. Going forward, for example, the CQC plans to gather information on an ongoing basis. In doing so, it will contact the people using supported living services and in some cases the local authority. If those using the service can see that the manager and staff have made concerted efforts to gain new knowledge and fresh perspectives which conform to set standards, they are more likely to provide positive feedback to the CQC. This feedback will be taken into account when the CQC assesses the service.
It is not enough just to follow CQC guidelines
While supported living services should of course adhere to CQC guidelines and standards, they shouldn’t be afraid to delve deeper. By this I mean, it is a particularly useful exercise to read the reports of those services that have achieved an outstanding rating. It is useful to do so as they provide information on the work others are doing well to achieve an enhanced rating.
However, providers should not wholly rely on CQC guidance. It does not provide services with a clear roadmap as to what training they should have in place, or how often certain training is required. Therefore, I would recommend that supported living services also work to Skills for Care standards because the training is laid out in a much more prescriptive way.
That said, it is important that providers adapt this approach in order to demonstrate that training includes specialist skills and knowledge required to meet the needs of service users that they support. If a service is using restrictive practices and interventions, then it is also important to ensure that the training providers it uses also have accreditation such as BILD and adhere to Restraint Reduction Network Training Standards.
Using and personalising QCS policies and making use of Skills for Care resources is one way of ensuring that providers stay ahead of the curve. However, I would also strongly advise that providers also incorporate best practice guidance, join specialist accreditation networks, and utilise the National Minimum Data Set for Social Care (NMDS-SC). Together, using these resources and employing these strategies will help supported living providers instil trust and build reassurance. When it comes to enticing individuals to a service, this is the true litmus test governing whether a service flourishes or flounders.
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