Quality in adult social care

The battle for Care Quality Commission (CQC) regulatory compliance is becoming an increasing burden for suppliers of adult social care in England.  CQC regulations and guidelines are creating the need for management processes to be adapted and improved to aid with the CQC registration process.  How do organisations big and small begin to understand the scale of this challenge?

 Over the past few years there has been increasing public awareness of the wide variation in the quality of social care provision in the UK. Numerous shocking and unfortunate failures have come to the fore, leading to public perception of social care dropping to an all-time low. The BBC’s infamous Panorama program “Britain’s Homecare Scandal” highlighted, very publicly, the desperate mis-management prevalent.

 Although the maltreatment of service users shown was a rare example, a greater consistency and control of the provision of services was needed; to this end the Care Quality Commission was established. The CQC took over from the Commission for Social Care Inspection, the Healthcare Commission, and the Mental Health Act Commission from 1st April 2009. With the amalgamation of these services it was hoped that the regulation of care providers would happen with greater ease, cohesion and clarity. The provision of care could now be gauged with a greater confidence by a public who had been confused about whom to approach for this information in the past. In addition, the transparency of the new system was intended to lead to a decrease in the ‘poor’ or ‘adequate’ services that according to the CQC more than 80,000 people in England are receiving.

The CQC will now continuously monitor compliance with a compulsory registration programme for all individuals or organisations that wish to supply adult social care. And the deadlines are coming up fast: all NHS trusts must be registered by April 2010 and adult social care and independent healthcare providers by October 2010. The CQC will then publish information on registered providers and undertake pro-active compliance monitoring to ensure that acceptable standards of quality are met.

If serious non-compliance is discovered or previous action plans have not been completed, then enforcement action could include warning notices, imposition or variation of conditions, suspension of registration to provide certain services, fines, prosecution or cancellation of registration.

For larger organisations the adoption of a formal approach to managing the provision of high quality services may be painful, but is at least possible. They have the resources to employ experienced quality professionals, implement computerised management and reporting systems and provide training for their staff.

But what of smaller organisations? Has the CQC considered the support they might need to manage the transition? There is a serious concern that smaller organisations may feel the challenge is much greater and could miss the deadlines or not put sufficient systems in place to meet new CQC regulations.

My experience over the past ten years in the provision of computerised tools to reduce the administrative burdens of operating quality management systems in NHS trusts and private social care providers has led me to recognise certain key points.

Smaller organisations need to share knowledge. It is vital to talk to other people. If smaller companies can share their growing experience of implementing quality systems, they can become more confident about the challenge. The craft behind developing these processes is widely documented, but for many it is the challenge of developing a new culture within their organisation. They need to realise that quality is not a by-product of what an organisation does, but an engrained ethos, widely recognised as a means of streamlining processes, effectively cutting costs and improving output.

Companies can also take the time to see what’s available to help them through the process - a range of software tools have been developed and proven and these can reduce the overhead in collecting and reporting information and automating workflow processes. Examples include tools for document approval and control, recording and monitoring staff training and competency, incident reporting and resolution, audit recording and non-conformance management.

 2Care, a provider a high quality, specialist support and care for adults who have experienced mental illness, are a case in point.  They recognised the administrative effort required in managing their existing quality system and that the driving of continuous improvement in services was unsustainable. They urgently needed tools to minimise the effort required and contacted Qualsys for assistance in creating an application that would suit there document management needs.  An electronic solution was sought, enabling multi-sited management of documentation, procedures and non-conformances, all within a compliant and auditable environment.  The administrative burden was significantly reduced and complying with legislation made easier as all their documentation was in place, showing the consistent management of processes. To read further into this story click here.

Additionally, the phenomenal growth of the Internet and low cost ways to access it has meant that software applications and data storage capability no longer have to be purchased and stored locally; they may be rented and shared. This not only saves on the cost of software licences and computer hardware but also removes the need to have in house IT experts.

 Bettal Quality Consultancy Ltd, suppliers of quality management systems and training to the social care sector have taken this idea of ‘Cloud’ computing and developed, in conjunction with Qualsys, a service for their customers which enables the prompt delivery of the correct compliance documentation.  Bettal are able to manage this library of information remotely to ensure that customers always have a document portfolio that is accurate, up-to-date and matches their business needs.  With minimal effort the customers can access this information via a web-browser; they can view the latest version of documentation and are assured that the content is compliant with all the latest legislation and standards. To read further into this story click here.

 The pressures to comply with an increasing multitude of regulations are greater than ever for social care providers.  With the very public announcements by the CQC of new measures with which all providers will be measured comes a new kind of administrative headache for those striving to concur.  With the right technology and training in place, small as well as large organisations can undertake the compliance challenge with increased confidence.  Leaving more time and energy available to concentrate on what is important, caring for the people who understand the improvements in quality greater than anyone else, the clients.

James Bywood. Contact James at: james.bywood@qualsys.co.uk

A précis of this article will be appearing in the March issue of Quality World.

For information about Qualsys contact Robert Oakley on +44 (0)114 282 3338.
Email robert.oakley@qualsys.co.uk

8th February 2010

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