The examples below provide insight into how other Good or Outstanding rated services are succeeding in this area of inspection.
Use the filter to choose different types of examples or select based on related prompt.
Involving a person in the auditing of care
A person experienced anxiety when they felt excluded from things that directly affected them. The person was given an explanation about audits that would happen in their home to ensure it was safe and to recognise issues early.
The person was asked if they would be able to help staff complete the audits. The person was delighted asking if they could start that evening. The person was asked each question and then ascertained the answer/evidence as appropriate. They understood the 'actions' process and who to raise particular issues to, for example, any maintenance issues to the office manager.
The person completed all audits in their home, which has supported with other learning areas such as maths, as they count their medication. The results from the person's audits were then compared with the manager's audits to ensure accuracy.
Read more about this service here.
Care provider: Kingdom Youth Services
Date published: March 2023
Using qualitative Interaction Schedule Audits (QUIS)
The registered manager and team often completed qualitative Interaction Schedule Audits (QUIS). This was a tool used to observe targeted staff interactions with people and observations were recorded, scored and then feedback was provided to staff, highlighting positive social interactions and areas for development.
Observations were completed during any point of care including during meals, were the outcome of this had been used to change practice and significant impact of this as reported under the effective section of this report.
Read more about this service here.
Care provider: The Royal Star & Garter Home - High Wycombe
Date published: January 2023
What it feels like to work for an 'outstanding' provider
We spoke to Ellen Toulson an assistant team leader and Steven Guest a support worker at City Care Partnership about what it feels like working for an ‘outstanding’ rated provider.
Read the full blog here.
Read more about this service here.
Care provider: City Care Partnership Ltd
Date published: December 2021
Using NICE guidance to improve the quality of care
Runwood Homes uses NICE guidance to support staff learning and training to drive quality improvement in their care home services.
The NICE guidance provides knowledge and clear information on improving the knowledge of staff care for their residents and enables improvement in the lives of the people they care for. The NICE guidance is a great source of quality information that’s easy to understand and implement.
See also: Social care guidance at NICE
Care provider: Runwood House
Date published: November 2021
Contributing to national good practice
In this one-minute audio clip from the Care Exchange podcast, Joseph Hughes explains how he shares the knowledge and experiences in national good practice.
You can listen to the full podcast here and access our latest episodes of The Care Exchange here.
You can read the related CQC inspection report here.
Care provider: City Care Partnership Ltd
Date published: May 2021
Quality improvements during the pandemic
The past year may have seen providers pause or delay some major improvement activities, but they’ve focused on some small to medium changes that have helped to improve the quality of care. Whilst some of these were initially introduced in direct response to COVID-19, they’re helping services to support and engage with people and staff in positive ways that are likely to be adopted longer-term.
We found that 46% of those booking onto Skills for Care’s ‘driving and evidencing improvements in difficult times’ webinar had introduced improvements that were making a positive difference. Understandably there’s been huge progress in services adopting more digital ways of working, but there are a multitude of other improvements prompted by an urgent need to deliver care differently.
Care provider: Various
Date published: February 2021
Securing support for long-term improvements
Back in 2017, we had some services rated good and some rated required improvement, as well as one service in special measures. We developed an improvement plan for each service and during 2018/19/20 achieved an overall good rating for every service. This included supported living, Shared Lives, respite and a residential care home. We started thinking about the journey towards achieving outstanding across our services, and our desire to become a provider of choice for people and an employer of choice.
The first part of this process was to evaluate our various services. We began by reviewing our management and leadership team to ensure we had experienced people with the skills and competencies we required for each service area.
We started to build a new management team by retaining some highly skilled managers, provided opportunities for existing staff to be promoted into management roles and recruited some external registered managers with experience of improving services and supporting people with autism, as well as people living with dementia.
Care provider: Vivo Care Choices
Date published: January 2021
"Securing support for long-term improvements"
In this blog, Jan Fryer is Operational Director at Vivo Care Choices tell us how Vivo’s commitment to long-term improvements have been achieved and put the service in a strong position when the pandemic hit.
Read more about this service here.
Care provider: Vivo Care Choices
Date published: January 2021
A strong framework of accountability
There was a strong framework of accountability to monitor performance and risk, leading to the delivery of demonstrable quality improvements to the service. Leaders and managers saw this as a key responsibility.
Daily, weekly and monthly audits had been carried out, including on people's plans of care, medicine records and behavioural incidents. Records showed where issues had been identified, appropriate action had been taken in a timely manner.
The service also strove for excellence through consultation, research and reflective practice. The service received the external accreditations of silver accreditation by Investors in People, Investing in Volunteers quality standard and Skills for Care-endorsed quality training provider and was a Disability Confident Employer.
Read more about this service here.
Care provider: Creative Support - Doncaster Personalised Services
Date published: February 2020
Creativity days
The provider planned to introduce 'staff creativity' days. These away days would allow staff time to work on a project of their choice, focussed on service improvement and innovation to enhance the quality of care. Ideas would be reviewed by the senior leadership team and implemented throughout the organisation.
Read more about the service here.
Care provider: J S Parker Limited North East
Date published: February 2020
How quality processes assure outstanding care is delivered
Staff, the registered manager and the provider carried out detailed self-assessments, compliance audits and mock inspections on all aspects of the service. They then rated each aspect outstanding, good, requires improvement or inadequate in-line with CQC inspection focus and characteristics.
When areas were identified as anything less than outstanding, actions were put into their service development plan and they sought feedback on improvements that could be made in order to progress to outstanding.
Staff were passionate about learning and embraced the latest and best practices. Champions ensured that all aspects of care and support reflected the most current and approved methods and practices. People and staff were encouraged to speak up and share their ideas on how to improve the service and the support given to people.
Team meetings were held regularly, and staff discussed ideas, improvements and reflected upon things that hadn’t gone so well to see how they could handle similar situations better in future. Champions discussed developments in their area of interest at team meetings to ensure learning was disseminated amongst staff and as one champion told me ‘to spread the passion.’
Read more about this service here.
Care provider: SENSE - 89 Hastings Avenue
Date published: April 2019
Accessing funding for training and a free digital system to record and monitor training
We use the Adult Social Care Workforce Data Set (ASC-WDS) to access training and claim back funding for apprenticeship qualifications, which ensures our staff are trained and skilled to fulfil their role to achieve the best possible outcomes for those we support on a daily basis. Our recent CQC report stated: “Staff received effective and detailed training that enabled them to carry out their role. There was an electronic system to record the training that staff had completed and to identify when training needed to be repeated.”
Care provider: Anonymous
Date published: January 2019
Assessing quality against your business plan
The annual business plan clearly summarised the organisation’s aims and objectives, with well-defined forward planning strategies being implemented. This helped the provider focus on continuous improvement by regular assessment and monitoring of the quality of service provided.
Care provider: Anonymous
Date published: April 2018
Involving staff in quality by delegating monitoring
The service was very effectively monitored through robust systems of governance. Members of the staff team had delegated responsibility for specific areas of monitoring the service, which was something they took seriously. For example, one team member was responsible for overseeing training and other team members for medicines, health and safety and fire safety. Two staff members monitored the quality and completion of documents, including care records and reviews.
This system helped ensure ownership of the service’s performance by every member of the team. Staff felt involved, consulted and that their views were genuinely valued and acted upon.
Care provider: Anonymous
Date published: April 2018
Seeking specificity from compliments
Our compliments book includes various different sections about our service, helping us to easily review these areas as part of our continuous improvement plans.
Care provider: No Place Like Home
Date published: April 2018
Removing bias from auditing
Understanding that a CQC inspector can choose to contact anyone who uses the service (and/or their family members), we’ve applied the same principle to our own internal audits. This ensures there’s no cherry picking who we speak to about their views on the service and how these can be improved.
Care provider: Bluebird Care
Date published: April 2018
Using people to support and drive quality assurance
The homecare agency recruited people with experience of using the service into quality assurance roles. Involving such people in the quality team had a profound impact on looking at the care they were delivering, which helped them recognise the importance of connecting with external initiatives and best practice.
Care provider: Anonymous
Date published: April 2018
Embedding quality assurance across an organisation
The service was part of a national franchise which produced guidance on quality assurance and continuous improvement. The guidance focussed on tailoring care to the individual, care visits of a longer duration, continuity of care and promoting independence. These were already embedded in the policies and day-to-day interactions of the service. The owner and registered manager work closely together to review in-line with this and ensure the service meets best practice.
Care provider: Anonymous
Date published: April 2018
Creating frameworks and processes for quality assurance
Recognising the importance of how the service needed to be able to evidence each area of a CQC inspection, we mapped every key line of enquiry to all the elements of our service. This helped us identify the things we do really well and create an action plan to inform further improvements. We developed a quality assurance function separate to our operations team. This included supporting with an independent lens, auditing and giving constructive feedback, working collaboratively on solutions for any area for improvement, monitoring for trends, driving change in the business and having a focus on positive outcomes for the people we support.
We’ve also implemented practical approaches to review and respond to new and emerging issues. For example, everything that’s happened over the weekend with our on-call team forms part of a meeting on Mondays. This enables operational managers to take any additional actions needed and discuss them within a clinical supervision/multidisciplinary forum, ensuring best practice and raising any areas for focus or resolution during the week to come. This robust process also supports the registered manager to know about any issues and to become involved if necessary.
Care provider: The Good Care Group
Date published: April 2018
Responding to and learning from incidents
There was a system to report and learn from incidents. For example, following a fall, the registered managers arranged a ‘lessons learnt’ exercise to assess how to prevent recurrence. In one situation, specialist advice was sought from an occupational therapist. Grab rails were provided and, as the incidents continued, a mat to monitor the person’s movement was supplied so that staff were alerted quickly.
Care provider: Anonymous
Date published: April 2018
Encouraging healthy competition around quality
A dedicated team was responsible for auditing care plans. Each care plan would be awarded a rating of red, amber or green, depending on the amount of information missing or if they’d been updated. This created healthy competition within the workforce to ensure they could achieve as many green ratings as possible.
Care provider: Anonymous
Date published: April 2018
Scoring performance against care requirements
We use key performance indicators that are based around the CQC key lines of enquiry. We’re then able to track progress and an associated quality score for each area of work and monitor improvements, including via the use of spot checks. This practical approach is good for staff as they can see where they’re improving. It’s helped to generate healthy competition across our services and managers.
Care provider: Creative Support Ltd
Date published: April 2018
Enlisting people as mystery shoppers
Some people had been supported to work as mystery shoppers to provide feedback on customer services and the business environment on behalf of various disability groups. Recent organisations included the National Trust, leisure centres, libraries and a local football club. This enabled people to contribute to making community and leisure services more accessible to people with disabilities.
Care provider: Anonymous
Date published: April 2018
Monitoring staff and encouraging improvement
The homecare agency used a combination of announced and unannounced monitoring visits, where, with the agreement of the person using the service, staff were observed as they provided personal care. The member of staff's appearance, timekeeping, reference to the care plan, completion of practical tasks such as meal preparation, use of equipment, medicine management skills and record keeping were also assessed. Staff were provided with written feedback, with comments about what they’d done well and with areas for improvement identified.
Care provider: Anonymous
Date published: April 2018
Sharing information and best practice around quality
At a registered managers’ network meeting in summer 2017, it became clear that there was a ‘gap’ in sharing information and support for people in the position of quality lead for their organisation. Skills for Care helped to coordinate a quality leads meeting.
From a group of four quality leads there are now 15 people who have responsibility for quality within their role, attending from different care providers and all pooling their knowledge and experience openly and honestly to improve services. The main focus is quality compliance which is always first on the agenda, with quality assurance as second focus.
The agenda includes information on recent inspections of providers which can be shared, recent information from the CQC, CQC KLOES, benchmarking services, CQC plans and other items i.e. STOMP, Time to Change’ engagement, how to talk to families, etc.
We share information from the training, events and conferences attended, all with a focus to improve quality. The meetings are held monthly and are excellent evidence for working in partnership with others under the well-led key question.
Care provider: Future Directions CIC
Date published: April 2018
Driving improvement and delivering high standards of care
Staff are supported in a number of ways to ensure the delivery of high standards. All staff receive regular supervisions, which allow for learning needs to be discussed, how learning can be applied into the workplace, and what additional support they need to achieve this. Continuous professional development is discussed at time of formal supervision and staff are given the opportunity to discuss their own development needs. Line managers also discuss with staff any needs that may have been identified whilst observing the individual in the workplace or needs that may have arisen due to changes in legislation or best practise.
Two years ago we comprehensively reviewed the documentation we used to record the health and wellbeing of the people we support and care for. We stripped previous processes back. This resulted in the production of an entirely new suite of person-centred documents which ensure all aspects of our responsibilities are met. At the centre of it all are the people we support. We looked at what people want and need to achieve. This led to us questioning what support is required to ensure these outcomes are met and how this would look for the individual. Our quality audit process is driven by this renewed focus on service user achievements, and encompasses all recorded information.
You can read the rest of this blog here
Care provider: Welmede Housing Association
Date published: December 2017
People and others roles in helping to manage the service
People were directly involved in the management of the service. They took part in meetings with their staff team where they could give feedback in ways that were meaningful to them about the service they received.
Circle of support meetings also involved external professionals, relatives, staff and people this promoted the discussion of best practice.
Read more about the service here.
Care provider: Dimensions Dorset West