The number of care providers falling into ‘Special Measures’ continues to rise, but why? What obstacles are preventing providers from stepping up to the mark when it comes to inspections and what lessons can be learned?
Detailed analysis of current inspection reports (undertaken by Care 4 Quality), focusing on inadequate rated care homes across England*, has revealed some key areas that are consistently impacting care providers’ ability to achieve positive ratings from regulatory bodies. Interestingly, those rated inadequate overall also rated inadequate in the category of being safe and well-led.
Alerting and educating care providers on the frequent areas of poor performance may go some way to helping them to prepare more proactively for future inspections, thereby improving future standards of care. Here we look at two of the most common problem areas where providers continue to struggle to deliver adequate care provision.
Management of accidents and incidents
Well over half (69%) of inadequate care providers were found not to be managing accidents and incidents robustly. For a high number (89%) the main issue was failure to provide evidence of ‘lessons learned’. The new KLOE, S6 introduced in November 2017, stipulates that care providers must demonstrate how they have learned lessons from a previous incident and how they have made improvements in terms of dealing with future scenarios. It’s possible that failure to manage incidents efficiently is driven by a perceived lack of staff resource to document the above, yet analysis of incidents and lessons learned needn’t be over complicated.
The key is to be able to prove what action was taken at the time of the incident or accident, who was informed and what measures were taken after the event to ensure the individual’s safety. Once this information is gathered regularly when an incident occurs, care managers will start to spot significant trends more easily and any analytical data can be evidenced. Care homes can then use that information to act on, embed into best practice and demonstrate positive outcomes.
Poor Privacy and Dignity Practice
A staggering 73% of care home rated inadequate, are also not protecting the privacy and dignity of those in their care. As in the case of managing incidents, this is an equally intrinsic element of ethical care provision and there are many good initiatives out there to take inspiration from, which aim to promote privacy and dignity within care settings. The high numbers of providers still failing to meet these basic duties is extremely alarming.
A step in the right direction would be to appoint a dedicated dignity champion within the team to take the lead of supporting staff in caring for people in a more dignified manner and ‘getting back to basics’ by asking staff to question ‘would this be ok for my own mother?’ Many good care homes are already adopting this approach with great success.
Taking the right steps
Our industry needs to focus on developing, improving and nurturing emerging leaders of the future. This means registered managers, with an array of different talents and strong management skills. Traditionally, care managers have fallen into managerial roles via the usual channel of ‘in-sector’ career ladders, as a result they are instinctively more ‘transactional’ in approach. So it can be helpful to assess the skills and managerial capabilities of the entire senior team (not just the care home manager or provider) because that way, you are more likely to identify the strength of the collective team’s skills and attributes thus, achieving more positive outcomes for care provision as a whole.
Regular, focused audits of key problem areas will also provide opportunities for development and improvement for the provider, and in turn, play some party in elevating care provision in the future.
*Research carried out by R.Drury, S.Bawden, R.Dowson-Wallace, H.Fuller (Care 4 Quality Ltd) Analysis of Inadequate CQC published reports between October 2018 – March 2019.
