Kevin Williams is Director of Governance, Performance and Office of the Chief Executive at Nugent, a charity supporting vulnerable children and young people and adults. Here he shares insights on navigating regulatory challenges, building trust within the leadership team, and leveraging opportunities in the pursuit of quality.
At Nugent, we operate an adoption service, an independent special school, children’s homes including a secure home, adult care homes, and community supported living services, providing a lifelong pathway of care and support for individuals and communities in need, from birth through to end of life.
The diversity of our range of services has historically posed problems for the charity. Our services previously operated in isolation of centralised processes, leading to a lack of visibility of performance and compliance, resulting in regulatory challenges. We were only aware of issues (non-conformances) at the point that the regulator inspected the services.
Our problems stemmed from the fact that the data we relied upon was provided by the services which gave us a translucent perspective at best. Furthermore, there was no formalised process for managing and monitoring non-conformance.
To realise our strategic ambitions, we devised Nugent’s Culture of Excellence Framework. The purpose of the framework was to:
- Improve quality management
- Foster a continuous improvement culture across the charity
- Generate data to enable enhanced monitoring of performance
The key to delivering this was investment in a centralised quality team (known as the Governance Team within Nugent). This team would implement a suite of processes and systems to enable them to monitor and report service performance before regulatory challenges could occur.
The first year was a period of discovery and uncomfortable truths. Some of our services pushed back against having a spotlight shone on them, but many of them embraced the support. Registered Managers are incredible individuals, but they cannot know everything, particularly when it comes to the regulations. Through our governance function, we have empowered Registered Managers to focus on the care provided to the people they support, whilst the Governance Team identify non-conformance and methods of improvement.
During our first year, we identified a home significantly underperforming, shortly before the regulator carried conducted an inspection and rated as it as inadequate. The Quality Team played a significant role in turning the service around, leading in areas such as production and quality of care and risk plans, colleague knowledge and skills assessments, internal and external communication, and targeted audits. The home was returned to a rating of good and has retained this rating to date.
We have enhanced our data collection to enable us to conduct in-depth analysis of service performance. Our at a glance approach focuses on 10 key metrics covering culture and values, finance, and governance, and allows Nugent’s services to compare against each other.
It has taken around 4 years for our quality management system to mature but it has been truly transformative for the charity, in terms of regulatory compliance, culture, and financial sustainability. We achieved ISO 9001:2015 quality management system certification in December 2023. From a regulatory perspective, this year we have two homes that have been rated as outstanding, with all our children’s and family services rated as good.
Last year, we supported a charity local to ourselves with their quality management system and carried out a range of inspections to provide them with a baseline to begin their quest for quality. Nugent benefitted through valuable insight into alternate care practices.
So, what was our key learning from the last 4 years?
Ensure that your leadership team are fully committed to the project, both financially and in acting upon the information they are provided.
Ensure you trust the source of the information presented as fact. Nugent removed away from services reporting their performance. No matter how difficult it is to read, the truth is the cornerstone of delivering continuous improvement.
Finally, ensure your framework results in action being taken for every non-conformance. The Deming Cycle is your best friend here, and if applied correctly, will deliver tangible results.
@wearenugent
care.wearenugent.org
