Managing Quality in Social Care Paul Johnston Impact Change Solutions Ltd 3 rd February 2012

1. Managing Quality in Social Care Paul Johnston Impact Change Solutions Ltd 3rd February 2012

2. Discussion points • Different concepts of ‘Quality’ • The role of the LA • Strategies for improving Quality • Quality Management Systems • Desirable features • Examples

3. Different concepts • Stakeholder perspectives • Quality Standards • Experience of using services • Outcomes achieved • SPRU Outcomes Measures • PSSRU: OPUS, OSCA, SCRQL, ASCOT • ASCOF

4. Different Perspectives or Common Ground? Quality Domains Source: Measuring for quality in Health & Social Care – RCN Position Statement, 2009

5. Common Definition of Quality International Association of Homes & Services for the Ageing (IAHSA) • Global quality improvement initiative • Characteristics of the ‘ideal quality ageing services’ provider • Person-directed care • Continuous quality improvement • Workforce excellence • Leadership & integration • Innovation • Community Involvement

6. The role of the LA • Create a vision for quality across the local care market • Provide a focus on local priorities • Define the improvement challenge • Manage quality within its own operation • Influence provider quality (via contracts, market position statements, relationships) • Report on standards across the market

7. The Role of the Provider • Care Standards legislation requires Regulated Providers to: • Establish and maintain a quality system • Review and improve quality of care • Make quality system reports available to the Regulators • Consult with Service Users and Representatives • No such requirement for Unregulated Providers • Micro Providers, Personal Assistants etc. • Need to encourage & incentivise suitable approaches

8. Strategies for Improving Quality • Vision & Leadership for Quality • Recognised standards (CQC Essential Standards, ISO 9000 etc) • Bias towards local priorities • Quality Management System • Audit - compliance, performance, processes & systems • Evaluation - aims, objectives, activities, outputs, outcomes, costs • Research – benchmarks, models, learning • Feedback – service users, staff • Improvement Plans • Organisational learning • Support mechanisms & incentives

9. Model Systems • Nationally / Internationally recognised • Sector-specific / Service-specific • In-house • Off-the-shelf • Support Mechanisms & Incentives

10. Quality Management Systems - Desirable Features • Must be owned & led by the organisation (can’t be imposed) • Evidence based, relevant • Person-centred, outcome focused • Informed by service user feedback • Stimulates action & change • Holds the organisation to account • Is transparent whilst remaining confidential • Council on Quality Leadership (CQL) – 8 key factors / 34 success indicators

11. (Inter)nationally Recognised Systems For example TQM, EFQM, ISO 9000, IIP, EQM, SERVQUAL etc • Industry-wide, but can be applied to H&SC subject to some adaptation of language & context • Can be resource-hungry • More suited to larger organisations • Risk of adding to ‘management control’ at the expense of service improvement

12. Sector-specific and Service-specific Systems • E-QALIN (European Quality Improving Learning in Residential Care Homes) • CQL Guide to Person Centred Excellence (Disability, Mental Illness, Older Adults) • Care Fit for VIPS (Dementia Care) • Outcomes STAR (various) • PEARL quality accreditation programme (Four Seasons Health Care)

13. Off-the-Shelf Systems • Support CQC registration • CQC Compliant • Various points of focus • Care & client management • Health & safety • Quality assurance • HR & Admin e.g. EQMS, Vistapoint, Qual A Sess etc.

15. CQL CQL • 8 Factors • 34 Indicators

18. Positively Enriching And enhancing Residents Lives (PEARL) • Accreditation scheme for FSHC’s dementia care facilities • Follows the VIPS model • Assessment against PEARL criteria • Action Plan to address gaps • Support for Home Manager • Reassessment & Accreditation

19. Off-the-shelf Compliance Management System • Document Storage & Retrieval (Document Manager) • User Interface to records (Navigator) • Change and Version Control (Change Manager) • Tailored to business requirements (System Manager) • Audit and action planning function (Audit Manager) • Integrates with Microsoft Office applications and SharePoint

20. How VistaPointTM can help your business: • Meets CQC and Ofsted requirements. • Meets Certification requirements for the ISO 9001:2008 Quality Standard. • Provides all the information you will need to comply with the "Essential Standards of Quality and Safety" and to complete your Provider Compliance Assessment.    • Systems available for a wide range of sectors. Simply select and click on the coloured boxes on the left for more information, sample documents and pricing. • Start-up businesses have all the information and help needed to get up and running. • Comprehensive, easy to use, well established and consistently successful. • Competitively priced, with discounts available for multiple packages. • All documents supported on a CD-ROM (MS Word format) to download to your computer so that you can quickly and easily edit them to suit your needs. • Regularly up-dated

21. Qual A Sess

22. Support & Incentives • Provider Capability? • System Effectiveness? • Outcome Performance? • Relationship approach (e.g. Warwickshire) • Audit approach (e.g. Coventry) • Financial approach (e.g. Torbay)

23. Financial Incentives C-QUIN • Torbay – Care Homes Market • General improvement (5 of 6 themes) • Specific improvement (NOF Fractures) • Payments linked to performance - £1000 per home • Relatively low take-up (36% of the market) • High pass rate (93%) • Application process described as ‘extremely detailed’ • Success described in terms of output and actions, rather than outcomes

24. Questions http://www.flickr.com/photos/horiavarlan/4273168957/