Social Care: Making Things Better

As CQC release a new report into the state of adult social care, we ask: Are we doing enough as social care providers?

“Having carried out over 33,000 inspections of around 24,000 different services, most of the adult social care sector is meeting the Mum Test, providing safe and high quality care that we would be happy for anyone we love, or ourselves, to receive. This is thanks to the thousands of dedicated staff and providers who work tirelessly to ensure people’s care is truly person-centred and meets their individual needs.”–Andrea Sutcliffe, Chief Inspector of Adult Social Care at the Care Quality Commission.

Apple House care homes are among the 77% of adult social care services that are ‘good’ and, as CQC themselves say, this should be celebrated.

But what of the rest?  How can providers pass the Mum Test?  How can they ensure that the service they provide to others is of a standard high enough that they would be satisfied to receive it themselves or for their loved ones?  What of the estimated 20,000 vulnerable individuals of our society currently being supported in one of the 2% of care homes that are ‘inadequate’ or the 17% that require improvement?

CQC inspect all social care providers and base their inspections around five key questions:

1. Are they safe?
2. Are they effective?
3. Are they caring?
4. Are they responsive?
5. Are they well-led?

CQC, and many other organisations, believe that staffing levels, training and motivation directly impact the quality of care delivered.  We agree wholeheartedly! Look again at the five key questions: all can be attributed in large part to staffing and not just numbers but quality.  Staff recruitment and retention is a challenge but we must always remember that it’s not just about recruiting, but it’s predominantly about ‘who’ we recruit, ensuring they’re caring and kind.  In our opinion, care is only as good as the people giving it; care homes only as good as their teams.

The good news for those of us within the learning disability specialty, is that 88% of LD specialism care homes are ‘good.’  This demonstrates that LD providers are ‘organising their services to meet people’s needs, and staff are involving people in their care and treating them with compassion, kindness, dignity and respect.’ [CQC, 2017]  However, it also means that 12% are ‘inadequate or require improvement.’  That’s a lot of people who are not being supported adequately or appropriately which of course is a great concern.

Pulse Today, the primary GP website, suggest that ‘The fragility of the adult social care market is now beginning to impact on the people who rely on these services.’  There are more people with long-term illnesses, more diagnoses being made, a challenging economic climate: all of these factors mean a greater demand on services and more problems for people in accessing appropriate care and care of a high standard.

Is funding affecting quality?

Institute For Government, in their spring 2017 publication, ‘Performance Tracker’ for adult social care, refer to the rise of adult social care in the political agenda late last year when announcements were made of additional social care funding.  However, they suggest that since 2010, spending on social care has fallen in real terms by a whopping 6% – but this is a fluid and ever-changing figure and we don’t want to get too political on our blog! 😉  Suffice to say there are ever-increasing demands on state-funded social care.  In this regard, they refer to the ADASS survey [Association of Directors of Adult Social Services, ADASS Budget Survey 2016, ADASS, 2016, p. 11] in which 82% of local authority social care directors reported that providers in their area were facing ‘quality challenges’ due to financial pressures.

How does the culture within care homes impact on quality?

“Positive culture was something that characterised good performance and improvement. Both staff, people who use services and inspectors commented on particularly positive and supportive cultures characterised by staff who were well-trained, caring, skilled, dedicated, enthusiastic and focused on positive outcomes for people. The cultures of the services were also highlighted as being open and transparent, with a culture of improvement based on good practice and feedback.”–CQC on positive culture in the best care homes.

So, culture within homes – culture that nurtures, motivates and supports staff is definitely a major factor in making things better within adult social care.  We believe that this ethos stems from good, solid leadership and positive teamwork.  We have a culture of not wearing uniforms: we work in people’s homes, they don’t live in our workplace.  We have a culture of being ‘family welcoming,’ as demonstrated by our accolade from John’s Campaign, supporting family friendly culture within residential care settings.

As CQC say, ‘There is a lot to be proud of in adult social care, but still more work to be done.’

Adult social care is evolving and it’s crucial that care providers evolve too, that we all continue to provide the very best quality of care possible and pass ‘The Mum’ test.

— Jane Montrose, Managing Director, Apple House Care Homes

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