Summary: The CQC is shining a bright light on the senior management of care home groups and expecting them to know the details of what is happening on the ground. A failure to do this leads to financial costs and risk in many areas. Geoff Lane talks about what he feels CQC mean by 'Well Led' and explains what he did to ensure that he met the CQC requirements.
What is Well Led?
In the last posting, I discussed my views on the financial pressures facing care home providers and the extra, sometimes unhelpful, pressure that the CQC puts on the industry. The subject certainly seemed to spark a number of discussions and thanks for including me in some of them. Hugely interesting.
It occurred to me and others that there was a possible confusion about what the term "Well led" means. So I'd like to focus this article on the CQC definition of "Well Led" in their new ratings assessment and particularly how it relates to quality.
In a recently published CQC inspection report on a care home, under the category of Well Led the inspection team made the following comments;
"There were systems in place to assess the quality of the service. However, when quality and safety issues were identified the provider had failed to ensure necessary improvements were carried out."
A bright light is being shone on Directors of care homes
Needless to say the inspection report rated this area as "Requires Improvement". Many owners and senior managers still seem to think that the responsibility for Well Led lies with the Registered Manager. Whilst it is true that the no amount of good support from the Directors will make up for the deficiencies of a Home Manager who either doesn't or cannot do their job, it is also clear that CQC are turning a bright light on the Directors and how they do their job.
Unsurprisingly, the CQC believe 'doing their job' includes knowing what is happening in all their care homes. Increasingly there is a focus on how technology can help them.
At this stage I always advise senior executives to 'hold their horses'.
I have met many providers who have put complicated and expensive systems in place to audit the quality in their homes, however the visibility of the outcomes and resulting actions are often restricted to Operations or Compliance functions.
In my experience, well run providers ensure that quality issues are very high on the board agenda and are regularly reviewed by the Directors. Furthermore, where resolution of the problems require decisions and active support from senior management this must be forthcoming. Knowledge is power.
Unfortunately in some providers, I have seen Directors are either unaware of the specific issues in their Homes or not proactively supporting their Home managers. The right technology support can help with this, you need to be able to see immediately if something is not right or a manager's engagement level has dropped off the grid.
CQC will not take ignorance by the Board as an excuse and will definitely not accept a review showing issues are known but not clearly understood and being visibly addressed under a clear governance process.
Frankly, if this strikes a chord with you then you are at high risk of being assessed as Requires Improvement for the Well Led criteria.
I am acutely aware of the pressures and workload on the Directors of Care businesses. There is no magic silver bullet to change this but by using stable technology that enables you to easily review the outcome of your audits and quickly identify issues that need your intervention, then you will be able to demonstrate an effective Quality Management System. Forget the bells and whistles, only solid and adaptable functions required - what's happening? who is responsible? has it been done? are we improving?
In future newsletters I'll return to the subject I promised in my last post: "How do you manage the likelihood that you will get snap inspected by the CQC and how you can proactively get all your Care Homes towards Outstanding?".
Do contact me if you want to discuss any of the issues I raised or my experiences and learning from engaging with the new CQC approach. Many thanks to the folks at IPROS for providing the platform.
By: Geoff Lane
Geoff Lane is an experienced hands-on Executive with a wide experience in executive management, business turnarounds and strategy development in the residential care sector. Most recently as CEO of Regal Care and previously COO at ILG and Finance Director at Capio Group. https://uk.linkedin.com/in/odcg2013
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