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Hans F. Hansen

CQC Outstanding and Well Led (part 2)

Thanks for the feedback about last week’s blog. If you have implemented the “outstanding plan” and found it successful, then please let us know.

So I said at the end of last week’s blog that CQC’s inspection model is built on what matters to people. it is the very essence of the five key questions and we wholeheartedly support linking inspection to the needs of people who access services, but what is the impact of achieving outstanding? Why is it important? What are the benefits of outstanding and how can you instill “outstanding” into the mindset of staff?

Some of the below text is taken directly from the CQC document I referenced last week: and any comments directly taken from the CQC documents are shown in italics:

Some of the best care we have found is in services that acknowledge there is always room for improvement – they are proactive about seeking feedback and they learn from concerns and complaints. This feeds into the continuous improvement cycle and having a clear understanding of this is vital and is actually part of the mindset we talked about in a previous post. If we think we can, we are probably right and if we think we can’t, well you probably guessed it.

We [CQC] have found that good leadership is a central part of improvement – services that improve tend to have leaders who are visible and accountable to staff, promote an open and positive organisational culture, and engage effectively with partners. We facilitated a Lead to Succeed recently with a provider in the Midlands and as part of module 2 – Developing Positive Culture, one of the participants commented “we often see the Directors in the care home” which is fantastic, because it is a foundation of the open and positive culture CQC are looking for evidence of.

Improvements in the quality of care people are receiving are happening despite tight financial constraints and increased demand across the sectors. So given what I described above, it makes sense to have robust leadership, a strong vision and a set of values which govern and direct ways of working, forming part of the solution to this ever-growing challenge.

Some of the other things that Outstanding providers do are below:
Leadership promotes a culture of high quality, person-centred care and its vision and values are driven by quality and safety
Constantly learning and striving to improve
Leadership that is continuously learning
Staff share a common philosophy, vision and values
Staff articulated the provider’s values in their own words
Staff spoke very highly of the leadership – they felt well-supported by managers
Managers were visible and approachable, staff training was encouraged for new learning and skills, and morale was excellent
The manager worked alongside staff, as a role model, and observe their practice
All staff understood the culture, vision and values
Staff told CQC how they were involved in the development of the strategy to achieve its vision

One of the things that struck me as I developed the list above is how often vision and values kept appearing (the list was much longer in the earlier drafts of this post), but what also stood out was “staff share” or “staff articulated” or “all staff understood”. Clearly, staff are a vital part of the inspection process; think back to the post about CQC Inspection Methodology and what I said at the beginning of this post – it is what matters to people and that is why “staff” are so important.

I think these are great examples of Values Based Leadership, something we will cover in a future blog…

Back to “what does outstanding look like”, the document above is something we use as part of our facilitation of module 5 for Lead to Succeed; it provides really useful pointers as to the evidence that CQC are looking for.

When everyone knows what an outstanding service looks like, they can begin to map themselves against it ensuring that they can identify where they’re doing well (with robust evidence) and any gaps; supported by a robust action plan, which everyone is aware of and is actively working towards achieving. Hopefully what we have talked about over the past couple of weeks has given you some pointers that will enable staff and leaders to know exactly what outstanding looks like and therefore what to do to build your action plan accordingly.

So to draw this post to close, I asked my colleague Pam Darroch (a former Care Quality Monitoring Officer) to share an example of how she supported an organisation to go from Requires Improvement to Outstanding. Her words are as follows:

“For the service I supported to Outstanding, I began by having a very honest and difficult conversation with the manager which led to other challenging conversations with staff. It’s crucial that the staff are on board and understand their part in it all, rather than inspection being seen as something which goes on behind the closed door of the manager’s office.”

“Within a month everyone could see their part and actions to address these coming to fruition. This resulted in staff looking forward to me returning so that they could give their updates to be recorded on the action plan.”

We are going to talk more about this example next week…

I hope that over the past few weeks you have been able to see some practical ways you can work towards achieving outstanding. I have included a link to the Skills for Care document that we mentioned a couple of times because it is useful and over the coming weeks we are going to look at more ideas from it.

In case you missed the earlier posts, please see links to earlier posts here:
Inspection Methodology
Outstanding Log
One Drawer Inspection Kit
Just Got Your PIR?

Finally, please send through any suggestions or ideas you might have.

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