Quality Matters

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This webpage is for adult social care registered managers and explains what quality means and how they can improve quality in their service. It brings together useful tools and resources to help you to understand and answer:

  • what does quality mean to me
  • how do I assess quality in my service
  • what measures can I use to understand quality
  • how will I know if the actions that I’ve taken have improved quality?

We’ve developed this webpage as part of the Quality Matters initiative, which is a shared commitment to high quality, person-centred adult social care.

What is the Quality Matters initiative?

Quality Matters aims to achieve a shared understanding of what high-quality care is, more effective and aligned support for quality in adult social care, and improved quality that we can measure.

It involves everyone who uses, provides, commissions or supports adult social care services, and explains how we can all work together to improve the quality of adult social care.

 

What quality means to you will be very individual. It might link to your own or families’ experience, and could consider factors such as what things cost, certain brands and locations. Everyone’s idea of quality will be slightly different.

Resources to help

These resources will help you to think about what quality means to you and your service. Some of them aren’t specifically for registered managers - however, they can help you to understand how commissioners and others think about quality.

Making it Real is a framework that sets out what good personalised care and support looks like. It’s an easy to use set of statements that focus on what matters to people, and describe what ‘good’ looks like from an individual’s perspective and what organisations should be doing to live up to those expectations. It’s an excellent tool to help define, assess and measure quality.

The six themes of Making it Real are:

  • wellbeing and independence: living the life I want, keeping safe and well
  • information and advice: having the information I need, when I need it
  • active and supportive communities: keeping family, friends and connections
  • flexible and integrated care and support: my own support, my own way
  • when things need to change: staying in control
  • workforce: the people who support me.

The framework can be used to help individuals, groups and services to think about what’s happening locally and to explore how well their aspiration are being met and what needs to change. The statements can be used as the basis for conversations between service providers and people who use their services, to assess how well the service is doing and to focus on making things better.

The ‘Our single shared vision for quality’ section of this guide shares a vision of what high-quality care means, which has been co-produced by people who use, work in and commission social care services. It shares a vision from the perspective of people who use services and for those that provide services. This vision can help you to think about what quality means to you and your service.

This programme provides support for social care, integration and health at a local and/or system level. It includes information, resources and support about a range of topics including commissioning and market shaping, health and wellbeing systems, innovation and transformation, Making Safeguarding Personal, pubic health and prevention, and managing transfers of care.

Registered managers and others in adult social care organisations might find it useful to understand some of the ways that local systems approach quality improvement and find opportunities to get involved.

This work is supported by a network of regional Care and Health Improvement Advisers. Find the contact details for your regional adviser here.

 

There are lots of guidelines and standards to help you to assess quality in your service. This will help you to identify specific actions to deliver against Making it Real. 

Don’t try to do everything at once - think about what quality means to you and your service, and pick a couple of areas that you would like to assess – the people who use your service, families and staff can help you to identify these areas.

Resources to help

These resources will help you to think about how to assess quality in your service.

The key lines of enquiry (KLOEs) are used to inspect whether regulated health and social care services are safe, effective, caring, responsive and well-led, and provide a baseline for good and outstanding care.

Registered managers or others involved in quality improvement and CQC inspections, can use the KLOEs to assess whether your service meets the required quality standards, identify what to improve and plan improvements to meet the standards.

These guidelines make evidence-based recommendations on a wide range of topics to improve health and social care.

They contain specific recommendations based on evidence about what works and what is good value for money, to help health and social care practitioners to improve practice and quality. Adult social care registered managers can be confident that they are providing the best quality care if they use NICE guidelines.   

This resource maps NICE quality statements and medicines recommendations against CQC key lines of enquiry (KLOEs).

It supports adult social care commissioners and providers to navigate NICE statements and recommendations, and gives helpful indicators or actions that could address the KLOEs. Commissioners can also include relevant content in service contracts and specifications.

 

Measuring quality can be hard, so ensure that you choose ways to measure quality that are easy for you to compare.

Resources to help

These resources will help you to think about how you can measure quality in your service.

These standards set out the priority areas for quality improvement within a range of areas of care and support, such as dementia care, physical activity, learning disability, medicines support and community engagement. Each standard gives you a set of statements to help you to improve quality and provides quality measures to help you to monitor the statements. 

These tools can be used by adult social care employers to evaluate current practice and plan activity to meet NICE recommendations. They can be used by individual services, or by groups of services, to develop a picture of activity in the local area.

CQC inspections are a great way to collect data and feedback about the quality of care that your service provides. The inspection report gives you a good measure of the quality of your service against the required standards.

This report evaluates the impact that CQC has on quality and improvement in health and social care – and suggests that the quality of care is improving with CQC’s involvement.

The framework, developed jointly by LGA and NHS Clinical Commissioners, updates and builds on the Commissioning for Better Outcomes Framework 2015 which was designed to support local health and care economies to strengthen their integrated commissioning for the benefit of local people.

The framework covers four areas: building the foundations, taking a person-centred, place-based and outcomes-focused approach, shaping provision to support people, places and populations, and continuously raising the ambition.

It’s useful for registered managers to know about this framework to help you to understand how commissioners think about integration and commissioning for integration.

 

Knowing if the actions you have taken have improved quality will be dependent on how open people are when they give you feedback.

As you reflect on the actions that you have taken to improve quality, keep all of the Making it Real themes in mind. Use the I and We statements to assess how and whether quality has improved for people using your service(s).

  • Living the life I want, keeping safe and well.
  • Having the information I need, when I need it.
  • Keeping family, friends and connections.
  • My own support, my own way.
  • Staying in control.
  • The people who support me.

Resources to help

These resources will help you to think about how you will know if the actions that you have taken have improved quality. 

Making it Real sets out six statements that are most important to people who need care and support, that you can use as a measure of good practice. You could ask the people that you support whether they agree with each statement – if they do, this is a good indicator that the actions that you’ve taken have improved quality. 

This report shares learning from a programme of targeted local system reviews in local authority areas, to find out how services are working together to support and care for people aged 65 and over. It makes recommendations for national and local leaders, to suggest the scale and pace of improvement needed for people to have better experiences when they use a combination of health and social care services. 

 

These resources will help you to make quality improvements in your service.

The seven steps, outlined in ‘Adult Social Care: Quality Matters Overview’, set out what we all need to do to maintain and improve the quality of care. You can adapt these seven steps in your service to guide you through the improvement process.

The steps are:

  • setting clear direction and priorities
  • bringing clarity to quality
  • measuring and publishing quality
  • recognising and rewarding quality
  • maintaining and safeguarding quality
  • building capacity
  • staying ahead.

This guide is for anyone involved in CQC inspections and quality improvement in regulated adult social care services. It explains the steps that you need to take to identify, plan and implement improvements across your service to ensure that it delivers high-quality care and support that meets CQC fundamental standards. It includes case studies and quotes from employers that have turned their services around from a ‘requires improvement’ rating to ‘good’ and ‘outstanding’.

These quick guides give best practice information and practical support about a range of different topics including giving medicines correctly, advance care planning, helping to prevent pressure ulcers and better home care for older people. They can help you to improve the quality of care that your service provides.

The Better Care Exchange is a collaborative, free to use social network for health and social care professionals. It enables networking, information and knowledge sharing on good practice for delivering better integrated care, and implementing Better Care Fund plans. It works as a ‘learning hub’ that pools the knowledge and skills of leading organisations and professionals across the sector.

Email england.bettercareexchange@nhs.net to request access to the Exchange.

Learning and development ensures that staff have the right skills and knowledge, and are competent, to carry out their role effectively. Investing in workforce development can help you to improve quality in your service. Skills for Care has resources to help adult social care employers to identify learning needs, plan effective learning and development, commission high quality training providers and apply for funding for qualifications.

Recruiting enough of the right people, with the right values and skills, and retaining them, is fundamental to high quality care and support.

Skills for Care has resources to help adult social care employers to plan recruitment, recruit the right people and retain staff.

Confident and capable managers ensure that services meet the required standards – they set the right culture and approach and should lead by example.

Skills for Care has resources to help adult social care employers to identify and develop new talent, develop managers and access tools to help managers to deliver a well-led service and lead high performing teams. 

 

This directory lists organisations that have signed up to Making it Real and are using the framework to deliver personalised care and support. You can use these examples to get ideas about how you can 'Make it Real'. 

This document shares case studies from nine adult social care services that had achieved a significant improvement on their CQC rating. It provides an honest insight from a wide range of people describing how it felt to be rated as inadequate, what impact this had, the challenges they had to overcome and how they got back on track.

The report explores how a number of high performing hospital trusts have used a systematic approach to quality improvement (QI) to ensure better patient outcomes and performance.

It shares learning from acute, community and mental health trusts adopting and embedding QI across their organisation, and highlights the experiences of staff and patients involved.

The report is based on interviews with trust staff from all levels, local QI teams and patient groups, as well as visits to six trusts to see their QI in action.

This report includes a collection of short case studies illustrating some of the qualities shown by care providers that are rated ‘good’ or ‘outstanding’ overall. It also shares the views of some people responsible for care quality and what they do to drive improvement.

There’s growing evidence that equality and human rights for staff and people who need care and support needs to play a central role in improving the quality of care.

This guide shares learning from employers that are doing this successfully, including some of the common ‘success factors’ and case studies. It’s for anyone that’s involved in quality improvement in regulated adult social care services, and you can use this learning to inform improvement in your service.

This webpage shares a range of case studies about innovative programmes and projects that local councils are involved in to improve the lives of people in our communities. It’s primarily for local government, but might be useful for registered managers and others in adult social care organisations.

This webpage shares over 800 examples of how NICE guidance and standards can improve local health and social care services. Registered managers can use the ‘Find a case study; page to look for examples that are relevant to their area of work or interest, such as improving nutrition support in care homes or improving medicines support in home care and care home services.