Why, when I know you are all working with quality everyday, and with so many systems and processes, does it still seem so elusive? Even organisations that are held up as exemplars in supporting people with learning disabilities can suffer their own scandals. MacIntyre have had two instances in quick succession forcing their Chief Executive, Bill Mumford to step down from his prominent role as head of the Winterbourne View Joint Improvement Programme.
Social care providers are expected to sign up for a plethora of quality codes and processes but to merely describe your service as ‘quality’ can either come across a tad trite or even arouse suspicion that it is merely expensive!
For those of you around in the 1990s, many of you have described the creeping change of the word quality from a simple adjective, to a corporate measure of performance – over twenty years later, social care providers are expected to sign up for a plethora of quality codes and processes – we have one here at ARC for our members – but to merely describe your service as ‘quality’ can come across as trite or even arouse suspicion that it is merely expensive! It is right to be cautious; following Winterbourne View it became clear that some of the most expensive and at first glance ‘quality’ buildings and surroundings were providing something very far from quality support.
The Driving Up Quality Code is bespoke to people with learning disabilities and it covers themes that other quality systems may miss out, such as governance and leadership.
Last year ARC with its partners in the Driving up Quality Alliance contributed to a new code to the quality scene, in an attempt to really make a difference to quality in support for people with learning disabilities. The Driving Up Quality Code is bespoke to people with learning disabilities and it covers themes that other quality systems may miss out, such as governance and leadership. The safety of individuals is encompassed but importantly there are also guarantees that people will have not only their needs but their aspirations supported and met as well.
The next stage in the quality journey must surely be to bring things together and assess what really makes a difference.
I am well aware that many ARC members are also subscribed to many other quality measures, as are we, including, Think Local Act Personal, Making it Real, on top of various ISO standards and Investors in People and that’s before you take into account meeting the standards expected for CQC registration. There is a great deal of overlap and duplication and to meet all the criteria takes considerable resources. It’s impressive how committed so many members are to getting this right, as well as the creative ways in which they ensure that they assess their performance in a co-productive way. The next stage in the quality journey must surely be to bring things together and assess what really makes a difference to people’s lives.
A vital ingredient that was clearly left out in the early days was to ensure co-production and mercifully this is now written in as an essential to subsequent codes. CQC’s recent consultation on its provider handbooks endeavoured to demonstrate how organisations could meet what Andrea Sutcliffe describes as the ‘Mum test’, namely, ‘would this be good enough for my mum?’, or for our sector ‘my daughter, my son, brother or sister’. CQC have developed as part of this process Key Lines of Enquiry that are designed to tease out for its inspectors what ‘quality’ person centred care and support really looks like and we’re part of the Alliance working with CQC to ensure that they use the DuQ Code as part of this. Your feedback will be used to develop the final plans which CQC will publish in September, with the changes coming into effect in October.
Despite all this, I wonder, if now is the time for us to consider consolidating what we actually know as quality so that when you consider how your services are doing, you’re not finding yourselves continually signing up to new initiatives and completing endless self assessments but actually work with tools that will mean that quality is meaningful to the people you are supporting and that standards continue to rise.