CQC study shows having enough good quality staff is vital for improvement in the adult social care sector

Published: 7 June 2018 Page last updated: 7 June 2018

Findings from the Care Quality Commission’s ‘Driving Improvement’ report – exploring how adult social care services from across the country have managed to turn around their inspection quality rating from ‘inadequate’ to ‘good’ – show that the recruitment and retention of capable, valued and supported staff has never been more critical to achieving the high quality care everyone has a right to expect.

Published today (Thursday 7 June), the collection of nine adult social care case studies provides an honest insight from a wide range of people – including those who use services, their families and carers, staff, managers, directors, chief executives and other professionals – 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.

Across the country CQC sees over 80% of adult social care services that were originally rated inadequate improve their overall rating and Driving Improvement highlights examples in County Durham, Staffordshire, Shropshire, Hampshire, Suffolk, Essex, Surrey, Kent and Dorset.

Commenting on the publication, Andrea Sutcliffe, CQC’s Chief Inspector of Adult Social Care, said: “As the independent quality regulator, we know the devastating impact inadequate adult social care has on people, their families and carers. That’s why it’s vital that the people in charge of providing care tackle the problems our inspections identify so improvement can be achieved. Our Driving Improvement publication shares the experiences of those who have been able to transform the care they deliver to explain how that journey of improvement can happen. My hope is that people running or working in care services rated as inadequate or requires improvement can use these case studies as practical guidance to improve for the benefit of the people they support and care for.

“Key lessons we have seen from the case studies include understanding and accepting that problems exist; creating a clear vision to improve and putting that into action; appointing strong leaders who can establish an open and transparent culture where improvement can truly thrive; and focusing on developing a workforce that is valued, well trained and supported to deliver safe, effective person-centred care.

“But we’re not saying that improvement is easy. Pressure on resources, increasing demands and workforce shortages mean these are challenging times for adult social care. Providers and their staff have a responsibility to deliver good care – but commissioners, funders and national bodies and the health and care system as a whole has a responsibility to work together to help create the environment that makes this possible.”

Minister for Care Caroline Dinenage said: “Despite the challenges facing the sector, many social care providers are doing an incredible job, with over 80% rated as good or outstanding by CQC. Those who have turned around their rating should be especially proud and CQC is rightly sharing these lessons with the whole sector so others can improve. I am committed to ensuring social care in England is of high quality, safe and compassionate and will shortly outline reforms so the sector is sustainable for the future.”

Emily Holzhausen OBE, Director of Policy and Public Affairs at Carers UK said: “The impact of good quality care goes far beyond the person needing the care to the wider health and wellbeing of millions of families and friends who care unpaid. Families who rely on good quality support will find it encouraging to see companies demonstrating improvements in care and the practical steps that they took to do this – measures that could be adopted by others. Trusted, well-trained, compassionate, reliable, affordable and appropriate services are highly valued by families and close friends who need them.”

Professor Martin Green OBE, Chief Executive of Care England, said: “Providers need the long term stability to sustain the quality of care that they strive to provide. CQC’s report demonstrates that change and innovation are evident throughout the sector. This needs to be both celebrated and replicated; however this is a major challenge given the confines of a poorly resourced sector. It is clear that we need to be able to invest more training and resources in our staff who are our biggest and most valuable resource”.

Bridget Warr CBE, Chief Executive of the United Kingdom Homecare Association (UKHCA), said: “The majority of people experience high quality social care, which is a tribute to our workforce, but a determination to improve when care falls short of expectations is vital. CQC’s report provides practical examples of the role that providers, funders and national bodies can take to support sustained improvement in a sector which is under-resourced, but essential to our society.”

Rhidian Hughes, Chief Executive of the Voluntary Organisations Disability Group (VODG) said: “Driving Improvement is an important resource for first line leaders and managers working in social care today. It takes us beyond the determinants of poor quality care towards a much richer, and practical, understanding of how to move services from inadequate to good. The report offers important insights and clearly shows that with a committed workforce, supported by strong leaders, services can make a positive step change in delivering good quality care.”

Tony Hunter, Chief Executive at the Social Care Institute for Excellence (SCIE), said: “Knowing what good looks like is valuable – but knowing how to improve is critical. The value of this new report is that it highlights practical steps that owners, managers and staff can take to move on from that initial shock of getting an inadequate rating. It is a real wake-up call and the most progressive organisations recognise this.”

Glen Garrod, President of the Association of Directors of Adult Social Services, said: “ADASS, the voice of social care leaders across the country, has long called for the kind of person-centred, tailored care that doesn’t just provide the support that older people or adults with disabilities need, but that enables people to exercise some choice and control and help them to live fulfilling and independent lives.

“These insights into the lives of people receiving support provide exceptional examples of transforming lives – which is what social care can achieve. It will come as no surprise to anyone working in social care that the teams who have been most able to retain and recruit high-quality staff have seen such brilliant results, which is why it’s essential that the upcoming Green Paper for social care delivers a sustainable financial base to deliver great social care for more people, enabling them to retain their place in society and continue to contribute. This is further evidence of the exceptional work dedicated and hard-working social care staff do day in, day out.

“We’ve been very clear that sector-led improvement could lead to real care breakthroughs – Quality Matters, which brings regulators, commissioners, providers and service users together, is an example of this working positively. We encourage not just colleagues in social care but those in health and housing services and the wider public sector to look at these examples and see if there’s anything they can learn from them which will help them locally.”

Join in the conversation on Twitter using the hashtag #DrivingImprovementASC


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My hope is that people running or working in care services rated as inadequate or requires improvement can use these case studies as practical guidance to improve for the benefit of the people they support and care for

Andrea Sutcliffe, Chief Inspector of Adult Social Care

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.