Driving improvement: Case studies from nine adult social care services

Published: 7 June 2018 Page last updated: 12 May 2022
Organisations we regulate

We interviewed nine adult social care services that had achieved a significant improvement on their rating.

Driving improvement: Case studies from adult social care services cover image

We spoke to a range of people at each service. This included people who use services and their families, registered managers, providers and owners, care staff, administrative and other staff, commissioners and social workers.

The experiences of the services show that improvement in adult social care is possible. The nine case studies highlight some clear actions that other providers can use to help them learn and improve.

Key themes

Reaction to the initial inspection report

Most providers react to a report highlighting failures with shock, surprise and disappointment. But usually when people stand back and have time to reflect, they understand the failings.

For some staff the report can come as a relief, as they may have been struggling – doing their very best but unable to deliver the care they wanted to.

For some, the report was a wake-up call; providers who allowed standards to slip, perhaps due to a range of pressures.


The value of a good leader cannot be underestimated. In most of the providers we spoke to, a new manager had come into the service to deliver the improvements. They engage with staff, people who use services and their families and are open to suggestions but set parameters and take tough decisions where necessary.

Cultural change

Failing organisations tend to have cultures in which staff are afraid to speak out, don’t feel they have a voice and are not listened to. Involving staff is one of the best ways to drive improvement.

Person-centred care

Typically, when a new manager took up the reins, they wanted to see care plans. And in most cases these were lacking in detail and did not show that the care being provided was person-centred. It is not possible to provide good care if the care staff do not understand the needs of the person being cared for.

Working with partners

Most of the services we feature received support to help them improve – mainly from the corporate provider, if there was one, or commissioning bodies.