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Blog - We need to talk about inspections….

Tuesday 12 March 2019

Preparing for an inspection from the Care Quality Commission by Deanna Mason, Optalis Head of Governance and Quality Assurance

"Having worked with a variety of care organisations and their boards or senior management teams it became clear over time that regardless of setting, division or service, there was common ground underpinning the fabric of integrity - that 'Golden Thread' that connects the 'what' to the 'why' and the 'how':

  • How the vision, mission and values are brought to life
  • The culture - how accessible and collaborative it is
  • The ethos for embedding lessons and change
  • Understanding what sustainable improvement means, and how it helps
  • Transparency of the journey towards improvement, and how that is cascaded to all staff
  • Engagement, and championing evidence-based change

Preparing for a review or inspection of any kind can often be an overwhelming experience. Once the request for information has been made (for example for the Care Quality Commission, it is the Provider Information Report – the name will soon be changing to Collection rather than Report as it will be collated from the company's online data), the klaxon then sounds loud and far for 'all hands' to rally and support the gathering and evidencing exercises that ensue with some urgency.

For managers (this is the focus here, as each are accountable for their service), this is a good opportunity to fully review the service with their deputies and leads to ensure that evidence is readily available, current and purposeful - to show the level of compliance and quality; a service should be confident enough in being transparent about its journey, articulating the governance elements and how they metamorphose into meeting the relevant objectives, and of course – outcomes.

Prepare to be appraised!

So, what's the easy answer to managing this better with more calm and clarity?

I'm afraid there is no easy answer, but there are answers within what we do every day; living the vision, the mission and the values.

If part of a practice, the process of the practice – or the policy that underpins the practice, is found to be 'lacking', yes absolutely it causes concern especially where there is a possibility (a risk) for a major impact to how the care is delivered, but it also opens up an opportunity to review and improve.

"I don't know" is as important a statement, as "Here, let me show you". Living in a culture that does not drive itself through blame - but learning, ensures that continuous improvement and learning from failure, as well as the enthusiasm to change, results in a service that drives safety and wellbeing as its core agenda.

There is always going to be someone with a clipboard, a scorecard, or a way to evaluate what is being delivered. What is important is that we can show the journey, evidence how the journey is assured (performance, quality, policies, etc.) and be confident in the mechanisms it uses to be successful.

What that evaluation outcome can provide is a good understanding of any critical areas for change, recommendations against best practices and insight to what we often miss in our own environments.

We often forget that success is more often than not built on failure; the "well it doesn't work that way" is very beneficial to achieving success.

Change, whether temporary (e.g. inspection) or permanent can be painful – but it doesn't last!

An Inspector Calls

Understanding that everyone who walks through the Optalis door has an impact on services, regardless of who they are and what their job is, and as important to the growth and development of a service. This is the 'Golden Thread'; the culture in practice against the outcome.

Engaging staff and 'encouraging the courage' to feel confident and positive is crucial to enduring the inspection with ease whilst reducing anxieties and allow for staff to articulate their impact to and experience of the service – as well as the organisation. 

When it comes to undergoing an Appraisal, a Review or an Inspection, it helps to have a 'setting' for those involved - a room or area that is just for reviewers (if no site visit is required), with a dedicated conduit to support their requirements. This gives a huge benefit in centralising information, showing the online areas managed, and the engagement.

A huge benefit to sourcing data, information or other evidence is that largely this is now housed through or within leaner platforms and mechanisms, enabling a fuller view of each service through performance and quality measures; dashboards, audits and action plans; alleviating the manual input or labour intensive mechanisms that heavily impact our time, the analysis and therefore the outcome.

Contact me (deanna.mason@optalis.org) if you would like to discuss this blog, or your service's quality, compliance, performance or governance."

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