In England a clean bill of health from the Care Quality Commission – the national health and adult social care regulator – is essential for continued business success. CQC publish inspection reports and notify commissioners and the national and local press when a provider is found to breach the standards. The impact on your business of the outcome of inspections can be substantial, for good or bad.
Many providers are yet to experience their first inspection under the new system of regulation brought in from April 2010. It is based on 28 Essential Standards of Quality and Safety which focus on the ‘outcomes’ those using services should experience if the provider meets the regulations set out in the Health and Social Care Act 2008 (Regulated Activities Regulations 2010).
Providers are however facing further new challenges with the fast rising tide of published service user/patient and carer feedback. Websites such as iwantgreatcare.com and patientopinion.org.uk and NHS Choices hold an increasing database of reported user experience. The government too announced plans to implement a review system by service users, in a similar fashion to TripAdvisor. The Daily Telegraph on 12 December 2011 published the story with the byline: “Care homes for the elderly are to be given star ratings by the public under a new online system, which ministers say will reveal “the good, the bad and the ugly”. Full details will be set out in a white paper on social care, due to be published in the spring, when the Government is also due to respond to a commission calling for radical changes to the way care of the elderly is funded. Commissioners and CQC can be expected to review all such feedback and there is no doubt it will influence where contracts are placed and how frequently the regulator undertakes unannounced inspections of providers who receive poor feedback.
Resources such as these are also increasingly being used by patients, service users and carers in selecting their preferred health or social care providers. There are real business advantages to being excellent at service user involvement as a means of enhancing quality and experience. Being able to demonstrate high quality services in ways that are meaningful to service users and patients will increasingly become an essential business requirement.
Many providers still depend on questionnaires filled in by their service users to find out how they are doing. It can however, be difficult to get a statistically significant response rate just by relying on completed questionnaires, the feedback is not ‘realtime’ and the methodology is not effective for many, such as those with cognitive impairment. Equally the impact of such feedback on influencing the behaviour of staff can be limited. It feels too historical and limited quite often. Crucially they often give no clear indication of what would, in the view of those using the service, improve matters. Many providers fail to involve those using services in deciding on action in response to feedback.
Given that the ‘gold standard’ for monitoring care standards compliance IS the outcome for patient and service users, it is important that providers of services adopt new and more effective methods of service user engagement. There are many proven techniques out there, including for people with dementia, learning difficulties or cognitive impairment.
With the regulatory move away from reliance on policies and procedures to ‘outcomes’, the most successful businesses will be those that understand and implement the cultural changes quickly and decisively. Many health care providers looking for support with the new regulations are turning to expert healthcare management consultants for advice on systems that enhance service user involvement, demonstrate compliance, monitor quality and flag where improvements are needed.