The Only Way To Make A Positive Impact In Care

On 11th October The State Of Care report was released by The Care Quality Commission and here’s a summary of the findings: 

? The CQC established that care providers need to collaborate and work together rather than compete

? The level of care you receive is dependent on where you live

? The number of people with an unmet care need has risen by 20%

? If additional funding is not received then there will be a longer term stress on the NHS system to provide care for those who could benefit from services like residential and community based projects

How well a service works with other providers in the local community is the pivotal point which can help provide and sustain longer term quality care for adults. One of the key findings was that organisations are too worried about their statistics; occupancy and reducing turnover that they’re failing to achieve the overall goal – quality care for vulnerable people. So what happens? Managers leave, Directors are left with a big hole, organisations shut down…and most importantly vulnerable people suffer more.

John was a Registered Manager for a 32 bedded Brain Injury service and when he came on board, 16 beds were occupied with a goal of having 25 within 12 months. He said, “The CQC rating was Good, but when you went in the service you could tell there were problems with funding. It looked a mess and to put it bluntly, I wouldn’t have wanted my loved ones in a place like this.”

Having taken the project on, John’s first call of action was to diagnose the problem at the root: they were not providing the quality of care that they should have been, had no referrals, the staff were unhappy and over 2 years the organisation had tried to turn it around with no success. On the verge of shutdown, John was the last hope.

He took his plan to senior management which had a 12 month vision to reduce turnover by 10%, increase occupancy by 50% and provide sustained quality care for vulnerable people. People being the key word. After approving the plan, the first thing John did was assess each care package and person and made an astonishing discovery. Most of the people there had too high a medical need that in reality, our service was not the right place for them in the long run. What an admission to make!

“I spoke to every member of staff to understand the world from their vantage point,” said John who realised staff were stretched to perform medical and complex care that they were only minimally trained to do so which had become the central reason as to why staff were unhappy and leaving.

Why would a service take on referrals knowing they cannot cater for their needs? Well that’s what happens out of desperation and knowing the referrals are not coming in that when they do, even though a long term care need cannot be met we take on people to meet occupancy goals. Exactly what The CQC said.

Rather than be faced with the fear of telling families that they had to move their loved ones, or worse yet just continue to keep providing sub-standard care, John took action and called the families of 5 of the residents in and explained the situation. A goal of 50% occupancy increase, but potentially moving on 30% of your residents is an extremely high risk move. But John saw an opportunity in adversity – he had a plan.

If they were not the right service to provide the medical and complex care the residents needed, then who was? That question led to John’s success. He was able to contact services around the area and match our residents to the right services. Combined with opening up the home once a week to non-residents to increase brand awareness and community presence, John was able to start the shift towards what the home had never had before: referrals!

The CQC are adamant that more funding is required to open up doors for collaboration, and stop services being so internally focused that we lose sight of the bigger picture. John was doing this 5 years ago but there’s not enough managers like him, who are passionate about care and actually care enough to make a dedicated plan centred around success.

By fixing the root – taking on residents the service was designed for, recruiting a bigger team of permanent staff that matched our residents and collaborating with other services that his predecessors saw as competitors , the results John got spoke for themselves.

Over 12 months John reached 100% occupancy, reduced staff turnover by 19% and actually reduced associated expenses (￡20,000 to ￡30,000 to replace one leaver as average in UK).

The CQC have only confirmed what great managers have already been doing, but it seems like there are not enough of you seeking out opportunities to collaborate and think outside the box.

Are you in the care industry? Do you have a family member or friend in care? Your views and ideas are important, especially since ideas create actions and actions will move our industry forward. I welcome you all to share your thoughts, you never know what change you can help create...