1. Key drivers for being an outstanding service
Paula Eaton & Paula Morgan
25th January 2017 1 1

2. CQC purpose and role Our purpose Our role
We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve
Our role
We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find, including performance ratings to help people choose care

3. Our five key questions

4. Ratings - Four point scale
High level characteristics of each rating level
Innovative, creative, constantly striving to improve, open and transparent
Consistent level of service people have a right to expect, robust arrangements in place for when things do go wrong
May have elements of good practice but inconsistent, potential or actual risk, inconsistent responses when things go wrong
Significant harm has or is likely to occur, shortfalls in practice, ineffective or no action taken to put things right or improve 4

5. State of Care 2016: Adult social care
The good news
Many services are providing good quality care – over 70%
More than three-quarters of re- inspected inadequate locations improved
84% of community social care locations, including 92% Shared Lives services, Good or Outstanding
Caring achieves highest scores – 90% Good, 2% Outstanding

6. For a good service to be rated outstanding
..there are additional key characteristics that make the service exceptional and distinctive
CQC publication. Residential adult social care services handbook appendices – March 2015

7. Making decisions - Is it outstanding?

8. State of Care: leadership
Strong leadership is emerging as more crucial than ever to delivering good care
Effective planning
Focus on delivering for people
Culture of openness and staff engagement
Willingness to collaborate with partners 8

9. The importance of managers9

10. Themes from Well-Led – Inadequate
Unawareness of best practice and notifications not being made to CQC
Lack of supervision and training opportunities
Ineffective systems to identify and manage risks / no process to assess lessons learned
Regular management changes / no registered manager
Poor care planning / lack of personalised care
Closed culture – views not listened to or acted on
Underdeveloped partnership working and community links
CQC Published reports – sampled for data on well-led. Sample size 177, 50 services with outstanding ratings (all outstanding ratings for well-led when the sample was extracted) for and 127 for services with inadequate ratings for well-led.

11. Themes from Well-Led – Outstanding
People who use services, relatives and staff
speak highly of the service
Effective monitoring and quality assurance
75% of services had a registered manager in post consistently
Open culture – people who use services/ staff/ relatives shared views and issues
Good leadership extends beyond the manager and those values inspire staff
A can do, will do attitude – staff dedication
Strong links with local community
Safe care actively promoted – effective oversight of care and staff communication
CQC Published reports – sampled for data on well-led. Sample size 177, 50 services with outstanding ratings (all outstanding ratings for well-led when the sample was extracted) for and 127 for services with inadequate ratings for well-led.

12. Outstanding characteristics
People are at the centre and staff want to give them a life not just a service
Good leadership extends beyond the manager and those values are cascaded to inspire staff
Open culture – people who use services/ staff/ relatives shared views and issues
Strong links with local community
75% have registered manager in post consistently
A can do, will do attitude – staff dedication
Safe care actively promoted – effective oversight of care and staff communication
Always looking to improve
LAs –
How can you commission for these outstanding qualities?
How can you manage existing contracts to reach and value services which demonstrate these qualities?
The better the relationship between LA and CQC, and the more a LA works proactively in partnership with local providers, the better the quality of care.

13. Common themes from ‘well-led’: Outstanding
“This place is brilliant, management care so much, as do the staff, everybody knows their role and the atmosphere is amazing.”
“I’m made to feel important, I’m constantly encouraged to always better myself.”
Passion Excellence Integrity Cooperation
CQC Published reports – sampled for data on well-led. Sample size 177, 50 services with outstanding ratings (all outstanding ratings for well-led when the sample was extracted) for and 127 for services with inadequate ratings for well-led.

14. What does this mean for individuals?
“I feel safe, I can live the life I want and I am supported to manage any risks”
“I am in control of planning my care and support”
“I have care and support that is directed by me and responsive to my needs”
“I can plan ahead and keep control in a crisis”
think local act personal – MAKING IT REAL Marking progress towards personalised, community–based support

15. An outstanding care home
‘Relatives and friends visiting the home told us they only had positive experiences and praise for this service’
‘Staff told us that they would not like to work anywhere else’
Vida Hall, Harrogate
Generic ASC deck (June Final)

16. ‘Outstanding’ can be achieved
"We didn't think we were outstanding. And perhaps that's why we were – I think it's because we see every single person as an individual. It is our privilege to support them to live the last years of
their life with as much happiness, love and security as we can give them."
Suzanne, Prince of Wales House, Ipswich
Generic ASC deck (June Final)

17. management inspire confidence and lead by example
Prince of Wales House, Ipswich
innovative and creative
‘My Story’ booklets give detailed biography of a person – with the clear message that their lives do not stop when they move into
care
commitment by managers to continually improve
vibrant and friendly environment
staff are motivated by a
strong culture of inclusivity
considers individuals and their
views and preferences
care is person-centred
management inspire confidence and lead by example
strong and visible leadership

18. Outstanding ASC published reports

19. Top tips for achieving an outstanding rating
Set out your ambition to be outstanding – It has to start at the top
Involve staff, residents, their relatives and other health professionals in developing strategies to help you achieve your ambition
Determine where you are now and identify the gaps you need to plug
Can you easily identify the outstanding features in your home? Will your staff, residents, other health professionals support your view?
What makes a difference between good and outstanding is often how the service pays attention to detail – simple things done well that have a significant impact on the people using the service
Think about how you will sustain high quality performance
Work hard on ‘your’ ability to demonstrate the impact your intervention is having on people. Ask yourself whether people, their relatives, staff and other professionals will corroboration your assessment of your quality when asked.

20. A wise woman once said…
“People will forget what you said, people will forget what you did, but people will never forget how you made them feel”
Maya Angelou 20

21. Paula Morgan Inspector
Thank you
@CareQualityComm
Paula Eaton Inspection Manager
Paula Morgan Inspector