Dementia care audit: pilot in care homes

Background

In 2013 the government described its plan to change the care and support system in its White Paper ‘Caring for our future: reforming care and support’. As part of quality-related plans for care and support, it stated the government’s intention to ‘pilot a new care audit in 2013 to highlight how well residential care providers are delivering dementia care, encouraging them all to improve their care’.

The Department of Health commissioned the Healthcare Quality Improvement Partnership (HQIP) – which runs the national and local clinical audit programmes – to lead on the development of an online care audit tool to be used to improve the care of people with dementia in care home settings. The aim is to test whether the benefits of a national audit approach, as used successfully in the NHS through clinical audit, can be realised in social care, if suitably adapted for the sector.

The Care Audit Advisory Group and Project Delivery Team

The Care Audit Advisory Group was set up in 2013 and met quarterly to inform and guide the delivery of the pilot. It was chaired by Pat Jones-Greenhalgh, national dementia lead for the Association of Directors Adult Social Services (ADASS), to represent people who use care services, carers, care providers, commissioners, regulators and standard-setters and includes representatives from organisations such as the Registered Nursing Home Association, National Care Forum and Skills for Care.

To deliver the work, an expert project team was put in place, whose members were:

• The Department of Health which has commissioned the pilot
• HQIP, responsible for the overall project management and development of audits within social care
• The Royal College of Psychiatrists, developed content and questions for the audit
• The Social Care Institute for Excellence, recruited care home sites, developing benchmarking software and providing training and support for the pilot
• Clinical Audit Support Centre partnering with Healthcare Quality Quest, evaluated pilots

Results of the Dementia Care Audit Pilot 2013/14

The Dementia Care Audit Pilot took place between February and March 2014, testing the concept of a national care audit in the social care sector (focused on dementia care).

The evidence and results from the Impact Evaluation Report, was presented on the 29 April 2014, to the Care Audit Advisory Group. The group produced further recommendations for the Department of Health to consider and a final response was provided by the Department, summarized below:

• The original terms of reference for the pilot project were as a first step in testing proof of concept for a nationally supported audit approach in social care; and whilst the evaluation suggested there was some desire, it did fall short of the original stated aims.
• In order to fully meet the objectives, further significant investment would be required and the Department of Health would be unable to provide this at present.
• To ensure important contributions and the learning from this project are not lost the Department of Health is, therefore, working with the National Institute for Health and Care Excellence, the Social Care Institute for Excellence and the Think Local Act Personal quality forum to develop a stronger evidence base for improving quality in the sector.
• If we can secure a stronger evidence base for what works then further roll-out of a care audit approach may be possible subject to funds being available in a future year.

In light of this, DH thought it prudent to disband the Care Advisory Group; however, should this work be picked up again we could reconvene if it is felt beneficial.