All social care practitioners, teams and provider organisations want to ensure that they deliver the best possible care they can, and that the services they offer meet best practice standards. Excellent practice already exists in many care settings, confirming the sectors' on-going commitment to quality. There is a long tradition of quality improvement in the sector and there are many examples of inspiring and imaginative practice, within individual organisations and at the sector level.
However, as the process of continuous quality improvement is still a developing field in social care, although there is a well-developed tradition of QI, as yet there is no systematic and sector-wide approach to quality improvement. Quality Cycles, used in comparable settings such as healthcare, where they are known as clinical audit, offer the potential to provide such a sector wide approach.
In the coming months we will look to promote the agreed approaches - changing the language and process as needed- through consultation, to pilot these in suitable settings, and to find early adopters to trial, test and refine the methods. Over time we will develop an education and training programme, and possibly national review projects that mirror those in healthcare. We will work with key organisations to develop sector specific ‘audit' tools for specific care environments.
We are pleased to be working in partnership with the Social Care Institute of Excellence (SCIE) as we take this work forward.
Quality matters in care services.
In healthcare, clinical audit is well established and is a fundamental building block of clinical governance, assuring the quality of services and driving continuous improvement. In contrast, the social care sector, despite serving a large and often vulnerable client group, has no nationally agreed framework and wider system of quality assurance and improvement to mirror that in health.
Whilst there is a genuine commitment to assuring and improving the quality of services, in the absence of a central approach, local providers often develop ad hoc systems responding to local needs and commissioning requirements. Not only does this create challenges for providers and their commissioners, but it limits comparability and usability from the perspective of someone using services.
Care audit is a means to showcase excellence across the sector, to identify unmet need or unacceptable variation in care, and to drive improvement where necessary.
We have to prove the quality of the care that we deliver and account for the resources that are allocated, to verify that people who use our services are receiving the best possible care in relation to these resources. We also need to be prepared to compare them to other models of care.
People who use services, family members, carers and advocates all want care to be of the highest quality and to be able to make meaningful choices based on clear, transparent and comparable information.
Increasingly providers want and need to understand how they can improve care, and demonstrate the quality of their services in a competitive marketplace.
In turn, commissioners need robust evidence of the quality of a provider's practice and the ability to compare services across the sector.
With a shift towards achieving high quality outcomes for people who use services and an increasing focus on value for money, there is urgent need for these goals to be supported by high quality intelligence and information systems.
Care audit is aligned with the expectations and requirements of government policy including departmental aims around personalisation, dignity, integration of health and social care, end of life care and dementia strategies as well as the requirements of statutory regulation.
High quality care services equal a high quality experience for the person using the service, carers, advocates and family members. Good care services put the people who use them at the heart of improvement work, and measure the things that are meaningful and important to the person in receipt of care.
Ultimately, a good outcome in social care will be determined by the person in receipt of that care, and delivered in partnership with the responsible professional organisation, team or individual. Much time has been given to thinking about how the essential process of care audit can best be utilised to make sure that the care people receive is not only competent in technical delivery but also that it meets the subjective needs of each individual.
The social care sector is currently experiencing a convergence of drivers and enablers to establishing a shared approach to quality improvement. These provide additional impetus to the genuine desire within the sector to improve quality and professionalism: