Care homes feature a diverse range of people involved in its running. There are the staff on the ground, interacting with residents and undertaking the tasks that ensure its functioning, managers who oversee the running of the care home, and directors, who make most of the high level decisions and oversee the governance of it. The CQC will want to see that these three different levels of staff are working in cohesion with other, in order to satisfy its fifth key line of enquiry which seeks to ensure that care homes are ‘well led’. Here’s our advice for ensuring that your care home is well governed and compliant.
What the CQC is looking for
When the CQC visits your care home, one of the five key areas that they’re going to be looking at is how well managed your care home is. To establish this, they can ask you, your managers and the carers at your home a set of core questions, seeking to understand:
- Does your care home have goals?
- Are strategies in place to help achieve these goals?
- How are the policies at the care home being overseen?
- Is ‘person centred’ care being promoted by these strategies?
- How are the risks at the home being managed?
- How engaged are the different types of personnel with the procedures at your care home?
- Is data informing your policy decisions?
- How well does your care home communicate with other agencies?
Challenges for care homes reaching compliance
The CQC’s requirement for care homes to be ‘well-led’ is all encompassing, allowing the regulator to explore a number of different areas within care home management to help them understand the decisions that have been made and the reasons behind them.
In our experience of working with both singular care homes and larger care home groups across England, there can be a number of challenges that commonly arise when trying to ensure compliance targets are met. This includes:
- Demonstrating good governance: Good decisions may be taken within the care home, but home struggle to effectively demonstrate the their thought processes and how that has had a positive impact in running the home. The CQC is is looking at evidence to make their assessment.
- Varying interests between those involved at the care home: Although the organisational structure within a care home will vary from home to home, there are typically three main groups: carers, managers and directors/providers. Unfortunately, these groups will not always agree on decision/or a course of action and this can sometimes lead to a breakdown in communication which will undermine how the CQC views the governance of your care home
- Rolling out policies/initiatives too quickly: Finally, many care homes try to cultivate change in their home too quickly, which can create inconsistencies in how care is administered and undermine the success of the policies/initiative in the long run.
Demonstrating good governance to the CQC
To demonstrate good governance to the regulator, they are going to want to see a clear set of objectives (or goals), strategies to meet these goals supported with evidence and using the learnings to inform future decisions in your care home policymaking.
While the CQC will want to see all individuals involved in the running of your home equally as enthusiastic and knowledgeable of the policies in place, it is ultimately the directors who make final policy decisions and must meet their criteria of a ‘fit and proper person’. This means that your directors will need to prove that they are effectively managing and have oversight of the sytems in place at the care home and mitigating any risks that may be arising.
While some care homes rely on their directors to provide this oversight, many instead prefer to rely on an external expert to offer this guidance. This is usually because, when people heavily involved in the bureaucracy of the home are auditing/reviewing them, errors can sometimes be missed and it can be better to rely on a fresh pair of eyes with full knowledge of up-to-date regulation targets. Our team has worked with countless homes to help them ensure they are meeting the Regulation 17 requirements of good governance, helping them understand the effectiveness of their policy decisions while also importantly enabling directors to spend more time on business and long-term goals.
Our expertise can also be invaluable to boards whose members have not been involved in the care industry and need expert advise. Directors bring a wealth of business and commercial experience, they will need to demonstrate a depth of knowledge of the care industry to prove that the board is ‘fit and proper’ by regulator standards. This is where our team can help, equipping directors with the information/advice they need to take decisions, proving to the regulator that the governance of the home is driven by person-centred care.
Effective communication across the organisation
When it comes to care home teams at every level, the people involved often all come from different backgrounds, with diverse day-to-day experiences and varying interests in where improvement is needed. This can sometimes lead to a breakdown in communication as, for instance, care workers may not be fully informed of the need to value commercials when taking major decisions, as opposed to the managerial staff. If there is a lack of cohesion between the different levels of management in your care home, this will undermine how well governed it is as, when new policies are implemented, staff may be unwilling to follow them as they haven’t been involved in the decision making process or the reasons that have required new policies to be put into place.
To mitigate such risks, it is important to establish clear channels of communication between yourselves and your managers, equipping them with the right information to feedback to staff why decisions have been taken. It is also crucial to provide your staff with the necessary training so that they can successfully implement policies as, if they fail to properly understand them, old habits will start to set back in.
We’ve successfully helped many providers cultivate change in their care homes, working with all levels of personnel to promote closer alignment and confidence in new policy decisions. Our team of expert care consultants have a deep understanding of the practicality of runningcare homes and how to best foster communication within an organisation to implement change successfully.