How our service went from a rating of inadequate to good

Featured article - 31 October 2016
By Steve Allen, Chief Executive of Friends of the Elderly

Last year, we at Friends of the Elderly (FotE) failed an inspection from the Care Quality Commission (CQC). In December 2015, the inspection resulted in a series of actions being taken by the CQC and the Local Authority based on concerns over safeguarding in one of our care homes. As a result, the home was put into special measures by the CQC and received an ‘Inadequate’ rating.

Eight months later, CQC revisited the care home and gave it a ‘Good’ rating. This level of turnaround is not common and there are lessons we can share in terms of the cost, capacity, energy and collaboration that had to be brought to bear to overcome the shockwave that hit the Charity at this time.

• SCIE's work with Friends of the Elderly
• Friends of the Elderly
• Campaign by Friends of the Elderly: Be a friend

The initial inspection report triggered a series of immediate responses, involving meetings with the local Safeguarding Adults Board (SAB) and regional CQC managers. The charity cooperated fully, created a comprehensive action plan and submitted a detailed improvement plan to the CQC. The plans were a collective effort from across the charity; time-limited, weighted, deliverable and fully-costed.

Senior members of the charity, including our Chairman, met with staff, residents and family members at the home early in the New Year. We were open and honest, acknowledging our shortcomings and apologising for letting residents down. This approach was welcomed and everyone was committed to helping us achieve the turnaround.

We then worked closely with the local SAB to deliver a detailed remediation plan which resulted in the SAB closing its concerns in February 2016.

Recognising that we needed to review, strengthen and embed our approach to Safeguarding, we commissioned the Social Care Institute for Excellence (SCIE) to deliver a comprehensive package of support.

• Read about how SCIE helped Friends of the Elderly

SCIE brought a structure and confidence to our improvement plans and helped us to apply the learnings across the Charity. Some of the key changes we have made resulting from this programme have been:

• Co-production and embedding new policies and procedures for safeguarding, Mental Capacity Act, DoLs and care plans
• Establishing a Concerns Helpline for service users, staff and others to report any concerns independently and confidentially
• Board level responsibility and accountability – including establishing an internal safeguarding sub-committee
• The introduction of a new Quality and Improvement Team to provide central monitoring and support and maintain quality standards
• The introduction of a systematic, competency-based approach to training
• Improved internal communications with staff, service users and relatives

These interventions are helping the Charity to achieve the following key outcomes: Service users feel safe; staff have a good understanding of abuse and what to do if they witness or suspect it; everyone knows how to raise a concern and would be happy to do so; and all departments understand their role in identifying and mitigating risks.

The main legacy of our project to date is team confidence in what is a complex Safeguarding arena, and an improvement in our internal and external communications, risk management and governance.

SCIE has helped us to deliver a ‘golden thread of safeguarding’ through all that we do. The journey continues, with the help of SCIE, to ensure that the well-being of people who use, work in, or visit our services is delivered as one of our primary objectives.

Friends of the Elderly operates 14 care homes, eight home care services (Triangle Community Services), day centres, volunteer-led befriending and a grants programme. The Charity also campaigns to alleviate loneliness and isolation among older people.