Sue Sheath, director of regulation and quality improvement at Barchester, provides advice on how to prioritise and assess quality in your service

At Barchester Healthcare, we know that external regulatory assessments are not sufficient, or frequent enough, to assure the quality of our services, as we know most ratings are currently out of date or misleading.

We cannot rely on this to tell us we are doing a great job. Instead, we need to focus on continuous internal assurance to ensure we are always inspection-ready.

Just like everyone else in the care sector, our focus at Barchester is on delivering great care for residents and patients, but it needs to be designed by us, not dictated to us by the regulators.

Delivering quality cannot just be when you are inspected or audited, it needs to be every minute of every day – that’s what our residents and patients deserve.

I want to share how we, at Barchester, do that.

First, I want to talk about quality.

This is defined by the needs, preferences, and like/dislikes of our residents and patients.

We need to understand these and capture them.

Quality doesn’t happen by chance, especially as, at Barchester, we deliver over 100 million recorded care interactions every year.

We need to know that every one of those interactions is to a high standard and is making people’s lives better.

We all like to focus on our external ratings, compare ourselves with others, and proudly display great ratings. But they don’t define everything we do.

The reality is that it simply isn’t sufficient.

We can’t wait for the regulators to tell us how well we are doing. We all need to define our vision and aspirations, and put systems in place to achieve these.

At Barchester, we aspire to be the best by:

• Focusing on the resident and patient
• Having the right people in place doing the right things, at the right time
• Promoting clear standards, processes, and procedures
• Monitoring the quality through our assurance and governance processes
• Delivering our best day in, day out – not just on inspection day

We recognise that moving into a care setting marks a new phase in someone’s life and we want to make that experience the best it can be. So, our focus is not just on delivering great clinical care and support, but actually enabling people to live their best lives through our Care and Life Enrichment Framework.

The framework has seven key pillars.

It starts in the centre, where we put the people we care for, and is underpinned by our people delivering great care through:

• The support and involvement of residents, family, and friends
• Providing the best living environments
• Creating good nutrition and a positive dining experience
• Facilitating life enrichment

The overarching element is quality assurance and continuous improvement to ensure we deliver on our commitments.

And, of course, delivering safe and appropriate care.

This has become the way in which we operate:

• We communicate with our residents and their family and friends, so they know what they can expect from us
• We induct our teams so they know what is expected of them
• We operate a whole-home approach to delivery, and everyone gets involved and does what it takes
• In order to ensure we comply with the framework, we have in place a set of governance arrangements to help us monitor, measure and assess the quality of our services

In addition, there are a number of game changers we have been using.

The Barchester Way

When people join, they learn about the ethos, the culture, and the way we do things – everyone does the same thing in the same way and to the same standard.

Quality Dashboard

An online data capture of key metrics we use to drive quality – whether that’s regulatory, clinical, resourcing, people or other.

Central Action Plan

A CAP for each service with central oversight.

Quality Improvement Review (QIR)

Each service receives at least one internal QIR per year depending on risk. These are unannounced, but supportive visits to assess quality against 32 key areas.

Divisional Quality Review Meetings

Attended by the most-senior people in our business who all have a keen interest in the quality of our services.

Quality-First Conferences

Held twice per year where we get every GM/HD, RD and MD and our senior management team together in plenary sessions and a series of workshops.

Rewarding Our Staff

We reward our managers and their teams on their successes. The quality ratings (internal and external) are an essential element of our bonus system.

Quality is a consistent theme through all aspects of what we do.

In summary, we believe you make quality happen by:

• Aspiring to excel
• Being clear about the standards your residents/patients can expect
• Working as one team with everyone invested in quality and encouraged to play a part
• Having good governance and quality assurance systems in place
• Assessing the quality of care and support against the standards
• Taking action when things aren’t right
• Monitoring progress
• Driving a culture of learning and continuous quality improvement