The Care Quality Commission is the independent regulator of health and adult social care in England and responsible for ensuring services provide high standards of care.

It has legal powers to take action where poor care is identified so how can you ensure that you stay on their good side? We have summarised the key learnings from inspection reports and utilised its Driving Improvement report to explore what trusts had done to become ‘well-led’ trusts.

Care Quality Commission standards.

These case studies will help you to identify potential areas of improvement within your own organisation and understand what is required to pass a CQC inspection with flying colours.

Excellence – being a high performing organisation

Caring – treating everyone with dignity and respect

Integrity – doing the right thing

Teamwork – learning from each other to be the best we can

The report states “effective leadership and a positive, open culture are important drivers of change. In hospitals rated as good or outstanding, the trust boards had worked hard to create a culture where staff felt valued and empowered to suggest improvements and question poor practice.”

Better CQC ratings.

Let’s take real life case studies as examples of how those who went into special measures came out at the other end of the tunnel with better CQC ratings.

Planning and prioritising.

University Hospitals of Morecambe Bay NHS Foundation Trust went into special measures in 2014 but they made significant improvements and by early 2017 was rated a 'good'. How? They started with asking the right questions. Chief executive, Jackie Daniel’s first questions were: “have we got a strategy? How are we approaching quality and safety? Are we building relationships with staff? What partnerships have we got to support what we do? How is our performance?” She then went on to identify gaps and setting priorities.

Quality first.

Throughout these case studies, it is evident that a focus on quality of service pays dividends in the long term, even if it seems resource heavy at the beginning. Ward Manager, Michelle McLaughlin, holds monthly governance meetings with her staff in which they look at learning from incidents, recalls and alerts. She believes this results in “better patient care and safety”. Medical Director, David Walker agrees and admitted that recruitment was the one activity that was pushed forward to improve quality.

Positivity and empowerment.

When East Lancashire Hospitals NHS Trust went into special measures, they started focusing on cultural change. Kevin McGee, Chief Executive, thoroughly believed that improvement “starts and ends with staff engagement” and Director of Nursing, Chris Pearson agrees.

Chris set up regular meetings with all ward managers and when he asked about something good that happened on the manager’s area in the first meeting, he was met with silence. That is when he knew that a change in culture was much needed to get staff members thinking about the positive contributions they make. He went one step further and introduced the Nursing Assessment Practice Framework as well in which each ward gets an unannounced visit from a panel of five staff members to carry out a CQC style inspection. This helps the teams to continuously assess the quality of care provided.

Changing media perceptions.

Often, it may seem like the media highlight only negative stories and health and social care organisations often feel the brunt for this. This can influence your public profile but the key is public engagement. Below are a few examples of how this can be done:

East Lancashire Hospitals NHS Trust came up with a new campaign called ‘Tell Ellie’ through which they took staff out into the community instead of waiting for patients to come to them.
Cambridge University Hospitals NHS Foundation Trust started a hashtag on Twitter. The #myCUH hashtag was created to help show staff involvement and also used by staff themselves to share their own improvement stories.
Wexham Park Hospital began the ‘Ask Andrew’ page which enables members of the public to get in touch with the Chief Executive with any queries or comments on the trust. This page is frequently used by the public who are more likely to feel listened to now.

Bridging the gap between the board and the ward

Supportive management is key to success in many cases. In the case of Mid Essex Hospital Services NHS Trust, ‘Clinical Tuesday’ was introduced through which matrons and lead nurses would come and work on the ward, bridging the gap between the management and the ward staff whilst increasing visibility of the more senior members of the team.

These examples have been mentioned as key to driving improvements within these trusts but they are also key in recruiting and retaining your staff. Attracting and keeping the right staff is often at the heart of service improvement. If you would like to find out more about our recruitment channels, please get in touch with your local team of health and social care recruitment specialists by clicking here.

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