The CQC State of Care Report. 2017/18 – Part 2.

Maintaining Standards is Not Easy

The original rating clearly has a significant bearing on this statistic. If the original rating were Good or Outstanding, then no change is a perfectly satisfactory result. In addition to this, services receiving a poor original rating have a clear incentive to improve. For services graded as Inadequate, there was an 89% improvement in the overall ratings, which by any standards is impressive.

The question is – What happens next? The data shows that 25% of services rated as either Good or Outstanding declined during the following year.  So the ability of the services to maintain their ratings from year to year is an important factor which is of real interest to us at Fastroi. The report acknowledges that high quality of care is not easily maintained and cites several areas that might lead to a ratings decline.

58% – No change
25% – Improved
17% Decline

Source: CQC State of Health Care and Adult Social Care in England Report 2017/2018. P31 Fig. 1.7
State of Care 2017/18: Full report PDF | 3.73 MB

A lack of leadership and governance is one of the major causes of declining quality, since the systems are not in place to monitor quality levels. Failures in medicinal adherence also puts customer safety at risk. Continuity of management and staffing concerns also carries risks for quality. Reliance upon short term agency workers is not cost efficient and also lowers the continuity of care that is so important to many customers. The report told the story of one person who received 42 different care workers in 1 week.  Staff retention levels are also affected by poor training and development, low wages with zero hours contracts and difficult working conditions. Poor relations between providers and managers have lead to out of date care plans, missing information, poor training and support for new staff and bullying to admit more customers.

Care Management Software Makes Helps Maintain Standards

It is clear that many of these services cannot be using any kind of Care Management Software. They may be able to make short term improvements and deliver high quality care for a short time, but they will always be susceptible to external factors. If changes creep in slowly, then they may be difficult to control and may only be spotted at the next inspection. If they occur quickly, then the results can be catastrophic.

Care Management Software is so effective because it is the tool that controls the process, not the person. This is significant because all of the issues mentioned above could not happen if the processes were properly controlled. It should be very easy for a manager to use the Care Management System to present all of the information about staffing levels, bed availability to service owners making the service less susceptible to influence or pressure. Staffing would become more stable, with staff feeling more comfortable in their positions and not being asked to run the service over capacity. This in turn will lead to higher retention levels and less agency staff being needed, lower costs, higher profits and a much less stressful environment. The result – Higher Quality of Care.

By running a Care Management System that controls the processes, services can improve and maintain the quality of their care from year to year. Clearly, achieving a Good or Outstanding CQC rating is not easy, and maintaining the rating also has its challenges. Employing a Care management System such as Real-Time Care from Fastroi, gives service providers and their staff the right tools to achieve Outstanding results for years to come.

The CQC State of Care Report. 2017/18

The Data Tells a Story

Through our analysis of the open data on the CQC website, we were able to learn a great deal about the issues that residential and domiciliary care companies are facing. We published the results of our analysis in a White Paper back in the Spring. The latest report from the CQC gives us a chance to look for any significant information that will help us understand whether we are supplying a product that meets the needs of customers in the UK.

We have focussed mainly on the Adult Social Care section but it is interesting to compare some of the higher level figures with the other sectors in the report. For example, there is a significant variation in the overall ratings across the sectors. Having a 30% variation across sectors ought to be setting alarm bells off across the industry.

96% of GP surgeries are rated as good or outstanding!
82% for Adult Social Care
78% for Mental Health
66% for NHS Acute care

Source: CQC State of Health Care and Adult Social Care in England Report 2017/2018. P29 Fig. 1.5.
State of Care 2017/18: Full report PDF | 3.73 MB

From this statistic alone, parity of care is clearly still a long way off.

How Does Technology Help CQC Performance?

Some other interesting things to note from the report. There is a huge amount being written about how technology can best be used to improve outcomes in both health and social care. The report only has a short paragraph which covers less than half a page on technology. One area that would be very interesting would be to understand the relationship between CQC performance and adoption of technology. This correlation is of particular interest to us at Fastroi and we will be looking into this in more depth the next blog.

The state of the adult social care system makes for interesting reading. The CQC inspected some 22,000 adult social care services which gives the industry a huge amount of actionable data. One of the more sobering statistics has seen the rate of emergency admissions for older people rising by 24-37% across the age groups. Clearly more work is needed to ensure that people are discharged from hospital as quickly as possible and can find the right care package as quickly as possible. One other aspect would be to understand the reasons for this increase and what could be done to reduce this.

The overall message from the report is one of maintaining the current situation. But with many services stretched to the limit, it is clear that improvements will be difficult to achieve. In our next blog, we will look at the causes and solutions to the problem of care companies who achieve high ratings one year, only to see them fall in subsequent years.