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1/10/2013: Driving Up Quality Provider Code is Launched

If you developed an important new national initiative, what would be on your wish list for a successful launch event?

  • High profile venue?
  • Celebrity host?
  • The backing of key politicians?
  • The support of those who will benefit from the initiative?
  • The support of other stakeholders?
  • Commitment from those who will implement the new initiative?
  • The support of ‘critical friends’?

The Launch of the Driving Up Quality Code was held in the Churchill Dining Room in the House of Commons, and the Rt. Hon. Paul Burstow was the host (yes to high profile venue and host). As the former Minister of State for Care Services he was in office when the Winterbourne View scandal was uncovered, and since this Code is the providers’ response to Winterbourne View, it was fitting that he should host this launch.

He spoke about how impressed he was that the provider sector had “stepped up and done something in response to Winterbourne View.  A meaningful life is a fun life, a life with laughter which means setting the climate (in service provision) to develop the right culture”.  He welcomed the fact that management and board members’ accountability was focused upon in the Code, and said he was very impressed with this piece of work (yes to support from politicians).

He finished by reminding us that care is about relationships.

Kim Foo and Paul Hayes, joint Chairs of the Driving Up Quality Alliance, spoke briefly about the outrage experienced by many providers when the abuse at Winterbourne View was revealed, and how this had driven representatives of 80% of the sector to come together to develop the Code, being launched here today.

Alicia Wood, CEO of the Housing and Support Alliance, and Sarah Maguire, Director of Quality at Choice Support, led the delegates through a whistle stop tour of the Code.  Alicia spoke passionately about the need to be unequivocal about what is right and wrong about services if we don’t want to measure good lives merely through minimum standards! She went on to say that Castle Beck was rotten to the core, and providers need to be better at listening to people who use services and family carers.  Providers who don’t want to do this should step away. “The care sector is plagued with mediocrity, disguised as something better, and we need to ask what a good life is, not what a good service is.”

Sarah talked about the role of good risk management, but questioned whether that really meant the vicar must have a DBS check before he can call round for tea! She questioned the over-reliance on policy and procedure that can exist, and how that can leave support staff unable to think for themselves. Sarah challenged providers to look at how much time and effort they spend developing leadership because boards really must know what is going on in the organisation, and how services are being delivered.

Cally Ward, from the National Valuing Families Forum, shared the families’ concerns about being listened to.  It was clear to families that Castlebeck was not alone in providing unacceptably bad services, when half of the 150 providers were shown to be non-compliant in the checks that followed Winterbourne View.  Families need to feel confident that they can trust those providers who are looking after their family members, she said, adding that “quality needs to happen when you’re not looking”, and reiterating Paul Burstow’s view that quality is about human relationships”.

Cally went on to talk about the valuable role of leadership in changing organisational culture, and how the Code could help families to choose the providers they want to look after their family members.  She also felt that families could make an enormous contribution to the effectiveness of the Code in three key ways:

  • Families are naturally Person-Centred and providers should listen to them;
  • at an operational level families can help with recruitment, induction, appraisals, 360° reviews and quality monitoring; and
  • At a strategic and governance level they can help organisations to think about corporate responsibility and the direction of the organisation.

“We are all in this together”, she said, “and family carers will tell it like it is”(yes to support of those who will benefit from the initiative).

Alan Rosenbach of CQC, and Laura Broughton, an Expert by Experience, talked about the significance of Winterbourne View for their organisation, and how it showed up a lack of quality and lack of safety in a system that let people down badly.  Laura said that the Driving Up Quality Code “is a good way forward” (yes to the support of those who will benefit from the initiative).

Alan acknowledged that this was the “first time providers have come together to put together something by themselves and for themselves”, describing this as one of the positive aspects of this initiative.

Picking up on Cally’s earlier comment about the 48% of services that CQC found to be non-compliant, Alan pointed out that 70% of people with learning disabilities being supported were in those non-compliant services, and this all brought into sharp focus, issues about CQC’s registration process.  Alan was quick to say that they did identify some very decent services too.

He continued by saying that CQC wanted to give this Code traction, and would have their specialist assessors ask, in detail, if a provider has looked at the Code, carried out a self-assessment, and would go on to look at their action plan for the Code. (yes to the support of critical friend)

Norman Lamb MP, Minister of State for Care and Support Services, said he was really delighted by this Code. Post Winterbourne View we had to see it as a national imperative that we improve the way we support people with learning disabilities.  “They have the same right to good quality care, but don’t always get it.”  Change has to come from the bottom up, he said, which was why he was so enthusiastic about the Code. He said he was “enormously impressed and appreciative of the work that has gone into developing this Code”, and went on to pledge to root out poor providers and lazy commissioners, because he knew there are lots of good providers and support workers who are committed to improving services.

“Families had faith in a service that failed them and had no ambition to improve”….and “the experiences of parents of people in Winterbourne View have really stuck with me”.

He finished by saying that change needs to come from the sector itself if the culture is to change, so it is key that it is led and owned by providers.  “I want the Code to build high value care, and in time to use it to support commissioning.  This initiative is incredibly welcome.” (yes to the support of key politicians).

Chris Bull, Chair of Joint Improvement Programme, welcomed the Code, saying it was important for several reasons:

  • Ownership;
  • Saying what good looks like; and
  • Not just about making services safer, but also about changing the nature of services

Chris talked about the work undertaken by the Programme to assess commissioners, which will be reported on later in the year.  He talked about writing again to commissioners to be clear about what is expected of them, and to assessment and treatment providers to ask what plans they have for moving people on. An Enhanced Quality Team has been established to work on three strands:

  • Commitment to families of Winterbourne View service users;
  • Looking at providers who give most cause for concern (with CQC); and
  • Working with commissioners in certain areas to take a “deep dive” look at the commissioning process.

Chris acknowledged that providers had to take responsibility for quality – if they waited for commissioners to tell them what good quality services are then it would take a long time.  They needed to think about their values and recognize that people needed the least restrictive setting possible to live good lives.  He appealed to providers to innovate, and make offers to commissioners. (yes to the support of other stakeholders)

Thirty-five organisations had already signed up to the Code before the launch date, and will be undertaking the self-assessment (yes to the commitment from those who will implement the initiative).