HQIP Case Study: Audley Quality improvement in social care

HQIP Case Study:AudleyQuality improvement in social careAudley develops and runs retirement villages across England and currently runs 6such villages with further villages planned and in development. Each village also hasan Audley Care team, which provides packages of domestic and support servicestailored to people’s individual needs, and which are available to both residents andpeople living locally. Audley is majority owned by private investors.Audley Care’s approach to qualityThe Board sees ensuring the quality of its services as the best way to protect itsreputation and so remain successful as a business. This is supported by threeapproaches to quality:National quality assurance through regular audits of every Audley Careteam undertaken by the Care Director, Barbara Hobbs;Local quality assurance procedures – these include spot checks by theAudley Care team to follow up new clients after a few days, a few weeks andthen every three months on a rolling basis; telephone interviews conductedby an external consultant with new clients and their next of kin after 2 to 6weeks, after three months and then every 6 months on a rolling basis; andpaper-based client surveys;National support to local teams through nationally developed policies andprocedures, a central HR function whose role includes supportingrecruitment, and a national training and development manager.Find out more: www.audleyretirement.co.uk

National quality assuranceBarbara Hobbs, Care Director,undertakes local audits of everyAudley Care Team. These arecompleted a minimum of everythree months, and more frequentlywhere a previous audit hasidentified areas for improvement.The audit is based on the 16outcomes specified in theRegulations of the Health and SocialCare Act, with some additionalaspects developed by Audley Care.The structure and components thatare used are designed to helpservices prepare for inspections bythe Care Quality Commission.Collecting the dataBarbara spends two days in thelocal branch reviewing thepaperwork, listening and observingpractice. The paper-based review isthorough and detailed and includesreviewing staff records, clientrecords, surveys, spot checks,complaints and incidents.Barbara then reviews theinformation from paper-basedclient satisfaction surveys andtelephone interviews with clientsand their next of kin to form acomplete picture of the care beingprovided.Barbara believes that just goingthrough the audit process helpsstaff to better understand thepolicies, how they protect clientsand promote quality, and their ownresponsibilities and accountability.Barbara comments:“Because workers are in people’shomes and working unsupervised,we need to ensure we arerecruiting people who have theskills to deliver care competentlyand safely and that they are doinga good job. To do this, we havespecific requirements andchecklists associated withrecruitment, and the auditincludes checking that the localmanager has ensured a personmeets all these before they arerecruited.”Clients and their next of kin alsovalue the on-going process ofcollecting feedback, which bothpromotes trust and confidence inthe service and provides anotherroute for people to feedback anyconcerns.Find out more: www.audleyretirement.co.uk

Using the evidence to achieveimprovementAt the end of the two days, Barbaradevelops a detailed report on theservice’s performance against eachof the specified outcomes, and goesthrough her findings with staff.Through the audit process not onlyare any issues in the serviceidentified, but the audit oftenidentifies individuals and servicesthat are working really well andthese positives are fed back to boththe service and the Board.Where the audit identifies someareas for improvement, the localteam are responsible for developinga plan for addressing these. Thenational HR team, Training andDevelopment Manager andOperational Director can all providesupport to local teams to addressissues.Barbara herself also providessupport and advice to the team onissues. The team then emailBarbara to report how the issue hasbeen resolved.Taking an organisation-wideoverview of the findingsEach village is a stand-alonebusiness unit, so whilst the Boardreceive a regular report collatingaudit findings across the villages,they also receive a report on eachvillage as their individual audit iscompleted.Barbara says:“Each of the villages is verydifferent and so the domiciliarycare we provide looks verydifferent, but through the auditswe do identify good ideas andapproaches that we can thenimplement across all the villages.”At the moment, the process is verymuch internally focused, ensuringthat local services are providing ahigh quality service, but theorganisation may start to use itsaudit findings externally to promotethe quality of what it provides in thefuture.If no issues are identified throughthe audit, then it is repeated after12 weeks.Find out more: www.audleyretirement.co.uk