Compliance
Mind the gap: care home good governance
Tony Thiru, chief executive of consultants Fulcrum Care, explores the divides between care home staff, managers and directors that undermine good governance and determine whether a care home is ‘well-led’, and how they can be bridged
In the care sector, as well as being led by the needs of our residents, many of the policy decisions that we take for our care homes are driven by the criteria that govern the Care Quality Commission’s (CQC) inspections of our homes. One of the key questions that the regulator will ask is whether your care home is well-led. In my experience, this is one of the
areas that care homes find the hardest to prove, as it requires them to demonstrate not only that there are strategies in place to help the home improve, but also that each level of personnel involved in the care home is equally supportive and knowledgeable about the strategies. So, how can you bridge the gap between the different players in your care home to ensure that it is well-led?
What will the CQC be looking for? The CQC places great importance on how well governed your care home is – and it is no wonder, without effective decision makers at the top of the chain, it is likely that a home will lack a coherent structure and direction, causing it to fall into disarray. To assess this, the CQC will ask questions that seek to uncover the culture, behaviour and effectiveness of all the major players within your care home, ranging from the carers through
management to the board of directors. Ultimately, this means that there is
no point in having a star-studded and competent board of directors if your staff are unaware of all the outstanding policies that they are trying to implement within the home. Equally, investing in training for your staff will be fruitless without also training your managers to understand how your staff can apply their training to everyday scenarios. So, the regulator is really trying to
understand whether your care home has the right plans and strategies in place to help you achieve your goals, how these goals are being monitored, and whether each level of personnel within your care
Many homes fall into the trap of investing in a new system for their care home, but when the CQC asks to see a paperchain of how this was implemented and what the results have been thus far, no such documents or audits can be produced
October 2021 •
www.thecarehomeenvironment.com
home is equally engaged and involved with the policies.
The difficulties implementing and demonstrating good governance However, if it was this simple, every care home would be able to demonstrate to the CQC an outstandingly well-led organisation, which is not the case. There is an array of different stumbling blocks that care homes can often trip up on, and it is never going to be as simple as just pinpointing one area to improve on. However, there are some general themes that I have come across when helping care homes across England to improve. Firstly, a lot of the problems that care
homes encounter when trying to prove their compliance with the CQC’s fifth line of enquiry stem from a failure to understand that the regulator will require them not only to roll-out new strategies, but also to ensure that they are being effectively overseen and that this can be demonstrated to the inspector. Many homes fall into the trap of investing in a new system for their care home, but when the CQC asks to see a paperchain of how this was implemented and what
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