Driving improvement: Case studies from nine adult social care services

We interviewed nine adult social care services that had achieved a significant improvement on their rating.

We spoke to a range of people at each service. This included people who use services and their families, registered managers, providers and owners, care staff, administrative and other staff, commissioners and social workers.

The experiences of the services show that improvement in adult social care is possible. The nine case studies highlight some clear actions that other providers can use to help them learn and improve.

Individuals who have made a difference

As our contribution to the celebrations of 70 years of the NHS, we have brought together stories highlighting individuals who made a significant impact on the care people receive.

While it’s the NHS that’s celebrating a birthday, the people working alongside it in adult social care have also played a vital and integral role.

This collection of short case studies is part of a series highlighting the work that individuals - from volunteers, to front line staff to senior leaders - have done to deliver great services across acute and mental health NHS trusts, primary care and adult social care.

Driving improvement: Individuals who have made a difference in adult social care services

Key themes

Reaction to the initial inspection report

Most providers react to a report highlighting failures with shock, surprise and disappointment. But usually when people stand back and have time to reflect, they understand the failings.

For some staff the report can come as a relief, as they may have been struggling – doing their very best but unable to deliver the care they wanted to.

For some, the report was a wake-up call; providers who allowed standards to slip, perhaps due to a range of pressures.

Leadership

The value of a good leader cannot be underestimated. In most of the providers we spoke to, a new manager had come into the service to deliver the improvements. They engage with staff, people who use services and their families and are open to suggestions but set parameters and take tough decisions where necessary.

Cultural change

Failing organisations tend to have cultures in which staff are afraid to speak out, don’t feel they have a voice and are not listened to. Involving staff is one of the best ways to drive improvement.

Person-centred care

Typically, when a new manager took up the reins, they wanted to see care plans. And in most cases these were lacking in detail and did not show that the care being provided was person-centred. It is not possible to provide good care if the care staff do not understand the needs of the person being cared for.

Working with partners

Most of the services we feature received support to help them improve – mainly from the corporate provider, if there was one, or commissioning bodies.