My name is Rebecca Dodd and I work with Iriss as an associate researcher. I have worked on a number of public and third sector projects involving education, libraries, health and wellbeing, youth issues and the arts. My role in the Care Inspectorate Project involves analysing a survey of Care Inspectorate employees and observing workshops held between Iriss and the Care Inspectorate and sharing my observations and conclusions.
On 1st February 2017 I observed a workshop held at the Scottish Youth Theatre, between IRISS and a group of care professionals, 4 of whom worked for the Care Inspectorate (1 Project lead, 3 Inspectors) and 11 Managers and Team Leaders who worked across 6 different Scottish Care Homes, the majority of which focused on residential elderly care. The purpose of this workshop was to encourage dialogue between managerial staff and inspectors with the aim of establishing effective relationships between care homes and inspectors and continually improving services.
The first part of the workshop involved asking the participants to establish ground rules. Participants agreed that all discussions were to remain confidential. Everyone agreed that it was best to frame feedback from a positive perspective while remaining honest, and acknowledged the need to agree to disagree. Speaking one at a time and reflection was also an essential ground rule. All participants agreed that all members of the group needed to acknowledge each other’s mutual investment in care. I was pleased to see inspectors and frontline care professionals so eager to establish effective modes of communication.
Participants were split into four groups and asked to respond to the following questions:
Question 1: What worked when it came to improvement? (include actions from both inspectors and services)
Common themes included trust between inspectors and management teams, and involving all staff in care homes in the self-evaluation and inspection processes. Signposting good practice was universally regarded as a positive step toward improvement, as well as having clear direction; it was agreed that communicating specific requirements for improvement often resulted in quick wins, a sense of achievement and improved morale. All participants agreed that improvement plans needed to be realistic in terms of time and finances.
Question 2: What didn’t work? Why?
Challenges included poor attitude and power balance between managers and inspectors, as well as a lack of consistency with inspectors. Failing to recognise degrees of improvement, together with excessive focus on grades also were considered ineffective ways of creating improvement. Service providers agreed that inspectors need to improve their appreciation for changes to everyday services such as new, challenging residents or high staff turnover. I was pleased to see that inspectors seemed receptive to this suggestion. Further discussion led to both sides agreeing that external pressures from the Care Commission, Care Home Owners and Local Authorities were not helpful in sustaining improvement.
Question 3: Rank what worked in order of effectiveness
Positive engagement and cooperation both within care facilities at all levels and with inspectors was consistently ranked as the most effective means of ensuring improvement. Clarity of expectations and clear directions for improvement were also top priorities. Recognition of resources and limitations, together with realistic planning for improvement rated the third highest. Focus on success was also a focal point.
Participants were invited to give feedback on the workshop, and one participant suggested the use of My Home Life cards. These cards contain a picture, and participants selected which card best represented their impression of the workshop. For example, one person selected a picture of a tree and said that they considered the workshop to represent growth; another selected a compass and said that it represented her service going in the right direction. I had never heard of Home Life Cards prior to the workshop, and would recommend their use in any group as a fun and effective icebreaker to get everyone talking. Overall, this workshop was highly successful and sure to open more positive dialogue at our next workshop in March.
– Rebecca Dodd