social care managers handbook

1 Contents

Introduction 6

Foreword 4

How the Handbook is structured

How you should use the Handbook

Welcome to this Handbook

Section 1: Social Care Values 10

Section 2: Personalised care 14

2.1 Explaining personalisation

2.2 Delivering personalisation2.2.1 Outcome-based working2.2.2 The person in personalisation2.2.3 Mental capacity

2.3 Considering risks2.3.1 Duty of care

2.4 Embedding personalisation in practice

2.4.1 Financial systems2.4.2 Marketing2.4.3 Developing staff2.4.4 Care plans and recording2.4.5 Delivery models2.4.6 Promoting personalisation

Section 3: Quality 28

3.1 Governance

3.2 Measuring quality3.2.1 Outcome-based frameworks3.2.2 Standards-based frameworks3.2.3 Other approaches to

measuring quality

3.3 Getting feedback

3.4 Improving quality3.4.1 Assuring quality

2 3

9.1 Understanding safeguarding

9.1.1 Recognising safeguarding issues

9.1.2 Risk factors 9.1.3 Embedding safeguarding

9.2 Reporting safeguarding concerns

9.3 Safeguarding investigations9.3.1 Participating in investigations9.3.2 Recording investigations

9.4 Safeguarding ‘radar’

8.1 Promoting health and wellbeing

8.1.1 Environment

8.2 Responding to health emergencies

8.3 Risk and hazard management

8.4 Reporting workplace incidents

8.5 Medicines administration

8.6 Moving and positioning

Contents Contents

Section 8: Health and wellbeing 82Section 4: Information 40

4.1 Information governance

4.2 Communicating information4.2.1 Verbal communication4.2.2 Written communication4.2.3 Accessibility4.2.4 Audiences

4.3 Collecting information4.3.1 Information sources

4.4 Using information4.4.1 Keeping information

confidential4.4.2 Breaking confidentiality4.4.3 Sharing information4.4.4 Disposing of information

Section 5: Resources 56

5.1 Defining resources5.1.1 Financial resources5.1.2 Human resources

5.2 Using resources

5.3 Managing and maintaining resources

Section 6: Teams and partners 62

6.1 Identifying teams and partners

6.2 Working with teams and partnerships

6.3 Leading teams

6.4 Developing and supervising teams

6.5 Managing teams

Section 7: Buildings 72

7.1 Managing buildings

7.2 Keeping buildings safe7.2.1 Hazardous substances7.2.2 Fire safety7.2.3 Infection control

7.3 Assessing risk in the workplace

7.4 Security7.4.1 Security against intruders7.4.2 Privacy and unwanted visitors7.4.3 Protection from abuse or harm7.4.4 Security of property

Section 9: Safeguarding 94

Section 10: Regulation and inspection 106

10.1 The regulatory regime

10.2 Dealing with inspection10.2.1 Is it safe?10.2.2 Is it effective?

10.2.3 Is it caring? 10.2.4 Is it responsive to people’s

needs? 10.2.5 Is it well led?

Section 11: Professional development 114

11.1 Workforce development

11.2 Your own professional development

11.2.1 Reflecting on your practice11.2.2 Keeping up to date with

research

About the Skills Academy 120

Special Thanks 122

Section Section Name4 5 Foreword

ForewordWelcome to this HandbookIf there is one thing I have learnt during my career in social care it is that quality leadership must always be at the heart of outstanding services that really understand core values like dignity, respect, compassion and person centred care. That’s why we created The Social Care Manager’s Handbook, with the support of the Department of Health, to support quality leaders across the sector.

This Handbook was created after extensive consultation with the sector which is vital. But its real strength is not only offering a useful mix of practical advice on key operational matters, like building management, but also focuses on how leadership translates values from an abstract concept into something that is in the DNA of every professional who offers care and support.

I have managed and led at different levels for some time now, and my thinking is often challenged by the up and coming leaders I mentor. I enjoy the moments that I am challenged, as it is a timely reminder that there is always something else we can do better. That need for self-awareness and constant evaluation underpins the thinking behind this Handbook and is particularly pertinent in a people business like adult social care.

This Handbook not only dovetails nicely with existing Skills Academy products, but also with Skills for Care’s materials, which means we are able to offer social care employers and their staff quality qualifications and learning opportunities throughout their careers.

I am delighted that the Handbook has been such a success and we look forward to bringing you the second edition next year. However, the biggest endorsement I can give the Handbook is that I wish it had been available when I started my management career, because I would have found it invaluable.

Sharon Allen

Chief Executive Officer, National Skills Academy for Social Care and Skills for Care

Section Section Name6 7 Introduction

Introduction As a Registered Manager or any manager in social care, you are the lead professional in your service. You are the role model for all the staff. The skills, knowledge and values that drive your work also set the standard. You have a statutory role and a wide range of responsibilities, but above all, you are the heart of your service.

Social care managers are the people who get on with turning the service’s vision and purpose statement into real practice on the ground. To do this well means putting the people who use your service at the centre of everything, and constantly reflecting on whether or not you are doing the very best that can be done.

8 9 IntroductionIntroduction

How the Handbook is structuredThis Handbook is set out in eleven sections that together, form a reference point for all the key aspects of your role.

Each section can be used independently. Each covers a particular area of the work of a social care manager and provides information, guidance and practical tips to support you in your day-to-day work.

The sections start with the fundamental things that matter to you: the social care values that underpin your work; personalisation, and the person-centred services you look to provide; and quality in social care.

Building on this, the subsequent sections focus on particular areas of work, such as Resources, dealing with Safeguarding, and Team working. In each area, you will find an overview, in plain English, of the main things to consider. The aim is to give you the key information you need.

At the start of each section, we list the relevant legislation, standards and frameworks that could apply and which you can use for guidance and support. The list includes the relevant parts of the Leadership Qualities Framework, the Manager Induction Standards and the CQC Inspection Framework.

At the end of each section, we provide more detailed references to sources of further information. Because the recognition of Registered Managers as lead professionals is still relatively new, there are varying amounts of existing support materials. Some areas of the work are already well-supported, so rather than repeat information already out there, links are provided. Other topics, for which fewer resources exist, are dealt with in more detail.

At each stage, there is a summary of what each section covers, so that you have a quick way to find what you’re looking for.

How you should use the HandbookThe Handbook is designed as a comprehensive guide to all the key aspects of your role, so that you can come back time and again and reference it as you need to. It is not intended to be digested in one go. Instead, we suggest that you go through each section, one part at a time, with your teams and with your service users, their carers and relatives.

We recommend that you read the first sections, on values, personalisation and quality, at the start, because these provide the foundations of all your work. Once you have done that, you can identify how these general principles apply to the other aspects of your role in practical terms.

The Handbook is intended to be a work in progress. Social care changes very fast, and this Handbook will be subject to regular update. The print edition will be published annually, and Members of the National Skills Academy for Social Care Registered Managers’ Programme will benefit from online updates throughout the year. Please check the Members’ area of the Skills Academy website at www.nsasocialcare.co.uk.

The Registered Managers’ Programme is a peer network, developed by managers for managers. If you have good practice or other useful information to share, please let us know at [email protected], so that it can be shared in future editions of the Handbook.

However you come to it, we hope that using this Handbook will enhance your understanding of your leadership role, and provide very practical support in enabling you to carry it out.

Section Section Name10 11 Social Care Values

Section 1: Social Care ValuesCompassion / Respect / Courage / Responsibility / Empathy / Imagination / Treating people with dignity / Adaptability / Innovation / Integrity

Relevant legislation, standards and frameworks

Legislation

• Care Act 2014

• Health and Social Care Act 2012

• Equality Act 2010

• Freedom of Information Act 2000

• Data Protection Act 1998

• Human Rights Act 1998

Leadership Qualities Framework

• Setting Direction

• Improving Services

• Delivering the Strategy

• Managing Services

• Working with Others

Manager Induction Standards

• 2.1 Understand systems for information management

• 2.2 Understand how communication systems and practices support positive outcomes for individuals

CQC Inspection FrameworkInformation in this section contributes towards the following Key Questions:

• Is it safe?

• Is it effective?

• Is it responsive?

• Is it caring

• Is it well-led?

“The best social care practice needs people who have real empathy for the individuals they work with.” Jo Cleary, Chair, National Skills Academy for Social Care.

Section 1

12 13Social Care Values Section 1Section 1

Social care valuesThe values that underpin social care have developed through recognising that the very best practice comes from the highest standards of personal and professional integrity, and the commitment to deliver a service that centres on and responds to the people who use it.

You will recognise in others the values that brought you into this job in the first place. These are the values which form the foundation of this handbook. Attributes such as compassion – you can’t teach it, but you can see those who have it and you know that they are the people you need in your staff group. Compassion means sympathy, empathy and caring rolled up into a genuine, purposeful and kind response that takes practical action to relieve someone’s distress or discomfort.

Treating people with dignity and respect will run through your service like a golden thread. As the professional role model, you will be aware of all the ways that you demonstrate respect for everyone who uses your service. While your staff will be able to follow your lead, they will also want to find support and guidance from supervision and in using the systems and processes that you have developed.

Part of according the people you support the respect and dignity they are due is active promotion of their independence. You will be continually working to assure yourself that your staff are not encouraging dependence, that every aspect of your service is designed to intervene as little as necessary, and seeks to maximise what people can do for themselves.

At the same time, you need to manage the risks that go alongside this. Getting the balance right between safeguarding and independence is a challenge and a daily concern for most managers. Respecting that people have a right to make choices and take risks, while at the same time recognising their right to a life free from harm and abuse, is just one of the finely balanced judgements that managers regularly have to make.

The integrity that has enabled you to progress to the role of lead professional in your organisation is an essential quality for all your staff. Integrity is not just about day-to-day honesty, important as that is. It is also about working in social care for the right reasons and showing the integrity of purpose that drives the best staff to provide the highest quality service.

The task is often made even more complex by the range of people and agencies who will attempt to impose their view of how things ought to be done. While of course you should welcome opportunities to explain your work, and to respond to suggested improvements, you remain the lead manager. It can never be good for your service to allow views to prevail that you believe will be detrimental to the quality of the service or the rights of the people you support.

Working in social care means having courage in some very difficult situations. Not all the decisions you make will be easy, and many of the situations you deal with will have practical and emotional risks and challenges. Your ability to support your staff in facing difficult circumstances will have come from your own experience and personal courage.

One of the qualities you will have looked for in your staff team is the ability to take responsibility; this might be for an individual, or for part of the service, or for other staff members. The other important aspect is about taking responsibility for your own actions. In the same way as you are very publicly responsible and accountable for the service you deliver, your staff need to be able to take responsibility for their own practice.

The best social care practice needs people who have real empathy for the individuals they work with. The ability to identify with someone and to understand and feel what they are feeling makes other values like respect and dignity fall into place. Like compassion, empathy is not something you can teach, but you can recognise and encourage it and show staff that this is an attribute that is valued in your service.

You will spend valuable time identifying, agreeing and sharing the values of your service, and in making sure they are reflected in your statement of purpose and making sure that they underpin everything that your service does.

You will find that the values you hold are reflected throughout all the sections of this handbook. They are a part of all aspects of the work of a manager. All of the information and practice recommendations in this handbook are based on social care values.

Social Care Values

Section Section Name14 15 Personalised CareSection 2

Section 2: Personalised careOutcome-based working / Culture change / Person-centred planning / Balancing risk and choice / Embedding personalisation in systems / Personalised medication / System change


Legislation

• Care Act 2014


• Putting People First 2007


• Community Care (Direct payments) Act 1996







• 4.1 Understand the importance of quality management in ensuring positive outcomes for people who use your service

• 4.2 Understand how to lead outcomes based and person centred practice

• 4.3 Understand positive risk taking in the context of outcomes based and person centred practice



• Is it caring?


This section takes you through what personalisation means; how you can make it a practical reality within your service; and some of the main implications of personalised care for your work in practice.

16 17 Personalised CarePersonalised Care Section 2Section 2

2.1 Explaining personalisationPersonalisation is all about fitting the service around the individual – not the individual fitting into the service. It is about recognising and treating people as individuals, people having choice and control over their lives, and people having independence and the ability to direct their own support services.

Personalising care services involves moving away from the traditional ‘gift model’ where we decided what people needed and then told them how we would provide it. We ‘consulted’ and ‘involved’ people in decisions about their care, but we were still in charge. In the past we would ‘care’ for people by putting large numbers in residential facilities and just keeping them there – known as ‘warehousing’ because nothing was done to re-able people. Residential care was for life.

Disabled people led the development of the ‘social model’ of disability. We began to understand that equality was what empowered people and gave them choices and the ability to make their own decisions. The social model showed that it was society that disabled people, not a physical or mental condition. If everything fitted around the individual, then the disability was overcome. The questions changed from ‘What is wrong with Mike that he can’t use the swimming pool?’ to ‘What is wrong with the swimming pool that means Mike can’t use it?’

The personalisation agenda changed traditional thinking. Many people started to take control of commissioning their own care and support through direct payments or by specifying the services they wanted the local authority to commission on their behalf. At this moment, with the exception of some areas that are part of a pilot scheme, people cannot use a personal budget to purchase long-term residential care, but it is the government’s intention to roll this out from 2016. As the lead professional, you are the public face of your service and your ability to market your service to customers is likely to become increasingly important.

Personalisation also signalled a change of thinking around the difference between ‘long term’ and ‘permanent’ care. Some significant changes in approach have led to a different way of thinking about residential provision and a recognition that people can sometimes move on into more independent ways of living after a period of re-ablement in residential care.

Assessment moved from the ‘deficit’ model of looking at the things that people were unable to do, to an ‘asset model’ where the starting point is looking at people’s strengths and abilities and what they can do for themselves. Services then fill in any gaps that the person identifies.

Personalisation is not just about putting people at the centre of everything you do. It’s about putting them in control of their own lives.

2.2 Delivering personalisationWhat does a personalised service look like?

• People make choices about their own support and how and when it is delivered.

• People choose their own lifestyle.

• Services are delivered for individuals and are based on people’s strengths and abilities.

• People live as independently as possible.

• People who use the service make decisions – not the staff delivering the service.

This is what will be behind the culture of your service. There are ways that you can change how services are delivered, but your leadership determines the culture and that makes the difference.


2.2.1 Outcome-based working

The key to delivering personalised care is outcome-based working.

Process How you go about

providing a personalised service and the systems

involved

Output For example, how many people you care for and support and for how long

Outcome The difference you made to

a person’s quality of life.

Input Mostly what

the workforce does

The move away from inputs being the basis of performance monitoring has made a major difference to how services are delivered. However, there are still ‘support plans’ that assess people’s needs as ‘4x30 minute calls a day’ with little comment about what outcomes the individual wants to achieve and no reference to the ‘so what?’ question in relation to commissioning ‘time and task’ provision.

As the leader of your service, you are the person best placed to challenge support plans based on inputs, and to encourage those assessing and brokering services to think personal. Your opposite number in a local authority commissioning your services is the Service Manager or Head of Service. If you are not getting support plans that include clear outcomes that allow you to plan a good quality personalised service – such as

“Sarah wants to feel less isolated and lonely”; “Joe wants to be involved in gardening again” – call a meeting and explain what you need from a support plan so that you can deliver effectively.

2.2.2 The person in personalisationKnowing the people you are providing a service for is another cornerstone of providing a personalised service. When your staff team takes the time to get to know someone and understand their preferences, beliefs and achievements, it is far more likely that the person will be treated with dignity and respect and not be seen as a ‘condition’ or a ‘set of symptoms’.

Families are important in a personalised service; you will be encouraging your staff to work in partnership with families, friends and any support from the local community.

Personalised care means getting your service used to having a different starting point, working from the point of what someone can do rather than the traditional ‘deficit model’ of assessing what they can’t do. A different starting point gives a different sort of plan, because people’s strengths are the basis for any care and the support plan fills in the gaps that individuals, their families, friends and local community can’t cover.

You know how much time and patience this takes, but in terms of the quality of your business, it is an investment that will bring rewards in terms of:

• quality of service

• positive feedback

• improved outcomes for individuals

• improved staff job satisfaction

• improved staff retention, and

• reduced safeguarding concerns.

It may not sound like a great business model, to support your clients to reach a point where they need you less or even no longer need you at all, but every positive outcome you achieve will promote your service and increase demand.

You may be commissioned by a local authority, or Continuing Health Care, or by the individual through a Personal Budget Individual Service Fund. Regardless of how the service is commissioned, the start of a new service provides an opportunity to work in partnership and to share ideas about new approaches and ways of working that can help to maximise independence.


2.3 Considering risks Giving people choice and control inevitably means giving people the choice to take risks. When everything was in our ‘gift’ we saw risks as negative and could ensure that risks were largely removed or reduced, but that is no longer the case.

Risks are part of life, but because people are vulnerable, we want to protect them. Delivering on personalisation means that you have recognised people’s right to take risks, and also recognise that taking risks is not necessarily a negative thing.

Traditionally we have taken the view that vulnerable people should be protected from risks, and so they should – from some of them. For example, someone who has no capacity to recognise danger should not be placed in a situation where serious harm could come to them.

Approaches to risk can also be positive; being able to take risks can be viewed as a benefit to the individual and their families. The Improvement and Efficiency Partnership (IEP) West Midlands developed the following helpful set of principles for positive risk-taking (see overleaf).

2.2.3 Mental capacityThe principles of the Mental Capacity Act 2005 underpin much of your work on personalisation. These principles can be summarised as follows:

• Everyone is assumed to have capacity unless there is evidence that they do not. There can be no assumptions based on an illness or condition.

• People must be fully supported to make decisions for themselves.

• Even if there is evidence that they lack capacity, they should be as involved as possible in any decisions.

• People are able to make unwise decisions. Making a decision that may seem unwise cannot be used as evidence of a lack of capacity.

• Any decisions made on behalf of someone who lacks capacity must be in their best interests.

• Any actions taken on behalf of a person who lacks capacity must be the least restrictive option.

A report in March 2014 from a House of Lords Committee (more information at the end of this section) found that more needs to be done to understand and use this legislation to inform and manage how capacity is understood, and especially how Deprivation of Liberty Safeguards (DoLS) are used. Their view was that people were being deprived of their liberty without proper checks and assessments being made.

If you are working in a residential or nursing home and you are regularly having to prevent someone from leaving, or confine them to a particular area, or restrict who can visit them or administer medication in order to control them, then the Mental Capacity Act requires that you make a DoLS application to the local authority:

• A Best Interests Assessor and a Mental Heath Assessor will visit the person, and speak to you and to their family.

• If it is considered that there is a deprivation of liberty, and that it is in the person’s best interests, you will be given authority to deprive the person of their liberty for a certain period of time.

• You will have to renew the application when it runs out if the situation remains the same.

Assuming capacity, and protecting people’s rights not to be kept against their will unless it is in their best interests, are vital aspects of a personalised service in the interests of the people you support.


2.3.1 Duty of careOne of the inevitable consequences of providing a personalised service is that you now have to balance a positive approach to risk against your duty of care. Your obligations are established in common law and you are open to legal action if you, or your staff, breach your duty of care by actions or inactions and this results in an injury.

An individual with capacity may choose to take risks; this is very different from them being placed in a position of risk through neglect or carelessness. There is an important distinction between enabling someone to choose to take reasonable risks and putting people at risk.

Finding this balance is vital to personalised care. It is about encouraging people to exercise their choices and do some risky things whilst not placing them in harm’s way. Working in partnership with people to explore their own ‘risk appetite’ and finding ways to reduce risks is likely to be part of your approach. Having a clearly documented policy around enabling risks and providing learning and development for your staff is a key element for effective practice in this area.

Enabling risks can be very positive, but recording decisions is important. Obviously, you do this in line with the seriousness of the potential risk; otherwise you will end up in a bureaucratic nightmare of recording. If a risk is a serious one, you may record the following:

• Risk identified

• Legislative framework followed, if any (e.g. Mental Capacity Act, Human Rights Act etc.)

• Any advice and guidance sought

• Meetings and discussions held with individuals, their carers, families, other agencies and other interested parties, and the views expressed including any unresolved differences of opinion

• Issues considered and rationale for risk-enablement plan development

• Record of plan agreed and signed off including identification of lead responsibilities for all elements

• Agreed arrangements for review.The Skills for Care 2011 guide Learning to Live with Risk also provides a helpful perspective of risk for service providers (see Further Information at the end of this section.)

Principles of working positively with risk

1. Risk is a normal everyday experience.

2. Risk is dynamic and constantly changing in response to changing circumstances, therefore its assessment and management need to be ongoing, with management plans being regularly updated and reviewed.

3. All people, including vulnerable people, have the right to take risks.

4. An individual’s right to take risks does not give them the right to put others at risk.

5. Risk can be minimised, but not always removed.

6. Information will sometimes be partial and should be tested to inform decision-making. Decisions should be made using information that is available within a reasonable period and should be checked for accuracy. Some decisions may need to be made prior to all information being available.

7. Identification of risk carries a responsibility to do something about it.

8. People who use services, their advocates and where appropriate, their family will be involved in risk assessment and decision-making.

9. Decisions will be based on clear reasoning using the principles of multi-disciplinary and inter-agency working in proportion to the risk and impact to self and others.

10. Risk management will involve everybody working together to achieve positive outcomes for people.

11. Confidentiality is a right, but not an absolute right and may be breached in exceptional circumstances when children or vulnerable adults are deemed to be at serious risk of harm or it is in the public interest.

12. Guidance procedures and risk assessment tools should support positive risk-taking including ensuring that staff receive appropriate organisational support and supervision from their immediate line management.

13. Where risk-taking results in negative outcomes for people who use services or others, the experience should be learnt from and used to inform future decisions.


Personalised care

Financial systems

Recording

Learning and

development

Marketing

Managing medication

Supervision

Care plans

Recruitment

Contracts

Rotas

2.4 Embedding personalisation in practiceYour work schedule each day is about implementing and embedding a personalised service into your systems and processes. Delivering a personalised care service involves a change to the whole system. Every aspect of what you lead, manage and deliver has to be aligned with the personalisation agenda.

2.4.1 Financial systemsAs block contracts are phased out, your financial systems have to change to accommodate a large number of individual contracts, and you will also need to be able to identify spending against personal budget allocations if you are managing an Individual Service Fund for someone.

2.4.2 MarketingAnother consequence of the end of block contracts is the need to market your service – yet another skill for managers to develop. This will involve you in:

• knowing your marketing budget – does it run to glossy ads in local magazines, or is it about developing an ‘off the peg’ website?

• understanding the commissioning intentions of local authorities through market position statements

• using web-based marketing tools

• using web-based procurement sites and checking for tenders

• placing bids to be included in commissioning frameworks if they are used locally

• seeking out feedback forums provided by user organisations

• delivering a high quality service – word of mouth recommendations are still the best marketing tool.

2.4.3 Developing staffLeading and shaping the culture of your service is your job, but this can be greatly supported by arranging the right learning and development opportunities for staff teams so that your leadership is reinforced through the learning. See the section about Professional Development later in this Handbook.

2.4.4 Care plans and recordingCare plans and recording are another key area of personalised care; it is not the best use of staff time to find out people’s life stories if they are not recorded. A recording system aligned with the aims of personalisation will encourage staff to focus on people’s strengths and positives rather than on what they cannot do.

Every aspect of what you lead, manage and deliver has to be aligned with the personalisation agenda.


2.4.5 Delivery modelsIf you want staff to spend time with individuals and work to achieve outcomes, then you will be finding ways to build in the flexibility needed for outcome-based working and looking at options for moving away from rigid time-and task-dominated rotas.

Some residential and supported living providers have developed a ‘core and flex’ model. The beauty of this is that it can be used, even where there is still a block contract in place, and it works to give people in residential care what is in effect an Individual Service Fund. It involves breaking down the ‘core’ or background hours that are shared by everyone and identifying the ‘flex’ hours that can be spent with each individual. These will differ between individuals, but could be 3 or 4 hours each month. The person can then decide how they want to use those flex hours to achieve the outcomes they are looking for. One woman wanted to visit her husband’s grave, another man wanted to go to watch bowling in the local park. The important thing is that people can make choices about how they use their time.

2.4.6 Promoting personalisationPeople making choices, taking risks and being in control of their lives is very positive, but not everyone sees it that way. You may have to promote the ideas to families and carers who want their loved one to be safe and protected, not taking decisions to do risky things.

Sometimes professional colleagues from other areas of work may struggle with the concept of doing ‘with’ rather than doing ‘to’. You may have to explain the principles behind how you work – or better still someone who uses your service could explain.

The best promotion is to look at real life examples of personalised care in action, so that people can see the real positive differences it has made to people’s lives.

Further informationADASS (2009) Personalisation and the law: Implementing Putting People First in the current legal framework. This guidance is intended for councils, but it may be useful for managers because it covers issues such as contracting and commissioning.http://www.thinklocalactpersonal.org.uk/Latest/Resource/?cid=637

Groundswell (2012) Choice and Control for All. A document about Individual Service Funds and how they can be used by providers to support individuals.http://www.groundswellpartnership.co.uk/choice-and-control-for-all

Helen Sanderson Associates (2012) Progress for Providers: Checking your progress in delivering personalised support for people living at home. This is a helpful document that allows you to see how well you are doing in delivering a personalised service. Also useful for staff teams to reflect on what else needs to happen.http://www.in-control.org.uk/publications/reports-and-discussion-papers/progress-for-providers-toolkit.aspx

House of Lords (2014) Mental Capacity Act 2005: post legislative Scrutiny.http://www.publications.parliament.uk/pa/ld201314/ldselect/ldmentalcap/139/139.pdf

IEP West Midlands (undated) A Positive Approach to Risk and Personalisation. A supportive guide about taking a risk enablement approach.http://www.westmidlandsiep.gov.uk/?page=808

SCIE (2009) Mental Capacity Act 2005 At a Glance. Quick guide to the key aspects of the Mental Capacity Act and Deprivation of Liberty Safeguards.http://www.scie.org.uk/publications/ataglance/ataglance05.asp

SCIE (2010) Personalisation e-learning modules. These modules may be useful for staff learning and development.http://www.scie.org.uk/publications/elearning/personalisation/

SCIE (2012) Personalisation: A Rough Guide. Good general guide to personalisation for all types of services.http://www.scie.org.uk/publications/guides/guide47/

Skills for Care (2011) Learning to live with risk: A provider’s guide to positive risk-taking. http://www.skillsforcare.org.uk/Document-library/Skills/Living-with-risk/Learningtolivewithriskshortguide.pdf

Section Section Name28 29 QualitySection 3

Section 3: Quality Governance / Quality measures / Getting feedback / Monitoring quality / Improving quality


• Health and Social Care Act 2008 (Regulated Activities Regulations) 2010

• CQC Essential Standards of Quality and Safety 2010

• Caring for our future White Paper 2012


• Improving services

• Evidencing best practice


• 12.1 Understand requirements for continuous quality improvement within your organisation or workplace(s)

• 12.2 Understand the importance of quality management in ensuring positive outcomes for people who use your service

NICE Guidelines and Quality Standards for Social Care

CQC Inspection FrameworkInformation in this section contributes towards the following Key Questions


• Is it caring?


In this section, we look at what quality actually means in social care services; what it means in governance terms; how you identify it; how you measure it; how you monitor it; and how you improve it on a continuous basis.

30 31 QualityQuality Section 3Section 3

3.1 GovernanceGovernance can be defined as the collection of systems and processes concerned with ensuring the overall direction, effectiveness, supervision and accountability of an organisation or service. The values, behaviours, decisions and processes in your service will and should be open to scrutiny. Good governance means that accountability is recognised and accepted, that lessons are really learned and that there is honesty and openness in seeing the best possible outcomes for people. At times the scrutiny that is part of good governance may expose poor practice or abuse. For Registered Managers, there is an expectation that they will take appropriate action to correct failings, as well as considering and correcting the situation that allowed any failings to occur.

Social care governance focuses on the responsibility of individual workers and teams to continuously learn from, and improve, their practice. It encourages professionals to take real pride in their practice and enables them to introduce changes and achieve better outcomes for carers and people who use services.

3.2 Measuring qualityQuality is a much abused word in social care. Every marketing statement from providers will state that they offer a ‘high quality’ or a ‘top quality’ service. There is a risk that quality will become a meaningless word.

There are some basic areas of practice required of any organisation that wants to deliver quality services. There has to be a commitment to equality and diversity. The Common Core Strategic Equality and Diversity Principles (Skills for Care) provide a sound basis for quality working. If you can evidence the principles in your organisation you will have a firm grounding in quality provision.

The principles are:

• Commitment to equality, diversity and human rights values

• Promotion of equality, diversity and human rights in decision making

• Advancement of equality, diversity and human rights

• Monitoring of equality, diversity and human rights performance

• Commitment to equal access and open standards.

There are dozens of quality frameworks with hundreds of different criteria for measuring quality in social care. It is difficult for managers to be clear about which framework to follow because they measure different things.

A guide from Think Local Act Personal, Driving up Quality in Adult Social Care, identifies three overarching factors that represent quality in services:

• the individual experience of people receiving care and support and their personal expectations and outcomes

• services which keep people safe through recognised standards, safeguards and the adoption of good practice, and

• the recognised processes that ensure the effectiveness of services including their value for money.

CQC have begun a wide-ranging set of changes to their inspection regime. In future, they will be asking five Key Questions about a service:

• Is it safe?


• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

It will also ask the question “Is this service good enough for your mother/partner/relative”?

See section 10 for more about the planned new approach to inspection.


3.2.2 Standards-based frameworksOther frameworks are based on measuring against a set of standards. These are often used by local authority quality assurance teams, and CQC currently uses the Essential Standards of Quality and Safety (see section 10 for more on CQC standards). These cover a range of standards relating to provision and, through an inspection process, judgements are made about the extent to which a provider meets the standards. This type of measurement assumes that quality is about the infrastructure and practice that supports an ‘ideal’ service. The Health and Social Care Act 2012 gave a new role to the National Institute for Health and Care Excellence (NICE) to develop guidelines and quality standards for social care, in addition to those they already produce for healthcare. There is a rolling programme of evidence-based social care standards development covering areas such as home care and challenging behaviour in people with learning disabilities. Check the NICE website to find any guidelines or standards relevant to your service.

3.2.3 Other approaches to measuring qualityOutcome-Based Accountability measures quality through reflecting on:

• How much did we do?

• How well did we do it?

• Who is better off?

Of course, this requires you to decide the criteria for judging how well your work was carried out and asking people if they feel better off as a result. This is something that can be usefully undertaken with people who use your service, families and staff.

The Senses Framework, developed by Sheffield Hallam University, proposes that senses play a significant part in creating an ‘enriched’ care environment for residents, staff and family. The six elements of this framework are sense of: security; continuity; belonging; purpose; achievement; and significance.

My Home Life, originally developed by the National Care Forum and Help the Aged in 2006, has eight key themes and has developed into an active movement promoting quality in care homes. There are also tools and frameworks specific to home care and to specialist areas of provision such as end of life care and dementia care.

3.2.1 Outcome-based frameworksThere are frameworks that use measures based on the quality of life that people using a service experience. The ASCOT (Adult Social Care Outcomes Tool) developed by the Personal Social Services Research Unit (PSSRU) at the University of Kent is an example of this. It uses the Social Care Related Quality of Life (SCRQoL) domains as a measure:

• Accommodation, cleanliness and comfort The person using the service feels their home environment, including all the rooms, is clean and comfortable.

• Control over daily life The person using the service can choose what to do and when to do it, having control over their daily life and activities.

• Dignity The negative and positive psychological impact of support and care on the personal sense of significance of the person using the service.

• Food and nutrition The person using the service feels they have a nutritious, varied and culturally appropriate diet with enough food and drink they enjoy at regular and timely intervals.

• Occupation The person using the service is sufficiently occupied in a range of meaningful activities whether it be formal employment, unpaid work, caring for others or leisure activities.

• Personal cleanliness and comfort The person using the service feels they are personally clean and comfortable and look presentable or, at best, are dressed and groomed in a way that reflects their personal preferences.

• Safety The person using the service feels safe and secure. This means being free from fear of abuse, falling or other physical harm and fear of being attacked or robbed.

• Social participation and involvement The person using the service is content with their social situation, where social situation is taken to mean the sustenance of meaningful relationships with friends, family and feeling involved or part of a community should this be important to them.


You may want to use an existing framework, or develop your own. It may be that your organisation has its own quality system and undertakes quality assurance on a regular basis.

One useful way of measuring your own performance is to use benchmarking. This works best if you are part of a Quality Circle, an action learning set or a provider forum. The opportunity to benchmark against professional colleagues is invaluable, but it is not always easy to achieve as many people are reluctant to share information that may be commercially sensitive.

Feedback from your own staff also matters. Your staff team are essential to your service and you need to know that they are satisfied and feel valued, supported and considered within the service. You may have to make staff feedback anonymous in order to get anything valuable; if you do, ask yourself why you had to do that and why staff did not feel able to provide feedback openly.

You may also ask for feedback from other professional colleagues who work in partnership with you, and from your neighbours in the local community.

You can collect some information yourself, for example:

• the number of outcomes achieved

• timeframes for responses

• staff sickness levels

• staff turnover

• consistency of carers

• how many people are participating in activity

• numbers of people who are self-medicating

• number of activities shared with the local community.

Not all of these will be appropriate for all services, but you can use those suggestions that are right for yours.

3.3 Getting feedbackHow do you get the information to help you look at the quality of your service? The feedback that you collect from the people using your service and their families is the most useful place to start. It is also worthwhile collecting feedback if you can, from people who considered using your service, but then chose not to. Finding out the reasons why can give you some very useful knowledge.

+ Are you satisfied with the service we provide?

+ Is there anything you wanted that we have not provided?

+ Which part of our service are you most satisfied with?

+ Is there anything you are not satisfied with? How could we improve?

Section Section Name36 37QualitySection 3

3.4 Improving qualityThere will always be things you want to do better, and the information and feedback that you collect will show you the areas on which you need to work.

The simplest approach is to identify what you need to do, work out how you will do it then develop an action plan. You may need to prepare an action plan for different stages. It may not be possible to achieve everything at once, so a staged approach may be easier. If there is a simple way, then use it. The most useful action plans have just a few headings which we have outlined on the opposite page.

How will we know when we’ve got there?

When will

we get there?

Where do

we want to

be?How will we get there?

Your action plan is your guide; you may need to adapt it as you progress.

Where are we now?


Further informationMy Home Life: began as a project and has now become a movement to improve the quality of residential care.http://myhomelife.org.uk/research/8-key-themes/

National Skills Academy for Social Care The Governance Toolkit. A useful e-learning programme for directors, trustees and owners with responsibility for governance.https://www.nsasocialcare.co.uk/programmes/governance-for-adult- social-care

NICE has the role of developing quality standards across health and social care. You can see the completed standards and those in progress on the website.http://www.nice.org.uk/guidance/qualitystandards/socialcare/home.jsp

Personal Social Services Research Unit ASCOT Framework. Provides a range of domains as a basis for measuring the quality of life of people using your service.http://www.pssru.ac.uk/ascot/domains.php

SCIE (2010) Finding Excellence in Adult Social Care Services. Looks at some of the main models of quality.http://www.scie.org.uk/publications/misc/definitionsofexcellence/files/definitionofexcellenceapproaches.pdf

Think Local Act Personal (2012) Driving up Quality in Adult Social Care provides an overarching view of the principles required for a Quality Framework.http://www.thinklocalactpersonal.org.uk/Latest/Resource/?cid=9407

3.4.1 Assuring qualityOne of the problems with measuring quality is that any measurement can only be a ‘snapshot’ at a particular moment. Also, quality is ultimately about relationships and how people experience your service. Bear in mind that this experience will change with time and circumstances, and a service that was a good experience for someone at one stage in their life may not be right for them now.

To be assured that quality is maintained and improved, you will have put a monitoring system in place so that you are regularly checking your service against whichever set of standards and criteria you choose.

You know what you want from your service and you know the quality of provision that the people who use it are entitled to expect. If you are conscious of the quality of what is delivered and never prepared to accept anything less than the best, you can promote a culture of care in your service that will guarantee safe, good quality care.

Section Section Name40 41 InformationSection 4

Section 4: InformationInformation governance / Methods of communication / Ways to collect information / Using information / Confidentiality / Sharing information / Disposing of information

Relevant legislation, standards and framework

Legislation

• Care Act 2014


• Equality Act 2010

• Freedom of Information Act 2000

• Data Protection Act 1998

• Human Rights Act 1998








• 2.1 Understand systems for information management

• 2.2 Understand how communication systems and practices support positive outcomes for individuals


• Is it safe?



This section covers the different forms of information; how you look after it; how you communicate it and the factors to take into consideration; how you share it; and how you use it.

42 43 InformationInformation Section 4Section 4

4.1 Information governanceEvery manager’s day starts and ends with information, and it is a key part of the hours in between. It is the basis of your work, and is essential in providing the best services. Information governance – basically how you look after information in your service – matters, regardless of the size of your service. Large national organisations will have information governance systems and processes. Smaller organisations still have to have information governance systems in place, usually just less complex ones.

Information governance has four basic aims:

• to support the provision of high quality care by promoting the effective and appropriate use of information

• to encourage staff to work closely together, preventing duplication of effort and enabling more efficient use of resources

• to develop support arrangements and provide staff with appropriate tools and support to enable them to discharge their responsibilities to consistently high standards

• to enable organisations to understand their own performance and manage improvement in a systematic and effective way.

Any organisation providing health or social care services has to comply with requirements around information governance. The NHS has produced a useful resource – ‘The Information Governance Toolkit’ – that has sections for social care services. The assessment within the toolkit gives you the opportunity to reflect on:

• management roles and responsibilities

• confidentiality and data protection, and

• information security.

See ‘Further information’ at the end of this section for a link to the toolkit.

4.2 Communicating informationMuch of how you handle information depends what it is for, and what use you intend to make of it. Information is usually something to be shared and communicated to others (exceptions to this are dealt with later in this section).

In your role, you will probably use every method of communication possible: verbal, written, electronic and visual, not forgetting the non-verbal communication that underpins everything. In a busy working day in any service, there are many people with whom you need to communicate about many different things. Regardless of the method of communication, the process is still the same. It is always worth going through the mental checklist below. It may seem simple, but regardless of how much experience you have, it is a habit worth developing.

+ Am I clear about what I want/need to communicate?

+ Do I have all of the information that I need to communicate?

+ Am I using the best method and approach?

+ Are the voice and body saying the same thing?

+ Have I checked that I have been understood?

+ Have I heard and understood the response to what I have communicated?

44 45 InformationInformationSection4 Section 4

4.2.1 Verbal communicationTalking is the most widely used communication method. The nature of your role means that you talk all the time: to the people you support, to staff, to families and friends, to other professionals, to suppliers, to commissioners – the list goes on. We use verbal communication because it:

• is the most usual way in which human beings make contact with each other

• is quick

• doesn’t usually need any equipment

• is convenient, and

• is generally how we make and build relationships.

Obviously some things have to be recorded to provide an audit trail or an information record, but sometimes it is what is said to explain the formal record that brings the records to life. For example, in a residential setting there will be handover summaries, but it is the handover meetings, when people share the ‘soft information’, that are often be the most useful.

4.2.2 Written communicationMost written communication is likely to be electronic. Only a limited number of hard copies of documents are used now. Occasionally, you may need to write a letter, perhaps to offer a job or conduct a disciplinary process, but day-to-day communication is likely to be by email, text or through an electronic information management system.

If formal letters or reports are being sent out, it is always worthwhile checking them over, just in case a letter contains inappropriate information or mistakes! A misspelt word or a grammatical error never gives a good impression of any organisation.

Plenty of communication is now by email or text message (SMS). Text is really useful for short messages, but is not secure. You may have set up secure email for sensitive and personal information; if not, it is worth considering. There are many different products available, but you could discuss it with your commissioners who can advise you on a system compatible with theirs.

Of course, because written communications are subject to the Data Protection Act, all organisations have to consider the importance of compliance with the requirements of the Act (see later in this section).

+ Is it in the right format and style?

+ Is it clear and free from jargon?

+ Does it cover all the key points you need to communicate?

+ Is it legible (if it is handwritten)?

+ Has the spelling been checked?

+ Have you thought about it potentially being read by the person you are writing about?

Regardless of the method, you will no doubt want your staff to be using a checklist like this one for all written communication.

Section Section Name46 47InformationSection 4

4.2.3 AccessibilityThere is nothing more useless than information that can’t be understood. The systems and processes that you set up for promoting effective communication will reflect the need for staff to check that they are using the appropriate method of communication for the people they want to reach.

You are also likely to spend some time working out the right methods for the right people. For example, you will be encouraging people to explore effective communication with people with sensory loss, or people with dementia or following a stroke. There are many options and you may decide that different staff members can develop skills in particular areas of communication. Makaton, signing, Easy Read, audio or using flash cards are specific skills that can benefit the whole of your service. You or some of your staff may have language skills to use with people whose first language is not English, or you may need to access translation services.

4.2.4 AudiencesYour life as a social care manager is spent in communicating all sorts of information to a wide range of different audiences. You will be used to working out the right way to communicate with the right audience. For example, you are hardly likely to notify someone of the death of their mother by text. Text, though, has its uses for arranging appointments, contacting staff or letting people know of changed arrangements.

Most information these days can be communicated by email, but your information governance systems may restrict what you can use email for. The development of secure email works well for large organisations like the NHS, local authorities and the police, but it is not always part of the planning for small and medium-sized businesses. As the manager, you may need a secure email system to communicate personal or sensitive information.

You know all about how to make good use of communication skills, or you wouldn’t be where you are, but it is always worth checking that all staff are following your example and working through the following checklist.

Whatever the audience, your communication skills are what keep your service running smoothly. Poor communication is at the heart of so many poorly performing services; it is identified, almost without exception, as a major factor in every Serious Case Review.

+ Why? Thinking about the purpose: To share information? To ask for information? To encourage action? To discourage action? To request assistance?

+ Who? Thinking about the audience: Service users? Families? Colleagues? Staff members? Neighbours? One person? Small group? Large group?

+ What? Thinking about the message: Good news? Bad news? Personal? Public? Complex? Simple?

+ How? Thinking about the format: Verbal? Written? Electronic? Visual? Presentation? Chat? Discussion?

+ When? Thinking about timing: As soon as possible? After the dust settles? When we know more?

+ Where? Thinking about the place: Workplace? Home? Public? Private?


Information such as research or feedback, while not so sensitive, is still valuable for how you run your service. Sorting out this kind of information can be time-consuming and easy to let slip. So much else gets in the way you can end up with a physical or electronic mountain of information. It is worthwhile developing a physical or electronic filing system so that you know:

• what information you have

• where it came from, and

• where to find it.

Because service and staff records come under your information governance processes, they are easy to keep track of. But it is also worth considering how you manage other less sensitive information: for example an article about a new piece of research could be really important. The chances are you have no time to read it, but a quick glance tells you that it is valuable and interesting. You want to look at it when you have time, so developing a system and a place to put it is time well spent.

Feedback is similar; you may have feedback because you have particularly asked for people’s views and opinions for a specific purpose, or it could be general feedback from service users, families, commissioners, neighbours or visitors. You may not always have the opportunity to deal with feedback immediately, but it is so valuable in helping to develop your service that any time spent filing it carefully is again well spent.

As part of your information governance arrangements, you will probably have a process of acknowledging safe receipt of any personal information that you receive. Being able to produce an audit trail for any information is another very good reason for comprehensive filing systems. Audit trails are important for inspections, reviews or enquiries, but also so that you can be assured that your service is operating a safe and traceable process.

4.3 Collecting informationInformation comes from a wide range of sources. You need to sort it and organise it in ways that are useful. Information can be a valuable resource for your service if the right information is collected and it is stored and useable to develop your business.

How you receive information will depend on what it is and what you want it for. Service user records are one obvious information grouping, but there are many others; staff records, policy updates, local community information, feedback or research documents.

Later in this section you will find some headlines about the principles of the Data Protection Act in relation to collecting personal information. The Act is clear that you may only collect the personal information that you actually need. You cannot collect and keep information because you may need it one day.

4.3.1 Information sourcesInformation may come from:

• partner organisations

• professional colleagues

• people using the service

• families and friends

• staff

• neighbours

• commissioners

• regulators

• professional bodies

• journals and other publications (print and digital).

The information they provide can be broadly split into primary and secondary information, i.e. original material or an analysis or interpretation of already existing material. Obviously service user information is primary information, but an analysis of service user information showing some trends or outcomes is secondary. In terms of information governance, it is principally the handling of primary information relating to people – people using your service or staff – that has to comply with legislation.


4.4.1 Keeping information confidentialHaving decided to keep information, it becomes subject to legislation and guidelines. The Data Protection Act lays down some basic principles to which that information must conform.

Data protection principle Implications for practice

Fairly and lawfully processed No surprises. People should know what information you are collecting, what you are going to do with it and who else you may share it with.

Processed for specified purposes

Only use personal information for the purpose for which it was obtained.

Adequate relevant and not excessive

Only collect and keep the information you require. You may not collect personal information ‘just in case’ you may need it.

Accurate and up to date Information has to be checked and changed as necessary. You may not keep out of date records; they need to be updated if people’s circumstances change. Check before creating a new record; duplicate records should not be held.

Not held for longer than necessary

Regular ‘spring cleaning’ of records. Check commissioners’ retention policies.

Processed in accordance with the data subject’s rights

People have rights to see their records and to refuse to have them shared. Systems must be able to cope with these rights.

Kept secure Basic procedures – passwords kept secure, safe haven faxes, clear desk policy, being aware of confidential conversations, checking of callers, policies on confidentiality, policies on disposing of confidential records, staff training in information governance.

Not transferred to countries outside Europe without adequate protection

Protection needs to be in place, obtain consent, check location of where information is going and how it will be protected.

In sum, the key requirement of information governance is that you have systems and processes that comply with the law. The Information Commissioner’s Office is the UK authority responsible for upholding information rights and data privacy. Their website (see Further Information at the end of this section) has plenty of guidance about your responsibilities and legal obligations relating to data and information.

4.4 Using informationInformation is best collected when it is to be used effectively for a valuable purpose. You can use information in a range of ways. Some examples are given below.

Information Purpose

Service user information Developing care plans and updating/maintaining records

Feedback Improving practice/developing services

Research and new thinking Reflecting on and developing staff team and professional practice

Concerns/allegations Safeguarding vulnerable adults

If you can’t find a use for it – don’t keep it. There is more on disposing of information later in this section. There is no need to keep everything that comes to you. All information should have to pass the CURB test. Is it:

• Current? No point keeping out of date information.

• Useful? Is it relevant for your service?

• Required? You have to keep statutory records or information that is needed by the regulator.

• Beneficial? Who and how will this benefit your service and/or the people who use it or work in it?


4.4.3 Sharing informationOne of the problems with the focus on information governance and data protection is that it has become a minefield and bred a climate of fear about what can and cannot be shared. Frequently ‘data protection’ is cited as a barrier to sharing information and can result in people receiving lower quality care than they might do. Following an information governance review in 2013, the government has produced A Guide to Confidentiality in Health and Social Care (HSCIC 2013). The Guide identifies five basic rules for handling confidential information:

1. Confidential information about service users or patients should be treated confidentially and respectfully.

2. Members of a care team should share information when it is needed for the safe and effective care of an individual.

3. Information that is shared for the benefit of the community should be anonymised.

4. An individual’s right to object to their information being shared should be respected.

5. Organisations should put policies, procedures and systems in place to ensure that confidentiality rules are followed.

The rules are helpful because they remove many of the artificial barriers put in place in the name of data protection.

Usually, formal information-sharing agreements are in place between organisations such as local authorities, health service bodies and police, and this will normally include commissioned services. You may wish to have sight of the information-sharing agreements of your commissioners, and clarify how your service fits into any protocols. The Care Quality Commission has its own code of practice about how and with whom it shares information. You can download this from their website (see Further Information below) so that you are clear about what they do with the information you provide.

As long as any service user-identifiable information that you share is for the safe and effective care of the individual, you should be free from challenge. You would need to be able to show that the information you have shared is relevant and is proportionate for the purposes for which it has been requested.

4.4.2 Breaking confidentialityEveryone who works in health and social care has a duty to pass on information when they know or suspect that a child or vulnerable adult who lacks capacity may be at risk, or is being or has been the subject of abuse or neglect.

Where similar concerns arise in relation to a vulnerable adult who has capacity the situation is less clear cut, and this is discussed in Section 4 on Safeguarding.

If you are made aware that a crime is to be committed, you must report the information to the police.

Occasionally there may be other situations where you are asked to provide confidential information as a result of a court order, or a requirement to notify a communicable disease.


Further informationCare Quality Commission: CQC has its own code of practice on how it shares information. This will help you to be clear on what information CQC can share with you and about you. http://www.cqc.org.uk/public/about-us/confidentiality-and-sharing-information

Communication Matters (2013) Shining a light on Augmentative and Alternative Communicationhttp://www.communicationmatters.org.uk/shining-a-light-on-aac

Department of Health (undated) The Information Governance Toolkit (interactive online resource). This is a useful way of checking the effectiveness of your information governance systemshttp://www.igt.hscic.gov.uk

Health and Social Care Information Centre (2013) A Guide to Confidentiality in Health and Social Care. This is a helpful guide to what confidentiality means in practice. http://www.hscic.gov.uk/confguideorg

Information Commissioner’s Office: ICO is in charge of upholding information rights. You can download guidance about your legal obligations and responsibilities.http:// www.ico.gov.uk

4.4.4 Disposing of informationBecause information can only be kept for the period that is absolutely necessary, you need to consider the regular disposal of confidential material. Depending on the size of your service, there may be clear policies about the retention period for records and the process for disposing of them. You may have a contract with a confidential waste disposal organisation that will collect and shred documents.

Often, disposing of paper-based records is easier than disposing of electronic ones. If you are responsible for deleting confidential electronic material or for replacing computers that contain confidential material, you will be aware of some of the difficulties and risks involved. Ensuring total disposal can often involve the destruction of a hard drive before a computer is scrapped, or the destruction of removable media such as CDs or DVDs. You have all heard the horror stories of confidential data found on a memory stick, or left on the hard drive of a computer sold on an auction website. You are required to treat data that is being destroyed as carefully as the data that is currently in use.

Section Section Name56 57 Resources Section 5

Section 5: Resources Defining resources / Accessing resources / Using resources effectively / Making good use of resources / Sharing resources / Maintaining resources


Legislation






• 6.1 Understand your responsibility for resource management

• 6.2 Understand finance management in your own organisation

• 6.3 Understand workforce allocation in relation to resource management




In this section, we look at the different kinds of resources; how you can access resources; how to use different kinds of resources effectively in the pursuit of quality services; how you maintain them; and how you might look at sharing them.

58 59 Resources Resources Section 5Section 5

5.1 Defining resourcesThere are various types of resources available to you as a social care manager:

• financial

• people

• buildings/spaces

• goodwill

• emotional.

There are never enough. You can always use more resources because there is always so much more that you want to do. You have to spend a considerable amount of time chasing resources of one sort or another so that you can improve the services you provide.

5.1.1 Financial resourcesAs a service provider, you are running a business and, like all businesses, your financial resources are dependent on two things:

• how many people are prepared to pay for your service

• how much people are prepared to pay for your service.

If you are part of a large organisation, you may only feel the impact of this at a secondary level, as your service will have a budget that you have to work to, and the overall income generation side of the business is dealt with at a national level. If you are a single provider, or part of a small group, you may be very aware of the impact of fee levels from commissioners or the importance of marketing to attract people with personal budgets, or self-funders.

You will know the importance of good financial management, and that you absolutely have to manage your budget for the future viability of your service. There are many financial management programmes available and it is likely that you will have an electronic system linked to staffing, rotas and purchasing. This may not be the case with smaller services and you may have had to develop your own system for managing costs.

Some resources you may be able to get hold of as part of a particular project or grant programme. They may be project or time specific, and you will probably need some level of expertise or advice about how to apply successfully, but this type of short-term funding can be used to start off a much longer term project or to pilot a development idea.

5.1.2 Human resourcesHow you approach dealing with human resources and creating an effective organisation can be summed up by the Social Care Commitment developed by Skills for Care:

• recruiting the right staff

• thorough induction

• supporting skills

• upholding standards

• taking responsibility

• effective supervision

• supporting staff.

Making a commitment in each of these areas ensures that you are making the best use of your most valuable resources – your staff team.

Recruiting the right people is the key to a successful service. If people are your most important resource, you have to make sure you have the right ones. How to recruit people with the right values and behaviours to care in the right way is the key question for all service providers. All social care employers – big, small and individual – are asking: how do we find and attract sufficient applicants for our vacant posts, and then how do we check that they are suitable for the work and are likely to stay, develop and progress? The National Skills Academy for Social Care has developed a Values-Based Recruitment Toolkit. This has useful resources for assisting with recruitment from advertising to interview questions (see Further Information).

People are at the centre of everything you do. The people that work for your service, who volunteer for you, and the people who use it, are all essential for it to run effectively. Having additional support from volunteers is not a matter of luck. Volunteers and local communities respond to an inclusive vision and to encouragement from you. Families and friends who provide a support group are one thing; they have an obvious link into your service. Voluntary support from members of the local community is different; they will respond to openness and a willingness to be involved on your part. If you want a community group to come along and spend some time offering an activity, then you have to be prepared to send cakes or plants or people to the local summer fair! Additional support from volunteers can add real value to your service.

60 61 Resources Resources Section 5Section 5

5.3 Managing and maintaining resourcesEffective management of resources is about getting the right amount of resource in the right place at the right time. This is where your planning and organisational skills are needed. A simple example: you are doing a presentation in the local community centre to talk about your service. One of your newly acquired resources is a shiny new projector. Only someone forgot to bring it to the community centre for the presentation…

The same goes for staff and volunteers. If people are volunteering, the golden rule is to make sure that there is something for them to do. Nothing is more likely to put off a volunteer than being asked to ‘have a look round and find yourself something to do’.

If you have good resources, then it pays to look after them. A large organisation is likely to have corporate maintenance arrangements, but if you are a single provider you may have already considered maintenance contracts for your physical and electronic assets. If you weigh the costs of a maintenance contract against the cost of employing someone with the appropriate skills, or of meeting costs as need arises, then you can judge the most economically viable option for your service.

All of your assets need to be maintained, including the human ones. The best way to maintain your human resources is to value them, and to tell them of their value.

Further informationNational Skills Academy for Social Care (2013) Values-Based Recruitment Toolkit. https://www.nsasocialcare.co.uk/values-based-recruitment-toolkit

Skills for Care (2013) Social Care Commitment.http://www.skillsforcare.org.uk/Standards/The-Social-Care-Commitment/The-Social-Care-Commitment.aspx

Skills for Care (2013) Finder Keepers: The Adult Social Care Retention Toolkit.http://www.skillsforcare.org.uk/Document-library/Finding-and-keeping-workers/Practical-toolkits/FindersKeepers.pdf

5.2 Using resourcesUsing resources wisely can make them stretch. Sharing resources with colleagues may mean that the same amount of resource can provide a service for twice as many people. For understandable reasons, providers are not always that good at working together, but if you are part of a provider forum or network you may find a colleague who can see the mutual benefit of sharing some resources from time to time. For example, sharing the cost of a training provider to deliver training to staff from your own and another nearby service will enable far more to be achieved for the same cost.

Linking to groups in the local community may also give you an opportunity to share resources for mutual benefit. Local involvement in an outing or an activity could make it possible to do more than you could have done alone. Community skills development is a way to help and empower local people to understand how the skills and knowledge they have can be enhanced and shared to improve the wellbeing of others in their communities. Much of that know-how is about social care skills.

Section Section Name62 63 Teams and partnersSection 6

Section 6: Teams and partners Team members and partners / Team around the person / Working with families / Working with colleagues

Relevant standards and frameworks




• 3.1 Understand the context of partnership working

• 3.2 Understand the importance of managing relationships




This section covers the differences between teams and partners; how to lead teams successfully; thinking about team development and supervision; managing teams; and working in partnerships.

64 65 Teams and partnersTeams and partners Section 6Section 6

6.1 Identifying teams and partnersIt is worth spending some time thinking through what teams and partners you actually work with. It may seem obvious, but it is not always clear cut. For example, you may be a member of more than one team and you may have links into many others.

Working on the basis that a team is a group with an objective, it can be useful to think about the teams that exist in your work environment:

• the staff team that you lead

• regional or national teams of managers if you work for a large organisation

• your organisation as a team

•‘teams around the person’ which will include families and other professional colleagues

• GPs, pharmacists and community nurses who manage medications as a team – this is just one of many examples of a multi-disciplinary team.

Groups can become teams. For example, a residential unit family network, where people discuss issues related to the home, is a group. But if the network decided one day that it would become a ‘Friends of’ group and start fundraising – then it becomes a team, because it has an objective to achieve.

The aims and objectives of a team can be:

• set by an organisation that employs the team

• decided by the members of the team, or

• focused on those who receive the service provided by the team.

You may be in a team for a short period. If you are involved in a ‘task and finish’ group you may only work together for a short time, but if you have an objective and work together to achieve it, then you are a team.

Partners are people who work together because they have a shared interest. You will work in partnership with the people who commission your services, whether NHS or local authority or the people who are using the service. You will also have partnerships with other colleagues, therapists, health staff, social workers, community nurses and local community and neighbourhood organisations. If you are working with an individual or organisation because you have a common interest – they are your partners.

Families and friends are key partners and an important part of the team around an individual. You have an important role in developing a culture that is supportive, and which recognises and values the essential contribution of families and friends to the wellbeing of the person they love and care about. For example, if a family member is visiting your care home, and the person visited does not recognise them, they might feel embarrassed, frustrated or upset. They need your help at this time; not only because you will want to help with their feelings, but also because they are a vital partner in supporting the wellbeing of the person using your service.


6.3 Leading teamsLeaders of successful teams contribute to the following:

• agreeing and sharing a common purpose, aims and objectives

• working on building relationships that value and respect all team members

• contributing to the planning process for all team activities

• making sure that all team members are involved in decision-making

• respecting and valuing the diversity of each team member

• valuing working together and recognising the difference between working at the same time and working together

• supporting the goals that have been agreed by the team

• praising and giving credit to the work of all team members

• using communication skills effectively when working with other members of the team

• ensuring the team has dialogue and not debate

• working to identify and resolve conflicts within the team

• examining the way the team is operating, and being unafraid to initiate constructive and supportive criticism

• contributing to the growth and development of the team as a whole, the members of the team and yourself as an individual.

Your position means that you will often be leading the teams that you take part in and you will have the responsibility of motivating and inspiring them to achieve. Casey Stengel, the famous baseball coach, once said::

“Finding good players is easy. Getting them to play as a team is another story.”

Maintaining the focus and the challenge of teams can help with keeping them keen and motivated. Teams also need to see their objectives achieved. Think about separating major challenges into smaller, achievable elements; this can help teams to feel that goals are being reached and successes can be celebrated.

6.2 Working with teams and partnershipsTeams and partnerships need some ground rules to work effectively. Rules are not always made explicit; they could be just generally accepted norms for professional working or they may be something you have discussed and agreed amongst team members. Ground rules help because they set out a structure for working and help people to feel more confident. Ground rules can be about how frequently, or for how long, the group meets, or about the length of meetings. They could be about confidentiality of information shared in the team or about how contributions to meetings will be made, or who leads the team. The important thing about ground rules is that they put a structure in place that should help the team in reaching its objectives.

Partnership also implies that each partner has responsibilities and that certain standards are expected. When people say that they are doing or sharing something ‘in the spirit of partnership’, it implies an element of trust and sharing, an assumption that one partner will not attempt to take advantage of the other and that there will be a mutual advantage from working together.

When you work as a member of a team you have to be prepared to take an element of responsibility for all of the other members of the team. This includes being prepared to support them, assist them and offer advice when this would be helpful. It also means that valuable information and updates on current thinking and skills should be shared amongst team members to enhance the performance of the team overall.

Teams and partnerships don’t work well if members do not feel valued and appreciated. Recognising and valuing the contribution of all members is a key part of successful teams.

You also should value your own contribution. Sometimes your life as a social care manager is just so busy that you don’t have time to think about just how good you really are! It is always useful to keep a ‘Well Done’ diary just for personal consumption. Make a note of something where you know you did well, or where you were complimented on a job well done. Leave it in a drawer and look at it on the bad days.


6.4 Developing and supervising teamsAs you hold managerial responsibility for a team, you will have developed skills in identifying potential. Any organisation, regardless of size, benefits from seeking out and developing its best talent. Succession planning is key to successful businesses and ‘home growing’ your future team leaders makes more economic sense than having to search around for new people every time you have a senior level vacancy. Staff being able to see that they have opportunities to progress is very motivating and is likely to result in improved retention of staff. It is another economically sound strategy.

Supervising staff is a part of your job that has a range of benefits. Firstly, for the staff: they are able to set aside some time to reflect and consider their work, to discuss any concerns, and plan their own professional development. Secondly, for you: it is an opportunity to monitor progress on individual issues among people using the service, identify any staffing issues, assure yourself about the work of staff members and develop relationships with your staff.

You and your staff will often find that you are acting as bereavement counsellors since many people you support will have lost those close to them. The very need for help in their own homes or to live in a residential setting will cause grief over lost capacity. You and your senior staff will want to ensure that there is supervision support to those staff since dealing with grief can have a substantial emotional effect.

Supervision has to be regular and to be viewed as a priority that is only postponed in the face of an emergency. There are two types of supervision; professional and management. There is a tendency to confuse supervision and management because in social care we tend to be supervised by our line manager. Professional supervision can be provided by anyone with the right qualifications and experience and is about people’s professional skills, growth and development. Professional supervision provides feedback and enables reflection. Management supervision is provided by a line manager and is about ensuring achievement of goals, following due process and being compliant with legislation and standards. In social care, we tend to deliver both types of supervision at the same time, usually by a line manager.

Leaders need to present teams with a vision that everyone can sign up to. It’s all well and good having a ‘purpose statement’ for your service, but you will have translated that into a clear vision that shows where the organisation is going, and how it will get there.

Visions matter and they are useful to motivate and gain commitment, but what really inspires people are results, seeing things happen and the feeling that they are achieving goals. Providing teams with a regular review of what has been achieved and what’s next will go a long way towards keeping people keen. Leaders have to direct and shape the teams they lead. Renewing this on a regular basis is useful, it helps people to know that they are still going in the direction they thought they were.

There is a difference between leadership and management; in your role you have to do both. Leaders lead people, managers manage work. Creating an effective team is about people first and then the work is the visible result of what the team has achieved.

Leaders have to make decisions and provide direction. The organisation that you lead is not a collective or a democracy; team members contribute to decision-making and share views that you consider and respect, but part of your job is to take decisions. Clear decisions, supported by clear evidence are usually welcomed and respected by team members, even if they disagree with them.


Further informationCommunity Care (2011) Expert guide to health and social care joint working. Designed for local authorities and the health service, but is useful for providers as it identifies principles of joint working as well as barriers and potential issues.http://www.communitycare.co.uk/2011/08/17/expert-guide-to-health-and-social-care-joint-working/

SCIE (2012) Factors that promote and hinder joint and integrated working between health and social care services. http://www.scie.org.uk/publications/briefings/briefing41/

6.5 Managing teamsThis is the other part of your role. As well as providing inspiring leadership, social care managers have to deliver a safe and effective service that is meeting its objectives and meeting contractual and legal requirements. This is the area where your performance management plans, goals and targets are monitored and measured. Constant review and vigilance means that any performance issues are picked up early and can be addressed before they become an issue.

Communicating well and keeping team members and partners ‘in the loop’ is vital here. The rumour mill rapidly fills gaps left by poor communication. Feedback on progress and performance motivates team members as they can see improvement. Teams need to feel that they can look to you for support and to know that, provided they have not been negligent or totally non-compliant, they can rely on you. It is easier for staff to look forward and keep making progress if they know that you are covering their backs.

Section Section Name72 73 BuildingsSection 7

Section 7: Buildings Building safety / Security / Fire safety / Regulations


Legislation

• Building Control Regulations 2013

• Fire Safety Risk Assessment 2006

• Regulatory Reform (Fire Safety) Order 2005

• Control of Substances Hazardous to Health (COSHH) Regulations 2002

• Management of Health and Safety at Work Regulations 1999




• 11.1 Understand your role in managing the business

This section concentrates on safety issues; how you manage buildings and keep them safe; how you assess risk in the workplace; and how you manage different aspects of security.

74 75 BuildingsBuildings Section 7Section 7

7.1 Managing buildingsFor most residential and day care services, your buildings are your major asset, so it pays to make sure that they are well looked after. Regular maintenance is essential. Large organisations will have a regular schedule of checking the building’s fabric and supply of gas, electricity and water. If you are managing a smaller organisation, you may have to do this using a spreadsheet or calendar to remind you when to check the roof or the drains or the windows. If your organisation does not have a maintenance team, developing your own list of local tradespeople is invaluable, especially those who will come out quickly and at strange hours in order to deal with a crisis.

Yet another of your responsibilities is maintaining the infrastructure and environment of your building. Checking provision of telephone and internet access and making sure that the gardens are maintained are just some of the tasks in your in-tray.

7.2 Keeping buildings safe

7.2.1 Hazardous substancesYou will know that the Control of Substances Hazardous to Health (COSHH) Regulations 2002 apply to substances that have been identified as toxic, corrosive or irritant. This includes cleaning materials, pesticides, acids, disinfectants and bleaches, and naturally occurring substances such as blood, bacteria and other bodily fluids.

The Health and Safety Executive states that employers must take a number of steps to protect employees from hazardous substances. Your employer is likely to delegate the responsibility to you and it is of considerable importance, so it will have to be balanced alongside other demands, bearing in mind the potential consequences of an error in this area.

Employers are required to focus on the following eight principles of good practice in the control of substances hazardous to health.

1. Design and operate processes and activities to minimise emission, release and spread of substances hazardous to health.

2. Take into account all relevant routes of exposure – inhalation, skin absorption and ingestion – when developing control measures.

3. Control exposure by measures that are proportionate to the health risk.

4. Choose the most effective and reliable control options that minimise the escape and spread of substances hazardous to health.

5. Where adequate control of exposure cannot be achieved by other means, provide, in combination with other control measures, suitable personal protective equipment.

6. Check and review regularly all elements of control measures for their continuing effectiveness.

7. Inform and train all employees on the hazards and risks from the substances with which they work and the use of control measures developed to minimise the risks.

8. Ensure that the introduction of control measures does not increase the overall risk to health and safety.

In addition to following the regulations about storing and using hazardous substances, managers have to make sure that procedures are in place for the safe disposal of any of the substances in the COSHH file, and also of any body fluids or body waste.


7.3 Assessing risk in the workplace Risk assessment in health and social care is important for everyone. Employers, employees and the self-employed are required by law to identify and assess risks in the workplace. This includes any situations where potential harm may be caused. There are five key stages to undertaking a risk assessment, which involve answering the following questions.

1. What is the purpose of the risk assessment?

2. Who has to assess the risk?

3. Whose risk should be assessed?

4. What should be assessed?

5. When should the risk be assessed?

The Management of Health and Safety at Work Regulations 1999 state that employers have to assess any risks which are associated with the workplace and work activities. This means all activities, from walking on wet floors to dealing with violence. Having carried out a risk assessment, the employer must then apply risk control measures. This means that actions must be identified to reduce the risks. For example, alarm buzzers may need to be installed or extra staff employed, as well as steps such as providing extra training for staff or written guidelines on how to deal with a particular hazard.

Managers need to ensure that the entire workforce is aware of the potential hazards in the particular workplace. These will vary according to the needs of the people being supported; obviously the types of hazards and risks for a group of older people with dementia are different from those for a group of people with learning disabilities or a group of young people who are being looked after.

7.2.2 Fire SafetyFire is a particularly serious risk for services operating from fixed premises. Managers have a responsibility to ensure that all staff attend annual fire lectures and that they are up-to-date with the procedures to be followed in the event of fire. The Regulatory Reform (Fire Safety) Order 2005 requires that all businesses must have a person responsible for fire safety and for carrying out a risk assessment. The government recommends a five-step approach to a fire risk assessment.

1. Identify hazards: anything that could start a fire, anything that could burn.

2. Identify who could be at risk and who could be especially at risk.

3. Evaluate the risks and take action to reduce them.

4. Record what has been found out about hazards and the actions taken. Develop a clear plan of how to prevent fire and how to keep people safe if there is a fire. Train staff so they know what to do in the case of fire.

5. Keep the assessment under regular review and make changes if necessary.

7.2.3 Infection controlYou are also responsible for ensuring that steps are taken to reduce the spread of infection. Infections are caused by micro-organisms (bacteria or viruses). The purpose of infection control is to break one or more links in the ‘chain of infection’ and thus stop the spread. This will include steps such as:

• all staff using correct hand washing procedure

• cleaning equipment with appropriate materials

• disposing of waste correctly

• wearing personal protective clothing where necessary

• maintaining personal hygiene.


Effective risk assessments make it possible for people to do things. Risk assessments are not about restricting what people do; they are about making sure that it is done safely. The potential for health and safety concerns to limit people’s activities and restrict their rights can be greatly decreased by good risk assessments that put sensible control measures in place to reduce the risks.

Life is full of risks, and everyone has the right to take informed risks in order to live as they wish. But a well carried-out risk assessment can make it less likely that any harm will result.

The hazard checklist in the following table is a general guide, which can help you to develop your own tailored checklist.

Area Hazards Check

Environment Floors Are they dry?

Carpets and rugs Are they worn or curled at the edges?

Doorways and corridors Are they clear of obstacles?

Electrical cables Are they trailing?

Equipment Beds Are the brakes on? Are they high enough?

Electrical or gas appliances

Are they worn? Have they been safety checked?

Lifting equipment Is it worn or damaged?

Mobility aids Are they worn or damaged?

Substances such as cleaning fluids

Are they correctly labelled?

Containers Are they leaking or damaged?

Waste disposal equipment

Is it faulty?

People Visitors to the building Should they be there?

Handling procedures Have they been assessed for risk?

Intruders Have the police been called?

Violent and aggressive behaviour

Has it been dealt with?

Who is out? Where are they? Who are they with? When are they due back?


7.4.3 Protection from abuse or harmPeople need to feel safe wherever they live and whoever is supporting them. It is part of providing a quality service. Your security checks will extend from your own staff to volunteers and others who may come onto the premises such as tradespeople and delivery drivers.

7.4.4 Security of propertyMaking sure that the property itself is safe and secure goes along with your regular maintenance and checking of all services. Issues such as PAT testing all electrical appliances, and regular maintenance and servicing of gas appliances all contribute to reducing any risk of damage or harm resulting from electrical fires or gas explosions. Ensuring that water temperature is at a safe level and that water heaters are working correctly also reduces the risk of injury.

Buildings are essential for many social care services and keeping them maintained and secure is down to the social care manager. Your job is essentially about people, but the buildings in which people live and work need to be safe, secure and well maintained.

Further informationDH (2013) Health Technical Memorandum 07-07: Sustainable health and social care buildings. Somewhat technical, but if you have an interest in sustainable buildings, you may find it helpful.https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/147950/HTM_07-07_Final.pdf

HSE (2001) Health and Safety in Care Homes. Essential reference covering all the key points for residential care environments.http://www.hse.gov.uk/pubns/books/hsg220.htm

7.4 SecurityPart of your responsibility is to consider the security of your service. Most social care services are not under lock and key. This is about ensuring that people have choice and that their rights are respected. They do also have a right to be secure. Security in a social care environment is about:

• security against intruders

• privacy and protection from unwanted visitors

• protection against being abused

• security of property.

7.4.1 Security against intrudersIn large organisations, such as NHS trusts, local authorities and most large companies, all employees are easily identifiable by ID badges with photographs. These usually contain a microchip that allows the card to be

‘swiped’ to gain access to secure parts of the building. This makes it easier to identify people who do not have a right to be on the premises.

If you are in a smaller organisation, you may issue badges to visitors or you may use a keypad with a code number known only to staff and those who are legitimately on the premises. It is often difficult to maintain security with such systems, as codes are forgotten or become widely known. In order to maintain security, it is necessary to change the codes regularly, and to make sure everyone is aware.

If your service provides home care, there is little you need to do in terms of buildings, but you will often have concerns about people’s security in their own homes and will have taken steps such as using Key Safe and agreeing passwords with regular callers.

Having a traditional alarm system in a residential unit is usually neither necessary nor feasible, but if you lead a day care service or a service where people may be out for long periods, then you may have a system installed and will have it regularly maintained.

7.4.2 Privacy and unwanted visitorsIf you provide a service in people’s own homes, whether in the community or in supported living, it is easier for people to decide who they want to see and if they want some time on their own. This can be less easy in a day centre or residential environment. As part of a personalised service, people must always be able to have some private and personal space and to choose the people they see. It can be hard for staff to have to turn away unwanted visitors who believe they have a right to see their relative; staff may need support from you, or your senior staff, to explain that people have the right to choose their visitors.

Section Section Name82 83 Health and wellbeingSection 8

Section 8: Health and wellbeing Health and wellbeing / Healthy lifestyle / Healthy environments Emergency response / Hazard management / Medicines management / Health and safety


Legislation

• Workplace Health and Safety Standards 2013

• Human Medicine Regulations 2012

• Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2008


• Control of Substances Hazardous to Health Regulations 2002

• Health and Safety at Work Act 1974

• Medicines Act 1968





• 1.3 Understand your role and responsibilities in providing a safe environment


• Is it safe?


• Is it well led?

This section looks at what health and wellbeing means in social care settings; how to promote healthy lifestyles and build a healthy environment; key health and safety issues; managing risks and hazards; managing medicines; and emergency responses.

Section Section Name84 85Health and wellbeingSection 8

8.1 Promoting health and wellbeingHealth and wellbeing are closely linked and people who are able to improve their level of overall health and activity, even a little, will gain significant benefits. Personalised care is about the body as well as the spirit. If people have choice and control over what happens in their lives and can be encouraged and supported to think positively about how they can live a healthier lifestyle, then changes can be very positive.

Your staff are likely to be spending significant amounts of time working alongside the people you support. This is an ideal opportunity to provide people with information and advice about how they can make positive changes to increase exercise and improve diet. Exercise does not have to be strenuous, it just needs to be appropriate for the individual and be something that they are willing to participate in. The resulting health benefits can improve people’s lives as well as reducing demands on health services. The emotional benefits and improvements in mood are also important, especially for people who are stressed or anxious or who have been feeling low.

Healthy eating can improve people’s quality of life by increasing energy, improving health and generally making people feel better. Your staff will already be providing healthy meals, but as you are checking over menus, it is always worth asking whether there is anything further that you can try in order to improve people’s health through having a better diet. The

‘Eatwell Plate1’ continues to be the standard for a healthy diet so menus broadly in line with that balance are likely to produce the best results.

ColaBeans

The Eatwell Plate Use the eatwell plate to help you get the balance right. It shows how much of what you eat should come from each food group.

Fruit and vegetables

Bread, rice, potatoes pasta and other starchy foods

Milk and dairy foods

Foods and drinks high in fat and/or sugar

Meat, fish, eggs, beans and other non-dairy sources of protein

1 Public Health England in association with the Welsh Government, the Scottish Government and the Food Standards Agency in Northern Ireland © Crown copyright 2013

86 87 Health and wellbeingHealth and wellbeingSection 8 Section 8

8.3 Risk and hazard managementIf you are managing a residential, nursing, supported living or day care facility you will be used to identifying and managing hazards and risks. You will also be checking that the workforce understands the importance of promptly reporting any hazards they notice such as:

• wet or slippery floors

• cluttered passageways or corridors

• rearranged furniture

• worn carpets or rugs

• electrical cables

• faulty brakes on beds

• worn or faulty electrical or gas appliances

• worn or damaged lifting equipment

• worn or damaged mobility aids

• incorrectly labelled substances, such as cleaning fluids

• leaking or damaged containers

• faulty waste-disposal equipment

• incorrect moving and positioning procedures

• unknown visitors to the building

• intruders

• violent or aggressive behaviour.

Risk aversion has unfortunately become embedded in parts of social care. Registered Managers who fully understand health and safety are able to act positively to manage risk and prevent unwarranted restriction of people’s lives.

Health and safety requirements and guidance rarely stop people from doing things that they want to do. There is an expectation that risk is assessed, understood by those involved and that risks are managed. Blanket refusal to restrict a person from doing something on the grounds of health and safety is not only damaging to personalised care but is also not a professional response to the legislation.

8.2 Responding to health emergenciesAn urgent first response is sometimes needed for the people you support, and you will have first aiders in your team who will be able to work with you in an emergency until paramedic help arrives. It is at those moments that you value the requirements around updated first aid training. Effective responses in emergencies are essential for a social care manager; not just because of ensuring rapid assistance for someone, but because a calm, authoritative and skilled response in an emergency adds to a culture of confidence both for staff and people using the service.

8.1.1 EnvironmentIf you are managing a service that provides a full time or daily living environment, it is worth considering how design and décor can contribute to people’s overall quality of life. You may not have much say over the design and shape of the building you work in, but there are often changes that can improve a living environment without a major redesign. Things like colour and décor influence people’s mood. There is plenty of information around designing spaces for people; see Further Information at the end of this section.

88 89 Health and wellbeingHealth and wellbeing Section 8Section 8

8.4 Reporting workplace incidentsThe Reporting of Injuries, Diseases and Dangerous Occurrences (RIDDOR) Regulations 1995 (amended 2008) require that accidents, dangerous occurrences and ill-health at work should be reported to the Health and Safety Executive ‘Incident Contact Centre’ (see Further Information at the end of this section). Managers, or employers, need to report the following if they occur among the workforce:

• deaths

• major injuries

• accidents resulting in more than three days off work

• certain diseases

• dangerous occurrences.

The Health and Safety Executive has more detailed information. This regulation does not apply to people using services.

8.5 Medicines administrationYou will be aware of how thinking is changing in relation to managing medicines, and moving on from the days of drug trolleys and people having medicines handed to them. A study undertaken in 2009-10 Care Homes Use of Medicines (CHUM) found that on any one day seven out of ten residents experienced medication errors, such as:

• missed doses

• medication given to wrong person

• medication administered incorrectly

• instructions not followed e.g. empty stomach, after food and so on.

This disturbing finding resulted in the ‘Safety of Medicines in Care Homes’ (2011) project led by the National Care Forum. It produced useful guides and materials for managers, staff and individuals and their families. See Further Information at the end of this section for more details.

We now start from the view that people should manage their own medicines as far as possible. Only where a risk assessment indicates that it is not possible should people not have control over their own medication. As part of providing personalised care, it all makes perfect sense and fits with a culture of shared support and working alongside people. According to the Guide for Employers produced by the Safety of Medicines in Care Homes project, effective medicine practice is characterised by:

• a shared vision of person-centered and safe care, effectively communicated

• a commitment to multi-disciplinary protocols on safe medication practice

• a ‘no blame’ approach to problem solving

• recognition that there are benefits from sensible risk-taking as well as potential harms

• investment in relationship-building and joint training across professions

• simple and regular audits of systems to understand how things work

• clarity of leadership roles and management tasks

• using and sharing information about what works

• local leadership networks promoting best practice and learning

• champions within care homes and networks.


Even in establishments that embrace the personalised approach, medication administration remains an area of concern about risk and safety. To effectively deliver the charter and the vision, and to comply with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and the Care Quality Commission Outcomes (Outcome 9), people must be supported to self-medicate or to actively participate in administering their medication.

The registered person must protect service users against the risks associated with the unsafe use and management of medicines, by making appropriate arrangements for the obtaining, recording, handling, using, safe keeping, dispensing, safe administration and disposal of medicines used for the purposes of the regulated activity.

Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) stipulates that people who use services:

• will have their medicines at the times they need them, and in a safe way

• wherever possible will have information about the medicine being prescribed made available to them or others acting on their behalf.

This is because providers who comply with the regulations will:

• handle medicines safely, securely and appropriately

• ensure that medicines are prescribed and given by people safely, and

• follow published guidance about how to use medicines safely.

8.6 Moving and positioningMoving and positioning (known in legislation as ‘manual handling’) is a major area of management responsibility in many services. Physically assisting and moving individuals is the single largest cause of injuries at work in health and care settings. The Manual Handling Operations Regulations 1992 require employers to avoid all manual handling where there is a risk of injury ‘so far as it is reasonably practical’. Where manual handling cannot be avoided, then a risk assessment must be undertaken and all appropriate steps must be taken to reduce risks. Everyone from the European Commission to the Royal College of Nursing has issued policies and directives about avoiding hazardous lifting.

The Provision and Use of Work Equipment Regulations (PUWER) 1998 require employers to ensure that all equipment used in the workplace is:

• suitable for the intended use and for conditions in which it is used

• safe for use, maintained in a safe condition and, in certain circumstances, inspected so that it continues to be safe

• used only by people who have received adequate information, instruction and training

• accompanied by suitable safety measures, for example, protective devices, markings and warnings.

The regulations also mean that where the risk assessment has shown that there is a risk to the workers from using the equipment, employers must ensure that suitably qualified people inspect equipment at regular intervals.

The Lifting Operations and Lifting Equipment Regulations (LOLER) 1998 apply to all workplaces. An employee does not have any responsibilities under LOLER, but under the Management of Health and Safety at Work Regulations, employees have a duty to ensure that they take reasonable care of themselves and others who may be affected by the actions that they undertake.


Further informationHealth and Safety Executive: Plenty of useful guidance as well as access to the Riddor Incident Contact Centre.http://www.hse.gov.uk/healthservices/index.htm

National Care Forum (2011) Safety of medicines in care homes project. Useful set of downloadable materials.http://www.nationalcareforum.org.uk/medsafetyresources.asp

NHS Choices (2014) Exercises for Older People. Evidence based guide to appropriate exercise regimes.http://www.nhs.uk/Tools/Pages/Exercises-for-older-people.aspx

Victorian Government Health Information (2014) Dementia Friendly Environments: A guide for residential care Useful guide from Australian state of Victoria.http://www.health.vic.gov.au/dementia/changes/interior-design.htm

Section Section Name94 95 SafeguardingSection 9

Section 9: Safeguarding Identifying safeguarding risks / Embedding safeguarding in practice / Reporting / Investigating / Recording / Monitoring


Legislation

• Care Act 2014

• Fraud Act 2006

• Safeguarding Vulnerable Groups Act 2006

• Mental Capacity Act 2005

• Sexual Offences Act 2003

• No Secrets: Guidance on Developing and Implementing Multi-agency Policies and Procedures to Protect Vulnerable Adults from Abuse 2000

• Care Standards Act 2000

• Criminal Justice Act 1998

• Public Disclosure Act 1998

• Protection from Harassment Act 1997

• Police and Criminal Evidence Act S17 1984

• Mental Health Act 1983

• Theft Act 1968

• Offences Against the Person Act 1861





• 8.1 Understand your role in promoting the protection of vulnerable adults

• 8.2 Understand your own responsibility to respond to suspected or alleged abuse of children and young people while working with adults

CQC Inspection frameworkInformation in this section contributes towards the following key questions:

• Is it safe?

• Is it caring?

This section starts with a basic understanding of safeguarding and what it means for you, your service users and your team; what kinds of issues are likely to fall within safeguarding – and which are not; what you need to do around reporting and investigating; and how you embed a culture of safety in your service.

96 97 SafeguardingSafeguarding Section 9Section 9

9.1 Understanding safeguardingSafeguarding is a way of working and a way of thinking – not a process. However it is easy for it to feel like a process when there seem to be significant amounts of bureaucracy involved. One of the issues that all social care managers have to address is how safeguarding reports are perceived by commissioners, contract managers and safeguarding teams. The problem for providers is that a lack of safeguarding reports can be interpreted as a service that is not recognising or reporting safeguarding incidents. Alternatively, too many reports of safeguarding incidents will raise concerns that there is a problem with the service. It can be a tricky balance to get right.

9.1.1 Recognising safeguarding issuesKnowing what is and what isn’t safeguarding will help with getting the right balance with reporting. Many safeguarding services will have guidance that identifies the thresholds at which matters are regarded as requiring intervention under safeguarding procedures. Working alongside the local safeguarding team and confirming their thresholds can be really useful.

The way thresholds are shared may vary, and some of the criteria may be different. The following table shows the kinds of examples you may find in a local authority safeguarding threshold document. It is intended to help you to identify the sorts of concerns that you need to report. These are examples only and by no means a definitive list.

The following are NOT likely to be considered as safeguarding concerns:

• Short term lack of stimulation or opportunities for people to engage in meaningful social and leisure activities where no harm occurs.

• Service users not given sufficient voice or involved in the running of the service.

• Service design where groups of service users living together are inappropriate.

• One-off incident of low staffing due to unpredictable circumstances, despite management efforts to address. No harm caused.

The following MAY be considered as safeguarding concerns:

• Denial of individuality and opportunities for service users to make informed choices and take responsible risks.

• Care planning documentation not person-centred.

• Denying adult at risk access to professional support and services such as advocacy.

• Poor, ill-informed or outmoded care practice – no significant harm.

• More than one incident of low staffing levels, no contingencies in place. No harm caused

The following ARE likely to be considered safeguarding issues:

• Rigid or inflexible routines.

• Service user’s dignity is undermined, e.g. lack of privacy during support with intimate care needs, shared clothing, underclothing, dentures etc.

• Failure to whistle blow on serious issues when internal procedures to highlight issues are exhausted.

• Failure to refer disclosure of abuse.

• Inappropriate or incomplete DNAR (Do Not Attempt Resuscitation).

• Ill-treatment of one or more adults at risk such as unsafe manual handling.

• Failure to report, monitor or improve bad care practices.

• Unsafe and unhygienic living environments.

• Failure to support an adult at risk to access health and or care treatments.

• Punitive responses to challenging behaviours.


9.1.3 Embedding safeguardingGetting your staff teams to think about safeguarding as a way of working is the key to developing a safe organisation.

Embedding personalisation is embedding safeguarding. People who are empowered by having choice and control over their lives are much less likely to be victims of abuse. Powerful people don’t generally get abused. Working in a personalised way means that staff see real people whom they treat with dignity and respect.

Creating a high level of awareness of potential abuse makes it more likely that it will be recognised. Staff find it very difficult to identify and report abuse by a colleague. Seeing abuse is never easy, but it is sometimes easier to report concerns about family, friends or neighbours than about people you work with.

Continual vigilance by everyone in your service is essential. Awareness of safeguarding issues should be a part of the culture like the ‘golden thread’ through all aspects of practice.

9.1.2 Risk factorsBeing aware of known risk factors makes recognition of abuse more likely, it also helps with prevention by thinking ahead in potentially risky areas. Several different pieces of research have identified some common high risk factors in relation to services that social care managers will do well to keep in mind:

• low staffing levels and/or high use of agency staff

• geographically isolated services

• a neglected physical environment

• weak management

• lack of practice leadership

• lack of policy awareness

• poor staff morale

• high proportion of service users who lack capacity and/or are very frail.

A number of risk factors for family carers have also been identified:

• isolation

• substance abuse

• mental health issues

• high stress levels

• resentment over caring role.

Recognising where there are high risk factors will help you in identifying situations in which you need to be very aware and alert for any signs of potential abuse.

Types of abuse: a quick reminder

• physical

• sexual

• financial

• psychological

• institutional

• discriminatory

• neglect (Sec 44 of the Mental Capacity Act makes it an offence to neglect someone who lacks capacity)


9.3 Safeguarding investigationsIf there is an allegation concerning a member of your staff, your procedures are likely to require you to suspend the person pending the outcome of the investigation or, at least, find them duties that do not bring them into contact with vulnerable adults.

Once the safeguarding or police investigation has concluded, and if the allegation is upheld, you will then have to follow your organisation’s disciplinary procedures to decide what happens to the member of staff.

If someone working in social care is arrested and charged with a criminal offence, the police will notify the Disclosure and Barring Service (DBS) and the local safeguarding team, as social care is a ‘notifiable profession’. If there are no criminal charges, but a safeguarding investigation concludes that an allegation is upheld, then the responsibility rests with you as the employer to notify the DBS.

Having a member of staff who abuses vulnerable people is always difficult to deal with and will inevitably make you question how it happened and reflect on what you could have done to prevent it. Everyone in the team is affected by that sort of event and a ‘review and reflect’ session with staff can help to re-settle a troubled team.

9.2 Reporting safeguarding concernsYou will have clear reporting procedures and all staff will be aware of them. Depending on the size and type of organisation, there may be a safeguarding lead who deals with all safeguarding reports and liaises with the local authority safeguarding team. In a smaller organisation, it may all be down to you to follow the procedure for reporting.

You are likely to be dealing with three broad types of safeguarding reports:

1. A potential safeguarding incident within your organisation that was reported to you, or that you became aware of such as a medication error or a diet and nutrition error

2. A safeguarding concern about a relative or friend that took place in the community

3. A whistle-blowing report from a member of your staff, or a person using your services, concerning a member of staff.

You will be reporting on each of these, initially through safeguarding procedures, but also directly to the police if you think there may have been a criminal offence.

If anyone using your service discloses abuse to you, or to a member of your staff, they are doing so because they want it to stop. You have the responsibility to make it stop.

The Public Interest Disclosure Act 1998 protects whistleblowers and ensures that they cannot be victimised by an employer for reporting abuse, or any other illegal acts. The Act protects people making disclosures about:

• a criminal offence

• the breach of a legal obligation

• a miscarriage of justice

• a danger to the health or safety of any individual

• damage to the environment

• deliberate covering up of information tending to show any of the above five matters.

The basis for being protected by the Act is that the worker is giving information that they ‘reasonably believe tends to show that one or more of the above matters is either happening now, took place in the past, or is likely to happen in the future’.

The worker must have reasonable belief that the information tends to show one or more of the offences or breaches listed above. It may not prove to be right - it might be discovered on investigation that they were wrong - but as long as the worker can show that they believed it to be so, and that it was a reasonable belief in the circumstances at the time of disclosure, then they are protected by the law.

Section Section Name102 103SafeguardingSection 9

9.3.1 Participating in investigationsYou should be fully involved in any safeguarding investigation. If you have managed to develop a good partnership with your local safeguarding team that should not be a problem, but if you have not worked closely with them now is the time to start.

On the basis that you are a person with a key interest in establishing the truth of any allegations, the investigation should be able to expect full co-operation and full disclosure of any information that you may have. Failure to share information with a safeguarding investigation would be a serious mistake.

Local authority safeguarding teams will all work slightly differently, but the process will generally follow seven stages outlined in the diagram opposite.

ALERT

REFERRAL

STRATEGY MEETING OR DISCUSSION

INVESTIGATION / ASSESSMENT

CASE CONFERENCE

REVIEW

CLOSURE

Safeguarding contact point

Information gathered within 24 hours

Information gathering Manager’s decision within 24 hours

Plan investigation/assessment

Within five working days

Investigation/assessment finding

Completed within four weeks (28 days or 20 working days) from the date of referral)

Further investigation/assessment or monitoring of protection plan

Completed within four weeks (28 days or 20 working days) from the completion of the investigation/assessment)

Completed within a maximum of six months after the case conference

At any stage

Stage Action Timescale


9.4 Safeguarding ‘radar’As a manager, you can never relax about safeguarding. You always need to monitor what is going on in your service. Regular ‘radar’ briefings with your senior staff are one of the most effective ways to keep aware of possible concerns before they develop. ‘Radar’ meetings are just that, asking ‘what’s on your radar?’. They are an important exchange of information with senior staff. It will often be about issues you may have no evidence about, but just a feeling that someone you support doesn’t seem quite right, or that there’s a member of staff you’re just a bit unsure about. Sharing this sort of intelligence with your senior team may help to pick up a potential issue before it becomes serious.

Further informationADASS has a range of publications about adult safeguarding.http://www.adass.org.uk/home/

Department of Health (2013) Adult safeguarding: updated statement of government policy. Principles that underpin safeguarding work and the outcomes that people can expecthttps://www.gov.uk/government/publications/adult-safeguarding-statement-of-government-policy-10-may-2013

SCIE (2011) Prevention in adult safeguarding. Useful report covering prevention of abusehttp://www.scie.org.uk/publications/reports/report41/files/report41

9.3.2 Recording investigations Making accurate records of all aspects of a safeguarding investigation matters, because it is always possible that it may end in court or in some other challenge and you will need easily accessible records. You may think that you will remember, but you may not.

You will have a process in place for getting all the staff involved to also make accurate records. Notes made at the time of the incident are acceptable evidence. Do not allow staff to delay recording what they know; delay means that some key details will be forgotten.

Part of training the staff providing services is to cover what needs to be recorded. Remind staff to make a clear difference between fact, opinion and hearsay when recording.

Section Section Name106 107 Regulation and inspectionSection 10

Section 10: Regulation and inspection The regulatory regime / Dealing with inspections

Relevant legislation• Health and Social Care Act 2008

• Health and Social Care Act (Regulated Activities) Regulations 2010


• Is it safe?


• Is it caring?

• Is it responsive

• Is it well-led?

This section covers the new regulatory and inspection regime from the Care Quality Commission; the key criteria against which all registered services will be inspected; the kinds of considerations inspectors are likely to use; being prepared for inspections and working positively with inspectors.

108 109 Regulation and inspectionRegulation and inspectionSection 10 Section 10

10.1 The regulatory regimeAll registered services are subject to regulation and inspection by the Care Quality Commission. In order to be a Registered Manager of a service, you have to satisfy CQC that you are a fit and proper person with the necessary experience and qualifications. A process of major change to the inspection regime began in early 2014. What this will mean for providers is not yet fully clear.

The current system of checking providers against the Essential Standards of Safety and Quality is to be replaced in due course. The new approach is intended to be much simpler, based on five Key Questions:

• Is it safe?


• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

Additionally, it asks the question “Is this good enough for my mother/partner/relative?”

Each of these raises another whole set of questions and how the inspectors will answer them is as yet undecided. Judgements will be made using nationally recognised guidelines, and it is clear that NICE Social Care Quality Standards will be used.

There are pilots being undertaken, and as a Registered Manager you may well want to take part in the piloting and consultation process.

10.2 Dealing with inspectionsFor Registered Managers, inspection can be a stressful time. However, if you can think of it as a regular and even a welcome additional opportunity to get feedback on how the service is performing, much of that stress can be removed or at least reduced. Some tips worth remembering:

• You are the lead professional – so it is right to be clear about decisions you have taken and willing to discuss the issues and factors that underpin your decisions.

• Have information ready and not scattered all over the place (see section 4 of this handbook).

• It is very worrying to an inspection team to discover some difficulty in a service that the manager did not know about. If there are things that are not right or need improvement, say so up front, and describe the actions in place to improve things.

110 111 Regulation and inspectionRegulation and inspection Section 10Section 10

10.2.4 Is it responsive to people’s needs?CQC is likely to want to assure itself that people are having a timely and appropriate response to their needs, whether physical or emotional. They are likely to look at records of any medical treatments and check that they were provided quickly. Individual records should be able to show that emotional needs such as a person in distress or concerns from a family member were addressed without delay and in a caring and compassionate way.

10.2.5 Is it well led?Your role here is a key part of answering this question, but not the only part. Inspectors will look at governance, so if there is a board of directors or trustees or an individual owner, then their expertise, actions and influence will also be looked at.

The inspectors will want to satisfy themselves that the organisation is transparent and that people using the service, their families and the staff can have access to, and influence in the organisation. They will want to look at the governance structure and how information is shared and the channels of communication. They are likely to ask to see evidence of how consultations have been carried out and whether or not everyone knows how to contact the people or person who has overall control of the organisation and service. They may look at staffing records and issues such as sickness levels and turnover, both of which can be indicators of low staff morale. The Leadership Qualities Framework for Adult Social Care can be a key guide for you here.

Some of what they will want here is about the question ‘Is it well managed?’ This will be down to your systems and processes, performance management against planned goals and targets and effective management of resources. The rest of it is about your drive and commitment and your own values and high standards being reflected throughout the whole service.

If you are delivering a personalised, high quality, safe service the answer to all the CQC questions will be ‘Yes’. Inspections matter, provided they can identify where the problems are so that people are removed from risk of harm. Inspections provide you with valuable feedback, but your service needs to be guided by the commitment to quality and safety and be built around each individual that it supports. Have confidence in what you do, and if you are doing it right, you will satisfy the inspectors. Your service is led by you – not by an inspection regime.

In the sections below we have outlined the kinds of considerations that may be raised for Registered Managers by the forthcoming CQC Key Questions approach to inspection.

10.2.1 Is it safe?Inspectors will want to be able to assure themselves that people are safeguarded and protected from harm and abuse. They will probably want to ask people about how safe they feel, and will want to see any safeguarding concern reports, look at records about staff training and ask questions about staff awareness and understanding of harm and abuse.

10.2.2 Is it effective?It is likely inspectors will want to know if your service is meeting people’s needs, or, more importantly, the outcomes that people have identified. They are likely to look at how people’s independence is being maximised and how they are being helped to exercise choice and control. Inspectors are likely to identify this through care plans, conversations with people and their families and through comparing the outcomes achieved with the outcomes identified. They are likely to want to know about activities and approaches designed to provide development and improvement. Monitoring and performance records could be useful in demonstrating progress.

10.2.3 Is it caring?Inspectors will want to satisfy themselves that the service is a compassionate one and that people are respected and lead dignified lives. The overall culture and atmosphere of a service, staff attitudes and approaches along with conversations with people and families are likely to form a basis for their judgements. This will be supported by evidence of a personalised approach that records time spent with people and whether or not staff have taken time and care to know the whole person.

112 113 Regulation and inspectionSection 10Regulation and inspectionSection 10

Further informationCare Quality Commission: The CQC website contains information about existing and planned inspection regimes, including A Fresh Start, and their Strategy and Business Plan 2013-2016.http://www.cqc.org.uk/public/about-us/our-performance-and-plans/our-strategy-and-business-plan

Section Section Name114 115 Professional developmentSection 11

Section 11: Professional development What professional development means / Identifying learning need / Reflective practice / Personal development plans


Legislation

• Social Care Act 2008

National Minimum Training Standards (Skills for Care) 2013


• Demonstrating Personal Qualities

• Evidencing Best Practice


• 9.1 Understand Professional Development

• 9.3 Understand the context of support and guidance

This section underpins the idea of continuous professional development. It covers what professional development means, both for you and for your teams; identifying learning needs; putting personal development plans together; and using reflective practice and coaching approaches alongside formal learning. It acts as your springboard for the future.

116 117 Professional developmentProfessional development Section 11Section 11

11.2 Your own professional developmentDo not neglect your own professional development. As the lead professional in your organisation, reflective practice and professional development plans are equally important for you, so that your professional skills are constantly developed and improved.

An excellent way to support your professional development is to join a professional network such as the Registered Managers’ Programme at the National Skills Academy for Social Care. Networks are a useful way to exchange professional development ideas, while at the same time not jeopardising any business sensitive information.

One of the formal ways of reflecting on your own practice and identifying strengths, weaknesses and areas for development is during training opportunities. On a course, or at a training day, aspects of your practice and areas of knowledge that are new to you will be discussed, and this will often open up avenues that you had not previously considered. This is one of the major benefits of making the most of all the training and education opportunities that are available to you.

How you are able to access supervision and development will vary depending on your circumstances. A large organisation providing many different services is likely to have a workforce development team who will provide you with professional support. If you are based in a smaller organisation or single residential care home, or in a small home care, supported living or shared lives service, you may have to source your own opportunities for development. One action you may consider is to link to a mentor, who can provide you with support, guidance and the opportunity to reflect. You can access a mentor through the Skills Academy Registered Managers’ Programme.

You will not have spent your time wisely if your work practise is not updated and improved as a result of reading research articles, watching TV programmes and training. With the enormous pressures on everybody in the social care services, it is often difficult to find time to keep up to date and to change the practices you are used to, but the benefits of doing so, both for you and for your organisation, will more than justify the time and effort.

11.1 Workforce developmentWorkforce development is one of your key roles, even in large organisations where there is a corporate workforce development plan and an in-house learning and development team.

Ensuring that the workforce can access appropriate development opportunities both for vocational qualifications and for continuing professional development is a priority, but there are other aspects of professional development that are equally important.

Supervision sessions with staff are opportunities to identify development needs, areas for further skills development, and future career aspirations. Supervision is your regular opportunity to really get to know your staff team and to explore how they are developing skills and knowledge. Your role as a supervisor is to support and advise staff and to make sure that they know and understand:

• their rights and responsibilities as an employee

• what their job involves and the procedures in place to help them carry it out well

• the approach to social care in your service – the beliefs, values and culture, and how you demonstrate values in the way you do your work

• their career development needs – their aspirations and any development needs for both their current role and to progress with the pathway they have chosen.

All members of the workforce – including you! – should have a professional development plan that identifies goals and targets for professional development. This should be a working document under continuous review. You will want to check that learning and development opportunities are identified and staff informed and encouraged to take them up.

Your teams will all benefit from looking at their own learning styles and understanding how they learn best and what motivates them to learn.

You will want to support all members of the workforce to become reflective practitioners and to use reflection to improve and develop practice. Providing constructive feedback and reviewing mistakes and ‘near misses’ in a ‘no blame’ environment encourages the development of a learning culture within the service and will support improvements in practice and professional performance.

118 119 Professional developmentProfessional development Section 11Section 11

Further informationNational Skills Academy for Social Care: leads the Registered Managers Programme, and has developed many resources to support managers in all aspects of their work.http://www.nsasocialcare.co.uk

Skills for Care: the workforce development body for social care in England; their website contains plenty of useful information about learning and development.http://www.skillsforcare.org.uk

SCIE: responsible for developing and disseminating the evidence base for social care; also has a helpful section about professional development.http://www.scie.org.uk/topic/developingskillsservices

11.2.1 Reflecting on your practiceReflection might feel like a luxury you don’t have time for – it isn’t. It is a very important way of improving and developing your own practice through understanding why you have acted in a particular way. Could you have done something differently? What were the reasons that something did or didn’t work? Reviewing and reflecting on your skills and learning needs helps you to be a better practitioner because you understand who you are and why you work in a particular way. Reflection helps you to find some answers, but it also helps you to uncover questions. Reflection and developing understanding is how you improve your skills and abilities and grow into a confident and competent practitioner.

11.2.2 Keeping up to date with researchThere are excellent sources of research for social care. The Social Care Institute for Excellence (SCIE) produces accessible research papers on current issues, as do organisations such as the National Skills Academy for Social Care, Skills for Care, the King’s Fund, the Joseph Rowntree Foundation and many universities.

Section Section Name120 121 About the Skills Academy

About the Skills Academy

Established in 2009, the National Skills Academy for Social Care is an employer-led membership organisation focusing on leadership in the sector. It is one of the largest membership bodies in social care, with individuals and organisations amongst its members, spanning providers and commissioners; residential and home care; the public, private and voluntary sectors; and all client groups. The Academy has a particular remit to work with Registered Managers, supporting them in their pivotal leadership role through a National Support Programme.

High quality leadership is fundamental to the delivery of high quality care. The 2012 White Paper, Caring for our future, emphasised the importance of leadership at all levels, from people entering the sector right the way through to strategic leaders. This view of leadership underpins the 2014 Care Act. And leadership is important for the future of social care: the sector needs to develop a pipeline of new talent, comfortable with working across traditional boundaries in integrated services and capable of inspiring the workforce of the future.

The Skills Academy therefore works to embed leadership at all levels of the social care workforce, using its Leadership Qualities Framework for Adult Social Care to instil the idea of leadership as being grounded in everyday behaviours, and therefore accessible to everyone, whatever their role. At the same time, the Academy reaches beyond the workforce to bring leadership skills and capabilities to people using services, their carers and the communities in which they live and work, so that strong leadership can support quality services and the vision we share for the sector can become a reality.

Section Section Name122 123 Special thanks

Special thanks The Skills Academy would like to thank the many individuals and organisations involved not just in this Handbook, but also in the wider initiative of supporting Registered Managers and other social care managers as leaders in adult social care.

Firstly, we would like to pay tribute to the Board of the Skills Academy, all of whom have made valuable contributions to the Handbook and who have championed the role of managers in social care.

We would like to thank Yvonne Nolan, Richard Banks, Sara Dunn and Vic Citarella of CPEA Ltd (www.cpea.co.uk) for their preparation and editing of the Handbook. Thanks are also due to the members of the Registered Managers’ Programme Steering Group, especially Jerry Garrett, John Burton, Penny Lawlor and Philip Nightingale, for their oversight of the project. We would like to thank Skills for Care for their support and advice. And we cannot end without acknowledging the support of Glen Mason, Graham Earnshaw and their colleagues at the Department of Health: without them, this Handbook would never have seen the light of day. Finally, we would like to record our appreciation of Goosebumps, who have designed this Handbook so that it is attractive, engaging and easy to read. Thank you all.

Debbie Sorkin

Chief Executive, National Skills Academy for Social Care, May 2014

social care managers handbook

Documents

section section name4

safeguarding investigations9

social care values

care plans

personalised care

person centred care

safeguarding radar8

social care managers