Firstly, we need to explore the difference between critical feedback and other feedback so that we can understand its importance. Critical feedback focuses entirely on the problem without providing or suggestion a workable solution, where as feedback focuses on recognising the problem and having ways to resolve the issue to move forward.

It is important that we do not view critical feedback as a criticism, but as a way of learning to improve and adapt for the future.

In this blog I look at the key aspects of the new Single Assessment Framework and how critical feedback plays a role, as well as providing some practical tools that you can implement to ensure you receive your own feedback and drive changes within your service.

The Single Assessment is no different than any other model or framework that the CQC or their predecessors have used in the past and is designed to assess and improve the quality of care. The major way the CQC have used feedback to create their new framework however is through speaking to people who use care services to establish what truly matters to people. Expressed as “We Statements”, they serve as a commitment that providers and system leaders must uphold.

We know that the key feature that runs through the new framework is that learning, collaboration between services, providers and systems and we can find this in the following ways:

• Safe – Learning Culture
• Effective – Monitoring and Improving Outcomes
• Responsive – Listening and Involving People / Planning for the Future
• Well-Led – Learning Improvement and Innovation / Freedom to Speak Up
• Caring – Throughout this key question, there is a heavy reliance on providers ensuring that every effort is made to take people’s wishes into account and respect their choices, to achieve the best possible outcomes for them.

Alongside the above, there is also a golden thread of transparency and candour.

So how can we gather more feedback? Here are some simple yet effective ways of getting it:

Surveys and Feedback

These can be for staff, the people you support, their relatives/representatives and for stakeholders. I truly believe the days of an annual survey have gone, and you need to be undertaking these at least once a quarter, so you can identify shortcomings and put into place measures to overcome these. I always say to my team, it’s better we have sight of a problem and to be able to put something in place to mitigate it, rather than the CQC finding out before us. There are ways you can gather more feedback:

• Surveys which are posted or emailed and responses collated.
• Feedback buttons in care homes that use smiley faces (google ‘emoji style feedback button’)
• QR codes in staff rooms
• At the end of each shift, have the digital solution you use to ask staff to rate their shift. You could even set this up with other areas of the shift, for example, wellbeing, travel time etc.
• Feedback boxes – encourage staff, people using the service, families and visitors staff to drop in anonymous feedback or ideas.
• After activities/mealtimes etc – ask people their views of what they liked and didn’t like.
• Directly during supervisions/appraisals, meetings etc.
• Feedback meetings – host regular meetings with people who use the service and families to discuss their experiences. Address concerns and actively seek solutions.
• Look at establishing Family Councils where relatives can discuss concerns, share experiences and propose improvements. These councils provide a platform for open dialogue and collaboration.
• Exit interviews – when someone leaves your service (both staff and customers/service users, conduct an exit interview to understand their reasons for leaving and gather insights for improvement.

I would recommend linking surveys to the Key Questions of the Single Assessment Framework.

The recently launched Survey/Feedback module within the Audit On Cloud platform by InvictIQ enables users to conduct surveys seamlessly while leveraging AI-powered sentiment analysis. This innovative feature not only facilitates the collection of feedback but also assists in understanding and categorising responses, allowing users to prioritise actions, especially in response to negative feedback. Additionally, automated reviews and key insights accompany each survey, enhancing the overall feedback management process.

Audits and Evidence-Based Checks

Auditing is essential for care providers, and it is important that you develop an audit matrix to evidence how often you are checking. Digital solutions such as Audit On Cloud by InvictIQ can support with this. Their AI powered Action Planning not only automates the process but also identifies gaps and areas of improvement in the specific Key Question or Quality Statements. Providers should ensure they have clear action plans from each identified issue, and then measurable steps to take to overcome these. Action plans are a great way to evidence continuous learning for the regulator.

Audits are a great way of checking if what we put in place is being carried out, but aside from the many audits we do in social care, you should also audit again evidence-based guidance. We know that the CQC website stats that they expect providers to be aware of best practice guidance and to following it. The CQC website under each Quality Statement has a section for best practice resources. Providers should use these and other best practice guidance (from National Institute for Health and Care Excellence – NICE) to benchmark their current practice using feedback from staff, people using their services, their representatives and stakeholders and then use this feedback to bridge the gap to make evidence-based best practice changes.

Quality Assurance Visits

Many large providers will have specialist in-house teams to undertake visits to assess the quality of care and to ensure everything is in place that should be.  Where possible use a third party to undertake a mock inspection or quality assurance visit so they are not biased and come in with a fresh pair of eyes. If you are part of a company with several services, could you swap with another manager and do a visit each? Could you budget to pay for an external consultant to carry one out on your behalf? If funds are tight, you could design your own quality assurance process, and I would look at ensuring:

• You are informed of what should be in place (including best practice)
• Develop a framework/tool to use during the inspection. It may be that you need to split this into manageable sections such as medication, mealtime experience, training etc.
• Undertake on a regular basis and focus on quality.
• Assess various aspects of care, including:
  • Safety – fire, health and safety, compliance with regulations.
  • Person-Centred Care – wellbeing, peoples needs are being met, care plans.
  • Staff Competence – training, skills, how people interact, supervisions are in-depth and being carried out in line with policy.
  • Environment – cleanliness, furniture is in good state, maintenance logs, accessibility etc.
  • Documentation – accurate, complete, person-centred, detailed etc.
  • Feedback
• Document your findings, including areas for development. Use a consistent format as this will allow for continuity and to follow up on actions.
• Develop improvement plans based on identified risks and deficiencies and set realistic goals and timeframes.
• Share findings with staff, people using the service and their families. Think about involving them in quality improvement discussions.
• Review and adapt your quality assurance toolkit as needed.

Final Thoughts

It is important that we adapt and evolve our services to ensure we continuously deliver high-quality and effective care. Upskilling your knowledge, through courses, events and reading blogs like this one will help you push yourself and raise awareness of things you can do within your service.  Remember that it is not always negative feedback, and you will receive positive comments and witness amazing care being delivered. Be sure to share positive comments, compliments and the good care you see being delivered with your team to motivate them and inspire them to do more of this.