Quality Assurance Processes

The Valuing People White Paper defined quality as ensuring that service providers provide high quality, evidence based and continuously improving services, which promote good outcomes for people.

Mindful of this First Initiatives facilitate a quality assurance process consisting of both internal and external monitoring systems, which strive to ensure there is a framework to continuously raise standards for people who use the services.

Internal audits have an essential role in verifying the existence and successful implementation of standards and systems. They provide objective evidence and form a key management tool for achieving improvement in the performance of the Organisation.

Improving quality does not remain a mere concept but is put into practice, followed up closely and regularly evaluated. Internal and external monitoring processes within First Initiatives facilitate and strengthen good partnerships and effective communication within the Organisation and with Authorities.

Exernal Systems

Investors in People

This is a government led initiative that places employees at the centre of the drive for quality, the key building block of success. The Investors in People (IIP) standard is a business tool that focuses on business improvement through key resources – its people. The process is therefore designed to forge a clear link between the business needs of the organisation and the skills of the workforce. The Investors in People standard is a framework based around four principles of good practice, these are: commitment, planning, action and evaluation.

The organisation undertakes self-assessment of its systems and policies against national standards and creates a portfolio of evidence. Further to achieving the IIP award ongoing monitoring ensures continual development.

The British Institute of Learning Disabilities (BILD) in conjunction with the National Development Team developed the Quality Network. An external quality coach facilitates the review workshops and an internal quality leader co-ordinates the review and produces a written report. It is an annual self-review process which brings together a review team made up of service managers, front-line staff, parents, carers, people who use the services and key stakeholders.

Each team member spends time with a service user and gains a picture of their life based on ten quality outcome statements linked to O’Brien’s accomplishments. An action plan is drawn up focusing on areas prioritised by the review team.

The process is a person-centred approach with a focus on checking outcomes and continuous improvement for people with autistic spectrum disorder and learning disabilities. A public statement is produced and the results of the review are published.

Commission for Social Care Inspection (CSCI)

This is an external inspection visit that is undertaken which can be announced or unannounced. The inspection reviews how the service meets set standards and is the main tool in which CSCI assesses the quality of the service provided to people. Triangulated evidence is gathered from direct and indirect observation, document reading, tour of building and discussions with service users and staff. Action plans are drawn up to address any requirements, which is followed up by the quality assurance co-ordinator. The inspectors score the standards assessed. The quality assurance co-ordinator produces a visual representation of the scores as a quick reference guide for the managers and trustees. The final report is a public document.

Supporting people funding is provided to people in tenancies, the service needs to meet certain standards that are laid out in a Quality Assessment Framework and complete a self-assessment. This is audited by the funding authority annually and is called a validation visit. Staff and service users are met and a range of documents are viewed. A report is produced and an action plan may be required which is co-ordinated by the service manager and overseen by Quality Assurance co-ordinator.

Internal Systems

Quality Assurance Audit

This is an annual internal monitoring system conducted by the quality assurance co-ordinator. Discussions take place with staff and service users to form an opinion of the standard of care/support provided in the unit. Documentation is viewed and the premises inspected. A written report is produced and copied to the manager and CSCI inspector. Any recommendations are followed up by the quality assurance co-ordinator. An annual development plan can be drawn up from gaps identified through CSCI visit and Quality Assurance visit.

This is a statutory requirement from CSCI that takes place monthly and is unannounced. Section 26 visits refer to adult services, carried out by an area manager. Regulation 33/34 visits refer to children’s services.

A National Director (North) carries out regulation 33 visits; Regulation 34 visits are conducted by Head of Residential Services. Discussions take place with staff and service users; records of events and any complaints are looked at. A written report is produced and copied to unit manager and quality assurance co-ordinator. CSCI inspector will view reports during an inspection. Any recommendations are followed up by the quality assurance co-ordinator.

An internal monitoring visit undertaken bi-monthly by the area manager. The process/format is as above. In Scotland it is carried out by manager from another unit and conducted 3 monthly. The report is copied for area co-ordinator and quality assurance co-ordinator.

The manager follows a set agenda, which informs the service manager/service co-ordinator of any current issues, produces a written report monthly. Information relating to individual service users/tenants can also be easily accessed from the report to inform the individual service user review.

The area manager and house manager meet to undertake quarterly budget appraisals. Areas covered include staffing levels and expenditure. The finance department conduct 6 monthly financial audits of the units. A report is kept on file and copied to house manager and area manager.

Service user Consultative Committee (SCC)

The SCC is a forum, which developed out of one of the Quality Network reviews. A member of staff from the practice support team facilitates the group. Meetings take place 3 monthly. Minutes are produced in written and pictorial form and circulated throughout the service.

These are circulated to staff and service users/family/carers by stakeholders and collated to inform inspections/monitoring visits. Internally questionnaires are to be disseminated to the same group of people including stakeholders on an annual basis. Information to be collated and to be incorporated into annual development and business plans to ensure steps are taken to continuously improve services for service users who are the central focus.

It is important that quality doesn’t remain a mere concept but it is put into practice, followed up closely and regularly evaluated. The internal/external monitoring process within First Initiatives facilitate and strengthen good partnerships and effective communication within the organisation and with authorities, working in tandem with governmental accountability and social responsibility.

Internal Quality Audit System