Since the Care Quality Commission (CQC) changed its inspection process, few learning disability care homes have achieved an outstanding rating. These ratings are notoriously difficult to come by, with less than 5% of the total number of inspected organisations achieving this rating. So, how has Resolve achieved this distinction in both their homes? Owners David King and Anne Graham explain.
Giving people the best chance
At Resolve, the ethos is on giving the residents the best possible life. All the residents have autism and/or a learning disability and a history of offending behaviour, with spells in hospital or prison. Most have had limited opportunities and meaningful life experiences.
This is something that the CQC has recognised, as David King remembers: “We got a press release from the deputy chief inspector at the CQC, which said: ‘the staff at Resolve should feel very proud of the work they do. I would recommend all other providers ask Resolve about how they achieve what they do.’
Feels like home
One of the main aims of Resolve is to ensure that environment and decor do not feel like a care home – they are the residents’ home and the building should reflect this, with modern and homely furnishings.
Developing Strong Relationships
Relationships are key to the Resolve way of working, and growing trust and an open relationship with each resident, is central to this.
“What we do is two-pronged. We are very focused on the management of risk – but equal to that is giving the service users a quality of life. We work hard to give someone the best quality of life possible while putting that effort in to make sure that everyone is protected,” says David King.
Graham adds: “It is important the service users are involved in decision-making and their care. They are involved in the writing of the care plans; they are agreed before they try new things. In doing this, service users’ anxieties are reduced and it also enables new experiences to be introduced at their pace.”
The team at Resolve also understand that contingency plans are necessary in case things don’t go as planned – and the service users are also involved in this.
Genuine community engagement
The emphasis at Resolve is for service users to have genuine engagement with the local community, doing activities that they enjoy and are purposeful. The ultimate goal is for them to be accepted as equals.
But it took a long time – and a lot of perseverance – for Resolve to get to the stage where its residents are valued in the community. Securing volunteering opportunities for residents was often met with rejection when organisations were told of the volunteers backgrounds and their learning disability and it took a long time to establish these openings. “But once they get to know our service users it is ‘can they come in and do an extra day?’, but it is getting that foot in the door”, says Graham, adding that it has been a crucial part of the residents’ development.
Staff Recruitment & Retention
To develop strong relationships with residents, a stable and dedicated staff team is needed, and another strong part of Resolve’s philosophy is in recruiting people who fit the service users.
David King says: “We have learnt that knowledge, skills, experience, qualifications are – almost irrelevant to what we do. In fact, sometimes it is better bringing in someone who has no experience because they don’t have these ingrained poor value-based practices that we steer clear of.
He adds that there is a great core staff team at Resolve, but they are now focusing on ensuing that turnover of staff is as low as possible, and the service users will play a full part in this.
“When we talk about ‘team’ we include the service users in that. This is their house, they contribute to everything, everything we do is working shoulder-to-shoulder,” he says.
Using technology to enhance resident engagement
Staff are able to spend the vast majority of their time with service users because Resolve has sought to streamline areas such as record-keeping and administration as much as possible. They have been able to do this by using an online case management system called Eclipse. The system has supported Resolve to maximise staff efficiency and improve care by simplifying and speeding up the day-to-day management and processing resident records – and impressed the CQC inspectors, according to Anne.
She adds that it also saves space. Resolve do not have paper records, so they don’t have to be kept in bulky filing cabinets, where it can be possible to lose files. It also means that accessing records is much quicker to do.
In addition, the Eclipse system is secure – more so than paper records. No longer can records be accidentally left out where someone can see it, for example and only authorised people who need to see it have access to it.
Eclipse is also useful for evidencing what the service provides for commissioners and purchasing authorities and how funding is being allocated. “If commissioners come in, they can see where every penny of their money is being spent. If we say we have taken people somewhere we can show that. We can upload photographs, which is also evidence that this has really occurred – you cannot do that with a paper file,” says Anne.
While Resolve is focused on the care and support provided to service users, it is still a business. However, they say their focus on providing the best possible service has also led to profitability.
“We are a business and profit cannot be a dirty word – we have to generate money to provide a service – but the profit, sustainability and viability side is almost secondary to the attention to detail that has made the service what it is,” says David. “That came as a by-product, almost.”
In the short to medium-term, the focus is on developing the service users’ skills, with the hope that some may, in time, be able to move into a more independent supported living setting. With another CQC inspection on the horizon too, they want to keep on developing so that their hard-won outstanding rating is retained.