Outstanding Care Guidance and Resources

Are you a care provider that is trying to achieve outstanding ratings for your next CQC inspection?

This page provides a range of tips and resources to help you identify what makes an outstanding care home or homecare agency.

Five key questions during CQC inspections

Outstanding Care - What does it look like?

The South West Adult Care Summit was held on the 12th April 2016 with a focus on Outstanding Care.

Skills for Care worked in partnership with Care Focus, Partners in Care, Cornwall Adult Health and Social Care Learning Partnership, Wiltshire and Swindon Care Skills Partnership, South West ADASS and Learn to Care.

Care providers from a range of different types of services provided their feedback on what makes outstanding.

Download printable PDF Outstanding Care - What dooes it look like?

What does outstanding care look like?

Care Partnerships for Outstanding Care Document

'Outstanding' - What does it look like?

This short film captures the essence of two care homes in Dorset, judged as 'outstanding' by the Care Quality Commission - a rating currently achieved by less than 1% of care providers in England. It explores what 'outstanding' looks like, the wonderful impact this rating has on their services, and steps other Care Providers can take to move towards an 'outstanding' rating of their own.

Outstanding CQC reports

In a perfect world every care provider would be outstanding so we have taken a look at a range of outstanding CQC reports to reveal the actions these services have done to achieve this.

The article is intended to provide care homes ideas and solutions which will help them works towards a CQC inspection report with an outstanding rating.

The five key questions that CQC ask about services during inspections are covered below with feedback from outstanding ratings on trhose key questions.

Outstanding - Safe

National Star College in Ullenwood
Source: http://www.cqc.org.uk/location/1-139161062/inspection-summary#safe

People were given the understanding and confidence to learn how to deal with discrimination and to recognise and report suspected abuse. Creative strategies were employed to keep people’s human rights at the forefront of everyone’s daily practice. Simple but innovative methods were used to empower people to have more control over their lives, to regain calm and a sense of well-being. Robust recruitment procedures ensured there were sufficient staff with the right skill mix, aptitude and insight to help people identify and manage risks effectively. Medicines were effectively administered and managed at times when people wanted them. People were supported to look after their own medicines as safely as possible.

Peregrine House in Whitby
Source: http://www.cqc.org.uk/location/1-110387047/inspection-summary#safe

People told us that they felt physically and emotionally secure. People had the opportunity to live a full life without undue restriction because of the way risk was managed. People were sure they received the right medicines at the right time because medicines were managed safely. Prescribed medicines were kept under close review to ensure they were always appropriate for current needs. There were exceptionally good staffing ratios, which were flexible to respond to people’s changing needs and the way they wished to live their lives. Staff were recruited so that only those who were committed to offering excellent care were employed. The registered manager was proactive in addressing issues of safety so that people were supported to live fulfilling lives.

Norwood in London
Source: http://www.cqc.org.uk/location/1-123927430/inspection-summary#safe

They had successfully implemented, and trained Staff to use an innovative structured approach to positively support people who behaviour challenges the service and minimise the use of physical intervention and medicines. Behaviour intervention plans were based on triggers and causes of the behaviours instead of the actual behaviours. There was evidence of a reduction of reactive approaches such as physical restraint and the use of medicines to manage such behaviours. Risks associated with people’s support were assessed and managed with clear and effective guidelines for staff. The service demonstrated a high level of protecting people from abuse and encouraged people to be open when raising concerns. There were sufficient staff deployed to meet people’s needs safely and in a timely manner. Recruitment procedures ensured staff were suitable to work with people in need of support. Medicines were managed safely and people were encouraged and supported to take their own medicines with assistance provided by staff. The service explored and introduced new innovative practices for the administration and safe keeping of medicines.

Vida Hall in Harrogate
Source: http://www.cqc.org.uk/location/1-596794515/inspection-summary#safe

Staff were knowledgeable in recognising signs of potential abuse and the reporting procedures to the local authority. Risk assessments were undertaken to establish any risks present for people who used the service, which helped to protect them. There were sufficient numbers of highly skilled and qualified staff deployed to ensure that people had their needs met in a timely way. The recruitment practices were innovative to ensure staff were matched to people using the service. We found the registered provider had systems in place to protect people against risks associated with the management of medicines; appropriate arrangements for the recording, safe administration, safe keeping, using and disposal of medicines were in place. Innovative ozone disinfection technology was used to maintain cleanliness and infection control in the laundry. An air exchange system throughout the building ensured fresh tempered air flowed at all times.

Outstanding - Responsive

Vale House in Oxford
Source: http://www.cqc.org.uk/location/1-364881644/inspection-summary#responsive

The service was devoted to getting to know the people they supported. There was a clear focus on the importance of knowing peoples histories and involving relatives at every point of peoples care. The service delivered a high standard of personalised care that was embedded within staff practice. People had access to a wide range of meaningful activities which were tailored to individual needs.

The Old Vicarage in Sherborne
Source: http://www.cqc.org.uk/location/1-128365577/inspection-summary#responsive

People’s care plans were detailed and personalised. These documents contained sufficient information to enable staff to meet their identified care needs. People were actively encouraged and supported to engage with the local community and there was a wide range of varied activities available within the service. The service was developing innovative techniques to help enable staff to understand people’s life history and interests.

Links Lodge in Blackpool
Source: http://www.cqc.org.uk/location/1-110425603/inspection-summary#responsive

People received care that was flexible and responsive to people’s individual needs and preferences, Staff were creative in enabling people to live as full a life as possible, particularly where their communication and other skills deteriorated. Care plans were personalised and people and their families had been involved in developing these. Staff used innovative and individual ways of involving people so that they were consulted, empowered, listened to and valued. The arrangements for social activities were inventive and met people’s individual preferences. People were encouraged to be part of their local community and to integrate into community groups in the area.

National Star College
Source: http://www.cqc.org.uk/location/1-139161062/inspection-summary#responsive

People’s care was extremely personalised and centred on their individual needs and aspirations. They were fully involved wherever possible working with staff to take full opportunity of everything college life had to offer them. Staff were exceptional at empowering people to make choices about their lives to improve their quality of life and to find creative ways of helping them through their journey to adult-hood. People had a variety of ways to feedback their views of their experience at college. They were listened to and lessons were learnt to improve college life.

Drayton Court in Nuneaton
Source: http://www.cqc.org.uk/location/1-113543597/inspection-summary#wellled

People planned their own care with support from relatives and staff. People’s preferences, likes and dislikes were understood by the staff from the person’s point of view. People were actively encouraged to engage with the local community, to maintain relationships that were important to them and to participate in new experiences. People’s views were actively and regularly sought, listened to and used to drive improvement in the service. Complaints and concerns were listened to, taken seriously and responded to promptly.

The Heights in High Wycombe
Source: http://www.cqc.org.uk/location/1-124111306/inspection-summary#responsive

People’s preferences and wishes were supported by staff and through care planning. The service responded appropriately if people had accidents or their needs changed, to help ensure they remained independent. People were supported to take part in a wide range of meaningful activities to increase their stimulation.

Outstanding - Caring

Vale House in Oxford
Source: http://www.cqc.org.uk/location/1-364881644/inspection-summary#caring

People were supported by staff that were committed to providing high quality. Relatives spoke positively about the end of life care at the home and the access they had to further support. The staff were friendly, polite and respectful when providing support to people. People’s relatives and friends were really satisfied with the staff and the high standard of care they provided.

Rivercourt Project Short Breaks in London
Source: http://www.cqc.org.uk/location/1-140858290/inspection-summary#caring

We saw excellent communication between people and the staff. People told us how much they liked staying at the service and looked forward to their next visit. The provider supported people to feel part of the local community and they participated in projects to support local charities and improve the environment. People’s privacy and dignity were respected, and compassionate care and support was provided when people experienced difficulties. The provider listened to people's views and developed new activities to meet their needs, including social events that welcomed people who used other services. Information was provided about how to access advocacy services.

Attleborough Grange in Nuneaton
Source: http://www.cqc.org.uk/location/1-113543337/inspection-summary#caring

People and relatives were delighted by staff’s kindness and valued their friendship. Care staff valued people’s experience and opinions and encouraged them to take pride in their lifetime’s achievements. People were encouraged and supported to live with meaning and purpose every day. Care staff respected people’s individuality and encouraged them to maintain their independence live the lives they wanted.

The Old Vicarage in Sherborne

The well-established staff team had developed caring and supportive relationships with people at The Old Vicarage. People were well cared for by staff who had sufficient time to provided dignified and compassionate care. The service provided consistent, high quality end of life care.

The Willows in Bromborough
Source: http://www.cqc.org.uk/location/1-2012446553/inspection-summary#caring

People and staff were seen to be getting on well together and staff demonstrated that they had their people’s care at the heart of their practice. We saw that the relationships and the communication which people had within the home were positive, enabling and therapeutic. People’s independence had been promoted markedly to the point that some had become self-caring in many aspects of their lives.

Stroud Lodge in Gloucester
Source: http://www.cqc.org.uk/location/1-121606972/inspection-summary#caring

Staff knew people really well and used this knowledge to care for them and support them in achieving their goals. People felt listened to and their views were taken into account and helped to shape the service. Staff were considerate of people’s feeling at all times and always treated people with the greatest respect and dignity.

Outstanding - Effective

Links Lodge in Blackpool
Source: http://www.cqc.org.uk/location/1-110425603/inspection-summary#effective

People received innovative care and support that was based on their needs and wishes. This promoted their wellbeing and encouraged them to enjoy a stimulating and meaningful life. Staff had good access to training and the management team used innovative ways of training staff to assist them in providing a high standard of care to people. Staff were encouraged to develop creative ways of seeking people’s views and encouraging communication. The management team worked in partnership with dementia and learning disability organisations to continuously improve and develop care. They used specific systems to make sure they were training staff to follow best practice. Staff used inventive methods to alert people to mealtimes and to increase people’s appetite. This assisted people to have a varied, interesting and nutritious diet. Procedures were in place to enable staff to assess peoples' mental capacity, where there were concerns about their ability to make decisions for themselves, and to support those who lacked capacity to manage risk.

The Willows in Bromborough
Source: http://www.cqc.org.uk/location/1-2012446553/inspection-summary#effective

The building was designed and built around the needs of the people who would be living in it and this had made a significant difference to their quality of life. Staff had received specialist training to ensure people‘s independence was promoted. Many of the documents relating to people and posters in the home were ‘easy read’ format which allowed people to understand more readily what they were about. Staff understood the Mental Capacity Act 2005 and the Deprivation of Liberties Safeguards. They made appropriate referrals.

Derwent Cottages in Scarborough
Source: http://www.cqc.org.uk/location/1-129459377/inspection-summary#effective

People were cared for by staff that had been properly trained. All staff received regular supervision and annual appraisals. These were linked to staff development and planning future training. People were supported to have enough to eat and drink. They ate a balanced diet with appropriate support from staff as required. People had access to healthcare professionals when it was necessary. The environment was adapted to meet the needs of the people who lived there but was at the same time homely. There was outside space for people to use. Signage was in the form of pictures. Activities were organised daily to enhance people’s lives.

Prince of Wales House in Ipswich
Source http://www.cqc.org.uk/location/1-121065943/inspection-summary#effective

People, their relatives and health professionals told us that care at the service was excellent and that the staff were kind and caring. The registered manager used innovative ways of ensuring that staff received the training and support they needed to deliver a high standard of care to people. Staff champions for designated roles had been appointed providing leadership for other staff. Suitable arrangements were in place that ensured people received good nutrition and hydration. People were supported to maintain good health and had access to appropriate services which ensured people received ongoing healthcare support. The environment had been arranged to promote people’s wellbeing. Staff worked creatively to best use the space to support people’s independence and personal identity.

Outstanding - Well-led

Attleborough Grange in Nuneaton
Source: http://www.cqc.org.uk/location/1-113543337/inspection-summary#wellled

The provider’s philosophy, vision and values were shared by all the staff, which resulted in a culture that valued people’s individual experiences and abilities. The provider worked with other specialist services and organisations to ensure people were at the heart of the service. People, their relatives and healthcare professionals were encouraged to share their opinions about the quality of the service, to ensure planned improvements focused on people’s experiences.

The Old Vicarage in Sherborne
Source: http://www.cqc.org.uk/location/1-128365577/inspection-summary#wellled

The provider and management team were strong role models and provided the well-motivated staff with appropriate leadership and support. There were effective quality assurance systems in place designed to both monitor the quality of care provided and drive improvements within the service.

Drayton Court in Nuneaton
Source: http://www.cqc.org.uk/location/1-113543597/inspection-summary#wellled

The provider’s philosophy, vision and values were shared by all the staff, which resulted in a culture that valued people’s individual experiences and abilities. The provider worked with other organisations and implemented innovative technologies to improve people’s experience and the quality of the service. People, their relatives and healthcare professionals were encouraged to share their opinions about the quality of the service, to ensure planned improvements focused on people’s experiences.

The Heights in High Wycombe
Source: http://www.cqc.org.uk/location/1-124111306/inspection-summary#wellled

People’s needs were appropriately met because the service had an experienced and skilled registered manager. There were clear visions and values at the service which staff promoted in how they supported people. The provider monitored the service to make sure it met people’s needs safely and effectively.

Hale Place Garden Lodge in Tonbridge
Source: http://www.cqc.org.uk/location/1-128976322/inspection-summary#wellled

There was an open and positive culture which focussed on people. The manager operated an ‘open door ‘policy, welcoming people and staff’s suggestions for improvement. The service sustained outstanding practice which had been recognised by a wide range of health and social care awards. The registered manager’s vision and values were imaginative and person-centred. They were developed and reviewed with people, their relatives and staff. Staff were motivated by the management team to strive for continuous improvement. There was a strong emphasis on continually striving to improve. A robust system was used to measure the quality of the care and service and as a result continual improvements had been made.

Eden House in Bishop Auckland
Source: http://www.cqc.org.uk/location/1-999096321/inspection-summary#wellled

There were clear values that included involvement, compassion, dignity, respect, equality and independence. There was a well-defined emphasis on fairness, support and transparency and an open culture. The management team had very robust and effective systems in place to assess and monitor the quality of the service, the quality assurance system operated to help to develop and drive improvement. The service worked in partnership with key organisations, including specialist health and social care professionals.