Inspection is not the answer to abuse in care

In response to the most recent Panorama revelations of abuse in care homes, the CQC has said it would work with the care sector to improve standards and is “determined to ensure problems are addressed”.

But neither the revelations nor the CQC’s response to them is new. In 2011, figures showed that more than a quarter of home care companies were not meeting standards on care and welfare. In 2012, six staff from a care home in Gloucestershire were jailed for “cruel and degrading abuse” of residents. In 2013, neglect and institutionalised abuse at a care home in West Sussex was blamed for the deaths of five elderly residents. In 2014, from a home in Lancashire, three staff were jailed for tormenting and abusing dementia patients. Even the CQC has been exposed (in 2013) for bullying and harassment of its own staff!

Inspection is irrelevant

I worked in British Steel in the nineteen seventies, where rejected product didn’t matter because “inspectors would pick it up” and “it could always go into the electric arc furnace”. The fact that thousands of pounds may have already been spent on the product by that stage was not understood. If it had been, then inspection may not have been necessary.

Subsequently western manufacturing industry was taught by the Japanese that you cannot “inspect quality into a product”. There are plenty of stories: Japanese companies sending little bags of unnecessary rejects with their deliveries because a “1% reject level” had been specified or UK car dealers closing their warranty departments when they switched dealership to Japanese cars, etc., etc. Quality assurance replaced inspection.

What manufacturing then saw in the late twentieth century were: operating procedures being documented; training records; traceability introduced; quality circles; and vocational education. “Inspection” was quietly dropped.

Furthermore it is even more impractical to inspect quality into a service than it is into a product. Since service is ethereal, rather than material, you have to be there at the point of service to inspect it. Even if an inspector has time to watch a reasonable sample of service delivery, employees modify their behaviour in the presence of an observer.

Focus on good management practices instead

Good recruitment pays for itself because you don’t need to keep doing it – or to keep sacking mistakes!

Engagement and commitment not only leads to better performance but it makes life very much easier for the employer.

Abuse is unlikely where renegade employees are surrounded by engaged and committed colleagues. Even if it occurred, it would surface in good time for action to be taken.

Supervisors need to be confident and know how to motivate, recognise, direct, persuade and influence – and how to have an effective “word” with someone when necessary.

The government has provided help so employers can deal with the occasional employee who creates serious problems: two year service protection from unfair dismissal claims; protected conversations; settlement opportunities. Learn what these are and how to use them if need be.

Training supervisors and employees pays dividends. There is so much for us all to learn, and it follows that by gaining knowledge, and by developing abilities, your employees (and hence you) are substantially protected from that dreaded concept “workplace stress”.

Here we have only scratched the surface of good management practices. There is much more on our workshops where you can also learn from others who face similar challenges.

Like death and taxes I predict that, sadly and irrationally, inspectors will always be with us. But if we have good management practices in place then those inspectors’ attention may go elsewhere.

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