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Service Audits – Capturing The True Picture

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Lucy Buxton identifies five simple steps providers can take to ‘temperature check’ their service.

Journalist and author BC Forbes said ‘If you don’t drive your business, you will be driven out of business’. Interesting thought, don’t you think?

Now, for those that don’t know me, I do a lot of thinking and this quote got me thinking. OK, just go with me for a minute. A lot of us drive, and if we don’t drive then we tend to take public transport. If we are responsible drivers, and the companies that supply public transport take their responsibilities seriously, then checks on the vehicle will be made before it is used. Simple things – like checking the oil level or the tyre pressures and topping up the screen wash. I’m sure the world of commercial transportation is way more complicated than that, but you get my drift.

But what happens if we don’t do those mundane things that are essential for safety, efficiency and quality? Things go wrong.

Another example of precautionary checking is to test the temperature of milk or food for a baby before its given to them.

What if it was the same with care? In fact, it is! But how often is it done?

‘All the time!’, I hear you say. But is that actually the case? In CQC’s State of Care report it said that ‘83% of adult social care services were rated good or outstanding’, meaning that 17% of adult social care services are not.

How can this be? One of the ways that it is possible, and one of the reasons why it is often the case, is that the ‘temperature check’ of the service/care home/care provision is not checked objectively – or even completed.

‘Of course it’s checked objectively Lucy! We audit our service,’. Really? You think that?

When you think about it, how much does an audit really check the temperature of your service? Does doing feedback surveys for staff, relatives and those cared for check it too? Of course, but that is only the first step. We can know the information, but what if we don’t then do anything with the information given? What if the templates we use are really not worth the paper they are printed on, and not aligned to best practice? What if the person completing the audit doesn’t know the reason for it, how to audit, or even have the confidence to actually reflect the truth without fear of making things look bad?

The point is, you don’t actually get a true temperature check. It’s a bit like checking your water temperature with a thermometer that hasn’t been accurately calibrated.

I’m sure you are wondering how you can do this, and really make sure your finger is on the pulse.

There are really simple steps you can take, basic things that – when busy and focused on the task in hand – you might miss.

  • Pause – Stop, and just observe.
  • Listen – Pay attention to the noise around you – or lack of – and then let your inquisitive, inquiring mind explore. It may be that you can’t hear any noise at all, and that further investigation of the medication charts shows too many folk on medication that means they are quieter. It may be that there is no noise because everyone is happy and content.
  • Look – Open your eyes, lift your head and see if people are smiling. See if staff have their heads down and eyes looking at the floor, busy rushing past you and failing to see your presence. Look to see if staff engage with those that they pass in the corridor – do they stop to say hi and pass the time of day for a few seconds?
  • Feel – Trust what you feel. Your unconscious mind probably has a sense of the room before your analytical self, so tune in, slow down and identify what you are feeling, and don’t ignore it. Many times over the years, I’ve acted on my nurses’ intuition, and it has saved lives.
  • Think – Reflect on conversations you’ve had and ask questions – really good questions.

Can it really be that easy? Of course. We know that in many cases, where serious case reviews have occurred, the signs were there – but everyone was just too busy not paying attention.

So, if you really want to calibrate your checks – Stop, Pause, Listen, Look, Feel and Think. Then take action on what you have found.