At MiHomecare, our aim is to establish a framework within which MiHomecare can demonstrate accountability for continuously improving the quality of services, taking corporate responsibility for performance and providing the highest possible standards of clinical and social care.
We understand that governance is the recognition of and maintenance of good practise, learning from mistakes and improving the quality of services provided to people that use our services.
There is no single task that defines governance, rather, there are a series of processes that build a robust picture of overall governance. These processes can be used by managers and staff to help improve and deliver high quality services. Some of these processes are defined under the following areas:
- Clinical or care effectiveness
- Continuous professional development
- Involvement of people using our services
- Remedying underperformance
- Risk management
Accountability of staff is defined within the organisation, with the registered manager being responsible for the overall management of their service. Within the services, there are clear and structured approaches to governance, with all staff working as part of a linear management organisation. All our branch managers are inducted, and trained to understand the importance of internal quality management systems and the key role that they play in leading the overall quality of their service.
Internal Audits are central to providing the evidence that the processes of governance are being followed. Auditing is undertaken as a regular activity to ensure that standard procedures are followed, with actions identified to meet any deviation or shortfall from expected standards. Relevant audits in areas of health and safety, medication management, infection control, care planning, safeguarding, environmental risks and other areas of the organisation are conducted regularly by branch teams and by our internal quality and performance team at regular intervals throughout the year.
Effectiveness of care is monitored to ensure adherence to procedures and to identify when any changes or further developments to practice are required. Areas such as nutrition, medication and falls are included in this process. This effectiveness is monitored and additional resources and support is identified where appropriate, either via district nurse intervention, GPs or other additional community health and social care support workers.
Continued professional development is always key to any continual improvement processes, so all our staff skills are reviewed and, where additional training is required, this is identified and provided. Wherever incidents arise, root cause analysis is carried out via our own internal quality governance board and recommendations implemented appropriately. These processes are completed in conjunction with our own internal Learning and Development leads within MiHomecare.
Involvement of service users is fundamental to our ability to understand performance. To make sure that governance is effective and holistic, service users are involved and asked for their feedback on the timeliness and quality of services provided. As an organisation, we listen and adapt to feedback accordingly. Systems such as surveys are used and changes made are fed back to our service users and their views recognised. This process is central to the concept of ‘person centred care’ and continuous improvement.
Remedying under performance is an integral part of our follow up to our quality governance processes. Shortfalls can be addressed either via additional supervision and or in team meetings. MiHomecare will always ensure its staff are aware of key policies such as whistleblowing, safeguarding, and accident and incident reporting.
Risk Management is considered at MiHomecare to be with clinical or non-clinical risk. This pillar of quality governance involves considering the benefits that a potential treatment may have against potential harmful effects. The non-clinical risks will often cover areas relating to the environment and the potential harm that may come to service users or staff. The following considerations of risk are always made at MiHomecare:
- Risks are identified using the risk assessment and management processes
- Reviews of complaints, accidents and incidents always forms part of risk management
- Lessons will be learned and inform future risk management.
OUR INTERNAL QUALITY TEAM
At MiHomecare, we recognise the importance of self-governance and have our own internal quality and performance team currently led by our Head Of Quality and Performance, Robert Floyd.
Rob Floyd joined MiHomecare in September 2017, with a remit to help us build on our current standards of quality and performance and ensure that the level of care we are providing is of the kind we would want for a much-loved family member. Rob has spent his career working with vulnerable groups, helping to improve their quality of life. He was drawn to social care as the job he most wanted to do from an early age. He worked with clients with learning difficulties and managed homes for the elderly, before entering the home care sector in 2009. Immediately prior to joining MiHomecare he was working as a Regional Quality Manager for a housing and social care provider.
He is looking forward to seeing what a difference he can make in this role and believes the organisation is currently at a size where it can introduce some focus, so that everyone understands and can play their part in ensuring we offer a service rooted in humanity and that our clients are happy to recommend us to others.
Rob is assisted by two Quality and Performance Managers who work across the company, carrying out regular audits in accordance with all of the key legislator expectations. They report back to our monthly quality governance board members to assist in the overall quality governance improvement plans.
As well as the audits carried out by the quality team, managers are involved in providing their own monthly branch manager reporting and are engaged in the following additional quality management work:
- Service user annual survey, analysis and actions
- Carer annual survey, analysis and actions
- Additional quality telephone calls to service users
- Additional quality visits undertaken in service user’s homes
- Carer observation work in the field including general observations, medication competency observations as well as moving and handling of service user observations.
- Internal staff and service user compliance is tracked and updated on their internal databases and tracked on their internal compliance trackers.
OUR INTERNAL GOVERNANCE BOARD
Our internal Governance board is represented by senior managers within the company including the internal quality team, the managing director, operations director and training and development leads. We also have nursing representatives who assist us with our clinical governance.
The board meets monthly to study the following activity within the company:
- Complaints and compliments company wide
- Any safeguarding and accident/incident work
- Information governance, training compliance and CQC compliance.
From these meetings, trends and activity are studied, analysed and acted upon accordingly.