Staff Health and Wellbeing in the New CQC Framework
There is a significant focus on staff wellbeing and well-led organisations in the new CQC framework.
The 6 categories of evidence include:
Peoples’ Experiences, Feedback from Partners, Feedback from Staff,
Processes, Observations of Care and Outcomes of Care.
All categories aim to lead to a sense of belonging and pride in the team, as well as creating a positive working environment for all.
Organisations now need to identify needs in order to improve confidence and well-being of staff.
Previously the focus was on user/patient opinions, this has moved to include employees.
Feedback should be gathered from a range of sources including: staff surveys, interviews and forums.
A well-led organisation will consider equality, diversity, inclusion and the freedom to speak up.
Evidence will be carefully documented, collated and made available to the CQC
Quality Statement are new but the Regulation &Fundamental Standards remain the same.
What the CQC are looking for and will require evidence of during a visit:
Safe & Effective Staff – appropriate staffing levels/ appropriate qualifications and skills/ adequate support and supervision/ effective recruitment/ regular training with clear records/ pre-employment safety checks/ clear policies and procedures/ robust induction/ appropriate licences/ planned exit interviews.
Workforce Wellbeing & Enablement – wellbeing is supported/ health and safety is high priority/ strategies to encourage employee engagement include: mentoring, training and needs analysis/ careful mentoring and management of staff including: feedback, meetings and action planning/ conflict resolution is addressed through policies, procedures, team building & recording systems/absences are managed using clear procedures & monitoring.
Freedom to Speak Up – promote openness, honesty and transparency/ empower staff and develop a clear sharing culture/ investigate issues and take action/ prevent future occurrences/ implement clear procedures and policies including: whistleblowing and grievance/ hold forums, reviews and conduct surveys/ have a clear vision and values, conduct performance appraisals and encourage career pathways.
Workforce Equality, Diversity & Inclusion (increased focus in this area) – prevent bullying, inequality, harassment & disparities/develop clear policies & procedures including: equal opportunities, recruitment, flex working & code of conduct/ ensure all staff are trained in equality, diversity & conduct and keep records/ develop a strong workplace ethos/ monitor and review staff – performance, pay and conduct.
Outstanding Employee Wellbeing
Holistic focus
Leadership driven
Clear employee voice
Flexibility
Workload management
Accessibility support for all
Growth opportunities for staff
Appreciation of achievements.
CQC – Single Assessment Framework Statements Linked to Staff Wellbeing
Learning culture
Safety is a top priority that involves everyone, including staff as well as people using the service. There is a culture of safety and learning. This is based on openness, transparency and learning from events that have either put people and staff at risk of harm, or that have caused them harm.
Risks are not overlooked or ignored. They are dealt with willingly as an opportunity to put things right, learn and improve.
People and staff are encouraged and supported to raise concerns, they feel confident that they will be treated with compassion and understanding, and won’t be blamed, or treated negatively if they do so.
Raising concerns helps to proactively identify and manage risks before safety events happen.
Incidents and complaints are appropriately investigated and reported.
Lessons are learned from safety incidents or complaints, resulting in changes that improve care for others.
Safe systems, pathways and transitions
Safety and continuity of care is a priority throughout people’s care journey. This happens through a collaborative, joined-up approach to safety that involves them along with staff and other partners in their care.
The views of people who use services, partners and staff are listened to and taken into account.
Safeguarding
People are appropriately supported when they feel unsafe or experience abuse or neglect.
Where applicable, there is a clear understanding of the Deprivation of Liberty Safeguards (DoLS) and this is only used when it is in the best interest of the person.
Safeguarding systems, processes and practices mean that people’s human rights are upheld and they are protected from discrimination.
People are supported to understand their rights, including their human rights, rights under the Mental Capacity Act 2005 and their rights under the Equality Act 2010.
Safe environments
Facilities, equipment and technology are well-maintained and consistently support staff to deliver safe and effective care.
Safe and effective staffing
There are robust and safe recruitment practices to make sure that all staff, including agency staff and volunteers, are suitably experienced, competent and able to carry out their role.
Recruitment, disciplinary and capability processes are fair and are reviewed to ensure there is no disadvantage based on any specific protected equality characteristic.
There are appropriate staffing levels and skill mix to make sure people receive consistently safe, good quality care that meets their needs.
Staff receive training appropriate and relevant to their role.
Staff receive the support they need to deliver safe care. This includes supervision, appraisal and support to develop, improve services and where needed, professional revalidation.
Staff at all levels have opportunities to learn, and poor performance is managed appropriately.
Delivering evidence-based care and treatment
The provider’s systems ensure that staff are up-to-date with national legislation, evidence-based good practice and required standards.
Staff and leaders are encouraged to learn about new and innovative approaches that evidence shows can improve the way their service delivers care.
How staff, teams and services work together
Staff have access to the information they need to appropriately assess, plan and deliver people’s care, treatment and support.
Kindness, compassion and dignity
There is a culture of kindness and respect between colleagues from other organisations.
Workforce wellbeing and enablement
People receive safe, effective and person-centred care as the provider recognises and meets the wellbeing needs of staff. These include the necessary resource and facilities for safe working, such as regular breaks and rest areas.
People benefit from staff who have regular opportunities to provide feedback, raise concerns and suggest ways to improve the service or staff experiences. If necessary, leaders provide a timely and considered response.
People’s experience of a service is driven by a culture that normalises good wellbeing through inclusivity, active listening, and open conversations. This enables staff to do their job well and to be well.
Staff are supported if they are struggling at work. This has a positive impact on the care they deliver to people.
Staff have easy access to personalised support that recognises the diversity of a workforce with proactive and reactive measures.
People are supported by staff who feel valued by their leaders and their colleagues. They have a sense of belonging and the ability to contribute to decision making.
Shared direction and culture
Leaders ensure there is a shared vision and strategy and that staff in all areas know, understand and support the vision, values and strategic goals and how their role helps in achieving them.
Staff and leaders ensure that the vision, values and strategy have been developed through a structured planning process in collaboration with people who use the service, staff and external partners.
Staff and leaders demonstrate a positive, compassionate, listening culture that promotes trust and understanding between them and people using the service and is focused on learning and improvement.
Staff at all levels have a well-developed understanding of equality, diversity and human rights, and they prioritise safe, high-quality, compassionate care.
Equality and diversity are actively promoted, and the causes of any workforce inequality are identified and action is taken to address these.
Staff and leaders ensure any risks to delivering the strategy, including relevant local factors, are understood and have an action plan to address them. They monitor and review progress against delivery of the strategy and relevant local plans.
Capable, compassionate and inclusive leaders
Leaders have the experience, capacity, capability and integrity to ensure that the organisational vision can be delivered and risks are well managed.
Leaders at every level are visible and lead by example, modelling inclusive behaviours.
High-quality leadership is sustained through safe, effective and inclusive recruitment and succession planning.
Leaders are knowledgeable about issues and priorities for the quality of services and can access appropriate support and development in their role.
Leaders are alert to any examples of poor culture that may affect the quality of people’s care and have a detrimental impact on staff. They address this quickly.
Freedom to speak up
Staff and leaders act with openness, honesty and transparency.
Staff and leaders actively promote staff empowerment to drive improvement. They encourage staff to raise concerns and promote the value of doing so. All staff are confident that their voices will be heard.
There is a culture of speaking up where staff actively raise concerns and those who do (including external whistleblowers) are supported, without fear of detriment. When concerns are raised, leaders investigate sensitively and confidentially, and lessons are shared and acted on.
When something goes wrong, people receive a sincere and timely apology and are told about any actions being taken to prevent the same happening again.
Workforce equality, diversity and inclusion
Leaders take action to continually review and improve the culture of the organisation in the context of equality, diversity and inclusion.
Leaders take action to improve where there are any disparities in the experience of staff with protected equality characteristics, or those from excluded and marginalised groups. Any interventions are monitored to evaluate their impact.
Leaders take steps to remove bias from practices to ensure equality of opportunity and experience for the workforce within their place of work, and throughout their employment. Checking accountability includes ongoing review of policies and procedures to tackle structural and institutional discrimination and bias to achieve a fair culture for all.
Leaders take action to prevent and address bullying and harassment at all levels and for all staff, with a clear focus on those with protected characteristics under the Equality Act and those from excluded and marginalised groups.
Leaders make reasonable adjustments to support disabled staff to carry out their roles well.
Leaders take active steps to ensure staff and leaders are representative of the population of people using the service.
Leaders ensure there are effective and proactive ways to engage with and involve staff, with a focus on hearing the voices of staff with protected equality characteristics and those who are excluded or marginalised, or who may be least heard within their service. Staff feel empowered and are confident that their concerns and ideas result in positive change to shape services and create a more equitable and inclusive organisation.
Governance, management and sustainability
There are clear and effective governance, management and accountability arrangements. Staff understand their role and responsibilities. Managers can account for the actions, behaviours and performance of staff.
The systems to manage current and future performance and risks to the quality of the service take a proportionate approach to managing risk that allows new and innovative ideas to be tested within the service.
Partnerships and communities
Staff and leaders are open and transparent, and they collaborate with all relevant external stakeholders and agencies.
Staff and leaders work in partnership with key organisations to support care provision, service development and joined-up care.
Staff and leaders engage with people, communities and partners to share learning with each other that results in continuous improvements to the service. They use these networks to identify new or innovative ideas that can lead to better outcomes for people.
Learning, improvement and innovation
Staff and leaders have a good understanding of how to make improvement happen. The approach is consistent and includes measuring outcomes and impact.
Staff and leaders ensure that people using the service, their families and carers are involved in developing and evaluating improvement and innovation initiatives.
There are processes to ensure that learning happens when things go wrong, and from examples of good practice. Leaders encourage reflection and collective problem-solving.
Staff are supported to prioritise time to develop their skills around improvement and innovation. There is a clear strategy for how to develop these capabilities and staff are consistently encouraged to contribute to improvement initiatives.
Leaders encourage staff to speak up with ideas for improvement and innovation and actively invest time to listen and engage. There is a strong sense of trust between leadership and staff.