Local authority and voluntary sector social care staff have, by and large, viewed quality assurance systems and management models with scepticism.
Sure, a social services department doesn’t make “products” or compete for “customers” or seek to post profits, so what can it learn (or earn) from embracing such an approach? Well, plenty, if the experiences of Devon Council are anything to go by.
In 1996, Devon social services was one of the first public sector organisations to use the European Foundation of Quality Management Excellence Model (EFQM, see panel below). “As part of our quality strategy we developed a programme of self-assessment. We based our self-assessment tools on the pure model but tried using different levels of evidence-gathering and detail appropriate to the function of the section using it,” says Adrian Forster, quality improvement officer and EFQM programme manager for Devon social services.
However, familiar problems raised their ugly heads. “Most felt that some of the language and concepts used in a pure version were inaccessible to many social care staff and created barriers that were not helpful,” admits Forster. “However, we still believed that the model was a powerful improvement tool, so we reviewed our approach and developed a more appropriate self-assessment workbook tailor-made to social care.”
Inevitably, for others considering embarking on an EFQM approach, the language, embedded in manufacturing management-speak, will cause unease. Despite central revisions to the model in 1999 aimed specifically at public services, the technical tone of the shop-floor production line remains. Indeed, it was the inability of the most famous quality assurance system, the former BS 5750 (later ISO 9001), to shed its armament industry origins, that proved a bridge too far for many.
Forster agrees that terminology needs to be disarmed if the greater good is to be served: “Sometimes the prompts in the model need unpicking: ‘Using innovative organisation methodologies to improve the way of working, eg, restructuring the supply chain, matrix working, flexible team working, high performance work teams.’ Try that one on a social work team! It’s not that the concepts aren’t valuable, it’s just we have not used that sort of language in social care; although there is an expectation that managers will improve their understanding of business concepts and tools.”
He continues: “The concept of ‘customer’, for example, is also a problem for some frontline staff and service users. They feel it gives the wrong impression as it implies purchasing power and resultant consumer choice. This can apply to non-front line staff who may provide internal services. People often struggle because we often serve various interests: national government, members, senior management. The trick here is to see the concept of being a customer as fluid. Today I am your customer, tomorrow you’re mine.”
For any system to work effectively, it also needs to link in with what is already happening – or else it is in danger of becoming a luxury extra that simply gets lost. “While we were introducing EFQM, we were at the same time developing a more sophisticated approach to performance planning. One of the problems we experienced in the early days was that the self-assessment outcomes (particularly the areas for improvement) became swamped by the pressures of normal business. By linking EFQM outcomes to performance planning we had a vehicle for making sure improvement ideas were not lost but remained on the agenda and were monitored and reviewed,” he says.
So why use this particular model? “Because it makes sense – it’s systematic, contains values such as constancy of purpose, leadership, management by evidence, using knowledge and skills, and at its heart is the need for organisations to use learning effectively,” says Forster.
And what tangible results has it provided? “We developed a differentiated approach to care management prompted by our EFQM programme. In advance of the performance assessment framework (PAF) indicators we started to measure our performance more effectively and have also increased our investment in the delivery of management information. We initiated staff attitude surveys, recognising the importance of morale and empowerment of the workforce. We have also provided key front-line staff with customer care training and invested in our customer care team. We are still developing our approach and are currently looking at linking EFQM to the government’s star rating assessment,” he says.
What is EFQM?
EFQM was founded in 1988 by the presidents of 14 major European companies (Bosch, BT, Bull, Ciba-Geigy, Dassault, Electrolux, Fiat, KLM, Nestl‚, Olivetti, Philips, Renault, Sulzer, Volkswagen). The impetus was the need to develop a European framework for quality improvement along the lines of the Malcolm Baldrige Model in the USA and the Deming Prize in Japan. The European Model for Business Excellence – now called the EFQM Excellence Model – was introduced in 1991 as the framework for organisational self-assessment. The model assesses the “excellence” of your organisation or service under nine main criteria: leadership, policy and strategy, people, partnerships and resources, processes, customer results, society results, and key performance results. Your current position is assessed against the model listing your “strengths” and your “areas for improvement” – highlighting where efforts are needed to secure improvement and requiring management action plans to achieve this.
- Don’t use the model in isolation – link it to your normal planning and improvement processes.
- Send a few people on licensed assessor training. Then they will really understand the model and act as champions.
- Your top team probably has enough on its plate as it is – so just get someone who is keen to run with this and let them get on with it.
- Get staff to learn the language of EFQM – it doesn’t matter if they don’t understand it, so long as they can recite it (for benefit of government inspectors) and you’ll be kissing those three stars.