Your guide to national audit tool to assess quality of dementia care

The care and support White Paper outlined plans to pilot an audit tool to help residential providers assess the quality of their dementia care. The work is being led by the Healthcare Quality Improvement Partnership; development officer Eve Riley, explains how it will work.

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What is a care audit?
Care audit is a quality improvement process. At its most basic, it involves looking at the way care is provided against agreed standards for high quality and, where indicated, taking action to improve practice to meet these standards, then re-measuring to check progress and make further improvements. Though locally developed audit tools exist in social care, there has been no systematic use of audits in the sector. The Department of Health has now agreed to fund a national care audit pilot concerning dementia care in residential settings.

What is Healthcare Quality Improvement Partnership’s (HQIP) role?
HQIP is a national charity established in 2008 to promote quality improvement in health and social care in the UK, and in particular to increase the impact of clinical audit in healthcare. We are funded by the Department of Health to promote clinical audit in healthcare, and also now in social care.

As part of our care audit work programme we will be running workshops, local training events and producing guidance to support the uptake of care audit methods. Two forthcoming resources – Care audit: A manual for frontline leaders and teams and Care audit: A guide for operational and strategic leaders – will be available in late autumn.

What will the care audit pilot involve?
The care audit pilot will focus on the quality of dementia care in residential care settings and will build on the evidence base to be set out in the forthcoming National Institute for Health and Clinical Excellence (Nice) quality standard for the care of people with dementia, to be published in April 2013.

From early 2014, care providers will have access to care audit tools and templates which they can use to test and confirm the quality of their care practice against the Nice standard for and identify areas for improvement.  

The pilot will be developed in consultation with providers and other stakeholders during 2012 and 2013 and audit tools will be made available free of charge for any residential care provider for use from the end of 2013. Participation will be voluntary and the results will not be collated or published nationally.

This work will be supported through a programme of education and training at a local level to support the culture of audit in social care.

Why are care audits a good idea?
Although there are lots of good examples of quality improvement work in social care there is currently no systematic means for providers to demonstrate or compare the quality of services, where they exceed statutory requirements such as Care Quality Commission registration. This absence is important because people who use services, family members, carers and advocates need to be able to make choices based on clear, accepted and transparent information about the quality of care they can expect to receive against agreed standards of quality.

Providers need to understand how they can improve care, and demonstrate the quality of their services in a competitive marketplace. Commissioners need robust evidence of the quality of a provider’s practice and the ability to compare services across the sector. If adopted widely, care audit will enable the sector to have a common approach to quality improvement.

What changes to services and/or outcomes would you expect as a result of using care audits?
There are likely to be significant benefits to providers who are taking part in care audits.  These include:
• Local improvement – services can work in partnership with people in receipt of care to design an audit that looks at issues of local importance and increase personalisation of services;
• Systematic review – care audit can help address quality issues systematically, providing reliable information to confirm the quality of services and highlight areas for improvement;
• Resource management – care audit can help providers to ensure better use of resources and provide the information to show others that their service is effective (and cost-effective);
• Training and education – care audit can identify opportunities for training and education and help staff demonstrate competence in key areas of care.

Do you expect care audits to be extended into other social care services?
Subject to a review of this first care audit further national projects may be developed around other topics and potentially in other care settings, for example, domiciliary care. Any future care audits designed for use in the social care sector will also be developed in consultation with the sector to ensure they are fit for purpose and achievable within the limited resources available.

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