Learning Disability Today
Supporting professionals working in learning disability and autism services

How we achieved an outstanding CQC rating


So we did it, we got that all elusive “Outstanding” rating from the Care Quality Commission.

Just two percent of adult social care services across England received an Outstanding rating in the last year and now we can say we are one of them.

“When you make mistakes admit to it and learn, don’t brush it aside. This builds trust, a culture of learning (rather than blame) and the residents ultimately benefit.”

I’ve worked at Aurora Orchard Manor, in Meldreth, Cambridgeshire, for a number of years, first as a support worker and now as the registered manager and in that time I’ve seen the service go through several incarnations.

So to be sat here in 2017 with an Outstanding rated service (for the second consecutive time) makes me very proud.

But I don’t want to be a member of an exclusive club, I want as many care homes as possible to achieve this standard of quality because that means the wonderful people we support are getting the care they need and deserve.

‘Echoing a regular life’

Aurora Orchard Manor offers a supportive living and learning environment for young adults (aged 18 plus) who have severe, profound and multiple learning difficulties resulting in complex learning needs. Many have additional physical, sensory and health needs.

The residents in our service experience many daily challenges – it’s our job to build opportunities.

So how did we do it, how did we achieve that Outstanding rating?

We try to echo a regular life as much as possible for the young people in our care.

To be Outstanding you must create a culture that creates as little separation as possible between the experience of the young people in your care and their peers who live in the community without disabilities.

The young people at Aurora Orchard Manor go to the pub, the cinema, the local shops and clubs – all the things that you would expect young men and women to do of their age – and on a regular basis.

And when someone is ill we go to the doctors surgery – just like any of us would. We don’t call the doctor to us, why should we? Our young people are fiercely independent, in spite of their challenges.

And it’s not just about supporting those who are easy to help go out into the community, everyone gets to experience a full life. We fundamentally believe in an equal opportunity to access the community.

Which leads on to the heart of an Outstanding home – a multi-disciplinary approach.

Each of our dedicated team members has a detailed knowledge of all the residents in our home so they always get the tailored care and support they need.

There is not a one size fits all solution here. We are utterly focused on outcomes and making the previously supposed ‘impossible’ possible.

“Money is not a guarantee of quality – creativity and resourcefulness are even more vital.”

That means having appropriate staffing levels and a culture of genuine compassion and support. Many people talk about this but it only counts if you actually live it. We do our best to do this every day.

It also means having the equipment and the technical knowledge to ensure we can provide the support that our residents need. If a moulded wheelchair is what is required to get someone out into the community then we will make that happen.

Integration is everything

I really believe that to be truly Outstanding you have to look far beyond the walls of the actual building in which your service exists.

Yes, of course that needs to be a safe, homely space where all the appropriate rules and regulations are followed, record keeping is correct and policies and procedures are in good order, but that is really just compliance – that should be the starting point for quality, not the end point.

Ensuring your home is fully integrated into the community so that residents feel they belong in their locality is EVERYTHING. Care homes should not be islands. We must build the bridges to a bigger life.

And yes, this costs money, but that’s not a guarantee of quality – creativity and resourcefulness are even more vital in my opinion.

Ultimately your reputation and the quality of care really is down to the culture in the home. Strong leadership and a strong team is essential.

I think our excellent induction systems have ensured people join our culture and do not bring old cultures with them. Yes, there is a place for e-learning in training but that is not enough to ensure someone comes on board with the vision of the organisation – you need hands on training.

Role modelling

At Aurora Orchard Manor we have a period during induction where new team members shadow more experienced staff until they are signed off as fully competent. This ensures no dilution of our quality of care.

And as a leader I believe it is essential to model the behaviours I want to see in my staff. That means I still do care shifts myself and make sure I’m out and about in the homes listening to residents and support workers.

These are the people who know the issues we face and we can respond quickly when faced with challenging issues. Team members have so much more respect for you and the culture when you walk in their shoes and see the challenges they face.

And it goes without saying that if you want to be outstanding, NEVER rest on your laurels.

Yes, this is our second outstanding rating but that’s because I honestly believe our job is never done, we must always be looking to improve and innovate.

The people we support lead very challenging lives and their conditions can change dramatically from one week to the next, that means we need to always be flexible and adaptable to their needs.

Care teams need to be constantly monitored and rebalanced to make sure we have the right mix of skills for the people in our care.

Finally, be open and transparent. When you make mistakes admit to it and learn, don’t brush it aside. This builds trust, a culture of learning (rather than blame) and the residents ultimately benefit.

I’m hugely proud of this Outstanding rating. As I mentioned earlier I’ve worked at Orchard Manor for more than a quarter of a century and every day I wake up and I am excited to come to work because I know the difference we make.

Recently a young man joined us. He’d been in hospital for six months with his mother by his side every day. In week one we were worried he would experience uncomfortable separation anxiety without her. He’s settled fabulously and hasn’t stopped laughing since he moved in. Now that’s outstanding.

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