At a hearing last week, a care worker from Fraserburgh was facing a ban from working in the profession primarily for lying about an incident of poor care, prompting a social media discussion about how you can ensure your staff tell you the whole truth.
Would registration of staff be the answer? Would mandatory signature on a Duty of Candour form do the trick? People ask about the role of the manager here and what about other people? Had they not seen the incident in question? Why did they not highlight the issue?
So what is the answer? It's a complex question with more than one answer. There are two critical issues here: leadership and feedback.
Strong leadership, with a balance between a 'no blame' culture and an expectation that people will always do their best in a caring and compassionate way, will engender a sound environment where people know what is expected of them, where they can reveal problems or issues without fear. People need to know that feedback will be treated with respect and acted upon. A signature on a document as part of a solid induction could help build that confidence but without that leadership fillip, then it won't make people tell the truth.
Evidence of activity can be generated in a number of ways; essentially the care provider needs a robust performance quality feedback loop. There are many ways to do this: NHS Choices, or the new Trip Advisor style website launched by the government; you can use CCTV surveillance, peer reviews, forums, focus groups, stakeholder surveys. A care provider needs both instant 'crisis' feedback and longer term 'benchmark' feedback. They need measurable information and they need insights. More importantly, they need confidence that the feedback they get is honest.
Care2Improve won't give you the instant crisis feedback and it won't give you the insights delivered by focus groups. What it will give you is a process that actively solicits feedback from a wide population that includes your staff and your service users. Care2Improve gives you a dashboard of useful metrics and themed qualitative comments. What's more important in the context of truth, as an independent service with anonymous responses, care providers can have the confidence that the feedback is honest.
And even more importantly, by using a process like Care2Improve as an integral part of a management cycle, by sharing the results and by getting buy in to the action plans it generates, care providers embed a sense of leadership and honesty into the culture of the business.