Agenda item

The Committee received a presentation on the Stockton-on-Tees Borough Council (SBC) Well-Led Programme which provided an update on developments around this leadership initiative.  Led by a SBC Transformation Manager, and supported by three care home leaders who had been through the programme, key features of the presentation included:

• Why the Well-Led Leadership Programme was introduced: Historically, Care Quality Commission (CQC) inspections had resulted in the identification of issues within the ‘Well-Led’ domain (one of its five key inspection elements).  In 2018, 50% of the Borough’s care homes were rated ‘Requires Improvement’ in relation to leadership; in some cases, this was deemed ‘Inadequate’. 

• What the programme entails: This initiative was not a training programme which led to a qualification.  Instead, it was an innovative approach to developing strong leadership across the residential care home sector, promoting and supporting new ways of working, challenging the status quo, and embracing (sometimes bold) change.

• Who was involved in the programme’s creation: A collaborative approach with stakeholders wrapped around the local care home sector – this included the former Tees Valley Clinical Commissioning Group, NHS Leadership Academy (North East and Yorkshire), the CQC, SBC, and local care home providers.

• How the programme works and what it seeks to achieve: Providers previously worked in isolation and were often competing against each other.  The programme sought to establish effective networks which enabled local care home leaders to share good practice and learn from each other’s experiences.  It specifically looks at problem-solving and improving professional practices via systematic observations and data collection, and seeks to strengthen an organisation through the development of several key pillars – leadership, working with change, culture, systems navigation, equality / diversity / inclusion, coaching, and values / ethics.

• Impact of the first and second cohort (2019-2020): Tangible difference was identified as a result of participation in the programme, with more providers receiving an overall rating of ‘Outstanding’ or ‘Good’ following subsequent CQC inspections and less receiving ‘Requires Improvement’. 

• Impact of the programme between 2019 and 2023: Numerous benefits have been attributed to this ‘well-led’ initiative since its inception, including greater co-operation, increasing tools and confidence to lead a service well, the creation of networks / celebration events / forums for sharing good practice (aiding improvements in service quality), and positive relations with regulators and inspectors.  Ultimately, CQC ratings had improved, and of the 73 people who had participated in the programme, 78% of those were still at their care service within the Borough (demonstrating impact on retention).  It was also noted that the programme kept going despite the challenges arising from the emergence of COVID-19 (moved to remote sessions).

• Care home leader reflections on their experiences and the benefits it had brought them following their involvement: Several quotes from those who had participated in the programme were included.  In addition, three care home leaders were in attendance (two who went through the first cohort and one who participated in the latest) to relay the impact of being involved, and emphasised the positive experience, learning and impact in terms of improvements in CQC feedback / outcomes.  As well as management, service leads had also accessed the programme to ensure the wider senior team had the skills and confidence to further develop the existing offer (e.g. day trips) – this had aided retention which was an achievement given the effects of the COVID pandemic.  Other comments included the value of learning about yourself, understanding how to adapt to different personalities, focusing on the culture of an organisation, and making staff feel important.  One provider had also developed a care home residents’ social group in co-operation with SBC.

• Cohort six (2023-2024) – supporting quality improvement: The current cohort started in September 2023 – two from services currently rated ‘Outstanding’ overall, 12 from services rated ‘Good’, and eight from services rated ‘Requires Improvement’.  Further information detailing the contents of the programme could be relayed if desired.

Commending officers and care home leaders for their presentation on this highly rated programme, the Committee was pleased to hear that participation had extended to those within the wider leadership team of local providers.  Members were encouraged to hear of the positive experiences of those accessing the initiative, as well as the ongoing collaborative working which had underpinned its success, all of which contributed to supporting vulnerable people and their families.

The Committee was informed that the associated Activity Co-ordinators Network was now well established and that a course had been developed around activity provision.  Despite sometimes negative media regarding the care sector, local initiatives were doing well, and Members encouraged SBC to keep promoting these messages.

Members asked how they, as Ward Councillors, could get involved with their local care home providers.  In response, SBC officers stated that they would happily facilitate conversations following the meeting, and highlighted the Activity Co-ordinators Network as a useful place to start as this gives a good introduction to the Borough’s offer.

A query was raised around the support provided to care homes by other organisations such as SBC, NHS Trusts and GPs.  Care home leaders in attendance spoke of their positive experiences with such entities, including an awareness that these relationships were much better locally than peers (employed by the same provider) had in other Local Authority areas.  There were lots of opportunities to get involved with various initiatives (specific reference was made to the support provided by the North Tees and Hartlepool NHS Foundation Trust Community Matron and Frailty Team, as well as virtual ward rounds and mental health nurse access via a local general practice) – the challenge was getting services to take these up.

As evidenced within a report later in the agenda for this meeting, the Committee drew attention to the increase in the number of services requiring improvement and queried the uptake of the programme for those providers with such a grading.  Assurance was given that eight providers with a current rating of ‘Requires Improvement (RI)’ were registered, and that one provider with all four of its services rated ‘RI’ or ‘Inadequate’ had signed-up to participate.  Members urged SBC to do what it could to sell the programme to those from providers currently graded ‘RI’.

AGREED that the Well-Led Programme update be noted.