The quality maze

At a time when we are inundated with information and stories about poor quality care, failures in the system, deficit cultures , you could be lulled into thinking the whole care system is catastrophic and that most people going into the care system are facing a Dickensian workhouse culture.

We hear little these days of some of the fabulous support that goes on around improving the quality of lives for vulnerable people. Whilst we have to hold up the mirror and accept that care and support in some areas is frankly unacceptable and that there is a decreasing funding pot, those of us in the sector who engage people to control their support in the best way possible (of which there are many) need to be encouraging and create structures to illustrate positive stories of real quality support that happens cross sector and cross setting.

There are a myriad of ' quality initiatives' all of which produce a tool, or a framework to help improvement. However if we replace the word 'initiatives' with the word 'life', it changes the emphasis and almost makes some of the initiatives redundant, as they remain rooted in charts, bean counting and hard data outcomes. When you focus on 'quality of life' the measurements become somewhat more difficult, they start to be based on a personal view of the recipient, who may not agree with the intellectualised measure of 'good' and may have a view that the service they receive is fabulous - because their measures are different.

So who is right then? It throws up different challenges in a system weighted towards a professional gift model that is shifting to more self-directed support.

Our TLAP work this year in the Quality work stream is very much focussed on trying to make sense of 'quality' initiatives and to showcase great personalised support cross sector so regulators can judge quality multidimensionally with the views of people receiving care and support at the forefront.