Getting to the heart of quality

Ahead of the publication of Demos' Commission on Residential Care report, TLAP's programme director Sam Bennett reflects on recent debate on the state of residential care and points to the features of good quality care as defined by TLAP's Quality Framework.

The final report from the Demos Commission on Residential Care (CORC) will be published shortly and Paul Burstow shared one of its recommendations in a Guardian blog last week - that Care workers should be paid a living wage with the professional recognition they deserve, alongside a minimum level of training and an independently accredited licence to practice. The Commission was a much needed opportunity for fresh thinking, looking at financial, operational, governance and cultural aspects of residential care and how these might be improved and it will be interesting to see the full set of recommendations when they emerge - including how the commission suggests they are taken forward and made real.

Des Kelly, Executive Director of the National Care Forum and Chair of TLAP's Quality Forum has been on the commission and also shared some of his thoughts through a blog where he talked about the importance of altering attitudes to residential care as a first step towards harnessing its potential to deliver high and consistent levels of quality care. This is a subject that sparks strong emotions (the comments to both blogs demonstrate that) with some fairly polarised views as to the place of residential care in a modern care and support system.

Standing back from the debate, it strikes me that whatever ones view on this, there can be no disputing the importance of ensuring that people living in residential care settings experience the best care possible. For me, whether in a care home or in your own home, this means starting with what matters most to people to be able to live a good life. This is at the heart of what TLAP means by quality.

TLAP's Quality Framework, developed through engagement across the sector, with commissioners, providers, the regulator, improvement bodies and people with care and support needs themselves, states that good quality care and support, "can only be achieved through a person-centred approach which understands someone's personal history, current circumstances, future aspirations and what is important to them" and prioritises the importance of relationships based upon dignity and respect, placing the person at the centre of the care they receive. It concludes that in a today's care and support system, services can only be deemed of high quality when people:

• Are enabled to live independent lives as defined by them, with informed choice and control through access to appropriate services and as much involvement in decisions about care and support as they want to have
• Have opportunities to participate in community life, engage in activities that match their interests, skills and abilities, and maintain good relationships
• Feel safe, secure and empowered because their human rights are safeguarded while they are supported to manage informed risks
• Have a positive experience of care provided through relationships based on mutual respect and consideration, where care is designed around their needs and is consistent and coordinated.

These principles apply equally in any setting and for all groups of people, and the very best of the services and evidence the Commission will have considered I am sure will have demonstrated how this is possible. Care is uniquely personal and good quality care will always mean different things to different people. For residential care, this means developing an understanding of how making care personal to the individual can improve everyone's experience - residents, staff and families. If the final report helps to better develop our understanding of what this looks like in residential care and identifies the best levers to pull to make this commonplace then it will have succeeded in moving the debate on.