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CQC assurance: your workforce is going to tell your best story

The importance of effective communication, developing a shared narrative and positive partnership work during Hertfordshire County Council’s CQC assurance preparation and assessment.


Introduction

Hertfordshire County Council was one of the first councils to be formally assessed by CQC. Their CQC assurance report, published in May 2024, rated Hertfordshire as good, with an overall score of 78 per cent. At the time of writing this case study, in September 2024, this was the highest CQC local authority assurance rating. Eight of the quality statements which CQC assessed were rated as good, with the quality statement ‘partnerships and communities’ rated as outstanding. 

Hertfordshire County Council has kindly shared learning from their experiences of CQC assurance. The council's senior management team also met with PCH to share their learning and reflections, highlighted in this case study. This case study is structured by the three overarching themes which emerged from this discussion.

Leading an effective communication plan across the council

Hertfordshire approached CQC assessment as a process where effective communication is key, “If you get your comms right, you've got everyone feeling included and feeling like we’re all in it together, working together and contributing.”

This was achieved by developing a comprehensive communication and engagement plan across the council and a clear local narrative, informed by qualitative and quantitative data. The lead member was regularly updated and there was Director visibility to all staff.

Information which was particularly helpful to Hertfordshire’s CQC preparation included insight from the pilot sites, the PCH/LGA peer review and conversations with colleagues who went through the process, for example, Norfolk. The team went to all regional and national events and webinars to gather updates. They built their insights into wider comms, for example, soft road shows, direct feedback and direct briefings.

The team approached the PCH/LGA peer review as the real assessment:

"We treated that as the real thing and went into that (peer review) with complete focus on attending it as it would be our assessment. And that made us very well prepared - I think we were a well-oiled machine by the time CQC came."

Developing a positive shared narrative about adult social care

There was a strong focus on understanding local data to develop a shared and consistent narrative about adult social care in Hertfordshire. The council ensured their self-assessment was kept up to date through quarterly reviews, when they evaluated data from their teams, surveys, and case studies. They ensured all the workforce was made aware of local data through Word versions of their self-assessment tool and information return, and through preparing data packs, including the demographic makeup of the population.

The workforce was prioritised at an early stage, with teams encouraged to reflect on their practice, impact and successes. Senior management supported frontline staff to convey positive outcomes, to describe what they are proud of and to explain the difference they had made to local people. They also ensured the workforce was clear about local areas of challenges and defined plans for improvement.

It was especially important to ensure that the local story for Hertfordshire included equality, diversity, and inclusion. Demonstrating an awareness of the local population and the needs of different communities, drawing from the council’s demographic profile, was critical. “It’s important to be able to convey that you know your communities. Also, your workforce and care market need to be representative of your local populations.” During the CQC assessment there was a focus on the council’s awareness of community groups which were seldom heard, how the workforce knew about these populations and what was being done to proactively engage and support marginalised communities.

Positive partnership and community engagement

Hertfordshire worked closely with all their partners throughout their CQC assurance, reflecting their usual collaborative approach. The council involved providers through briefings and webinars which explained the process, highlighted good practice across Hertfordshire and there were opportunities to discuss questions or concerns.

Before the onsite visit CQC contacted local partners, including Healthwatch, voluntary, community faith and social enterprise (VCFSE) organisations and care providers, to complete a survey. CQC also contacted VCFSE organisations representing unpaid carers to identify carers they could speak to.

Hertfordshire is a centre of excellence for co-production. The council has eight boards, which include a range of statutory and lived experience representation. Each board is co-chaired by a person with lived experience. Meetings are used to discuss strategies and areas important to the people represented by each board.

The council has a mixed methods approach to co-production, with some being completed by the council and other work led through a number of contracts with VCFSE providers. Co-production is facilitated in areas where local people live, rather than in council buildings. VCFSE groups represent different communities to ensure resources are relevant for local people.

Hertfordshire is now building on an improvement plan which was developed after thoroughly reviewing their assurance report. They aligned it with the existing improvement plan which was based on feedback from the PCH/LGA peer review, other audits, regional peer assurance and their self-assessment tool.

Reflections following CQC assurance

Top tips from Hertfordshire County Council

  • It’s imperative for councils to have somebody who's got ultimate lead and oversight at a board level.
  • It’s key to drill down on quite a small team of people with skills to be able to take certain areas forwards, depending on the local context this may include the Principal Social Worker (PSW), comms, performance, business support and practice.
  • Managers may feel excluded as CQC does not include them in the interviews. It’s important to remember managers because they're supporting staff, and they are part of the system. If you get your comms right, “we're in this together”, that really helps.
  • The leadership culture needs to encourage honest and open communication.
  • Ensure staff feel comfortable sharing their concerns before the CQC visit and consider providing dedicated space/outlets to do that, for example the PSW in Hertfordshire led drop in cafes as opportunities for discussions.
  • At an early stage encourage your teams to reflect on the things they are proud of and the impact and difference they have made.
  • Make sure all staff can explain the link between audit, reflection and development.
  • Consider early in the preparations how your teams are going to navigate through available data and tools to develop a shared narrative. 
  • You need to be able to directly represent the voice of people with care and support needs and unpaid carers. It is important to develop your local story in relation to equality, diversity and inclusion, including how you hear from people, such as through surveys and feedback.
  • Ensure that teams know the bigger picture and their communities, including people who are seldom heard.
  • Don't forget ‘something you said we did’. Ensure that the people who've been involved in co-production know that their input has made a difference. 

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