Resistance to change

Change is almost never easy. However, for care services rated as inadequate or as requiring improvement by the Care Quality Commission (CQC), a period of change will inevitably be required as part of their turnaround. Embracing the status quo is simply not an option if they are to improve the safety and quality of services and meet the standards required by the regulator.

Unfortunately, such services are often those most resistant to change. In our work assisting such care providers, we find staff commonly embracing the status quo and adopting a passively (or in some cases, actively) belligerent attitude to change. ‘We have always done it that way’ are words a change consultant will typically hear time and again as part of initial resistance to the implementation of any new practice.

It should also be acknowledged that this behaviour can result from things that are ordinarily encouraged, such as consistent staffing and long-relationships with external stakeholders and family members. But when these create a closed culture within the service, they inhibit progress and development and can lead to abuse and restrictive practices, issues with staff competence and training, a lack of managerial oversight, and a cover-up culture that fails in its reporting responsibilities. Opportunities for improvement are missed as practices are not analysed or reviewed. Over time, this thought process becomes so embedded into everyday practise that the service begins to fail.

Helping Social Care Providers Change and Improve

In some instances, resistance can extend to the senior managers/provider. It is therefore paramount that a change consultant works with the whole team as part of any turnaround project. Breaking an embedded culture can be immensely challenging and requires and element of trust from both directors and those leading day-to-day delivery of care. The consultant should set clear expectations, timescales, and resource requirements, and be given both the responsibility and autonomy to make crucial decisions to support the necessary changes.

In failing care services, it’s also not uncommon for there to have been little financial investment over recent years, which has allowed services to fall behind. It is therefore important that providers understand and agree to a significant financial commitment to enable certain change. This may be in a number of areas:

• New policies and procedures including latest best practices may be needed as part of implementing new ways of working.
• New technologies may be needed to support reporting, audits, and appropriate care planning.
• Staff training may be needed to update and maintain staff members’ knowledge and competencies of best practices.

This may all sound overwhelming. But it needn’t be. By embracing change, promoting innovation, and keeping an open mind to new ideas, the safety and quality of services can be improved to the level the regulator requires – but more importantly, that our services users deserve.

W&P has significant experience working with care businesses to identify and implement improvements. Our CQC Rating Improvement Service is offered specifically to support providers of services rated as inadequate or requiring improvement. We also offer compliance audits and mock inspections, staff training, and up-to-date policies and procedures to support your change journey. Contact us to speak with a member of our team about how we can help.

For more information on Resistance to change talk to W&P Assessment and Training Centre