Quality and Safety Governance Review and Development Support Service for Western Care Association

“Western Care Association commissioned HCI to carry out a Quality and Safety Governance review. HCI guided us through the implementation of the report recommendations and subsequently supported us in the development of a Quality and Safety Strategy and Governance Structures. We are really impressed with the quality of HCI’s work. Their expert guidance will help us embed a culture of safety and support us in meeting our quality and safety objectives.”

Tia Crowley

Chief Executive Officer, Western Care Association

Background

Western Care Association (WCA) is a disability service provider based in Co. Mayo. They provide disability support services on behalf of the HSE to approximately 1,300 service users across Co. Mayo. Services include residential and respite care, adult day services, home-sharing, supported living service, social work and therapeutic supports.

In line with their clear commitment to providing the best possible care, WCA commissioned HCI to undertake a review of the current Quality and Safety Governance Structures and Systems at WCA and make recommendations for the Quality and Safety Management System (QSMS). This would subsequently support the development of a new Strategic Plan for WCA and the development of an enhanced QSMS.

Objectives

Review WCA’s QSMS programme, structures, processes, information systems and outcome measurements.
Make recommendations to support the development of an overarching QSMS for WCA.
Make recommendations to support the establishment of the quality and safety function including development of job descriptions and role development, teams and committees.
Support the development of the QSMS through the provision of a best practice processes and frameworks arising from the recommendations.

Solution

To support Western Care Association in the review and development of the Quality and Safety Governance Structure and System, HCI provided the following services:

Detailed documentation review of the current QSMS.

Interviews with staff.

Staff survey on the Culture of Service User Safety.

Review of the Information Management System.

Review and analysis of information gathered and development of report.

Development of Quality and Safety Governance Structures.

Reengineering of Quality and Safety processes.

Development of Quality and Safety Strategy.

Development of job descriptions for Quality and Safety functions.

Development of QSMS policies and procedures.

Development of Key Performance Indicators (KPIs) and Quality and Safety Report Template.

Challenges

Complex organisation with multiple dispersed small locations, subject to varying regulatory requirements.
Currently undergoing reconfiguration of the governance structures including the Board and Sub-Committees.
Multiple IT systems in place to manage different elements of the Quality and Safety Management system, no single centralised system.
Staff challenges with access to technology.
Multiple internal quality reports generated, no comprehensive quality report for the service.

Outcome

HCI provided WCA with a comprehensive report on their QSMS and Governance Structures. This report detailed the findings of the review and recommendations to support the development of an overarching QSMS for the entire organisation. Following the report, HCI provided WCA with support in the development of their Quality and Safety Governance Structures, including job descriptions for the quality and safety teams and committees, and their Quality and Safety Strategy which provides a roadmap for the Quality and Safety function.

In addition, HCI developed a set of processes that are reflective of WCA’s Quality and Safety Function. The processes will aid in embedding a quality and safety culture within the organisation and will provide a framework for corporate governance. HCI also developed KPI’s which will be used to ensure that WCA are achieving their Quality and Safety objectives and providing the best support to its service users.

Benefits

Opportunity to review the governance structures currently in place and consider how they should be structured.
Comprehensive and independent review of QSMS, carried out by regulatory, quality and safety experts.
Report gave WCA a set of clear recommendations, acting as a roadmap for improvement.
Expert follow up support in development of the recommended Governance structures and Quality and Safety Strategy.
The Staff Survey on the Culture of Service User Safety highlighted the areas of good practice and areas for review in relation the culture of safety within the organisation.
Improvement in the quality and safety of the service and care delivered to service users, building on Western Care Association’s strong culture of person-centred care.