A “powerful” new research report has identified the ‘red flags’ that indicate harmful cultures in care.
The Care Quality Commission (CQC) commissioned the Patient Experience Library to analyse early warning signs and harmful patterns of behaviour from 10 years of avoidable harm inquiries in the health and social care sector.
The resulting report, Responding to challenge, uses real-life examples to demonstrate the ‘red flags’ that could indicate a poor culture within organisations and use these to:
- Recognise avoidable harm
- Break harmful patterns
- Understand what poor and harmful cultures look like
- Open up evidence-based conversations
- Support organisational learning and training
Identifying harmful cultures in care
The report, published early last month, found that problem cultures in care often involve multiple people who have failed to identify or deal with avoidable harm.
The report identifies 3 states in which problem cultures can result in failures. These are:
- Complacency
- Avoidance
- Denial
It also sets out 6 different organisational subcultures that can amount to an overall harmful culture within a care organisation where failures occur. These are:
- Reporting culture
- Compliance culture
- Caring culture
- Teamwork culture
- Accountability culture
- Learning culture
For example, in reporting cultures, complacency might look like inadequate routine reporting and record-keeping. This could result in failures such as care plans that are not personalised, lack detail and miss multiple entries. This, in turn, results in poor care.
In caring cultures, avoidance could look like a reluctance to involve patients or families in their care. This can result in a lack of effective communication and a failure to obtain relevant information, again leading to inadequate care.
Red Flag Tracker Tool to spot harmful cultures in care
This analysis led to the development of the free, open-access Red Flag Tracker tool to help people spot early warning signs of harmful cultures. The idea is that anyone who feels something is wrong within a service can use this online resource to check their concerns against the evidence.
The researchers hope the report will give people a better understanding of what culture means in healthcare and how it can go wrong.
In their report, they explain that patients need safeguarding but that we lack a common language to describe harmful cultures in healthcare. The report offers a “starting point” and an evidence-based approach for identifying “commonly understood red flags for poor professional and organisational behaviours.”
Put simply, the report’s authors explain: “To break the cycle of catastrophic failures, we need to see the pattern that underpins it.”
Chair of the CQC, Professor Sir Mike Richards, said the “powerful report” highlighted the importance of identifying any issues early in order to stop avoidable harm from occurring. He also said the report demonstrated how “complex organisations have multi-faceted cultures.”
He added:
“To understand how well-led an organisation is, there needs to be engagement with staff at all levels, particularly frontline staff, to work out whether the culture set by leadership is correct and is providing the right framework for improving services for people.”
Supporting positive cultures in care
First Response Training (FRT) is a leading, national training provider.
They deliver over 7,000 courses each year in the fields of health and safety, first aid, fire safety, food safety, mental health, health and social care and other special focus topics.
Their diverse portfolio includes training awards designed for health and social organisations, such as Person Centred Care and Support, Promoting Dignity in Care, Safeguarding Adults, Duty of Care, Equality, Diversity and Inclusion, Understanding Mental Health and many others.
A trainer from FRT explains:
“All care and support should be person-centred, dignified and compassionate, helping people to lead fulfilling, meaningful lives that promote independence and wellbeing. This starts at the top with leadership and a positive organisational culture.
“When failures in care happen, they can be catastrophic and have a severe negative impact on the lives of people receiving care, their families and carers. It is important that we have this common language to help us articulate when we feel something isn’t right, with an evidence base that validates those feelings and enables us to feel confident to speak out, tackling poor cultures and dealing with failures in care.
“All of our health and social care training courses are underpinned with the concepts of personalisation, dignity and compassion in care and promoting independence.”
For more information on the training that FRT can provide, please call them today on freephone 0800 310 2300 or send an e-mail to info@firstresponsetraining.com.