Views Voyage Care Voice – S2E6: High quality support in our brain injury rehabilitation services
After a successful pilot season of Voyage Care’s first ever podcast, we are excited share our second season with everyone! Relaunching as Voyage Care Voice, our podcast will be showcasing real people with real insights.
In today’s episode, we’re hearing from Kim Kauldhar, Operations Manager, Vicki Bennet, Operations Manager and Victoria Richardson, Business Development Manager. They’ll be discussing the importance of high-quality care and support in our brain injury rehabilitation specialist services.
Brain injury rehabilitation support
We provide specialist care and support to adults with brain injuries in our 19 rehabilitation services across the UK, as well as in transitional and step-down properties, out in the community and in people’s own homes. We work with you to create a holistic and individually tailored rehabilitation support pathway. To learn more about our brain injury rehabilitation support, visit our dedicated brain injury rehabilitation area on our website.
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Read the transcript of the podcast below.
Kim Kauldhar:
Hello and welcome to the Voyage Care podcast. What we’re talking about today is all about quality. I’m Kim Kauldhar and I’m an operation’s manager. I’m responsible for services in acquired brain injury services in Bristol, Gloucester, Tewkesbury, Nuneaton and Dudley. I’ll introduce you to my two colleagues, Vicky Bennett and Victoria Richardson. So, over to you, Vicky, do you want to tell everybody a bit about you?
Vicki Bennett:
Hi, I’m Vicky Bennett. I’m the operation’s manager for brain injury services in the north and ISS services.
Vicky Richardson:
I’m Vicky Richardson and my job title is business development manager, but I work as part of the adult placements team. So, my role is to go out and complete assessments on potential new people to support within our brain injury services. And part of my role is to look at what therapies they may need and commission that service in for those people into those services.
Kim Kauldhar:
So, Vicky Bennett, quality is kind of a big broad subject, but what does quality mean to you in terms of our ABI provision?
Vicki Bennett:
I’m going to be quite cliche and say delivering good quality care, which is obviously our valued purpose. However, for me, it means a lot that the people we support are happy. They’re happy living there. They’re getting great quality carers and the best that they can have. And above that, I think the big thing for me around quality is I’ve got two regional quality checkers that work within my portfolio, but they’re also residents in my services and to get their reports back is I’d say we can have CQC come in. We can have our own internal audits come in. I can go on audit service, the manager can.
Vicki Bennett:
But to get that feedback from an expert by experience is the best feedback we can get really. For them to say I’d be happy to live here, I’d be happy to do the activities that they do, I’d be happy to eat the food that they eat. Not necessarily all around the paperwork. I’d be happy to travel to see my mum in that vehicle. How can I put it? I’d be happy that I’m getting my little cruise around town to go the cinema. And I feel them start to get a little bit forgotten about.
Kim Kauldhar:
Yeah, that’s kind of gold dust, isn’t it? That is so important to really get that real understanding from people who are actually experiencing it is so important. Isn’t it? The kind of the formal stuff that we have to do around quality. So I think from Voyage Care’s perspective from me working in other businesses, what I find is really interesting, there’s a very clear approach to quality in terms of our internal process, your quality checkers and people who we support, who are providing the support. But then we’ve got Headway who come in and look at the quality of service. We’ve got CQC from a perspective and then our own internal processes haven’t we, so it’s quite robust. Don’t you think so Vicky Richardson?
Vicky Richardson:
It is. And I think from my perspective in the role that I play within the team, I meet commissioners. I meet people within the brain injury sector and the fact that we have Headway has quite a prestigious name within the sector. So obviously we’ve got all our internal quality assurance procedures and the sort of inform more informal things that we do on a day to day basis, internal reporting. But actually, from outside provision, having Headway as a name on our services, gives them a type of prestige that our competitors don’t have. And also, the people from Headway know our services very well. So, when people ring them for recommendations, they’re able to talk in depth about the types of services we provide, which obviously they can’t with some of our competitors.
Kim Kauldhar:
So, it kind of gives us a quite a clear edge, doesn’t it? In terms of acquired brain injury services, it really does.
Vicky Richardson:
It definitely does. And I think attending recent sort of conferences and events, I did find that was mentioned quite often by people from commissioning and CC. Oh, you’re Headway accredited. So, I think that’s something that’s quite important to them.
Kim Kauldhar:
Yeah, absolutely. I was thinking about, CQC, Vicky Bennett. We have CQC and it comes in from a different perspective, don’t you think? So we’ve got our own internal process. Headway looking specifically at ABI, but CQC are coming in from a different perspective altogether. So, how do you think that fits with the rest of our processes? Do you think it works?
Vicki Bennett:
Definitely, I’d say especially with the new way of working with CQC and the focus on more feedback than actual evidence of things, it’s like a jigsaw, the way all of our auditing comes together. You’ve got our internal that look of the paperwork, make sure we have them the most up to date, make sure protocols are robust, you’ve got CQC that are now looking at it from a family perspective, a personal support perspective, a staffing perspective. Then you’ve got Headway that are looking solely at the brain injury. It’s kind of like a jigsaw that brings it all together. You’ve got us when we’re auditing, we’re going off the back of our internal quality, but from an operational point of view.
Kim Kauldhar:
Absolutely.
Vicki Bennett:
CQC, definitely. We’re all thriving to be outstanding services. I know. And I’m sure I’ve probably done everybody’s head in with the fact that I’m always saying we need to go back a bit further, we need to get them at least to be outstanding to get it overall. But CQC is just the benchmark for the outstanding. It is going that bit of above and beyond, which is what Voyage is all about around the quality.
Kim Kauldhar:
So tell us Vicky, because I know you’ve got a service that’s outstanding. So what do you think makes the difference in terms of outstanding and make good to outstanding? What are we all looking to aspire to?
Vicki Bennett:
I’ve got two services that are outstanding Kim.
Kim Kauldhar:
Sorry, sorry, sorry sorry, sorry.
Vicki Bennett:
Basically reading the report around paperwork and staff morale and people looking after it, it’s been pretty consistent between the two reports, but for example, one of the elements that got us outstanding within the Woodland service was there was a gentleman who struggled to sleep of a night. And he would be trying to leave the service and go to the pub because he was a total nocturnal, his day was his night. And I saw a thing on Facebook about in larger homes where staff were wearing pyjamas on a night with patients with dementia. To kind of remind them that it’s night time. So we introduced that at the service and it worked and there was evidence of over four months how we’d managed to try and get a more of as we would call it normal sleeping pattern. And you can see the improvement in his quality of life. He was making his medical appointments. He was able to get up to just go out and have some daylight and fresh air. It’s the little things that you don’t necessarily get out with a book about standards.
Kim Kauldhar:
Yeah, It’s really interesting. Isn’t it, Vicky Richardson? Because I was thinking just from what Vicky said there, that there’s kind of a couple of aspects to quality if you like. One is the systems and processes and the other is the kind of behaviours, relationships, that kind of thing. And quality is quite a complex thing. Do you see that in terms of when you are visiting services or working with managers that there needs to be that combination?
Vicky Richardson:
What’s been demonstrated through the pandemic is how we have to be innovative and think outside of the box. And I think in terms of being outstanding, these difficult times have given managers lots of opportunities to come up with things that would be working in very different ways. For example, we’re very used to having our therapists come into services on a day to day basis to provide support. So, initially during the early part of the pandemic, it was quite difficult to be able to provide that. And then obviously that was re looked at and therapists began to come in as part of essential care and support.
Vicky Richardson:
But initially, how do we provide that? How do we still give people that behavioural support? How do we help people meet that need? How do we help people overcome what is already tough time for these people? Part of the rehab journey and the pandemic on top of that, inhibiting them from accessing all the things that we’ve identified that they need. So I think for managers, it’s about having the ability to be able to think about things in a very different way and perform your tasks in an innovative and different way to what we’ve been used to doing.
Kim Kauldhar:
If we’ve got all these structures in place, we’ve got our own quality checkers, we’ve got our own internal quality. We do our quality visits, we’ve got CQC, we’ve got Headway. I just wonder, why do you think things still go wrong?
Vicky Richardson:
I’d like to answer that because I think services like ours are provided by human beings. And inevitably, human beings will from time to time get things not quite right. And I think we are providing a people’s service and I think for me, it’s about that experience and what you learn from it. So yes, it’s about looking when things have gone wrong and working out how we can get it more right next time. Because I think hindsight’s a marvellous thing and I suppose we have the benefit of being able to use and debrief and work with staff and talk about things and how things can be improved and accepting that we want to make improvements and things be better next time. So, I think inevitably where humans are working with other humans, things will happen. And we are working with a complex group of people who have complex behaviours and we’re doing it in uncertain times and times that we never anticipated working in, in our professional lives. So, I think lots of good things are learned from things going wrong.
Kim Kauldhar:
I totally agree. What do you think Vicky Bennett? What do you think about that kind of concept that if those quality checks did their job, we’d be 100 percent compliant? What do you think?
Vicki Bennett:
We could put in as many systems and processes as we’d like to but to second what Vicky said, we’re human, we’re going to get human error, mistakes are going to happen. And it’s more how you learn from them and make sure that they never repeat again. And what you take from that and what your teams take from that. It’d be silly to say that we’re perfect and we’re never going to make a mistake.
Kim Kauldhar:
I think you’re absolutely right. From my perspective, I believe that leadership is key in the way in which services are delivered and the way in which a leader is somebody who walks the talk, who shows people the way, knows their vision, knows their purpose, knows where they’re going and they can easily share that with their team. And they’re great at empathy and have a passion to work with their team, to get the best out of people. And I think that alongside all those great systems and processes. I’ve got that kind of belief like you guys really, that it’s that that makes the difference. Do you know what I mean? And that’s the glue really, that brings it all together. And I think actually Vicky Bennett, that actually is an example, it kind of highlights your example of when you’ve got a service that’s outstanding because I think it’s part of leadership that’s got you there. Do you know what I mean? And it’s that part of quality that gets you there, that leadership aspect.
Vicki Bennett:
Yeah. And I’d say obviously from the other service that got outstanding as well, it’s kind of the same. So yes. Paperwork and everything was correct. Everything was up to date. Part plans were robust, but there is a paragraph in there. And what had happened is the ladies who live in that service are a little bit older and they don’t have many funds because unfortunately they’ve been looked after in a care facility for a long time so they haven’t really got much money. And you have weekly or monthly meetings with everyone and ask them what they’d like to do, what activities would they like to see. And all the ladies said, all they want to do is go and get the hair done every day. And they haven’t got the money to go to the salon every day. I mean, I don’t think anybody could afford a salon every day.
Vicki Bennett:
So, what they did is, the staff team got together and thought, how can we do this? So, they had a spare room, a small spare room at the service, and we’ve turned it into a salon. So, after personal care, every day, now the ladies go down to our salon and have the hair blow dried and curled and straightened. So, they’ve got that salon feeling. Everything was robust and everything was in. And the quality was really good, but for the outstanding was going above that quality benchmark and we listened to people, we knew we couldn’t facilitate what they wanted with going to a salon every day, so how could we make that happen?
Kim Kauldhar:
And the manager had to say yes to that, didn’t they? They had to have that foresight to think, this is something that we can make happen. And they allowed the staff to get on and do it. And that’s the amazing thing, I think, don’t you?
Vicki Bennett:
Definitely. And definitely with my portfolio and my managers and team, although no has to be said occasionally, we always look for a solution to it. And that’s what it was. No, we can’t take it the salon every day. So we’re going to bring the salon to you every day instead. And this is what we’ll do. It’s got a nail bar in there. It’s got two stations. Those salons are very helpful was and gave us like the hairdressing stations, things like that. It’s amazing.
Kim Kauldhar:
That’s fantastic. So guys, I just wondering about new starters. How do they understand why quality’s so important in their role?
Vicki Bennett:
I think the main key as part of their induction is ensuring they understand our ethos and that they’re working for us to empower people and live the life they want to live.
Kim Kauldhar:
Yeah, absolutely. And that leads into the ethos of the organization, doesn’t it?
Vicki Bennett:
Definitely.
Kim Kauldhar:
And what I was just wondering, kind of thinking, what does great quality care look like? I can think of a couple of examples. I was just wondering Vicky Richardson do you have any examples you can pull on that when you’ve actually seen great quality care?
Vicky Richardson:
I think I see great quality care, every time I visit services, because I think the services are very homely. People have had their own input into those environments. Every service is very individual to the people that live there. They’ve created their own comforts, but I think sort of taking a step on from that, I think great quality care is obviously about where that person wants to be. So it’s about supporting that person to be where they want to be and get them where they need to go and doing that in a way that that person feels empowered. And that person feels in control of that journey. And I think that’s something that our BIR services are particularly good at because we spend time listening to people. I mean, I attend MDT meetings where we talk about that person where they’re going, and what their end outcome looks like.
Vicky Richardson:
And if that person’s able to, they’re part of that meeting and that structure and that discussion about where they’re going next and what life looks like for them. I mean, we take people into our service on the proviso that we don’t want to keep you for very long, thank you very much in the nicest possible way, we want you to be where you want to be. Seeing examples of how good quality impacts people’s lives. Every day, when we’re supporting people on from our services, we see the difference that those services have made to those people in terms of them not requiring high levels of care and support for the rest of their lives.
Kim Kauldhar:
Yeah, absolutely. I’m actually at a service today and some of the questions on the audit, carrying out an audit, living and breathing what we’re talking about. And there’s a number of questions to ask the people we support about how do they feel? Do they feel respected? Do they feel engaged? Do they feel safe? And so, I sat with a couple of people downstairs, but I was actually watching a lady and she’s in a wheelchair and has very limited mobility. She likes digestives, but she doesn’t like them with chocolate, the milk chocolate on, she likes white chocolate. And I don’t think they can find it. So, I went into the kitchen and there is somebody supporting her to melt the white chocolate and create white chocolate digestives and then she asked for an afternoon tea. So, they’re now currently kind of getting themselves some sandwiches on doilies and sitting around and having a lovely afternoon. And, and I watched the staff and you know, they’re amazing, really amazing. I’m getting emotional. Anyway.
Vicki Bennett:
That’s the sort of store. It doesn’t get audited. It’s not written in policy, it’s not written in anything else, but its quality care we deliver.
Kim Kauldhar:
It’s why after 20 years I came back.
Kim Kauldhar:
I just really enjoyed that chat. So, it’s really interesting hearing about quality from all the different perspectives that we’ve been able to look at. So, thanks both Vicky Bennett and Vicky Richardson for your time. It’s been great.
Vicki Bennett:
Thanks for having me on Kim.
Vicky Richardson:
Thank you, Kim, for having me on your podcast today, I really enjoyed it.
Kim Kauldhar:
Thanks for listening. To find out more about our focus on quality. Please visit our website www.voyagecare.com.
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