Governance and Quality.

Governance is a framework, which includes systems and processes to ensure that the care and support delivered by your service meets current legislation, is ethical and includes a process to facilitate continuous improvement. Governance also examines the culture within the organisation which is demonstrated through the values and behaviours exhibited by staff, and decisions that are made within the service. Good governance will improve practice if: 

■ a culture of openness and transparency is championed by the nominated individual 

■ all staff feel accountable for what they do and say 

■ the organisation has a strong “no blame” culture so it is safe to speak out when mistakes are made 

■ lessons learned are acted upon to improve outcomes for individuals. 

Triangulated approach

Stage 1 Robust policies and procedures in place as a roadmap to quality 

Stage 2 Openness and transparency is championed 

Stage 3 The organisation has a strong “no blame” culture 

Stage 4 Lessons learned are acted upon to improve outcomes 

Stage 5 Governance 

Registered Managers and the Nominated Individual must ensure that effective governance is carried out, including the use of audits, observations, feedback, etc., to monitor and drive continuous improvement within the service. The governance system must include scrutiny by the board, or equivalent level of seniority. If poor practice or abuse is exposed, appropriate action must be taken to ensure that the failings are addressed immediately. It is important to explore how the failing occurred and lessons learned to ensure that it cannot happen again. If the nominated individual has concerns about the service that breach regulations or fundamental standards, which are not being addressed, they have a duty of care to report this to CQC. 

Governance can be broken down into five stages, which are shown in the diagram above, and described in more detail below. 

Stage 1 – Establish systems and processes 

Stage 2 – Openness and transparency – Duty of candour 

Stage 3 – No blame culture 

Stage 4 – Acting upon lessons learned 

Stage 5 – Governance