What Residents Have Taught Me About Quality

When people talk about care quality in social care, the conversation often turns to audits, governance frameworks, performance indicators and inspection ratings. But these are not how residents experience quality.

Residents have never told me that they are interested in governance structures. They don't ask about audit schedules or quality assurance processes. What they talk about is whether they feel listened to, whether staff know them, whether they have choices, and whether they feel at home. If we want to understand quality, we need to listen to the people experiencing it every day. Resident voice is one of the most important indicators we have.

Some of the most valuable quality improvements I've been involved in have come directly from residents.

I've seen residents help complete and review audits and tell us whether our findings reflected the reality of daily life. One gentleman who had worked in health and safety helped me complete an environment audit, his knowledge was far better than mine! His input was invaluable.

I've seen residents shape menus, influence activities, contribute ideas about how communal spaces should look and feel, and challenge decisions that professionals assumed were the right ones.

Sometimes the most important feedback comes from the simplest question:

"How is it for you?"

The answer may not appear on a dashboard or in an audit report, but it can tell us a great deal about whether people feel listened to, respected and able to live the life they choose. This is where I find the true picture of quality.

Good governance should create the conditions for those conversations to happen. It should help organisations listen, respond and improve. The purpose of governance isn't to produce reports. It's to improve people's experiences and outcomes.

With the CQC continuing to place greater emphasis on people's experiences and ongoing feedback, organisations need to be able to demonstrate not only what systems they have in place, but how they use them to understand what matters to the people they support.

One question worth asking is:

If a resident walked through your quality processes with you, would they recognise their voice in the decisions being made? Would they see where their feedback had influenced change?

The place people live should never be shaped without them.

The most valuable quality assurance tool is simply asking, listening and acting on what people tell you.

Cultivating quality through collaboration: a reminder to listen, include, and act.