1. Better Leadership, Better Care: Strengthening leadership and driving up quality in organisations
Integrated Care Council Conference
Maureen Hinds
Head of Programmes - National Skills Academy for Social Care
Thanks for inviting me to speak here today.... Let me start with a quote from John Buchan
John Buchan (1875 – 1940) - was a Scottish novelist, (he wrote the 39 steps), he was a historian and politician who served as the 15th Governor General of Canada from 1935 – 1940, when he died in office. Prior to this he had been an MP in Britain from
This is what he had to say

2. for the greatness is already there....
Leadership
The task of Leadership is not to put greatness into humanity, but to elicit it,
for the greatness is already there....
(John Buchan 1875 – 1940)
The task of Leadership is not to put greatness into humanity, but to elicit it, for the greatness is already there...

3. The role of leadership in social care
Introduction: the role of the Skills Academy in social care leadership
What leadership means in social care: why it matters, how it helps
How you can strengthen leadership and drive quality: practical (and non-costly)
things you can do:
Use The Leadership Qualities Framework
Recruit and select for social care values
See leadership for everyone
Use coaching and reflective approaches
Use the national Registered Managers’ Programme
Measure something
Collaborate, celebrate and influence: stand up for social care
Everyone has a part to play: leadership starts with all of us
In this session I hope to show how leadership can help you drive up quality whilst at the same time start to address workforce issues.
We’ll start with a bit of background about the Skills Academy and why we’re interested in leadership, but most of this session will be about what leadership is, what it is not, and about practical, and low/nil cost ways in which you can strengthen leadership in your organisations.
We need good leadership in the system.

4. Introduction: the role of the Skills Academy around leadership
“The sector needs high-quality leadership at all levels... [it] is essential to the delivery of all the proposals in this White Paper.”
Caring for our future: reforming care and support, July 2012
“[Social Care] lacks confidence. As a result it is timid in its vision and ambition for how adult social care services can be delivered.”
Social Care: A Review. Dame Denise Platt, 2007
“There is a unique culture within social care....Social care is often positioned ‘in the shadows’. This is disempowering [and] has the effect of reducing confidence and stifling innovation.”
Feedback from Skills Academy consultation on Leadership Strategy for Adult Social Care, 2012
To start with, a bit of background about the Academy and why we’re interested in leadership.
The origins of the Academy go back to 2007, when Dame Denise Platt, who used to head the forerunner of CQC, wrote a report for Ivan Lewis, then the Care Minister. Her starting point was a very important one.
Social Care, she said, when done well, has the power to transform people’s lives – and that should always be where we start from. But at the same time, there was a real inequality in relation to health, housing, welfare – pretty much any sector you care to name.
Fundamentally, the sector lacked confidence, especially leadership confidence.

5. The role of the Skills Academy: Leading on leadership in social care
Specific remit to improve leadership and
commissioning, and to support Registered Managers
Employer-led: but as well as employers we also reach training providers, local authorities and other commissioners, alongside individuals
Covering adult social care but also working with
health and children’s services
Membership body for individuals and organisations
More members than most, including SCA
Leadership guidance/programmes for all levels Endorsement for high quality trainers
Backed by Department of Health
Working with CQC on what ‘well-led’ will mean
The role of the Skills Academy is to lead on leadership. We’re a national body and a charity, backed by the Department of Health, our main funders. On 10 June 2014, the National Skills Academy for Social Care merged with Skills for Care, to maximise the impact of our combined knowledge and expertise. Our strap line going forward will be Leadership, Learning and Development.
We cover adult social care but also increasingly work with health, housing, community safety, environmental services and others as well as children’s services, in settings that are integrated.
We’re employer-led – 70% of our members are employers – but we also cover local authorities, training providers, national charities and individuals – our members can include anyone connected to social care.
We run a range of leadership programmes; we have an Endorsement Framework for recognising and badging high quality adult social care training providers; and we work at national policy level, with The Leadership Qualities Framework , our guide to good leadership in social care; we developed a national leadership strategy, for Adult Social Care called ...‘Leadership Starts with Me.

6. Examples of Skills Academy Members All regions, all client groups, all sectors
Cheshire Homecare Services Ltd
As I said , we were a Membership body – and here are some of our Members. We have almost 3000 members now, making us one of the largest Membership organisations in the sector. We have employers of all sizes, covering a wide range of settings and client groups; in all areas of the country. We cover the private, not-for-profit and public sectors. And we have commissioners, training providers and other organisations alongside over 1200 individual Registered Managers. So if you want to be connected to someone in social care, get in touch with us – if we don’t know them we probably know someone who will.

7. Stronger together.....
One stop shop for 17,000 Adult Social Care employers
Cover induction right through to Senior management roles
One strategically focused organisation to support million strong workforce
As i mentioned, one of the things that happened back in June this year was the long awaited merger between the National Skills Academy for Social Care and Skills for Care.

8. Leadership: What does it mean in social care?
Think of a good leader that you know.
Then think of one word that would
describe them.
Let’s try this exercise – think of a leader that you know, and then think of just one word to describe them...
Does anyone wish to share? Tell us who they are and what is the word that you would use to describe that person

9. So it’s about behaviours, and taking responsibility for them
Leadership: What we think it means in social care (i): based on behaviours
Not just about authority at the top of organisations
It’s a practical understanding – and awareness – about how you do what you do, and the impact on others
So it’s about behaviours, and taking responsibility for them
And it’s everyone’s business – people working at all levels in social care
“People do not experience our values, they experience our behaviours.”
Bill Mumford, CEO, MacIntyre
Audience feedback That’s all very helpful, and shows that leadership means many different things to different people.
So what do we mean when we talk about leadership?
Here is what WE think leadership means in social care – it really is all about behaviours - and it’s not a traditional view.
We don’t see leadership as residing exclusively with the Chief Executive or with a Director, or with a senior management team.
Leadership isn’t just about strategy. It’s about behaviours – how we each behave, every day. We can talk about our values, but the way these values get demonstrated is through our behaviours – as Bill Mumford, CE of one of our Founder Members, MacIntyre, said ‘People do not experience our values, they experience our behaviours.’
And it follows that if leadership is about behaviours, it’s everybody’s business, wherever they sit in social care. You can take responsibility for your own practice and address poor practice if you see it happening.

10. Leadership: What we think it means – Systems Leadership
About leading: when you’re not in charge when you need to ask when you have no money Systemic – i.e. not piecemeal or divided into silos - and based on shared ambition Participative – i.e. involving many people’s energies, ideas, talent and expertise Emergent – i.e. allows for partial/clumsy solutions , able to work with uncertainty ...and based on trust/relationships – so back to behaviours 8 prototypes, 25 current programmes around the country
We also see leadership as being about what people do when the situation is not typical, for example when you are not actually in charge, or have to ask questions, or when you are not controlling the budget – or there is no budget!
Leadership is not silo based – it has to be grounded in a shared ambition that everyone in the organisation is bought into.
We have to take on and use people’s individual gifts, and skills, these may not always be apparent – be prepared to analyse the different leadership styles of the people that you work with – the loudest and most push are not necessarily the best leaders
Being able to work with uncertainty is a real skill that not everyone has
But it is key that there is mutual trust – which goes back to behaviours again

11. Need to do more – and more complex - with less
Leadership: why it matters, especially now : (i) In times of change/difficulty, good leadership is a lifeline
Unprecedented mix of circumstances: demand, supply, structural change, cultural
stasis – leading to:
Funding pressures for employers and managers – at just the time demand is growing: both private and public sector issue
Need to do more – and more complex - with less
Working with wider group of stakeholders – CCGs, public health, personal budget holders, housing, planning
Need for adaptability/innovation - reconfiguring services, working with new client groups, providing flexible care models
Need to re-inculcate the old virtues and values – dignity, compassion – emphasised especially post-Winterbourne, Mid-Staffs: see Cavendish Review, Driving Up Quality Code, Social Care Commitment
And leadership matters, especially now. On the one hand, demand is rising and getting steadily more complex.
And at the same time, resources – both public and private – are shrinking. Local authority provision has already been cut back significantly. It’s hard for providers to keep up with the degree and rapidity of structural change going on in healthcare, and to know what all the various new bodies do. And we are having to face all this change against a background discourse, at least in the national media, that is often negative about social care.
We have a whole new set of circumstances, that are ever changing, to deal with. And these lead us to these issues:
Funding – cutbacks, having to do more and more with less and less
More stakeholders that must be involved – with the new NHS model, and community services such as housing, leisure, transport
We cannot afford to be inflexible – it is very much a case of move with the times, or risk dying...
And we have to get back to the virtues and values that brought most of us into social care in the first place – and what enraged so many of us with we saw what happened at Winterbourne, and Mid Staffs. We need to work with the initiatives that have been put in place to address poor practice.

12. Leadership: why it matters, especially now : (i) Good leadership is the basis for delivering excellent care
Research base: “Who Cares?” NSA research survey:
94% of respondents linked quality of leadership with quality of service
93% wanted more investment in leadership development
Policy context: “Delivering the vision demands a capable and well- trained workforce...[and increased] leadership capacity in order to deliver...” A Vision for Adult Social Care, November 2010
Anecdotal evidence: The biggest variable in staff feeling empowered and engaged is the quality of management and leadership

13. How you can strengthen leadership in your service: Use The Leadership Qualities Framework
Guide to what good leadership looks like
Describes what good leadership looks like
in different settings and situations
Defines good leadership for people at
different levels:
Front-line Staff
Front-line Leaders
Operational Leaders
Strategic Leaders
Basis in values and behaviours that follow on from them
Grounded in everyday practice and written in plain English, so accessible to everyone
Applicable in integrated services
And there are lots of things you can do to strengthen leadership for the benefit of the workforce and the organisation as a whole. Firstly, please do use the Leadership Qualities Framework. It’s your plain English guide to what good leadership looks like in adult social care.
It sets this out for people at different levels – Care Assistants, First-time Managers, Operational Leaders such as Registered Managers and people working at more senior level – so you can inculcate a leadership culture throughout an organisation. And it mirrors similar frameworks in health, so you can use it in integrated services.

14. The Leadership Qualities Framework: How it works
Based on structure of NHS Leadership Framework
Groups behaviours into seven areas, called Dimensions
Five Dimensions relate to areas in which all social care professionals need to demonstrate leadership
Two apply specifically to senior staff
Each Dimension has four elements
The LQF takes each element and gives a short description of what quality leadership looks like at different levels
The way it works is very simple. It uses 7 areas, called Dimensions – things like Managing Services, Improving Services, Demonstrating Personal Qualities and Delivering a Strategy.
For each of these Dimensions, there are four elements. And the Framework sets out what good leadership looks like for each element, depending on what level you’re working at in social care.
So for example: in the ‘Managing Services’ Dimension, one of the four elements is about how to manage resources. The LQF sets out what Care Assistants, First-time Managers, Operational Leaders and Strategic Leaders each need to do in order to show that they’re doing this well.

15. The Leadership Qualities Framework: how it can help you in strengthening different aspects of your service
Use the descriptions that show what good leadership looks like at different levels of your organisation – e.g. for safeguarding or managing
Use these in recruitment, induction, supervision, performance management and appraisal
Use online self-assessments for benchmarking: 360° feedback tool: 1:1 organisational assessment – to measure, track and strengthen leadership capacity
The LQF is mapped to CQC Essential Standards and the Social Care Commitment: so use it as part of the inspection process
So, these are the ways in which you can use the LQF:
Use the descriptions to show what good leadership looks like
And you can use in a range of settings, induction, supervision, appraisal, support disciplinary processes
It works with 360 feedback tools and online self assessment
Helps support the inspection process by helping to define what “well led” looks like in a Social Care setting.

16. The Social Care Manager’s Handbook
Developed in consultation with sector
The ‘go-to’ guide for Registered Managers and others
Social care Values form foundation
11 Sections mapped across LQF, legislation, CQC Inspection Framework
Free to Registered Manager Members, or £35 to non-RM members
In hard copy and online
The new Social Care Manager’s Handbook gives you just about everything you need to know as a Registered Manager, and we developed it with the sector, so it is what they said they wanted.
We want this to be the ‘go to’ guide for social care leaders as well as Registered Managers
It is easy to use, with 11 sections that link back to the Leadership Qualities Framework, as well as the Care Act and Manager Induction Standards
As it is such an extensive guide, we are only able to offer it free if you are a Registered Manager member, so it is a key benefit of membership. For others it is £35, and it will be updated annually.

17. New initiative launched July 2013
How you can strengthen leadership in your service: Actively recruit and select for leadership behaviours and social care values: Use the VBRT
New initiative launched July 2013
Online toolkit for employers and managers
Aims to place values-based recruitment in everyone’s reach
ims to reduce isolation, better-equip
Explains the approach and what it means for social care
Examples of job ads
Examples of interview questions
Simple online personality profile tool being piloted by not-for-profit providers with candidates for front-line roles
Link to LQF and other information sources
100 organisations have signed up to be part of the pilot and over 6000 reports have been produced around the profiling tool.
Even if you don’t want to use the LQF, there are other things you can do. Firstly, you can build leadership in your workforce by consciously recruiting for social care values.
The Skills Academy has launched a free online toolkit for employers, including a personality profile, suggested interview questions and job ads – to help you do this.
Some employers are already adopting this approach. MacIntyre started out, for example, by asking their staff and service users ‘what makes a great care worker?’. Who were the really outstanding, consistent people. They took the results and built them, over time, into a personality profile that has changed their workforce and had a direct impact on service quality.
But you don’t have to do everything at once. Just have a look at the website and perhaps think about asking some values-based questions to your interviews, to start with, and take things from there.

18. Graduate Management Training Scheme..Purpose...
To providers the Executives of the future into Adult Social Care
The Scheme is intended to meet the needs of social care practically, stimulate new thinking in social care in support of realising personalisation, and help improve its perceived status. It provides a year of management and leadership experience for graduates in order to develop the management skills necessary to become a successful leader in the field.
Now working with our 5th cohort of trainees
Fully funded 12 month fast track management programme

19. Aspects of the Programme
Workplace-based learning within host organisation
Development days
ILM Management Qualification
Managing in Social Care Development Days
Action Learning Sets
A range of learning methods (including leadership centre, development days, distance learning and virtual classroom sessions, scheduled tutorials and action learning)
A series of assignments to complete
Peer coaches
Real-time project work
Real-time return on investment

20. Example: Front-Line Leaders Programme
How you can strengthen leadership in your service: Focus on behaviours and use coaching/reflective approaches
Example: Front-Line Leaders Programme
“I am now constantly assessing my own practice and have the means to better myself, which in turn creates a happier, smoother workplace, which most importantly improves the quality of service we offer.”
Leadership development for front-line or first-time leaders
Workplace-based: uses coaching and self reflection, building self-awareness around impact on others and using outcomes as basis for action
Thirdly, we’ve found that using coaching and reflective approaches is an effective way to instil leadership behaviours. The quote here is from a participant on one of our programmes, called ‘Front-Line Leaders’, which is based on these approaches.
The key thing is when the participant talks about constantly assessing their own practice – in other words, by adopting these approaches to learning and development, what you’re doing is building in continuous improvement.
So whoever your training provider is, ask them what they do around coaching and self-reflection.

21. How you can strengthen leadership in your service: Join the national Registered Managers’ Programme Results from Everyday Excellence
We have a specific remit in relation to Registered Managers. Back in 2012 we conducted a survey amongst Registered Managers and the resulting analysis was made into a brochure called Everyday Excellence. It reinforced what we already knew, that good quality care starts with good leadership. Registered managers have a vital role to play in driving up quality.

22. How you can strengthen leadership in your service: Get involved in the national Registered Managers’ Programme from the Skills Academy
New programme launched March 2013
Aims to reduce isolation, better-equip
Registered Managers for their role,
strengthen leadership confidence
Expert online and phone advice on HR, legal and professional issues
Online information/resources, + new Guide
Membership group/community of practice
within the Skills Academy
Funding for local networks, workshops and
action learning sets around the country
‘Bottom-up’ approach – working with local groups, employers and care associations
The Registered Managers programme has been a great success, with 1200 members, over 40 local networks.
The Care Minister Norman Lamb welcomed our 1000th member to Richmond House last year
And we are just in the planning stages of a celebration to mark the first year of the programme, we will keep you posted on that.

23. How you can strengthen leadership in your service: Come together in a new social care landscape
Practice leadership - networks and forums of support, e.g. for Registered Managers Collaborative leadership - links with commissioners – health, social care, individual Community leadership - links with and for community groups and micro-employers: focus on assets and social capital
This programme has been very successful, and we are recruiting for the next cohort. It’s a partnership between us and a range of organisations, including ADASS and Skills for Care.
It works because it is collaborative, working well with commissioners, individuals, as well as health and social care
And it develops leadership in the community, by and for social care leaders that also use services.

24. WorldSkills 2013 UK National Final Medal Winners, Caring Competition
How you can strengthen leadership in your service: Recognise, celebrate and influence: stand up for social care
And stand up for, and celebrate, social care. No need to hide, or to say ‘I just work in social care.’ We have a lot to be proud of in this sector... But unfortunately not much of it makes it onto Panorama or sells newspapers.
WorldSkills 2013 UK National Final
Medal Winners, Caring Competition

25. How you can strengthen leadership in your service: Celebrate and influence: stand up for social care
Social care as key driver of local economies Social care as growth sector Social care as local employer Social care as community hub/link Social care as source of innovation Social care as source of good news stories for local media/MPs/ CCGs Councils/Health and Wellbeing Boards Social care staff as people to be celebrated
Put staff in for regional and national awards, and vocational competitions like WorldSkills. Take the initiative in talking to local media, to your MPs and Councillors, to show them what excellent care you provide. Don’t forget, social care organisations are commonly great local employers and drivers of local economies. Social care is one of the fastest-growing sectors there is – it already holds over 1.7million jobs, and Skills for Care estimate that it will need a million more by So show your leadership by celebrating what we do and the way we transform people’s lives.
We were very proud to win the WorldSkills UK Partner of the Year award earlier in the year, real testament to the benefit of encouraging people to join and excel in the sector. I went along to the House of Commons to receive the award on behalf of the Academy, the judges, actresses employers, colleges and of course the participants..... that was a very proud moment.

26. Summary: Leadership is part of what you do every day
Leadership is about behaviours: taking responsibility for your own practice and addressing poor practice elsewhere. And it can be shared
It follows that leadership can support great service quality, embedding it as everyone’s business
You can use the Leadership Qualities Framework and Leadership Starts with Me to instil and embed leadership behaviours which actively promote quality
There are lots of other free online tools and techniques to help you
There is a national Registered Managers’ Network for you to join
You can embody what good leadership behaviours look like right here, right now
You can instil a high quality culture through celebrating great social care

27. Everyone has a part to play: Leadership starts with all of us.
Because everyone can do something about changing what they do and how they do it.
So everyone can be a leader to some degree.
Everyone can have a go, and everyone can make a difference.
And everyone can be a force for change and a force for good.
To summarise: strengthening leadership can really help you in improving and delivering quality.
Because leadership is about behaviours, everyone can do something about improving what they do and how they do it.
So everyone can be a leader; everyone can have a go and make a difference.
And everyone can be a force for change, every single person within the workforce has a role to play.
Thank you.

28. Adaptability & imagination Treating people with dignity and respect
Strengthening leadership in your organisation: select for leadership behaviours and social care values
Communication
Compassion
Adaptability & imagination
Treating people with dignity and respect
Empathy
Team working
Integrity
Self-awareness
Courage & responsibility
Ability to build relationships
We’re not stacking shelves in a supermarket.... We are in the business of human complexity.... The stuff that requires us to form relationships, communicate, deal with life and death situations including for some of us managing some pretty complex and distressing end of life care, .....this all requires special skills including having a quiet mind and an open heart.
New values-based toolkit being launched next week – Recruit for values , train for skills. Starting point: “what makes a great care worker?” Joint work between The Department of Health, Skills for Care, McIntyre and National Skills Academy for Social Care
This led to a personality profile for people who consistently deliver high quality, personalised care, and framework for recruitment and selection. It emphasises personal responsibility and accountability. Service users experience our values through our behaviours.
Funnily enough, I was speaking at a conference in the Midlands a few weeks ago and happened to hear Professor Martin Green the CEO of ECCA speaking . He mentioned that he had been out to dinner the week before with one of the senior Civil Servants from the Foreign & Common wealth Office who mentioned that the FCO were recruiting for Fast Track Graduate scheme for the Diplomatic service . The qualities that they were looking for were exactly the same ones that we were using to describe “what makes a good care worker.?” plus the ability to speak a modern European language. These fast track graduates join as trainees on £27k per year and get to see the World So I will just leave that one with you.....

29. We can all make that difference ...
As the recently departed Robin Williams said in the film Patch Adams
“Our job is improving the quality of life, not just delaying death”.
Thank you for your time.

30. The National Skills Academy for Social Care www. nsasocialcare. co
The National Skills Academy for Social Care