Over half of the Care Quality Commission’s (CQC) ‘Outstanding’ ratings require ‘evidence’ of creativity and/or innovation and, despite their elusiveness, it is these two words that are at the heart of what it takes to be, and remain, ‘Outstanding’.
As Christine Asbury, WCS Care’s Chief Executive and a founding member of the Centre for Creativity and Innovation in Care states, ‘Creativity and innovation is central to delivering WCS Care’s values, and we do this by giving our staff the freedom and confidence to try new things to ensure every day is well lived for residents.’
It’s an approach that works for WCS Care – around 40% of their care homes are recognised as ‘Outstanding’.
We all know that there can be inconsistencies in inspection, but some of the most successful leaders in the sector agree that by focusing on a creative approach to care and support, free from fear of inspection, the best results are likely to come.
Creativity in social care
The word ‘creativity’ is itself a barrier to ‘Outstanding’ care, for almost everyone has a different perception of what it means to be creative. It’s ‘thinking outside the box’, it’s making things (a cake, a painting), it’s being expressive (singing, dancing, writing), it’s problem-solving, and, too often, it is ‘not me’. With so many different opinions on what is ‘creative’ and not enough confidence, no wonder people don’t know where to start.
That is why I believe it is incredibly important for the sector to agree its meaning, and the definition we use at the Centre for Creativity and Innovation in Care (CC&IC) is ‘bringing something new and of value to life’.
There are plenty of definitions, but almost all have these two components – newness and value. If something is new but doesn’t have value, then it is a novelty, frippery or timewasting and so the other element of value must be absolutely grounded in real outcomes for the people that use your services. Equally, to make something of value (care planning, an event, a team meeting) creative, you need to add an element of surprise or delight – the ‘ooh, ahh, wow factor’.
However, here’s the extra challenge; care homes need to innovate continuously in order to keep surprising and delighting clients and regulators. The first time around, you may wow your inspector with one or two unusual approaches, but the bar is going to be raised in the intervening period, and next time you are going to need almost every member of staff and resident mentioning new things that have happened that have delivered valuable outcomes. For that to happen you need a culture of innovation in care.
Innovation is essentially the process of making creativity consistent, but it is too often seen as the domain of the technology companies. However, according to PWC, by 2018 innovation spending in healthcare will outstrip the technology sector. There is every reason to innovate in social care, what is required is the leadership to implement and support it.
Paul Musgrave, Chief Executive of Forest Healthcare and founding member of CC&IC added, ‘We want creativity to be routine. We want it to be so business as usual that we don’t even have to think about it, although, of course, that doesn’t mean we won’t have a lot of fun along the way bringing life and vibrancy to how we care.’
A creative social care culture
If you want to be continually creative over time, you need a culture of creativity and innovation. If you want ongoing originality, that is also demonstrably valuable, it can’t just be about implementing the latest thing, you need to have continual innovation within your organisation.
To achieve this, you need:
- Creative leadership. According to Collective Genius: The Art and Practice of Leading Innovation, being a leader is about ‘setting the stage’ for others to perform on, not ‘acting on it’.
- A creative climate. Nurturing behaviours around trust, debate, playfulness and freedom that are easily observable and can be learned.
- Creative business processes. Specific internal structures and systems that encourage, support, facilitate and permit newness.
These factors significantly impact a care company’s ability to keep innovating and they correlate to financial performance, through staff engagement, occupancy, fees and valuation. They are interlinked and interdependent, they reveal the values and heart of an organisation, by shining a light on what the organisation prioritises. A leader sets the climate through business processes. If any of these elements are out of kilter, a less than positive cycle prevails.
I often see leaders whose priorities aren’t aligned with their actual day-to-day behaviours. They want creativity and innovation, but spend their time on counter-productive (from an innovation standpoint) management processes. Instead of recognising people who try something new (regardless of whether or not it works), they prioritise the processes that disempower the individual, reducing their freedom to be creative, without realising the impact of that decision. An overreliance on audits, compliance monitoring, rigid agendas, task lists, timetables etc can show a lack of creative leadership. Of course, we need these things to run safe and effective services, but too much control and not enough trust will certainly get in the way of new innovative ideas and an innovative culture.
Paul Musgrave, Chief Executive at Forest Healthcare has recognised that creativity isn’t a component of a process within a process. He believes that to make progress, you have to invest in the leadership, the climate and the supporting processes that make these things flourish.
He explained, ‘We have to embrace the opportunity to turn the way we operate on its head; creative care can’t be something that we do when everything else is done, because that day will never come. It is the thing we should focus on first and then everything else will get easier, this is why we have joined CC&IC to consolidate and develop this approach. 20 years of business research tells us that this kind of forward-thinking investment in developing and supporting a consistent, creative culture will lead to increased innovation potential and improved business results, and we have seen the results in all of our homes, including our three “Outstanding” ones.’
Embedding creativity and innovation in social care
Organisational creativity needs to be thought about at all levels – the level of the individual staff member, the team and the whole organisation – in order to achieve innovation as business as usual.
At individual level, it is about building creative confidence and skills in staff. It’s certainly not money or accreditation that help achieve this. It is intrinsic motivation that forms part of the magic formula. People doing new and useful things for their own sake, for the personal reward of a job well done, or a great outcome. Attracting staff who want to innovate and who come with passion and an open mind, free from the constraints of ‘that is how we’ve always done it’.
Everyone is creative, we all do things that are new and valuable every day, in the conversations we have, in the problems we solve. In part, it is about developing creative confidence in every team member, whatever their role in the organisation. There is plenty of research that the more creative we believe ourselves to be, the more creative we are.
The conditions that we operate in day-to-day have a significant impact on how much our creativity will or won’t show up at work. How teams are led and operate have an impact on the behaviours you see from staff and the overall customer experience. How safe we feel as individuals has an impact on how willing we are to suggest and try out new things – if staff have more control and freedom to innovate and be creative, they will. Simple.
At the organisational level, it’s important to ask yourself, is there a strategic investment in creativity and innovation? Do you have a strategy for creativity? Is it embedded in your practices and processes? Is the way you manage risk getting in the way? Does the hierarchy help or hinder what you want to achieve on the frontline? Are you rewarding your regional and service managers in the right way? Do people have the freedom to act on their intrinsic motivation?
Be creative first, the rest will follow
We work with chief executives who are passionate about embedding creativity at the heart of their care organisations and the wider social care sector. They recognise that creativity can’t wait for all the process and boring work to be done, they have flipped their thinking – creativity comes first and it enables the rest to follow with more ease.
This makes organisations more attractive to stakeholders, more appealing to customers and employees and, as a by-product, to the Care Quality Commission.
However, it doesn’t stop there. Committing to creativity and innovation to deliver better care is great, but it needs to be evidenced. It’s important to measure and benchmark the observable behaviours that deliver a culture of creativity and innovation, support people to shift their behaviours and work collaboratively with other senior leaders to develop new practices and approaches for the sector.
The sector shouldn’t be complacent. ‘Good’ and ‘Outstanding’ care is fantastic, but it can’t stop there. There is value in continuous creativity and innovation and making these aspects of social care ‘business as usual’.
The final word goes to Christine Asbury, who says, ‘Don’t be afraid to try new things and don’t be put off if things don’t work first time, every time – you’re only human, you just have to keep trying until it works well for you and, most importantly, the people you care for.
‘Once you’ve got your approach to high quality care right and it has clear benefits for residents, the rest will fall into place – but you can’t rest on your laurels; it’s vital to keep finding new ways to adapt and move forward, regardless of your home’s rating.
‘We’re keen to join with other innovative organisations to share approaches and push for a transformation of care together – being part of the Centre for Creativity and Innovation in Care will help achieve that.’ CMM
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