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When undergoing a CQC inspection – Good Governance can substantially improve the rating for Well-Led. Governance in a health care setting is often misunderstood, and everyone does something different, which is understandable given the diverse nature of health and social care.

Whether the organisation you are responsible for is a single small unit or a large corporate organisation, good governance is vital. The larger the organisation, the easier a governance system can become, usually because more resources are available. At Swift Management, we recognise how complex a complete governance system can be for the smaller provider.

Good governance concepts are the same, from large NHS trusts to small care homes! The information and outcomes should be the same. How this is achieved may be different.

The diagram above demonstrates the elements to consider when embedding a governance system. More frequently than before, when things go wrong, investigations look at what led up to the incident, what did people do, and most importantly, what did the policy say?

In any organisation, things can go wrong. But when something happens, how an organisation manages the response is all-important, were lessons learnt? Were the changes made to embed what was learnt to prevent the same thing from happening again?

For many smaller providers, it is difficult for the management team to invest sufficient time to ensure that all the elements of good governance are implemented and kept under review. When something goes wrong, it is hard to step back and look at the issue objectively, looking at why the issue occurred and reviewing processes to ensure learning from the problem. On many occasions, when things go wrong, the people involved want to know that an organisation understands what happened and they have taken action to stop it from happening again. Looking at an issue using Root Cause Analysis can help identify the issues objectively and help organise an action plan to put things right for the future.

When things go wrong, some managers want to apportion blame. However, usually, there is more to an incident than simply one person; it can be a whole host of things. By conducting a root cause analysis objectively, this can become quickly apparent.

The Swift Management Team can offer reviews of governance structures and make recommendations to ensure that a company has the processes in place and is working effectively.

To enhance the review process, we can offer training and support to:

• Set up Good Governance processes
• Train staff in governance processes
• Train managers to undertake Root Cause Analysis
• Work with boards to establish a good governance framework
• Review Policies and Procedures
• Undertake investigations on a providers behalf
• Work with management to resolve complex and challenging complaint situations