I hosted a webinar yesterday on what separates Outstanding learning disability providers from those rated Requires Improvement. We'd analysed 50 CQC reports to find the patterns (you can find the wider research here), but the real insights behind those patterns came from the two brilliant and experienced guests I had on stage: Emma Smith, Quality Assurance and Compliance Manager at Peak 15, and Louie Werth, founder of Care Research.
The pattern in our research was clear: outstanding providers don't have more data than everyone else, but they do act on what they already have. The way they act on it, more often than not, is by turning it into a story.
As Louie put it:
"CQC inspectors, for now, are not AI robots. They will actually process the stories a lot easier."
This ability to tell a story about how care is happening isn’t a soft skill and shouldn’t be treated that way. Narrative building is increasingly becoming a part of great evidencing – and it might just be one of the elements that moves you into Outstanding territory.
Emma's experience backs this up. Ask a staff team to fill in an audit form and you get compliance. Ask them to tell you about someone they support, and they’ll start to tell you a story.
"When I speak to staff teams and ask them to tell me about a person's journey, to tell me a story about them, they say, “okay”, because that's really straightforward. And they could talk about that person for hours because they know them so well. And that's when you're going to draw out the really outstanding things they're doing."
The knowledge is almost always there, and if you can build a culture where team members feel comfortable telling these stories – your evidencing quality is going to reach new heights.
"I think our staff teams don't record it because they're doing it. And they're more focused on doing it very well than recording it very well. And they just think, well, that's just us. That's just what we do. I didn't realise that that was outstanding."
If your best practice is invisible to the people delivering it because it’s second nature to them, it's going to be invisible to an inspector too.
We got a great question from the audience about how to evidence care for non-verbal service users. If someone can't tell an inspector their goal was met, how do you prove it happened?
Emma's answer was specific rather than theoretical. It's in the language staff use in care plans and notes, not just the fact that a plan exists:
"If you say over the last two years, this person has found a new hobby and that's because staff have offered them lots of different activities, that's going to show you that there's been some improvement, that there have been outcomes."
It doesn't need to be a big goal. Small, logged steps count:
"It could be something as simple as testing, can they hold their purse rather than staff holding it? And that could be a really simple goal, and you can have some evidence under that, like some pictures."
Photos, short videos, voice notes. Louie made the point that these aren't new skills for staff to learn. People already take photos and send voice notes on their own phones every day. The job is translating a habit people already have into evidence that's captured somewhere useful.
Capturing photos, videos and having voice to text functionality is something that we have designed into Log my Care – so that teams can capture these moments and stories within their existing workflows.
It would be easy to walk away from our research thinking the answer is a better audit or a stricter checklist. Emma's own experience says otherwise. Her team changed their audits from "is the risk assessment up to date, yes or no" to checking a handful in detail for quality. Two years later, when a second service dipped into requires improvement, her team had already flagged more gaps than the inspector did.
The audit process became much more honest about what it was actually looking for.
Louie's framing for what to look for is two words: improvement, change. Not "is everything as it should be", but "what's different now compared with before, and can someone tell me why."
If you're trying to move a service from Requires Improvement to Outstanding, the highest-impact thing you can do this month probably is to give your staff permission and language to tell you what they already know. Ask them to tell you a story about someone they support. See what comes out, and then work out how best to capture it. This process is as much a journey for the people in your team, as it is for the people you support.
Huge thanks to Emma Smith and Louie Werth for the insight, and for being generous enough to share their own services' mistakes as well as what's working. That honesty is rare and it's exactly what made this session useful.
If you'd like the full research report from our 50 CQC reports, you can download it here.
You can also book a demo with our digital care advisors, you can show you how Log my Care supports teams with this storytelling and evidencing process directly in the platform – so your team can capture moments as they go instead of relying on memory later.