GUEST COLUMN: Issac Theophilos offers recipe for outstanding care


Issac Theophilos, author of the best-seller, ‘How to get outstanding’, provides his recipe for outstanding care.

Achieving Outstanding is a mindset game! I would like to get some ‘famous’ myths out of your head before exploring the details on how to achieve an Outstanding rating.

Outstanding rating myth buster:

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Myth 1: Outstanding rating is based on the inspector

Inspectors would usually want to celebrate, appreciate and showcase your great work. Recommending an Outstanding rating is extra work for your inspector because they need to prove that your care home is already Good, and they also need to portray your outstanding stories to the CQC’s panels. You can make their life easy by giving them what they need. The chances are, no one is going to bother about your unique stories if you have not made an effort to shout about them.

“Ask, and it shall be given you; seek, and ye shall find; knock, and it shall be opened unto you.”

Myth 2: There is no financial incentive to have an Outstanding rating.

Utterly wrong. Market studies have found that Outstanding rated care homes charge £200 on average extra compared to the rest of the market. People want their relatives to go to the best care homes, and are prepared to pay for it. You will get these additional fees if you know how to portray your ‘value’ properly to your clients.

Myth 3: The manager will get poached if you have an Outstanding rating.

Regardless of your rating, the manager is likely to get poached anyway. The sector already has a shortage of good managers. Usually, great managers are the ones who want the excitement of trialling out new things. Enjoy them while they are with you. Identify their motivation and work along with them. Nothing in this world is guaranteed, so why do you expect a great manager to stay with you for their whole career?  The real question is: How robust is your succession planning?

Myth 4: Only luxurious care homes can achieve an Outstanding rating.

If your care home is safe and clean, and the care is right, you can achieve an Outstanding rating. There is no mention of ‘luxury’ anywhere in the KLOE characteristics.

Myth 5: It is hard to retain an Outstanding rating

Most of the time Outstanding care homes have great people and robust processes to repeat their achievement. Only a very few care homes have lost their Outstanding rating because the manager/owner moved on. If your business is too ‘people-centric’, you are at risk, whereas if people function around systems and processes, the chances of losing a rating are much less. Once you know the trick, you can aim for more stars next time.

Getting the fundamentals right

There is no point in shouting about your great stories if your fundamentals are not right. When I say ‘fundamentals’, I am referring to CQC fundamental standards. You are not fit to be in a care home leadership role if you cannot tell me all the fundamental standards without looking at the CQC website. Getting the fundamentals right means you should have systems in place to deliver and monitor the quality of standards your service users have the ‘right’ to receive. When I do mock inspections, I am not interested in your ‘super’ stories if you cannot prove to me people are getting adequate nutrition, are safeguarded from abuse, consents are in place and your training is meeting the expected standards.

The recipe for ‘Soupe à exceptionnelle’

An Outstanding Manager – 1

A supporting deputy manager – 1

A great supporting owner/regional manager – 1

Admin – to deal with all the non-clinical activities

Permanent staff – Plenty

Activity coordinators – to add to the vibe

Daily motivation and appreciation – Add to the taste

A clean and safe environment – A must ingredient

An external auditor – Used as a thermometer

Add all the above ingredients to a bowl called ‘systems and processes’. Heat it with ‘regulations’. Once cooked, it should meet the fundamental needs of the people you are looking after. Freeze it to make sure it stays the same all the time. Defrost and serve with a bowl of pudding called ‘over
and beyond’.

Stock the shelves to make sure you are not running out of ingredients. A thermometer (auditor) should be used to check the cooking temperature and the results.

This is a simple way to explain how to achieve an Outstanding rating. All you need is great people around you and knowledge to make it happen. Look around to see if you have great people to make your care home the best in town.

Once you have great people around you, take a few days off to read and study the CQC’s ‘Outstanding rating characteristics’. Find out what more you can do to be exceptional. My definition of Outstanding is: “Anything that you do over and beyond that makes a measurable difference to your service users, staff and the community.” The key is, it is not ‘what you do’; it is the ‘outcomes’ that matter.

Quick wins

If you are already a very good care service with established systems and processes, I want to share some ‘quick wins’ for you to achieve an Outstanding rating.

Safe – You can score points on Safe by encouraging ‘positive’ risk-taking stories.

Effective  – Collect all the ‘clinical’ outcomes experienced by your clients after coming to your care.

Caring –  Collect all the ‘outstanding care’ stories. Remember, not the usual ones. See the definition above.

Responsive –  It should be an easy win as you might be already doing many ‘activities’ which make a real difference to people’s wellbeing.

Well-led – The rest of the domains speak about your leadership anyway. But showcase some work around developing the right culture, quality improvement and community involvement.

Mission ‘Outstanding’

The first step to achieving an Outstanding is to switch on your ‘willingness to do it’. If I can do it, if 600+ care homes can do it, you can do it too. The myths explained above are lame excuses to defend the laziness of some leaders. You are not such a leader. You are the one who wants to operate an Outstanding rated care home, ready to tell your grandchildren about your career success stories.

You do not want to be that manager who retires with just a Good rating; you are the manager or an owner who wants to make a ‘real difference’. What I am trying to say is – the journey starts with you. Your habits, behaviour, thinking and mindset decides how exceptional you are as a leader. Any organisation can grow only to the level of its leaders.

About the Author:

Issac Theophilos is the author of the Amazon best-selling book, ‘How to get outstanding, an ultimate guide for care homes’. He is one of the top care home consultants who completed more than a hundred independent mock inspections for care homes in England. Previous to this, Issac was a manager of a five-star rated nursing home. Issac is also the founder of, the only online marketplace for the social care sector.


Linkedin, Twitter and Facebook: Issac Theophilos


Phone: 0333 090 4479

Tags : Best practiceInnovation

The author Lee Peart

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