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Appreciative Inquiry

14th July 2016 | Categories: Adult Social Care , Inspections , Scottish Social Care

Appreciative InquiryLiving up to the image

A number of years ago a study was carried out on schoolchildren’s self-image and how this could be changed. In summary, it appeared that labelling a child as clever boosted their performance and attainment, while the reverse was true: calling them below average in intellect harmed their progress and performance. The labels were assigned randomly to children from an average class. The study was called the Pygmalion study. Researchers concluded that a negative image by those in charge comes across unconsciously and has adverse consequences for that child. The child appeared not to be able to shake off the negative bias which they sensed, but adjusted their own performance to match that image, but seeing a child as clever somehow increased their cleverness.

Problems, problems

I think there are lessons to be learnt from this in the regulation and management of social care services also. While there are crises abounding in today’s care environment, there are also services which are hugely successful. If management and inspection focus on weak areas, in order to supposedly produce improvement, there is a risk that overall performance will be levelled out, and performance will actually decline. A workforce will assume that the management is interested in only problem areas, and will live up this by focussing on problems also. Instead, we should be rewarding and celebrating success where it occurs, and focussing on how to spread and share this success in all other areas.

Resources for positive training and development

This thinking figures in the recent release of a study resource promoting ‘Appreciative Inquiry’, making discovery and dissemination of success the goal rather than only the elimination of failures. The resource pack was compiled by the Scottish Social Services Council, who are the professional registration body for social care workers in Scotland, and NHS Education for Scotland. The resources were used to support services in health and social care integration which is underway at present, but the author’s state the techniques and training can be taken up and applied by anyone interested in service improvement or redesign.

Basically Appreciative Inquiry works by asking staff to record and think about what works well in their service, and how the identified success can be applied elsewhere. Unlike traditional inquiries, such as in for example a Serious Case Review, the appreciative inquiry directly seeks to embed this positive evaluation in all operations and by all staff in the service on an ongoing basis. The websites identified in the resource pack have many case studies which show the benefits.

To my mind, one outstanding merit of the approach is that it brings a fresh perspective and is intrinsically motivating rather than demotivating. It is almost like a state of mind, which can be adopted to see your own service possibly in a new light. Carried out as an exercise, it gets beneath the surface, to highlight not just what works well, but why that works well. That is powerful knowledge in overall development and quality of any service.

A fresh look?

I looked at a report of a recent regulatory inspection of one region in Scotland, designed to look at how social and health care integration was progressing. To its credit, the inspection process had flagged up excellent practice where it was found. I thought these areas of best practice should figure in the recommendations, as signposts to improvement opportunities, but sadly this was not generally the case. The recommendations appeared often based on under-achieving areas. Services look at recommendations, rather than simple commendations, and I think the inspection could have benefitted from a more positive, appreciative approach in this instance.

Tony Clarke – Scottish Care Inspectorate Specialist


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CQC Outcomes are now called Key Lines of Enquiry. CQC Essential Standards are now CQC Fundamental Standards.