Napier House - A Quality Assured Home

Napier House is a local authority residential home in Newcastle upon Tyne, the majority of whose 40 residents are elderly mentally infirm. In September 1991, it became the first care organization in Europe to become registered under British Standard 5750 (EN 29000/ISO9000) for quality assurance of its direct services to residents or patients.

This achievement belongs primarily to the staff of Napier House, who describe their own experience of developing their quality assurance system in a companion paper (see following article). In this article, our aim is to present some of the more general considerations relating to the project, and its relevance to quality assurance across the whole spectrum of human care services.

In particular, we comment on how Napier's staff used the quality assurance programme to strengthen their team spirit and their passion for quality, to blend the systematic approach of BS 5750 with all the motivational aspects of a total quality culture.

WHY BS 5750?

In setting out to define a practical plan of action in respect of quality, Newcastle Social Services Department had first to confront a plethora of alternative and often apparently conflicting advice on what quality is and how it should be achieved. The vast literature on the subject has a frightening tendency to become more confusing the more one reads, embracing concepts such as quality dimensions, quality loops, quality chains, quality circles, quality teams, quality audits, quality initiatives, quality culture, quality assurance and, of course, total quality, which is even more confusing than all the rest because it is all the rest.

In amongst all this literature, one document stood out as being superficially the least relevant, and potentially the most useful, BS 5750. Compared with all the motivational treatises and the literature devoted to quality of care, it is exceedingly dull. Its language is the language of manufacturing industry, of nuts and bolts and micrometers, with a small-print footnote saying "the term product is also used to denote service", and not a single mention of human beings except as "personnel". It does however define a system for achieving quality, and a system was what was needed to make sense of everything else.

The great attraction of BS 5750's system is that, because it is essentially just a system...