Independent care consultancy: ‘Every decision will be yours’

Steve Watson comes from a nursing family, with both his mum and sister working in the profession. He started his training in 1985 and had lots of different roles within the NHS, including becoming a modern matron. In 2006, he joined the Welsh government as an inspector in adult social care, working for what’s now the Care Inspectorate Wales (CIW). After 8 years he left and set up his first independent care consultancy to provide advice to care homes and help drive up quality. 

He tells us all about the role and how he got started.

Why set up your own business? 

I was never motivated by making large amounts of money. I wanted a liveable wage and a satisfying career, where I could really concentrate on helping others to drive up quality. That’s always been the most important aspect for me.

I wanted to give a bit of help to those who needed it, using what I’d learned through my work at CIW. My view is: if you focus on quality, then your care home rating will take care of itself. 

Nursing is no longer just about providing ward-based hands-on care. The world is your oyster, and you can work in all kinds of different settings. As a nurse, you understand what makes good – and bad – care and you can help others achieve the highest quality.  

What does your role as an independent consultant involve? 

Every day is very different. For example, I might do a mock inspection, which takes a minimum of 2 days. One day is spent doing a deep dive into what’s happening at the home and then the next writing a report, including an action plan of how things can be improved.

If you focus on quality, then your care home rating will take care of itself

For new services, I might be helping out with the registration process, ensuring that the owners understand their responsibilities and then carrying out some staff training. I might also advise on specific topics, including signposting to other sources of expertise where needed.

What kinds of issues are facing independent care homes at the moment?

Social care has as many challenges as the NHS, including funding issues. We’re still reeling from the pandemic, plus we have cost-of-living pressures and difficulties in recruiting staff. Spiralling fuel bills are also problematic.

I know of 3 really good homes I inspected in north Wales that have all closed within the last 6 months – that’s nearly 200 residents who must find a new home. 

Health and social care needs much more support than it’s currently receiving. It still feels very much that it’s NHS first and then social care second. But we’re symbiotic and neither can operate properly without the other. 

Any top tips to help someone become an independent consultant? 

Make sure you have the knowledge you need, as every decision will be yours. You need back-to-front and inside-out understanding of all the regulations – which means it’s probably an easier step for someone who has been part of that world, whether they’ve been involved in inspecting or commissioning.

You need to have experience of holding people to account through standards or regulations. You also need to make sure you keep yourself up-to-date and it’s important to develop a good network too – join the RCN’s Care Home Network.

Lightening the load for someone who’s struggling can make it all feel worthwhile

It's not easy, but when you get the successes – even the small ones – it’s great. Lightening the load for someone who’s struggling can make it all feel worthwhile. The best you can hope for is achieving “outstanding” on a report, after your interventions.

But the day afterwards, the work begins to keep that outstanding rating. A lot of the role is imparting your knowledge to someone, so that when you walk away they can carry on. It’s no good if everything just falls apart. It’s all about continuity and empowering people. 

Tell us about your RCN involvement?

I joined the RCN in 1986, becoming a student rep. I became a steward when I registered. I also had a spell as a full-time RCN assistant officer, based in Exeter. I only gave up being an RCN steward when I worked for the Welsh government, but I became a learning rep instead. I then advised RCN Wales on the independent sector on a short-term contract for a few months. 

I’ve also been an RCN board member for the North West, more recently joining the Welsh board where I’m vice-chair and represent the independent sector. In February, I was elected unopposed to RCN Council to represent Wales. 

As an RCN Council member, what are your priorities? 

I’m here to give members a voice. Alongside speaking up for members in Wales, part of my focus is looking at what we can do for those staff who aren’t on Agenda for Change contracts.

There was some good work happening but unfortunately much of that’s on hold at the moment as we concentrate on the current pay negotiations. We need to get back on track when it’s possible.