North Wales Queen’s Nurses supporting Excellence in Care Homes

Betsi Cadwaladr University Health Board (BCUHB) is leading the way in improving care standards for older people living in care homes across North Wales. At the heart of this effort is the implementation of Clinical Quality Support Tools (CQSTs) — a key part of the Health Board’s Quality Assurance Framework (QAF). The BCU Quality Development Team explain more.

What Are CQSTs?

CQSTs are clinically focused, risk-based audit tools designed to:

• Promote safe, effective, and evidence-based care.
• Identify and share good practice.
• Highlight concerns early and support timely interventions.
• Guide workforce development through targeted training.

These tools cover key areas of care delivery:

• Nutrition and Hydration
• Infection Prevention
• Training & Education
• End of Life / Palliative Care
• Continence and CAUTI
• Tissue Viability
• Medicine Management
• Reporting and Recording
• Prevention of Falls
• Cognition and Wellbeing

Each CQST includes focused questions, a tailored action plan, and access to an electronic resource pack—updated annually or in line with national guidance. These packs are supported by BCUHB’s Specialist Nurses, ensuring care homes have the latest information and Guidance at their fingertips.

A Collaborative Approach

Developed in partnership with the six North Wales local authorities and the independent care sector, the QAF represents a shared commitment to excellence. CQSTs are used by BCUHB’s Integrated Health Community (IHC) and are developed and monitored annually by the Care Home Quality Development Team to support care homes in delivering high standards of care.

While CQSTs are not currently mandatory within commissioning contracts, their use is strongly encouraged as a positive support mechanism to enhance care quality.

Continuous Improvement in Action

CQSTs are more than monitoring tools—they’re a vehicle for improvement. They help care homes:

• Develop and implement improvement plans.
• Access training and education resources.
• Participate in annual webinars hosted by the Corporate Quality Development Team.
• Share learning and key themes across the wider health and social care community.

The Goal: Better Outcomes for Residents

By embedding CQSTs into everyday practice, BCUHB is helping care homes deliver safer, more effective care. These tools foster a culture of continuous improvement, ensuring care delivery aligns with the latest evidence-based standards.

With the support of Practice Development Teams and the Corporate Quality Development Team, care homes are encouraged engage in regular webinars and ongoing education opportunities help embed best practice and drive continuous improvement.

Meet the BCU Quality Development Team

Want to learn more?

For further information on the Quality Assurance Framework or Clinical Quality Support Tools (CQSTs), please contact:

• Marianne Walmsley – Head of Quality for Care Homes – Marianne.Walmsley@wales.nhs.uk
• Kara Roberts – Quality Matron for Commissioning Services – Kara.l.Roberts@wales.nhs.uk