CQC to Look at Oral Health in Care Homes

Andrea Sutcliffe CBE, Chief Inspector of Adult Social Care, has announced a review of oral healthcare practices in care homes.

Writing about this issue Andrea commented:

“Although many residents of care homes are supported to maintain good oral health, there is evidence to show that some services struggle to provide the support people need.  The consequences can be devastating. The gruesome pictures of blackened, infected teeth CQC’s Senior National Professional Dental Advisor showed me recently were awful and I can just imagine the impact this has on people in pain or embarrassed about the way they look. I was also shocked by some of the other consequences he explained as mouth infections can spread and cause, for example, respiratory problems like pneumonia and other cardiovascular problems.”

Managing oral health poses particular challenges to those working in adult social care:

  • Residents of care homes may have poor manual dexterity, limited mobility, vision problems and cognitive difficulties.
  • Long-term conditions such as Parkinson’s disease and dementia can make it harder to hold and use a toothbrush and go for dental treatment.
  • There are challenges for staff too who may not have the time and understanding to support people appropriately particularly if this is not seen as a high priority in the service or they face resistance from the person they are trying to assist.

Whilst oral health care is not specifically mentioned in the Key Lines of Enquiry, the CQC has expressed concern about a lack of focus in this area.

The CQC has now asked the Primary Medical Services to conduct a thematic review to gather information and produce a national report on the quality of oral health in care homes at present.  Staff will attend inspections to ask some additional questions and speak to staff and those who use services. They will also be looking at whether care homes are following the NICE guidance on oral health in care homes and if not, what the reason for this is.

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Renting Privately Whilst at University – Know Your Rights

Students returning to university this autumn and renting a home for the first time don’t have to put up with rogue landlords.

When things go wrong with rented properties, students have the right to get them fixed – and the government has published How To Rent guides to help out.

Legislation protects students and their money from rogue landlords and agents. And new laws coming into force on 1 October, around the time when a new term starts, will mean landlords must provide adequate size bedrooms and sufficient rubbish bins.

What students should know on move-in day:

  1. Your deposit must be protected in a government-backed scheme – get a certificate from your landlord or agent.
  2. Check the property is safe – think fire, electrical, gas safety certificate, and hygiene. If you have concerns, raise them with your landlord or agent immediately.
  3. Agree an inventory with your landlord or agent – or you could lose money when you move out.
  4. By law, landlords must install a smoke alarm on each floor (and carbon monoxide alarms if needed) but it’s your job to regularly check they are working.
  5. Know who is responsible for bills (water, electricity, gas) and take meter readings.
  6. Landlords or agents must be reachable to fix problems quickly – make sure you have their contact details.
  7. Landlords or agents must deal with any problems with the water, electricity and gas supply, and maintain appliances and furniture they have supplied. Councils can step in when landlords don’t do their job, and there are independent schemes to help resolve disputes with letting agents.
  8. Houses lived in by 5 or more independent people will soon have to be licensed in an extension of laws which previously only covered buildings of 3 storeys or more.
  9. Homes of any number of storeys will be covered under the extension, meaning more students will be helped – with tiny bedrooms (of less than 6.51 square metres for one adult) banned and landlords forced to provide the right bins to homes.

As well as this, new regulations taking effect from 1st April 2019 will keep renters’ money safe by only allowing letting agents that join a government-approved client money protection scheme to handle their money.

Students should use the How to rent and How to rent a safe home checklists on Gov.uk.

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Writers and Performers Join Forces in Campaign to End Indefinite Detention

This week saw the start of a new writer-and-actor led initiative to raise awareness around the call to end indefinite detention of refugees.

The initiative is being supported by a raft of well-known actors including Jeremy Irons, Christopher Eccleston, Shobu Kapoor, Maxine Peake, Zoe Wanamaker and Niamh Cusack and writers Kamila Shamsie, Patience Agbabi, Neel Mukherjee.

Participants have been filmed reading the tales of those who have experienced detention and those who have worked with them.  All writers and actors have donated their work and the studio space was also donated.

A new tale will appear online each day for 28 days.  The 28th tale will be read in Westminster, taking the tales to parliamentarians who have the power to bring about legislative change and end the injustice of immigration detention. Click here to read the 28 Tales.

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Are You Up To Date With The Latest CQC Regulatory Changes?

Following a consultation earlier this year, the CQC updated its guidance for independent healthcare providers in England and the resulting changes started to come into effect on 2nd July.

The guidance sets out how the CQC will begin rating independent healthcare services that were previously unrated, such as independent ambulance services, independent substance misuse services and cosmetic surgery services.

Following inspection, ratings will be awarded for whether these services are safe, effective, responsive, caring and well-led at overall service and location level, using the same ratings principles used for all other services.

The guidance also confirmed that as part of the changes the CQC will:

  • Introduce ‘CQC Insight’– a data monitoring tool currently in use for NHS hospital trusts and primary care providers – for independent healthcare services, starting with mental health and acute services.
  • Adopt a more intelligence-driven model of regulation informed by ongoing monitoring of the quality and safety of care.
  • Increase the number of unannounced inspections, moving towards maximum re-inspection intervals based on service ratings.
  • Develop a digital routine provider information request (requesting information between inspections) to further improve their ability to monitor services.
  • Develop proposals for registering parent companies/groups.
  • Assess and rate ‘outpatients’ and ‘diagnostic imaging’ services separately to better reflect the way these services are organised and managed at many independent hospitals.

What This Means in Practice

Routine Inspections

The CQC is prioritising routine inspections as follows:

  • Services not previously inspected but which the CQC now have the powers to rate
  • Services that the CQC has inspected but not yet rated
  • Services that pose a higher risk
  • Newly-registered providers

The CQC will not normally announce the day it intends to inspect services, although, in the case of routine inspections, it is usually within three months of information relating to the inspection being submitted to the CQC.

The inspection will be carried out for a minimum of one day, although this may be longer depending on the type and size of service being inspected. Inspections that last longer than one day may not necessarily take place on consecutive days.

All inspections will follow the new health assessment framework, with a significant focus on ‘well-led’.

They aim to complete the first round of inspections, awarding all services a rating, by 2021.

Once inspected services should expect their next inspection, provided no causes for concern are raised, within the following timescales:

  • Services rated as outstanding – within five years
  • Services rated as good – within three and a half years
  • Services rated as requires improvement – within two years
  • Services rated as inadequate – within one year

Additional/Focused Inspections

Where concerns have been raised either by an inspector or those monitoring services for the CQC, additional, focused inspections will be carried out.  These focused inspections may look at one aspect of care or a reduced number key questions.  After a focused inspection, the overall rating for a location can change – up or down, helping providers who have made significant improvements in their service communicate this to patients, their families and carers.  Focused inspections will normally be unannounced and do not include a provider information request.


Services which have not been subject to the ratings regime until now will be rated for the first time after their next comprehensive inspection.  They will be rated against each of the CQC’s standard 5 questions, with an aggregated, overall rating, also being awarded.

Monitoring of Services

  • Each service provider will be awarded a Relationship Owner who will develop close links with service. They will meet service providers at least once a year, although this may not be face to face.
  • The CQC Insight tool, used to plan inspection timetables, taking into account all the information held on a service, is being rolled out across the healthcare system starting in September. The first wave of the roll out includes independent acute and mental health hospitals.

Further Developments

  • Over the summer the CQC consulted on plans to make corporate/group providers more accountable for the quality and safety of services delivered. Proposals included revising registration criteria to cover organisations that can exercise ‘direction and control’ over the quality and safety of services, as well as those directly involved in the delivery of care.  Whilst we are sometime away from new guidance being issued and changes being made to the registration system, a report summarising the findings of the consultation is due for publication in the autumn.
  • Work is being done with NHS Trusts looking at making changes to the format of inspection reports, with additional information being provided in appendices. If pilots are successful these changes will be rolled out across all inspection reports.
  • The CQC is developing plans for information returns to be made between inspections. Proposals for this requirement have not yet been published and so a date for implementation is some time off.

What Independent Healthcare Service Providers Should be Doing Now

  • Ensure that policies, procedures and quality assurance systems are upto date, taking account of the new requirements and the CQC’s focus on ‘well-led’.
  • Ensure that staff across the organisation understand their duties and responsibilities and that they have had all appropriate training.
  • Ensure that staff understand the inspection process, and their role is assisting inspectors should they arrive whilst they are at work.

How We Can Help…

Words Worth Reading Ltd offers a comprehensive range of documentation and consultancy services to the healthcare industry. These include Care Quality Commission (CQC) Registration and compliance, Information Governance and even mandatory nurse training. We are familiar with the detailed requirements of healthcare monitoring authorities in all four of the countries of the United Kingdom.  Find out more about how we can help you by:

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CQC and Live Music Now Set Care Homes a Musical Challenge!

Live Music Now and the Care Quality Commission are challenging care homes throughout Britain to do something musical and extraordinary to celebrate the Last Night of the Proms.

During the first week of September 2018, they are urging care homes to share a photograph or video making music together – staff, residents, musicians, anyone – just make sure you have the appropriate consent first!

You could share it via your own social media using the hashtags #LiveMusicinCare #LastNightoftheProms and #CareAware or send it by email (info@livemusicnow.org.uk).  Download a complete campaign media pack here.

If you’d like to join in, but don’t know how to start, there is lots of advice available below, with links to sites with further information – it doesn’t need to be difficult or expensive. Later life should be a time of creativity and discovery. Music and the arts should be available to everyone, regardless of whether they are living independently or in residential care.

Tips for making music in care homes

  1. Many care homes take opportunities to make music informally throughout the day – such as care workers singing while dressing residents, songs before lunch, or CDs playing in corners where residents gather.
  2. Musicians might come to your care home to perform, enabling residents to join in with the performances.
  3. Musicians or volunteers get residents making music themselves. Some musicians might bring “buddies” – volunteers singers who sit among the residents sensitively helping them sing and get the most out of the activity.
  4. Music therapists work intensively and clinically, often one-to-one with residents.
  5. Karoake machines, sing-a-long CDs and similar are useful ways to enable non-musicians to lead the live experience.

Use a combination of these approaches, using music and singing throughout the day to help residents, motivate and cheer staff – making your home a much nicer place to be!

There is a whole website of practical resources and tutorial videos, to inspire you to make music in your care home. Visit www.achoirineverycarehome.co.uk for more!


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Deadline For Society of Authors Writing Grants is 1st September!

The Society of Authors loves to support both emerging and established writing talent from across the writing genres and has a range of grants available to both fiction and non-fiction writers as well as poets.

This year over 50 authors will receive cheques amounting to £180,000 enabling them to complete their latest projects.

Each application is different and there is no single use for the funds, designed to ensure that financial realities don’t get in the way of writers completing their work. Typically the grants are used to assist with research costs or to buy writers the time they need to focus on their work.

New Applicants

If you would like to apply for a grant the next deadline is 1 September and all applicants will be contacted before the end of the year.

After 1 September, in a change to the usual process, all authors are encouraged to submit their applications via email to funding@societyofauthors.org.

Recent Winners

Tom Bullough

“It is no less a lonely business, writing, even when you come to your fifth novel. I have been working for three years on A Bird Is Born Twice: a story suffused with Welsh myth and history, inspired by a 15th-century rood screen and with a cast including sirens, satyrs and cynocephali – quite unlike the novels I have written before. An Authors’ Foundation grant means, of course, time – I can now see my way through the months to its end – but it also means a great boost in spirits and confidence, a sense that others too believe in this project. For both of these things, I am enormously grateful.”

Rachel Seiffert

“I am currently researching and drafting a novel starting in the Caribbean in the 1600s, during England’s first forays into Empire and slave trading.  Thomas Gilbert, an Englishman and former indentured servant, will be the protagonist to start the narrative, which will explore the lure of the New World, the human cost of ownership and being owned, the vital importance of liberty, and its limits too, in a world where all must struggle to seek advantage. The award will fund a research trip to Barbados, allowing me time to consult the National Archives which have holdings from the earliest days of English settlement through to abolition and beyond; it will also enable me to explore the island’s botany and topography.”

Chris Power

“The importance to me of this Eric Ambler Award is profound, and so is my gratitude for it. It means time to work – the most valuable thing a writer can be given – and the ability to undertake research trips that are vital for the novel I’m writing.”

Burhana Islam

“I am wholly grateful to have been awarded an Author’s Foundation grant for my verse novel-in-progress, Sticks and Stones. Being a teacher, as well as having responsibilities at home, makes it difficult to fit in time to write, but because of the grant, I can really work on something that means the world to me. The Society of Authors supports writers from all walks of life and this opportunity is not only a much-needed confidence boost, but it almost feels like it validates my own aims of getting a marginalised voice out to readers, one that needs be heard in this day and age. Truth be told, I cannot be more grateful for that.”

JJ Bola

“I express my complete gratitude to the Society of Authors for the award of an Authors’ foundation grant, for my current project; a non-fiction book on masculinity. As a young, minority, working class writer, living and working in London, this grant will allow me to make greater research and contributions on this subject, connecting on a closer level with young people, young boys and the local community, through workshops and talks. And it alleviates some of the pressures of having to survive in an austerity driven, financially challenging city, which will help me concentrate more on the quality of work that I can produce.”

Justin Chambers-Coe

“I am delighted to have been awarded an Authors Foundation grant and I am grateful for the support of the Society of Authors and the K Blundell Trust. This grant will enable me to complete work on The Magic of Mums (provisional title) my second collection of children’s poetry with Otter-Barry books, a follow up to my debut The Dictionary of Dads. Supporting my family on the wages of a working poet has never been easy but the recent cuts to education budgets have begun to seriously impact on my income, as more and more schools struggle to find funds for author visits. As well as buying me time to write, this grant will also enable me to offer a few free visits to schools to help research and trial the new poems, as well as inspiring young people to create work of their own.”

Find out more about submitting your application on the Society of Authors website – click here.

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Bristol PhD Student Sells New Diabetes Treatment in $800m deal!

A Bristol University PhD student is set to become one of the richest men in the South West after the company he co-founded was sold for around $800 million (£626 million).

Ziylo, a University of Bristol spin-out company, has been bought by global healthcare company Novo Nordisk in a deal which could be worth around $800 million.

The deal, which is one of the biggest in the University’s history, could lead to the development of the world’s first glucose-responsive insulin and transform the treatment of diabetes.

The World Health Organization estimate that over 382 million people worldwide, including 4.05 million people in the UK, have diabetes – a metabolic disorder affecting blood sugar levels. Everyone with Type 1 diabetes and some people with Type 2 diabetes need to take insulin, either by injection or a pump, to control their blood glucose levels.

Ziylo has developed an innovative technology platform, which could be a key component to enable the next generation of insulin, able to react and adapt to glucose levels in the blood, therefore eliminating the risk of hypoglycaemia – dangerously low blood sugar levels – and leading to better metabolic control for people living with the disease.

It’s a real success story for researchers in the Davis Research Group in the School of Chemistry who had been working on the problem for many years before Ziylo was established as a start-up company in 2014. It’s likely their lab-based work will now be turned into a real-world application to improves the lives of people around the world.

Ziylo’s glucose binding molecules are synthetic molecules that were designed by Professor Anthony Davis, who has been at the forefront of research into synthetic sugar receptors for the last 20 years.

Professor Davis co-founded Ziylo with his PhD student Dr Harry Destecroix and Tom Smart.

Dr Harry Destecroix, CEO of Ziylo, said: “Novo Nordisk, as the leader in the diabetes field, is the ideal company to maximise the potential of the Ziylo’s glucose binding molecules in glucose responsive insulins and diabetes applications, and it brings hope of a truly ground-breaking treatment to diabetes patients.”

The acquisition gives Novo Nordisk full rights to Ziylo’s glucose binding molecule platform to develop glucose responsive insulins.

The development of glucose responsive insulins is a key strategic area for Novo Nordisk in its effort to develop this next generation of insulin which would lead to a safer and more effective insulin therapy.

Anthony Davis, Professor of Supramolecular Chemistry at the University of Bristol and Director & Co-Founder of Ziylo, added: “The glucose-responsive insulin we will develop with Novo Nordisk combines a natural molecule (insulin) with an artificial component (Ziylo’s glucose binding molecules). This combination of natural and unnatural could be a new approach to biodesign.

“These unique molecules were inspired by nature and work in much the same way as natural glucose receptors. A group of chemists, called supramolecular chemists, have been working on this problem for many years. Often, they make molecules which behave quite like natural molecules, but usually they don’t work quite well enough for real-world applications.

“The success of the Ziylo molecules shows that, with persistence, the problems can be solved and that biological molecules can be matched as well as mimicked.”


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Real Time Care Planning Leads to CQC Outstanding Rating

The Care Quality Commission has found the care being provided at Ryecourt Nursing Home, Bispham, Blackpool, to be Outstanding following an inspection in May this year.

Ryecourt Nursing Home provides accommodation and nursing care for up to 35 people. At the time of the inspection, 34 people were living at the home.

Ryecourt Nursing Home was rated as Outstanding overall and for being effective, caring, responsive and well-led, and Good for being safe.

Key Findings

  • Staff were very well trained and supported with continuing development, so much so that there had been no unplanned hospital admissions.
  • The service used a ‘live’ system to plan people’s care, enabling staff to adapt the care being provided when people’s capacity fluctuated.
  • The service supported nursing advancement through a preceptorship program, mentoring staff in upskilling them in care and treatment.
  • The provider had introduced a video-link process to enable healthcare professionals to remotely assess the risks associated with malnutrition, this reduced delays in people being assessed and given further treatment.

Debbie Westhead, Deputy Chief Inspector of Adult Social Care said “This service shows what can be achieved through continuous improvement and dedication to person-centred care. The provider had clearly recognised the benefit of having an available and well trained and skilled team.

“We received numerous positive comments about the care being provided and saw how well the service anticipated and quickly adapted to people’s changing needs. We also saw how the service had worked to promote a dementia-friendly environment. Many areas of the service, as well as the care, were designed to support people’s well-being and helped them to stay physically and mentally active, and better engaged socially.

“The provider focused on developing a better service, continually reviewing the care being provided to find areas that can be improved on and implementing quality changes. People’s dignity, independence and wishes were respected when changes were considered.

“To have improved to Outstanding in three key questions and overall is a fantastic achievement. Congratulations to everyone involved with Ryecourt Nursing Home.”

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Raise the Profile of Your Small Business Through the Small Business Awards

The Federation of Small Businesses (FSB) has launched its search to find the greatest small businesses from across the UK. From exporters to start-ups, from innovators to green businesses, and from family businesses to the best young entrepreneurs, small firms are being encouraged to enter FSB’s 2019 Celebrating Small Business awards.

The annual awards recognise a sector that makes up 99.9 per cent of all private sector businesses.

As the number of self-employed people continues to rise and confidence amongst the sector is at its highest level for a year, entries are expected to exceed 2,000, with more businesses recognising the value of industry awards as part of their business plan.

FSB National Chairman Mike Cherry said: “Small businesses and the self-employed from across the UK contribute so much to our economy and our communities. The FSB Celebrating Small Business Awards recognise the best, most innovative and most determined of these, from every sector, industry and background.

“This is why we choose to keep entries to the awards free, and have them open to all smaller businesses and self-employed people, whether they are current FSB members or not. The entrepreneurial spirit in the UK is alive and well, with small businesses now numbering an incredible 5.7 million. Everyone should help us to celebrate that.”

Twelve area finals will be taking place between January and April 2019 across the UK, with the UK national final taking place on 23 May 2019 at Evolution Battersea, London. Here, 10 UK category award winners will be announced from which the FSB Small Business of the Year 2019 will be chosen.

Last year’s FSB Small Business of the Year 2018 winner was scale-up superfood brand Creative Nature from Surrey. Julianne Ponan, founder and CEO of Creative Nature, said: “Winning the title of FSB Small Business of the Year 2018 has a had a superb impact on us; we’ve been invited to open the market at London Stock Exchange, to speak at business shows and have had fantastic media coverage. I recommend entering the awards to all businesses. We’re enjoying every moment of it!”

The award categories for the 2019 FSB Celebrating Small Business Awards are:

  • International Business of the Year
  • Ethical and Green Business of the Year
  • Business and Product Innovation Award
  • Digital Innovation of the Year
  • Micro Business of the Year
  • Start-Up Business of the Year
  • Scale-Up Business of the Year
  • Family Business of the Year
  • Young Entrepreneur of the Year (aged 30 and under)
  • Employer of the Year
  • Community Award (area level only)

The 12 UK area finals will be held in: Scotland; Wales; Northern Ireland; East Midlands; West Midlands; North East England; Yorkshire & The Humber; South West England; South East England; East of England; North West England; and London.

The awards are free to enter and are open to all small firms. To enter, visit www.fsbawards.co.ukfrom 10 August.


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Inadequate Risk Assessment and Care Planning Leads to CQC Registration Being Cancelled

The Care Quality Commission has cancelled the registration of a Croydon care home – effectively closing it down.

Carlton House in Chatsworth Road, Croydon, remained rated Inadequate overall at its most recent inspection in March 2018. It was rated Inadequate for being safe, effective and well-led. It was rated Requires Improvement for being caring and responsive.

Carlton House, is a residential care service that registered to provide housing and personal support for up to 15 adults who have a range of needs including mental health and learning disabilities. It is run by Dr Emmanuel Owusu and Mrs Celia Erica Akuffo.

During this inspection in March 2018, CQC found eight breaches of care regulations, some of which had been highlighted at previous inspections. The provider had not made sufficient improvements to change the rating or meet the regulations.

  • People’s risk assessments and care plans continued to be out of date.
  • Environmental risk was high. Inspectors found risks relating to excessive hot water in people’s rooms and communal bathrooms. The risk had been noted but nothing had been done to keep people safe.
  • Staff knew about safeguarding people from abuse and neglect but inspectors were concerned because the provider had failed to report, act upon and investigate some incidents.
  • Inspectors found the service was not clean. People’s rooms were dirty and in need of essential maintenance. There were no records of cleaning schedules for people’s rooms and tasks were allocated to staff verbally so the provider was unable to evidence how they monitored the hygiene and cleanliness of the service.
  • The mix and number of people using the service and the a new layout of the rooms continued to give CQC concerns about the number of toilets and bathing facilities available and accessible for people.  Men and women used the service and moving from floor to floor to use bath shower rooms and toilets impacted on people’s dignity and privacy.
  • There continued to be issues with people’s medicine records. Information was still not available to staff to explain how people liked to take their medicine.
  • There continued to be some concerns with people’s healthcare needs. When people’s health needs changed these were not always acted on. When healthcare professionals gave advice this was not always followed.
  • The service continued to be poorly led. Systems were not in place to identify health and safety issues that could put people who used the service and staff at risk.
  • There were no robust systems to check the quality of the service.

Debbie Ivanova, CQC’s Deputy Chief Inspector of Adult Social Care, said:“The quality of care at Carlton House, fell a long way below the standard expected, and we have now used our enforcement powers to cancel its registration.”

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