CQC Warns Health and Care Services are Straining at the Seams

The Care Quality Commission’s (CQC) annual assessment of the quality of health and social care in England, CQC State of Care, has been published and warns that whilst the health and care system is currently managing to deliver safe care, it is under threat as the system struggles with complex new types of demand, access and costs.

As at 31 July 2017:

  • 78% of adult social care services were rated good (71% were rated good at 31 July 2016), with 19% (2016: 26%) rated as needing improvement.
  • 55% of NHS acute hospital core services (2016: 51%) were rated good with 37% (2016: 39%) rated as needing improvement.
  • 68% of NHS mental health core services (2016: 61%) were rated good with 24% (2016: 33%) rated as needing improvement.
  • 89% of GP practices (2016: 83%) were rated good with 6% (2016: 10%) rated as needing improvement.

While recognising improvements this year, there is also deterioration that must be addressed. Looking at providers rated good overall the first time CQC inspected, the majority have remained good. But of the services that were re-inspected, 26% of mental health services and 23% of adult social care services originally rated good dropped at least one rating. Also, two out of the 11 NHS acute hospitals that we re-inspected had deteriorated, and only 2% of re-inspected GP practices deteriorated.

Whilst celebrating good and improving practice, the report also looks to the future and sounds the alarm bells.  The changing nature of demand – increasing numbers of older people who are physically frail, many with dementia, more people with long term complex conditions – placing unprecedented pressure on the system. In acute hospitals, this means more people waiting over four hours at A&E; more planned operations cancelled, and people waiting longer for treatment.  In adult social care, the number of beds in nursing homes has decreased across most of England and domiciliary care contracts are being handed back to councils because providers say the funding is insufficient to meet people’s needs; estimates show that one in eight older people are not receiving the help they need.

Sir David Behan, Chief Executive of CQC, said “The fact that the quality of care has been maintained in the toughest climate that most can remember is testament to the efforts of frontline staff, managers and leaders. Many providers have used our inspection reports to improve, and we have seen improvements in safety in particular, although this area remains a big concern and focus for us. However, as people’s health and care needs change and become more complex, a model of care designed for the 20th century is at full stretch and struggling to cope with 21st century problems.”

“Last year, CQC warned that social care was ‘approaching tipping point’ – a point where deterioration in quality would outpace improvement and there would be a significant increase in people whose needs weren’t being met. We said this based on five pieces of evidence – on bed numbers, market fragility, unmet need and local authority funding and quality. This year, nursing home bed numbers are down, more contracts have been handed back and Age UK estimates that there is more unmet need. Helpfully, however, an extra £2bn has been made available through the Better Care Fund – and improvement in quality continues to outpace deterioration, although the rate of improvement has slowed.”

“The future of the social care system is one of the greatest unresolved public policy issues of our time – a long term sustainable solution is urgently required. The anticipated green paper on adult social care will provide the opportunity for Parliament, the public and professionals to consider how we can collectively develop an appropriately funded social care system that can meet people’s needs, now and in the future.”

“If services are to deliver consistently for people, there must be better coordination of care to create a sustainable and effective health and care system. Staff and leaders can’t work any harder; the answer must be to work more collaboratively, not just between sectors but between agencies and professionals, supported and incentivised by the national health and care organisations. People should be able to expect consistent, personalised, safe care, and to be able to access that care when they need it – whether that’s delivered in an acute hospital, a nursing home, a community mental health hospital, a GP surgery or in their own home.”

In his comments, Peter Wyman, Chair of the CQC, signposted key indicators of excellent care “We often see personalised care at its best where there is strong leadership and a positive culture, and we have pointed to where a shared vision and outward-looking approach have been central to improvement – and to where providers have reached out to local communities and partners, involving patient and the public in shaping services, and collaborating with local groups. I have visited many providers myself over the course of the year and have been frequently impressed, not just by their hard work and commitment, but by their vision and innovation. We have seen examples of services working together – often harnessing new innovations and technology, including collaborating to share data – to transform care around people’s needs, with positive results on outcomes, access and people’s experience.”

 

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Supported Living Service With Manage Risk, Maximise Life Ethos Rated as Outstanding by CQC

The Care Quality Commission (CQC) has found the quality of care provided by Broom Lane, Manchester to be Outstanding following an inspection in July 2017.

Broom Lane, Manchester, provides person-centred support to people aged 18 and over living with autism and or a learning disability. The service was rated good for being safe, and outstanding for being effective, caring and responsive well-led.

The model of support offered at Broom Lane provided a unique combination of transition services with varied supported living accommodation. Five apartments were designed for people with significant social communication issues and who cannot share space easily with others.

Inspectors found there was a truly open and welcoming atmosphere on entering the premises. The registered manager, staff and people who used the service at the home were enthusiastic about the inspection visit and were eager to share experiences.

Debbie Westhead, Deputy Chief Inspector of Adult Social Care, said “This is an outstanding service that helps people transition into mainstream social housing. On entering the home, we found it to be open and welcoming, exemplified by its ethos: ‘Manage Risk, Maximise Life’ – with people being supported to have as much freedom of choice in their lives as possible.”

“This service was very well-led in that it benefited from a long-serving and well established management team. The registered manager was well supported by area team leaders and benefited from the input of an experienced regional manager.”

At provider level, the director of health & social care maintained oversight and knew the service well.

“There was a discernible results-driven approach to this service. A flagship initiative for the service was the continued development of Yew Tree Activity Hub. This community based resource offered a comprehensive programme of activities that were suited to people who enjoyed more physical work or for those who flourished by being creative and expressive. The service was exceptional at developing new and innovative ways to enable people who used their network of services to access inclusive and purposeful paid and unpaid employment opportunities.”

“People received support which was in line with their needs and preferences, in that they had a wide range of individual assessments tailored to meet the needs of people living with autism and/or a learning disability. This included comprehensive assessments and support plans centred on promoting independence.”

“The provider was exceptional at developing new and innovative ways to enable people who used their network of services to access inclusive and purposeful paid and unpaid employment opportunities. It is for these reasons and many more that we have rated Broom Lane as Outstanding.”

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Domestic Abuse Amongst Students & Young People Under Investigation

ITV’s Good Morning Britain are conducting research into the issue of domestic abuse among students and young people.

 

Did you know that 56 per cent of young people experience controlling behaviour in a relationship?
Domestic abuse in young people can often be overlooked. Good Morning Britain want to build a national picture on the thoughts of young people, and what is ‘appropriate’ in a relationship.

 

The NUS and Good Morning Britain are inviting young people of all genders to take part in a short and anonymous survey (60 seconds of your time) to help build a national picture.

The results will be revealed live on the show next week.

If you’re happy to answer some questions on the topic, you can complete the survey below.

Survey

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General Practice Declared the Highest Performing Sector Regulated by the CQC

The most detailed analysis yet of the quality and safety of general medical practice in England has found that nearly 90% of general practices in England have been rated as ‘good’, making this the highest performing sector that the CQC regulates.

With GPs facing ongoing pressures around capacity, patient demand and workload and at a time of service redesign, the best general practices are driving change and embracing innovation to make sure they are able to deliver even better care into the future.

In a national report, published today (Thursday 21 September 2017), the Care Quality Commission (CQC) has found that at the end of its first inspection programme of general practices when many had been re-inspected, 4% were rated ’outstanding’, 86% were ’good’, 8% were ‘requires improvement’ and 2% were ‘inadequate’ overall.

What Gets You an Outstanding Rating?

General practices with the highest ratings are those that demonstrate strong leadership; have an understanding of everyone’s responsibilities in the practice team; have a clear knowledge of the different needs of their patient groups; and recognise the importance of working as part of their wider local health economies.

Prof Steve Field, Chief Inspector of General Practice at the Care Quality Commission, said: “This is the first time that we have such a detailed national view of the quality of general practice in England, made possible through CQC’s regulation. Having inspected and rated 7,365 general practices across the country, we have found that the clear majority are safe and of a high quality. Where we identified concerns, most practices have taken action and improved. GPs, practice managers and other primary care staff should be commended for their efforts.

“The challenge is for this focus on quality to be maintained and for general practice to be supported in continuing to give patients this same high standard of care in future while embracing and driving the changes elsewhere in the system. The pressures on GPs are very real but we have found many practices are already delivering care in new and innovative ways to benefit their patients and the wider community.

“The General Practice Forward View sets out the plan for sustainable and high-quality primary care in England. Nearly eighteen months later, the commitments made must continue to be targeted and delivered appropriately to meet people’s local primary care needs. Otherwise, improvements in the quality of care will come to a standstill. We want to encourage continual improvement in the quality of care in general practice so that patients, whoever they are and wherever they are in England, get the high standard of care they have come to expect and deserve.”

 

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SMEs Should Consider Switching Water Supplier

Over half of SMEs are unaware that they can switch their water retailer according to Populus research.

We all rely on water, but busy micro, small and medium sized enterprises (SMEs), face an ever-increasing number of demands on their time, which can make it hard to keep on top of water bills.

The opening of the retail water market to businesses in April of this year was widely hailed as an opportunity for SMEs to cut costs and enjoyed more tailored customer services. Businesses in Scotland have enjoyed a deregulated water market since 2008.

However, Populus research shows that while awareness is growing, a number of SMEs still remain in the dark when it comes to better water deals. The latest research conducted by Populus for the Consumer Council for Water (CCWater) tracks awareness of the retail water market among SMEs.

They found that:

  • Just over 2 in 5 (43%) of SMEs were aware they could switch their water retailer.
  • Over half (52%) of SMEs who took part in the latest survey said they were likely to explore their choices during the next six months.
  • About 2 in 5 (39%) were unlikely to switch or negotiate a better water deal felt their organisation did not use enough water to save any money.

Research shows that there is more work to be done to show SMEs that even the smallest business could benefit from tailored services, simpler billing, and better customer service; little things that could add up to make all the difference for SMEs.

The full CCWater report can be viewed online here.

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Pressure Mounts on Government to Halt Rise in University Fees

A Labour motion calling on the government to reverse a planned increase in university tuition fees in England from this Autumn was approved in the House of Commons this week.

The motion was called following an opposition day debate but no actual vote was held as the Conservatives did not oppose the motion.

The government says it is not bound by the result, but shadow education secretary Angela Rayner said the vote reflected the will “of this House”.  Anglea Rayner went on to claim that, if not stopped, the planned tuition fee increases would see students paying up to £1000 more for their courses from this autumn.

Amatey Doku, NUS Vice President (Higher Education) said “Today’s debate is a victory for students, who are already paying an astronomical sum in tuition fees and are graduating with a burden of up to £57,000 in debt.”

“We welcome the support from the opposition and crossbenchers who have cornered the government onto wobbly legal ground over tuition fees. If they defy the will of the House, they place themselves in a constitutional crisis. More importantly, they face a moral dilemma: if they bulldoze ahead with these increases there will be lasting repercussions for generations of students to come. Young people will be watching carefully to see if the government is genuinely on their side.”

 

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Man Booker Prize Shortlist for 2017 Announced

The shortlisted authors and books for the 2017 Man Booker Prize have been announced and the list includes two first-time female writers, and two previously shortlisted authors, Mohsin Hamid and Ali Smith, the latter making the list for the fourth time!

The shortlist, which features three women and three men, covers a wide range of subjects, from the struggle of a family trying to retain its self-sufficiency in rural England to a love story between two refugees seeking to flee an unnamed city in the throes of civil war.

In the fourth year that the prize has been open to writers of any nationality, the shortlist is made up of two British, one British-Pakistani and three American writers.

Two novels from independent publishers, Faber & Faber and Bloomsbury, are shortlisted, alongside two from Penguin Random House imprint Hamish Hamilton and two from Hachette imprints, Weidenfeld & Nicolson and JM Originals.

The Shortlist

4321 by Paul Auster (US) (Faber & Faber)
History of Wolves by Emily Fridlund (US) (Weidenfeld & Nicolson)
Exit West by Mohsin Hamid (UK-Pakistan) (Hamish Hamilton)
Elmet by Fiona Mozley (UK) (JM Originals)
Lincoln in the Bardo by George Saunders (US) (Bloomsbury Publishing)
Autumn by Ali Smith (UK) (Hamish Hamilton)

The judges remarked that the novels, each in its own way, challenge and subtly shift our preconceptions — about the nature of love, about the experience of time, about questions of identity and even death.

Lola, Baroness Young commented “‘With six unique and intrepid books that collectively push against the borders of convention, this year’s shortlist both acknowledges established authors and introduces new voices to the literary stage. Playful, sincere, unsettling, fierce: here is a group of novels grown from tradition but also radical and contemporary. The emotional, cultural, political and intellectual range of these books is remarkable, and the ways in which they challenge our thinking is a testament to the power of literature.’

The 2017 winner will be announced on Tuesday 17 October in London’s Guildhall, at a dinner that brings together the shortlisted authors and well-known figures from the literary world. The ceremony will be broadcast by the BBC.

In the meantime, there will be a number of public events featuring the shortlisted authors. These include an event at the Nottingham Lakeside Arts Theatre in partnership with Nottingham UNESCO City of Literature on Tuesday 10 October and two events at The Times & The Sunday Times Cheltenham Literature Festival on Saturday 14 October. The traditional Man Booker Prize readings will take place at the Southbank Centre on the eve of the prize, 16 October, hosted by broadcaster and author Gemma Cairney.

Further events with the winner will be announced in due course.

The shortlisted authors each receive £2,500 and a specially bound edition of their book. The winner will receive a further £50,000 and can expect international recognition.

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CQC Leaves Nursing Home in Special Measures After Failing Inspection

The Care Quality Commission (CQC) has told Nada Residential and Nursing Home that they must make improvements to protect the safety and welfare of people they care for. Nada is a privately owned care home that is situated in the Cheetham Hill area of Manchester.

Following the latest inspection, the home was rated as inadequate for safety, responsiveness, well-led and effectiveness and as requiring improvement for caring.

Key Findings

Inspectors found continued breaches with regard to:

  • fire safety checks,
  • medicines management,
  • the environment,
  • the lack of service specific staff training for the needs of the people living at the home,
  • and a lack of quality assurance systems used to improve the service provided by the home.

Debbie Westhead, Deputy Chief Inspector of Adult Social Care in the North, said “No improvements had been made to the building since the last inspection. The environment was tired and in need of refurbishment. Recommendations from an environmental health audit to replace cupboards in the kitchen had not been actioned.”

“I was also very concerned to see that fire safety checks and records in the service did not demonstrate the service was safe, and this represents very poor practice.“

“We also noted that people did not receive person centred care and their needs were not discussed with them.”

“People are entitled to services which provide safe, effective, compassionate and high quality care, consequently this service remains in special measures. We are currently considering our options in relation to enforcement action and if not enough improvement is made, we will take action in line with our enforcement policy to begin the process of preventing the provider from operating this service.”

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Why Authors Can’t Afford to Ignore Goodreads

Goodreads, the world’s largest site for readers and book recommendations, launched in January 2007 with the aim of helping people find and share books they love.

Visitors to the site can:

  • See what books their friends are reading.
  • Track the books they are reading, have read, and want to read.
  • Check out personalized book recommendations.
  • Find out if a book is a good fit from the community’s reviews section.

In a recent blog post Penguin Random House recommended that all their authors should get registered on the site and join the Goodreads Author Program (which is free!).

Any author, anywhere in the world, can join the Goodreads Author Program for free. All you need is an Internet connection and a published book (or a soon-to-be published book) that can be found in their database. The Goodreads Author Program allows published authors to claim their profile page to promote their book and engage with readers. Once verified, your author profile will include the official Goodreads Author badge, which you can use to tell your fans to follow you on Goodreads.

Once Registered You Can..

  • Ensure the information held about you is up to date and accurate!
  • Run a giveaway, connect your blog, advertise your books and create a buzz!
  • Take questions from readers using Ask The Author, write reviews, and show off your taste in literature. Readers love to learn what books their favorite authors are reading!

Of all the features on Goodreads, Ask the Author is one of the best.  Readers can engage with authors in an unfiltered way and Goodreads shares questions in its newsfeed once they are answered.  Encouraging you to answer and preventing any questions you would not want seen being shared – you just don’t answer them 🙂  You can even ask yourself questions and provide the answers to get them into the newsfeed – perhaps reflecting questions that have come up in other, face to face, environments.

Penguin Random House also rate the section of the site that enables you to see what your friends are reading, track books you want to read, find reviews and ratings of your favorites  “For a reader, this can be a critical resource for discovering new titles, and for an author, this can be the perfect place to let your fans and soon-to-be fans get to know more about you.”

Rate other people’s books in a meaningful and engaging way and readers of those reviews may well click through to find out more about you and your books.

Once You Are on Goodreads…

  • Keep your profile up to date.  Make sure the right genres are showing in your profile, that pictures are current etc…
  • Engage with readers by answering their questions.
  • Review other people’s books and you may find new readers, who like your writing style, click through to find out more about you.
  • Join in, or set, a Reading Challenge.  These are really popular on Goodreads, you can share your progress and cheer on others – each interaction counts as one of your weekly posts and will show up in follower’s feed.
  • Ask people to follow you: If you have a stronger following on Twitter, Facebook, or Instagram, share your Goodreads profile with those fans and ask them to give you a follow.
  • Post frequently – posts don’t need to be long, some can be worthy, other light, but aim to post three to five times a week.

For a full introduction to how to claim your profile on Goodreads, click here

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CQC Rates Staff Owned Social Enterprise as Outstanding

First Community Health & Care C.I.C, a staff-owned social enterprise that provides services across the area of East Surrey and parts of West Sussex to a population of 178, 000 people, has been rated as Outstanding by the CQC.

Inspectors visited community services for adults and community services for children and young people based at Redhill, and Caterham Dene Hospital. Inspectors rated services Outstanding for being caring, responsive to people’s needs and well-led and Good for being safe and effective.

Inspectors found that the staff, teams and services were committed to develop strong links with other health care providers, local charities and support groups, delivering joined-up care to people who use the services.

The organisational culture was open, trusting, caring of the employees and there was a tangible commitment to supporting staff to deliver high quality services. Staff were encouraged to be shareholders and this ownership led to innovation and a real ‘can do’ attitude. All staff were proud ambassadors for the organisation.

There was a proactive approach to understanding the needs of different groups of people and to deliver care in a way that promoted equality. This was most evident in the way the service met the needs of the vulnerable, homeless, Gypsy, Roma and Traveller and refugee communities and those in vulnerable circumstances with complex social needs.

The Chief Inspector of Hospitals, Professor Ted Baker, said “We found the commitment of First Community Health & Care C.I.C staff to deliver high quality healthcare services in a caring and compassionate way to a range of diverse communities highly commendable.”

“While all services were delivered in a truly caring and compassionate way, we found the children’s services were exceptional in the way they were adapted to meet the needs of the community.”

“I would like to congratulate the entire staff and leadership team for the work that they do in providing an Outstanding service to the people in their care.”

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