CQC Reports Competing Priorities and Performance Measures Damaging Care for the Elderly

The CQC has been reviewing how those aged over 65 access and move between health and care services in targeted local authority areas.  With their findings in a third of the areas they are reviewing now published, the CQC has taken time out to step back and look at the bigger picture.

Whilst they commended those working within health and adult social care services, finding them passionate about providing the best possible experience to the older people within their care, they did find systemic problems.  Their efforts were too often compromised by the competing priorities, performance measures and accountabilities of each organisation, resulting in limited choice and difficulties when moving between services, with the system appearing confusing and fragmented.

Emerging Themes

  • the ‘whole system approach’ that focuses on integrated and person-centred care is not being realised as best as it could.
  • how providers and commissioners work together could be improved
  • lack of capacity is a real issue.
  • market supply and workforce issues are also barriers to achieving a seamless whole system approach.
  • Service commissioners and providers need to look beyond delayed transfers of care in isolation to resolve the problems that local systems are facing.

Prof Steve Field, chief inspector of general practice and integrated care, who is the executive lead for this work, said: “In too many instances, older people find the experience of moving between health and social care services confusing.  Too often, care is fragmented, choice is limited and people are uncertain about who is coordinating their care needs. Many people are worrying about what support will be in place when they return home from hospital, or who will be there to give their carer a break from looking after them full-time.

“In response, we encourage all system partners to have a clearly communicated health and social care offer that responds to people’s local needs, to provide a stronger focus on wellbeing initiatives that can help people to stay out of hospital and to address variation that can inhibit people’s access and choice.

“These are our interim findings and suggestions for improvement at this stage. We will report to the Secretaries of States for Health and Communities & Local Government again in the summer once we have completed all 20 reviews.”

The final report, following the completion of all 20 reviews, is due to be published in the summer of 2018.

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CQC Health and Social Care Review of Greater Manchester Reveals Disparities in the System

The CQC has published a report looking at how people move through the health and social care system in Greater Manchester, with a focus on how services work together.

This report is one of 20 targeted reviews of local authority areas looking specifically at how people move through the health and social care system. The reviews look at how hospitals, community health services, GP practices, care homes and homecare agencies work together to provide seamless care for older people living in a local area.

The CQC found that there was a sense of a true partnership between health and social care services in Manchester, with partners building relationships across the system, including voluntary, community and social enterprise agencies.

Local leaders of both Manchester City Council and NHS Manchester Clinical Commissioning Group envisaged that the current challenges in health outcomes for Manchester would be addressed through the radical transformation in the integrated commissioning of care services.

However, the system in Manchester has significant problems that must be addressed in the immediate future. People’s experiences of receiving services differed across the city, there were high numbers of emergency admissions to hospital, and once people were in hospital, they were more likely to remain there for longer than they should.

Key Challenges Facing The System

  • In the north of the city there were good arrangements to support people in the community to prevent hospital admission. However, once people were admitted to hospital their discharge was more likely to be delayed.
  • In the centre of the city there were fewer joined-up services to prevent hospital admission, although when people were ready go home or to a new place of residence, they were less likely to be delayed.
  • People who attended A&E often had to wait for more than four hours, and there were high numbers of people who had to wait for more than an hour in ambulances. This could be distressing for people who were unwell and waiting to be seen.
  • People living in care homes in Manchester were at a greater risk of becoming unwell from avoidable illnesses such as pneumonia and urinary tract infections than people in similar areas.
  • Care for people at the end of their lives was inconsistent; although in the north of the city there was a multi-disciplinary team to support people in their own homes, this was not available to people in the centre or south of the city and there was no hospice in Manchester to support people at the end of their lives.

Professor Steve Field, Chief Inspector of Primary Care Services, said “I know that Manchester’s political and healthcare leaders have a strong understanding of the challenges posed by poor population health, and poor health and care outcomes.”

“Our review of Manchester’s services and how they work together has found encouraging progress has been made in the establishment of joint commissioning, creating conditions for change.”

“There is a lot to do. Overall we could see there were areas of good practice in parts of the system. Where services were already integrated, staff reported that relationships between professionals such as occupational therapists and physiotherapists were good, with improved communication and information sharing.”

“We found there were workforce pressures in a number of areas, and social workers were carrying high and complex caseloads. This meant that there was a waiting list for assessments and a risk that people who were not having their needs assessed could end up as emergency cases.”

“However – the key organisations have now created a clear strategy that is built on partnership working. We found that this was clearly understood at all levels of health and social care commissioning organisations, providers and voluntary sector organisations. Staff that we met throughout the review were enthusiastic and believe that it is a force for positive change.”

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SME Commissioner Promises to Sort Out Payment Disputes in Wales

Wales’ small businesses now have more support to take action against unfair payment practices.

The Small Business Commissioner, Paul Uppal, will support 208,000 small businesses in Wales to resolve payment disputes and tackle larger businesses unfair payment practices to drive culture change.

SMEs can access new guidance through the commissioner’s website and they can submit late payment complaints to the Commissioner.

Paul Uppal, Small Business Commissioner, said “Having run my own small business for over twenty years I am well aware that integrity and trust are key to running and building a successful business. My mission is to help all small businesses nurture positive and lasting relationships with their customers that work in the best interests of both.

Today I am launching a new website so small businesses know their rights, as well as how to contact me if they need further action to be taken when the larger businesses they supply owe them money.”

This is one of a number of measures Government is taking to tackle a late payment culture. Regulations came into force in April 2017 requiring large businesses to publicly report the average time they take to pay their suppliers. This allows suppliers, including small businesses, to make informed decisions about who they do business with.

Firms can check when large businesses pay their suppliers on GOV.UK. So far over 200 of the UK’s largest businesses have submitted payment reports.

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Two-Year Accelerated Degrees One Step Closer

The government has launched a consultation on accelerated degrees.

Accelerated degrees offer the same qualifications and are quality-assured in the same way as a standard degree, but are delivered over a shorter, usually two-year timespan. This means when most students are completing their third year of study, an accelerated degree student will be starting work and getting a salary.

Proposals include a £5,500 (20 per cent) saving for students in total tuition costs compared to a standard three-year course (although the yearly cost is actually higher than on a three-year degree course). When added to the average salary of £19,000 in the first year after graduating, it means a potential £25,000 benefit overall.

For the taxpayer, it means significantly lower tuition loan outlay, higher rates of repayment and therefore a lower cost to the public purse of higher education. A higher proportion of students on accelerated degrees will also repay their loans in full.

Providers already offering accelerated degrees report on more engaged students, positive employer feedback and the opportunity to attract a wider pool of applicants, including mature students who often want to retrain and enter the workplace more quickly.

New fee arrangements for these degrees are set to be in place by September 2019, subject to parliamentary approval.

Professor Les Ebdon, Director of Fair Access to Higher Education, said “Accelerated degrees are an attractive option for mature students who have missed out on the chance to go to university as a young person. Having often battled disadvantage, these students can thrive in higher education and I hope that now many more will be able to take up the life-changing opportunity to get a degree.”

Providers offering accelerated degrees will need to meet exactly the same quality assurance measures as for the standard three-year equivalent degrees.

The new regulator, the Office for Students, will also support the provision of accelerated degrees when it becomes a legal entity in 2018.

The consultation will run until February 2018.

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World Book Night for 2018 Has a Mental Health Focus

The Reading Agency has announced the list of books to be given away on World Book Night, 23 April 2018.

The varied titles, donated by publishers from Penguin Random House and Hachette to small presses Nine Arches and Cassava Republic, include a diverse selection of commercial and literary fiction, poetry, non-fiction and young adult, each selected to inspire people who don’t regularly read to pick up a book and get reading.

With 1 in 4 people in the UK experiencing a mental health problem each year, The Reading Agency’s research shows that reading can increase empathy, improve relationships with others and reduce the symptoms of depression. The charity aims to harness this with several titles exploring mental health and wellbeing on the list, including Mindfulness: A Practical Guide to Finding Peace in a Frantic World by Mark Williams and Danny Penman, The Recovery Letters by Olivia Sagan & James Withey (eds.) and Open by Gemma Cairney. Other titles include British Book Awards Book of the Year 2016 The Loney by Andrew Michael Hurley, poetry collection Kith by Jo Bell and My Name is Leon by Kit de Waal.

For the second year running, a more targeted approach to World Book Night book distribution will see The Reading Agency working with public libraries, prisons, colleges, care homes, youth centres, mental health groups and other charities to get books into the hands of new readers on 23 April, when events celebrating reading will also take place nationwide. Organisations can apply to take part from today via worldbooknight.org.

The books

The complete list of titles donated by publishers for World Book Night 2018:

Kith by Jo Bell (Nine Arches)
Our Summer Together by Fanny Blake (Orion)
Open by Gemma Cairney (Pan Macmillan)
Dangerous Lady by Martina Cole (Headline)
Elizabeth is Missing by Emma Healey (Penguin)
After the Fire by Will Hill (Usborne)
The Woman in Black by Susan Hill (Vintage)
The Loney by Andrew Michael Hurley (John Murray)
Gilded Cage by Vic James (Pan Macmillan)
The Beach Wedding by Dorothy Koomson (Cornerstone)
Satellite by Nick Lake (Hachette Children’s)
Genuine Fraud by E. Lockhart (Bonnier)
You Don’t Know Me by Imran Mahmood (Michael Joseph)
Like A Mule Bringing Ice Cream to the Sun by Sarah Ladipo Manyika (Cassava Republic)
My Everything by Katie Marsh (Hodder)
One of us is Lying by Karen M McManus (Penguin Random House Children’s)
At My Mother’s Knee by Paul O’Grady (Transworld)
The Recovery Letters, Olivia Sagan & James Withey (Eds.) (Jessica Kingsley)
The Detective’s Daughter by Lesley Thomson (Head of Zeus)
My Name is Leon by Kit de Waal (Penguin)
What the Dog Knows by Cat Warren (Scribe)
Mindfulness: A Practical Guide to Finding Peace in a Frantic World by Mark Williams and Danny Penman (Piatkus)
Carry on Jeeves by PG Wodehouse (Cornerstone)

Sue Wilkinson, Chief Executive, The Reading Agency said “We know from our work on the Reading Well programme that there is a powerful link between reading and positive mental health. We are delighted to be able to include on the 2018 World Book Night list several titles that deal with this directly as well as others that we hope will lift readers’ moods or help them confront life’s difficulties.  

“Our aim with World Book Night has always been to reach and develop new readers and we can’t wait to work again with all of the wonderful public libraries, prisons, colleges and others who do such a terrific job of getting our brilliant books into the hands of people who don’t think reading is for them.”

After World Book Night 2017, results from a follow-up survey showed that The Reading Agency’s renewed, targeted approach to book distribution enabled organisations to help get more people reading. 91% of participating organisations rated their experience of taking part as excellent or good and 89% thought that the books donated by publishers in 2017 helped encourage people to read more often.

Get involved

Apply for your organisation to take part in World Book Night 2018

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Carefully Matching Carers to Clients Leads to Outstanding Rating by CQC

The Care Quality Commission has found the quality of care provided by Home Instead Senior Care – Eastbourne and Hailsham in Polegate, East Sussex, to be Outstanding following an inspection in October.

Home Instead Senior Care is registered to provide personal care and support to people living in their own homes. At the time of the inspection, 29 people were using the service.

Inspectors found staff were caring and compassionate and people were being provided with safe, responsive, caring, effective and well-led care.

Home Instead Senior Care was rated Outstanding for being caring, responsive and well-led and Good for being effective and safe.

Deborah Ivanova, CQC’s Deputy Chief Inspector for Adult Social Care in the south region said “Our inspection team was really impressed by the level of care and support offered to people at Home Instead Senior Care in Eastbourne and Hailsham.”

“People felt safe receiving care in their homes and told inspectors they didn’t have concerns. Care plans were personalised and contained information to provide care in a way people wished.”

“The service matched caregivers with similar interests, hobbies and personalities to those receiving care. People we spoke with said they received support from caregivers they knew well and everyone said staff went above and beyond what was expected. The service went the ‘extra mile’ in considering the needs of people and their caregivers, by holding various events and competitions to further promote and develop positive relationships with people and their families.”

“People and their relatives were actively encouraged to make their views known and were involved in making decisions about care. Staff had a very good understanding about what was important to people, going to considerable lengths to ensure people’s needs and wishes were met. It was clear that people liked and trusted them and were at ease in their presence.”

“Dementia and had two dementia friends’ champions – who are volunteers who encourage others to make a positive difference to people living with dementia – that had been trained by the Alzheimer’s society.”

“All of this meant people received a high standard of care, which is why it has been rated Outstanding.”


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Are You Ready for Small Business Saturday?

Saturday the 2nd December is Small Business Saturday – a celebration of small businesses everywhere!

Small Business Saturday UK is a grassroots, non-commercial campaign which has been running for 5 years and is going from strength to strength.  The event highlights small business success and encourages consumers to ‘shop local’ and support small businesses in their communities.

On Small Business Saturday, customers across the U.K go out and support all types of small businesses, online, in offices and in stores.  Many small businesses take part in the day by hosting events and offering discounts and there is still time to get involved.

  • Download the marketing pack for the event for free from the Small Business Saturday website, full of advice and guidance which will put you in good stead throughout the year!
  • Share news of your events with the hashtag #SmallBizSatUk and start connecting with new customers.
  • Register and advertise your business on the Small Business Finder for free!  Not only will potential customers find you, but media outlets looking for hooks for stories about the event in your area might discover you too!
  • Visit Marketing by Minal and get their top tips for marketing on this crucial pre-Christmas shopping day.
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See Stephen Hawking’s PhD Thesis Online

Step inside the mind of the young Stephen Hawking as his PhD thesis goes online.

Stephen Hawking’s PhD thesis, ‘Properties of expanding universes’, has been made freely available to anyone, anywhere in the world, via the University of Cambridge’s Open Access repository, Apollo.

The Apollo database is home to over 200,000 digital objects including 15,000 research articles, 10,000 images, 2,400 theses and 1,000 datasets.

Talking about the release of the document Professor Hawking said: “Anyone, anywhere in the world should have free, unhindered access to not just my research, but to the research of every great and enquiring mind across the spectrum of human understanding.

“By making my PhD thesis Open Access, I hope to inspire people around the world to look up at the stars and not down at their feet; to wonder about our place in the universe and to try and make sense of the cosmos. Anyone, anywhere in the world should have free, unhindered access to not just my research, but to the research of every great and enquiring mind across the spectrum of human understanding.

“Each generation stands on the shoulders of those who have gone before them, just as I did as a young PhD student in Cambridge, inspired by the work of Isaac Newton, James Clerk Maxwell and Albert Einstein. It’s wonderful to hear how many people have already shown an interest in downloading my thesis – hopefully they won’t be disappointed now that they finally have access to it!”

 Dr Arthur Smith, Deputy Head of Scholarly Communication, said: “From October 2017 onwards, all PhD students graduating from the University of Cambridge will be required to deposit an electronic copy of their doctoral work for future preservation. And like Professor Hawking, we hope that many students will also take the opportunity to freely distribute their work online by making their thesis Open Access. We would also invite former University alumni to consider making their theses Open Access, too.

“While the University is committed to archiving all these it is often a struggle gaining permission to open up historic theses. With the online publication of Professor Hawking’s thesis, Cambridge now hopes to encourage its former academics – which includes 98 Nobel Affiliates – to make their work freely available to all.”

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Rochdale Care Home is a Shinning Example of Excellent Care

The CQC has rated Healey House, in Rochdale, Lancashire as Outstanding following an inspection in September.

Healey House provides accommodation and personal support for people with a learning disability. At the time of the inspection there were nine people living at the home.

Inspectors were particularly impressed with the level of interaction with those in the home’s care and the pride staff take.  In their report they noted:

  • There was an excellent standard of organisation within the service that fully supported continuous improvement and ensured people received a high-quality service that met their needs and expectations.
  • People living in the home told us they felt safe and staff treated them well.
  • People’s independence was actively encouraged. The registered manager and staff displayed clear resolve to make a positive difference to people’s lives. Staff encouraged and supported people to access activities within the community.

Debbie Westhead, Deputy Chief Inspector of Adult Social Care in the North, said “We found the quality of care provided at Healey House in Whitworth, Rochdale to be outstanding.

“It was clear that staff at this service placed people at the heart of the care being provided and really promoted their right to be independent and determine how they live their lives.

“Our inspectors saw lovely relationships between staff and people living at the home with caring, good humoured and friendly interactions.

“All the staff at Healey House should be very proud of the care they are providing and I hope other providers look to their example of what outstanding care should look like.”

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Government Seeking Authors’ Views on PLR Rates

The Department for Digital, Culture, Media & Sport (DCMS) is seeking authors’ views on the British Library Board’s proposed PLR rate for 2018.

The British Library Board is responsible for making a recommendation to the Secretary of State of the amount to be paid from the PLR fund to authors, illustrators and other contributors to compensate them for the loan of their books by public libraries.  The amount due to each author is based on a rate per loan, calculated on the basis of the size of the fund and an estimate of the number of loans that will be made during the period.

The board is recommending that the rate is increased to 8.2 pence per loan, an increase of 0.38 pence over last year.  This increase reflects the fact that library cuts mean that the estimated number of PLR-registered loans has decreased.

In response to the consultation the Society of Authors has stated that is accepts the change but with the following recommendations:

  • They urge the government to include volunteer-run libraries in PLR.
  • The government ring-fences and increases the (already meagre) PLR fund in any future spending review.
  • They urge the Government to fulfil its obligation to provide, protect and maintain a comprehensive and efficient library service.

Let the government know your views on the matter by emailing rate_per_loan@culture.gov.uk, or by writing to:

4th Floor
Parliament Street
London SW1A 2BQ

But hurry – the deadline is the 24th November!

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