Are You Ready for National Start-Ups Day on 22nd October?

National Start-Up’s Day celebrates the UK’s flourishing start-up community for a third consecutive year on the 22nd October 2018.

Established in 2016, the #NationalStartupsDay campaign builds on the success of the past two years; last year, on Twitter the hashtag trended across the UK, generating hundreds of thousands of impressions while top brands, entrepreneurs and organisations gave their support to the campaign through social media engagement.

The event is designed to showcase exciting and innovative start-ups, while connecting start-up founders with advice and materials to help them succeed in business.

Supporters in previous years include the FSB, Dragons’ Den star Jenny Campbell, Margot James, Tech Nation, and Startup Bootcamp, while the message was also spread overseas with the French Embassy and the US economic development administration sharing their support.

All those involved in business, from start-ups to larger businesses with valuable advice for those starting out, are encouraged to get involved with the campaign and spread the word by sharing the hashtag #NationalStartupsDay and #PeoplesChampion on Monday 22 October 2018.

Organisers will be generating awareness of the UK’s most promising and innovative early-stage small businesses by showcasing profiles of over 70 inspiring start-ups in the running for #PeoplesChampion nominations for the Startups Awards 2018.

Readers and start-up peers will get the chance to vote for the companies they deem to be most deserving of the People’s Champion title, with the winner set to be revealed at the Startups Awards 2018 ceremony on Wednesday 21 November.

They will also be sharing a host of dedicated free advice, guides and materials across our social media accounts – on TwitterInstagram, and Facebook – to support start-ups and encourage the next generation of entrepreneurs.

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CQC Reports One In Seven Older People Can’t Access The Care Services They Need

This year’s State of Care Report from the CQC shows that most people receiving care are still getting good care – but there are significant issues accessing care, with one in seven older people having unmet care needs.

The Care Quality Commission’s (CQC) annual assessment of the quality of health and social care in England shows that overall, quality has been largely maintained, and in some cases improved, from last year. This is despite continuing challenges around demand and funding, coupled with significant workforce pressures as all sectors struggle to recruit and retain staff. The efforts of staff, leaders and carers to ensure that people continue to receive good, safe care despite these challenges has been recognised and applauded in the report.

Key Challenges For The Care System

The report concludes that people’s experience of care varies depending on where they live; and that these experiences are often determined by how well different parts of local system work together.

Ineffective collaboration between local health and care services can result in people not being able to access the care and support services in the community that would avoid unnecessary admissions to hospital, which in turn leads to increased demand for acute services.

The most visible impact of this is the pressure on emergency departments as demand continues to rise, with July 2018 seeing the highest number of attendances on record.

Many people have more difficulty accessing support or to have to travel unreasonable distances to get it. For example, inappropriate out of area mental health placements – with some people being placed hundreds of miles from their homes – vary considerably by region. And the CQC’s review of children and young people’s mental health services found that some children and young people were ‘at crisis point’ before they got the specialist care and support they needed, with average waiting times varying significantly according to local processes, systems and targets.

Posing a threat to effective collaboration between health and social care is the continued fragility of the adult social care market, with providers closing or ceasing to trade and contracts being handed back to local authorities. Unmet need continues to rise, with Age UK estimating that 1.4 million older people do not have access to the care and support they need. In two years, the number of older people living with an unmet care need has risen by almost 20%, to nearly one in seven older people. While the government made a welcome NHS funding announcement in June 2018, the impact of this, and last week’s short-term crisis funding for adult social care, risks being undermined by the lack of a long-term funding solution for social care.

Peter Wyman, Chair of the Care Quality Commission said “The fact that quality has been broadly maintained in the face of enormous challenges on demand, funding and workforce is a huge testament to staff and leaders.

“But we cannot ignore the fact that not everyone is getting good care. Safety remains a real concern: although there have been some small improvements 40% of NHS acute hospitals’ core services and 37% of NHS mental health trusts’ core services were rated as requires improvement on safety. All providers are facing similar challenges – in acute hospitals, the pressure on emergency departments is especially visible – but while many are responding in a way that maintains quality of care, some are not.

“Our other big concern is the fragility of the adult social care market. Two years ago, we warned that social care was ‘approaching a tipping point’ – as unmet need continues to rise, this tipping point has already been reached for some people who are not getting the good quality care they need. It is increasingly clear without a long-term funding settlement for adult social care, the additional funding for the NHS will be spent treating people with complex conditions for whom care in the community would have been more effective both in terms of their health and wellbeing and use of public money.”

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Libraries PLR Rate to Rise For Writers

The Government is proposing to increase the rate of PLR payments to 8.52p per loan for 2017/18, an increase of 0.32p for each loan. However it has admitted that the number of loans has continued to decline.

Public Lending Right (PLR) is the right for authors and other rights holders to receive payments from a central fund in relation to public lending of their books by libraries in the UK. It is paid retrospectively, and the proposed increase relates to loans made in 2017/18.

The British Library Board is responsible for making an annual recommendation to the Government of the rate that should be paid for each year. The Board has proposed a rate per loan of 8.52p, an increase of 0.32p from the previous year.

This proposal only relates to loans of physical copies of books and audiobooks. Although PLR has now been extended to remote e-lending, this change was brought into effect at the beginning of the 2018/19 period, with the first payments due to be made in early 2020.

Although this is, of course, good news for authors they are not likely to see a dramatic increase in earnings, as library lending continues to decline.  This reflects the cuts in library services that have taken place across the country, as well as the exclusion of some volunteer-run libraries from the PLR scheme.

Nicola Solomon, Chief Executive of the Society of Authors, said: “We are pleased with the proposal to increase the PLR rate. PLR is a vital source of income for many authors, and the UK’s funding pot for PLR is considerably below that of comparable EU countries.

“However we are saddened to learn that the number of loans of books registered for PLR is decreasing. This is no doubt caused by cuts in library services and the exclusion of some volunteer-run libraries from the scheme. We urge the Government to include volunteer-run libraries within the PLR scheme so that true figures for library lending can be recorded and remunerated.

“We also note that no additional funds have so far been allocated to the PLR fund to coincide with the extension of PLR to e-lending. We are delighted that this change has been implemented, but it needs to be accompanied by an increase in the overall fund, and we urge the Government to review this before the first payments on e-book and e-audio loans are made in 2020.”

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Unregistered Domiciliary Care Provider Prosecuted by CQC

A company director that illegally provided domiciliary care services from three north London addresses has been fined more than £3,500 at Highbury Corner Magistrates’ Court.

The company was not registered with the Care Quality Commission as required by the Health and Social Care Act 2008.

Mr Yousef Jowaheer was fined £1200 for each offence (two offences as Director for CapeHealth Care and Cape Home Care‎) and was also ordered to pay £170 victim surcharge and £966.40 costs, making a total of £3536.40.

He was disqualified as a company director for five years following the hearing on 3 August 2018.

Mr Jowaheer ran care services from different addresses in north London at: Broadhurst Gardens, Camden; Talbot House, Imperial Drive, Harrow and Canada House Business Centre, Ruislip, Hillingdon, over a period of years.

Andrea Sutcliffe, CQC’s Chief Inspector of Adult Social Care, said:“It has taken over two years for this individual to be located, and brought to justice and I would like to thank CQC staff that tracked down and helped prosecute Mr Jowaheer. We register and regulate services so that people can be protected and ensure they get good quality care.”

The company is no longer providing care services.

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Lack of Management Oversight Contributes to CQC Inadequate Rating

A GP practice in the London borough of Newham has been rated Inadequate overall by the Care Quality Commission. Previously it was rated as Good.

Boleyn Road Practice, which looks after more than 6,500 patients, was rated Inadequate for being safe, caring, responsive and well-led. It was rated Requires Improvement for being effective.

There were fundamental and significant concerns regarding governance and leadership and management capability.

  • Inspectors found that staff safety training, medicines management, premises and equipment safety, cervical screening and management oversight all needed to improve.
  • Staff had not always and treated patients with compassion, kindness, dignity and respect.
  • Patients were not always able to access care when they needed it.

Areas where the practice must now make improvements include:

  • Ensuring that all patients are treated with dignity and respect.
  • Ensuring care and treatment is provided in a safe way to patients.
  • Ensuring that equipment and the premises are fit for use.
  • Ensuring good governance in accordance with the fundamental standards of care.
  • Ensuring staff receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties.
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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.

Ratings

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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