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BHCR 2006 Vol 1 Issue 10

(Click the icon to download)
© Brunswicks LLP 2008

This week's article

Editorial

We have seen several government scandals unfold

relating to the lists of those barred from working with

children and vulnerable adults – no doubt everyone

recalls the Ruth Kelly debacle when her department

was not able to confirm the numbers of paedophiles

and sex offenders who, notwithstanding they were

barred from working with children, were nevertheless

allowed them to do so.

The latest scandal to break this weekend centres on

the Home Office and the Criminal Records

Bureau. It seems that almost 1,500 people who

wished to work in the health and social care sector

were prevented from doing so because they had

allegedly been convicted of a variety of crimes.

These people are desperately needed in the sector.

The Government’s response some may think was

high handed and arrogant. Tony Blair was reported

as having said in relation to the errors that it is better

to be safe than sorry.

For me, more worrying is the fact that this story

identifies only errors which wrongly label someone

as a criminal; what about those criminals who are

not identified as such in CRB Disclosures?

e his speech.

Parliament

22 May 2006 – House of Lords, Safeguarding

Vulnerable Groups Bill, Amendments

House of Lords – Health Bill, further

consideration.

23 May 2006 - House of Commons – Education &

Inspections Bill – Remaining stages

For further items, click here

Next

Abuse

1. Top priest told to retire as Pope toughens

stand on child abuse

20 May 2006—The Guardian

Pope Benedict ordered one of the Roman Catholic

church’s most influential figures, currently facing multiple

allegations of sex abuse, to give up his ministry

and retire to a life of “prayer and repentance”.

86-year-old Father Marcial Maciel only escaped full

trial in an ecclesiastical court because of his advanced

age and frail health.

2. Government to help care providers stamp

out abuse by workers

17 May 2006 – DoH

The new Care Services Minister, Ivan Lewis has

pledged the Government’s support to help care providers

stamp out abuse by workers by issuing a stepby-

step guide underlining social care providers’

statutory obligation to report abuse incidents. Ivan

Lewis also indicated that he was launching a new

section of the Department of Health website devoted

to ‘Dignity in Care’.

For full report click here

3. Worried paedophiles make most calls to

child abuse line

15 May 2006 - The Times

Analysis of calls to ‘Stop It Now!,’ a telephone

helpline, over the past three years shows that 45% of

calls are from abusers or potential abusers concerned

about their sexual feelings or behaviour towards

children.

The report is due to be published next month.

4. World Elder Abuse Day - 15 June 2006

15 June 2006 has been designated by the International

Network for the Prevention of Elder Abuse

(INPEA) as ‘World Elder Abuse Awareness Day’

backed by organisations such as the United Nations

and the World Health Organisation. The day’s objective

is to help people understand what elder abuse is,

and what steps can be taken to prevent it.

Please can you cascade this down in your organisation.

AEA are trying to reach as many people

as possible.

On the website is an Information Pack for organizations.

They also have one for the General Public.

AEA is organising a series of events to commemorate

World Elder Abuse Awareness Day on Thursday

June 15 2006, such as a skydive, a team of runners

in the British 10k, information stalls and collections

at Croydon and Sutton town centres and a lecture

in partnership with the Institute of Gerontology at

King's College London.

A host of individuals and organisations are also getting

involved with the day. AEA have had a great response

from care homes, sheltered housing

schemes, adult protection co-coordinators, local

councils and PCTs who are all getting involved, be it

through a coffee morning or holding an open day.

They are also asking the general public to help with

the campaign.

AEA is also launching a campaign for the day,

and they would like you to write to:

your GP, to enlist their help in raising awareness;

your local MP, requesting that direct funding be

provided for adult protection services; and

your local regulator, asking for more regular inspections

of all homes rather than less and for an

improvement in the distribution of medicine to residents.

For more details click here

Business News

5. CareUK

22 May 2006—Care UK

Care UK announced its trading statement for the six

months to 31.03.06. The high lights are that turnover

at £93.3m is up 18% on the same period last

year. Profit before tax and amortisation was up 10%

at £5.7m.

For full report click here

6. £300m PFI superhospital

17 May 2006 – The Herald

A $300m Scottish hospital has been announced, to

replace Falkirk and Stirling Royal infirmaries. It will

consist of a village of buildings and house 800 beds,

and will be the biggest private finance project of its

kind in the country.

Care Homes

7. Apology in care home closure plan

16 May 2006 – BBC News

Staffordshire County Council has apologised for distress

caused over plans to close homes for the old

and disabled, after a cabinet meeting heard that

there had been “insufficient action” to involve people

directly affected by proposed changes.

For full report click here

8. Arsonists set fire to care home

15 May 2006 – Cambridge Evening News

Cottenham Court Nursing Home in Cambridge had to

evacuate four residents after a fire broke out. Investigation

by firefighters revealed that the fire had been

started deliberately. No-one was hurt.

Case Reports

9. Carer Jailed

15 May 2006—The Evening Chronicle

Cindy Lockett, a care worker has been jailed for eight

months after stealing a disabled widow’s life savings.

The 79-year-old woman suffers from severe arthritis

and Lockett, 42, systematically siphoned off thousands

of pounds from her savings.

10. Watts

The Court of Appeal had asked the European Court

of justice for guidance on interpretation of European

law, as a result the ECJ decided that the NHS must

refund the cost of foreign care in circumstances in

which patients face enduring ‘undue delays’ for surgery

in Britain.

Mrs Watts had a £3,900 replacement hip operation in

France when Bedford Primary Care Trust said that it

would not reimburse the cost. The Court did not

award her the £3,900 as it said that whether the delay

she faced was ‘undue delay’ should be decided by

the British courts.

So, this matter is not yet over, but, perhaps it is in the

final few furlongs.

11. Hulme v Director of Public Prosecutions

The Magistrates were entitled to conclude that, on the

evidence before it, a woman who suffered from a

mental disorder was unable to refuse to be touched

sexually for the purpose of the Sexual Offences Act

2003.

Children

12. Child protection scheme trialled

20 May 2006 – BBC News

Scotland’s child protection system is piloting a new

system to create a computer file for every child in the

Highlands. From 3 September, teachers, police and

social workers will then be able to access the files

which will be kept “live” on each child until they reach

16 years old. The new measures are part of the

Scottish Executive’s programme called “Getting It

Right For Every Child”.

For full report click here

13. Couple 'abused foster children'

19 May 2006 – BBC News

A gay couple originally approved as foster carers by

Wakefield Council in July 2004 have been found

guilty of abusing vulnerable boys placed in their foster

care. The jury will be deliberating further charges on

Monday 22 May.

14. People who download child pornography

may pose low risk to children, says expert

18 May 2006 – Community Care

Sex crime expert Ray Wyre has said that people who

download child pornography may pose a low risk to

children and should be assessed accordingly. He

stated that police are "not gathering evidence in a

way that can confirm low or high risk," and that “the

rights of offenders’ own children must also be considered”.

For full report click here

15. Harman launches proposals to improve

systems for taking children into care

18 May 2006 – Community Care

New proposals have been announced to ensure that

the welfare of children is at the heart of the processes

involved in taking a child into care. The "Review of

the Child Care Proceedings System in England and

Wales" was published by Constitutional Affairs Minister,

the Rt Hon Harriet Harman QC MP and parliamentary

under secretary of state for children and

families, Parmjit Dhanda MP.

For full report click here

16. Hughes admits more is needed to be

done to support looked-after-children

18 May 2006 – Community Care

Children's minister Beverley Hughes today admitted

that the government has to do more to support

looked-after children because the difference between

the outcomes for looked-after-children and other children

was "completely unacceptable".

For full report click here

17. Child care proceedings under the Children

Act 1989

18 May 2006—DCA

A report reviewing studies of child care proceedings,

and was commissioned as a briefing paper for the

Child Care Proceedings Review. Key findings include

the seriousness of the cases which come before the

courts, involving vulnerable parents often with chaotic

lifestyles and health problems.

For full report click here

18. Nursery staff in E.coli refresher

18 May 2006 – BBC News

Staff at an Aberdeenshire nursery have been volunteered

for refresher training after two children took ill

with suspected E. coli O157 at the nursery. Test results

whether or not E. coli 0157 is present at the

nursery will be available soon and the two children

have since been discharged from hospital.

For full report click here

19. Regulator‘s Summit with Nursery Chain

in E-Coli Outbreak

17 May 2006 – Care Commission

For full report – see CSCI, CSIW, Healthcare Commission and

Scottish Care Commission – item 43

20. E coli nursery outbreak blamed on failure

to follow basic hygiene rules

Scotsman – 17 May 2006

According to a leading NHS official, poor hygiene

standards were to blame for the outbreak of deadly E

coli at a Fife nursery. Hand-washing was also pinpointed

as one basic fundamental to be checked.

The total includes two more possible cases of E coli

infection that emerged at a second nursery in Dunfermline,

based at Lynburn Primary School. One

child who attended both the Careshare and Lynburn

nurseries was confirmed as having the E coli 0157

infection, but has been allowed to remain at home.

Four of the nine confirmed cases are at Glasgow's

Yorkhill Hospital, where their condition was yesterday

said to be stable.

The number of possible and confirmed cases has so

far risen to 37. The most likely scenario quoted has

been that an adult or child got infected outside the

nursery and led to person-to-person spread within the

nursery. The Lauder nursery had already been criticised

by the Care Commission over its infection control

procedures in January this year. Its failure to address

highlighted problems could lead to enforcement

action backed by the threat of compulsory closure.

21. Money spent on learning difficulties services

does not improve lives

17 May 2006 – Community Care

For full report see Learning Disabilities—item 52

22. Mainstream schools can’t manage special

needs pupils, say teachers

17 May 2006 - The Times

For full report see Learning Disabilities—item 53

23. Childcare Provider Details XML Schema

16 May 2006 – UK Gov Talk

A schema designed to be used for overview information

(such as search results) of childcare providers,

as well as comprehensive details such as type, opening

times, contact details, facilities and costs. It

makes use of existing address and contact structures

to keep it as interoperable and accessible as possible.

For full report click here

24. NSPCC Launches 'Don't Hide it' Sex

Abuse Campaign as Rape Reports to Child-

Line Reach New High

15 May 2006 - NSPCC

The NSPCC has launched a major campaign against

child sexual abuse after the latest figures from Child

Line have revealed that rape is the type of sexual

harm most reported to it by children. Over eight and

a half thousand calls about sexual abuse were made

last year and just over half the calls (51%) were about

rape.

For full report click here

25. Worried paedophiles make most calls to

child abuse line

15 May 2006 - The Times

For full report – see Abuse – item 3

Conferences & Courses

26. The Future of Childcare Provision: Inspection and

Regulation Under the Childcare Bill

25 May 2006, Central London

If you would like to book a place please e-mail

dave.eastman@capita.co.uk or fax the relevant booking

form to 0870 165 8989.

27. Active Third Age – Enabling Access to

Work Opportunities, Guidance and Employment

for Older Workers

25 May 2006 - Central London

Key Speakers include:

Professor Stephen McNair, Director, Centre for Research

into the Older Workforce

Elizabeth Farmer, Director, Positive Experience

Andrew Harrop, Policy Manager, Age Concern

Chaired by: Baroness Greengross, Chief Executive,

International Longevity Centre UK

Mervyn Eastman, Chief Executive, Better Government

for Older People

To see a full conference brochure for this event, including

a full list of speakers and a booking form,

please click here. If you have problems with this link

or need any further information, please call Dave

Eastman direct on 0207 808 5309.

28. Commissioning Getting it Right for Everyone

1 June 2006—ECCA

Venue : Manchester Conference Centre, University

of Manchester

Audience : Directors of Social Services, Finance

Directors, Planning & Commissioning Managers in

Social Services, SHAs & PCTs, Independent Care

Home Providers, Independent Home Care Providers,

Patient & User Groups, Lawyers, Banks & other Finance

Institutions and Care Contracting Officers.

Speakers : David Behan (CSCI), Penny Banks

(Kings Fund), John Dixon (ADSS), Martin Green

(ECCA)

For further details click here

29. Quality Care for Older People: funding

and finance for the future

8 June 2006, central London

Counsel and Care’s forthcoming conference will take

place on . Sir Derek Wanless will give his thoughts

on the future of social care funding alongside the

new Minister for Social Care, Ivan Lewis. For details

and booking arrangements, see

www.neilstewartassociates.com/sh207

30. David Cameron to address providers

23 June 2006, near Oxford

David Cameron is to meet with providers at this

CareTalk event. Organisers Julia Barnes and Andrew

Parffrey said "If you believe that Care must be

available, affordable and accessible to all, come and

put your points to The Right Honourable David Cameron

and other WATCH panellists".

For details of how to get involved click here...or email:-

ssscaretalk@hotmail.com

and please forward to other Providers now!

31. OLDER PEOPLE’S ADVOCACY ALLIANCE

(OPAAL) UK

19 July 2006, Paragon Hotel, Birmingham

A national conference to present the findings of the

OPAAL national development project, with an opportunity

to contribute to the final report.

Booking form and agenda

Workshop descriptions

32. The Care Show

Birmingham NEC—25 & 26 October 2006

Bournemouth BIC—20 & 21 March 2007

Details : 01425 470666

www.careshow.co.uk

33. NCA Announces Early Details Of Their

Annual Conference

The 2006 NCA Annual Conference and Exhibition will

be held on 1 and 2 November 2006 at the Britannia

International Hotel in the heart of London’s Docklands.

The NCA’s annual conference is seen as a crucial

fixture in the independent care homes sector calendar,

at which care home owners, key MPs and care

industry specialists gather to discuss the state of the

care industry.

The Conference Agenda is almost complete and

speakers already confirmed include David Behan,

Chief Inspector of the Commission for Social Care

Inspection (CSCI) and Rodney Brooks, Chairman of

the General Social Care Council (GSCC).

Sheila Scott Chief Executive NCA said today: “I am

delighted to say that Professor Ian Philp, National

Director for Older People’s Services at the Department

of Health, has confirmed that he will be one of

the keynote speakers.”

Professor Philp, has responsibility for implementing

the national service framework for care of older people

in England with a brief to stamp out ageism in the

NHS.

34. NCA delighted to announce that the New

Minister for Social Care Ivan Lewis MP is to

Address NCA Annual Conference on 1 November

2006

16 May 2006 – NCA

NCA have announced today that the new Minister for

Social Care, Ivan Lewis MP has agreed to address

NCA’s Annual Conference at 9.30am on Wednesday

1 November 2006 at the Britannia International Hotel

in London.

Attendance at the conference is open to all and further

information and a booking form can be obtained

from NCA, 45-49 Leather Lane, London EC1N 7TJ,

0207 831 7090. infor@nca.gb.com or

www.nca.gb.com

Consultations

35. Consultation on amendments to the Care

Standards Tribunal Regulations

Closing Date: 2 June 2006

This consultation seeks views on a new set of Care

Standards Tribunal regulations, including reviewing

disqualification orders and appeal periods for childcare

providers and social workers.

For consultation click here

36. Code of Practice for the Mental Capacity

Act 2005: A consultation

Closing date: 2 June 2006

A consultation inviting comments on content and

style from all interested parties on the draft Code of

Practice, which is to provide guidance and information

for those working with or caring for those who

cannot make decisions for themselves, or those who

have a limited capacity to do so without assistance.

Press release:

For press release click here

For consultation click here

37. Have your say on assessing healthcare

services

Closing date: 5 June 2006

A consultation on plans for developing the annual

health check and proposed approach to assessing

the performance of NHS trusts in 2006/2007. Feedback

is also welcome on proposals for measuring

improvement in NHS organisations relating to the

Government’s developmental standards, designed to

drive up the quality of care for patients.

For consultation click here

38. Consultation on the Strategy for a Scotland

with an Ageing Population

Closing date: 5 June 2006

Scottish Executive consultation on Scotland's ageing

population. The Executive plan to develop a strategy

for Scotland's ageing population and are asking for

views on how older people's contribute to society,

older people and work, services for older people,

health and well-being, and housing, transport and

surroundings. Responses should be submitted to:

Nicole.ronald@scotland.gsi.gov.uk

Or: Nicole Ronald, Scottish Executive, Area 2G(S),

Victoria Quay, Leith, Edinburgh, EH6 6QQ

For consultation click here

39. Plans to amend the Mental Health Act

1983 - Race Equality Impact Assessment

Closing date: 6 June 2006

Under the Race Relations (Amendment) Act 2000,

public authorities (in this case the Department of

Health) are required to undertake a race equality impact

assessment of new policies and functions. The

consultation is for people or organisations who wish

to take part in the impact assessment of the Department's

proposals to amend the Mental Health Act

1983.

For consultation click here

40. Department of Health draft simplication

plan

Closing date: 20 June 2006

A draft plan setting out how to streamline data gathering,

reconfiguration of DoH’s arms length bodies and

a wider review of health and social care regulations

aiming to balance patient safety with reducing administrative

burdens amongst other points.

For consultation click here

41. Health services for young people

Closing date: 10 July 2006

A consultation inviting comments and proposals on

how best to deliver children and young people’s

health services. The Action Framework for Children

and Young People’s Health in Scotland is aiming to

be a one-stop shop for everyone involved in caring

for Scotland’s children.

For press release click here

For consultation click here

42. Guidance on the role of Director of Adult

Social Services: Consultation outcome

16 May 2006 – DoH

Launch date: 21 March 2005

Closing date: 28 July 2005

Outcome published: 15 May 2006

Describing the outcome of the Department's consultation

on the role of the Director of Adult Social Services

and includes statutory and best practice guidance

on the post.

For full report click here

CSCI, CSIW, Healthcare

Commission &

Scottish Care Commission

43. Regulator‘s Summit with Nursery Chain in

E-Coli Outbreak

17 May 2006 – Care Commission

The Care Commission is carrying out a detailed review

of infection control procedures at all nurseries

run by the company at the centre of the Dunfermline

E-coli outbreak. Careshare, an operator of 21 nurseries

across Scotland, has also been advised it will face

a series of spot checks to ensure staff are doing everything

they can to prevent the spread of infection.

For full report click here

44. Memorandum of Understanding between

HM Inspectorate of Prisons and the Healthcare

Commission

16 May 2006 – Home Office

A document detailing the framework agreed by HM

Inspectorate of Prisons and the Healthcare Commission

for co-operation and communication in relation to

the inspection of health services in places of detention.

For full report click here

45. CSCI highlight foster care recruitment

crisis

15 May 2006 – Care Commission

After a publication of a new report showing that repeated

upheaval traumatises children, the Commission

for Social Care Inspection has challenged fostering

agencies to prioritise the recruitment and retention

of foster carers. The report, entitled The

Right People for Me—Helping Children Do Well in

Long-Term Foster Care, revealed that over one in

ten (13%) of all children in foster care faced the upheaval

and instability of being moved from one place

to another three or more times during a single year.

It argues that many children in foster care have been

traumatised by difficult histories, separation and loss,

and concludes that finding the right foster carers who

can look after these children for more than just a few

months at a time is vital.

46. First National Report on the Quality of

Childminding in Scotland

15 May 2006 – Care Commission

The Care Commission have revealed their findings

on the quality of Childminding in Scotland, one of the

nation’s most important childcare services. Thousands

of families rely on childminders on a daily basis,

but there has never been a clear picture of the

state of this vital sector.

For full report click here

Education

47. Cameron urges active parent role

20 May 2006 – BBC News

David Cameron, leader of the Conservatives has

backed a call by the chief inspector of schools for

parents to take a more active role in their children’s

lives. He said that parents should ensure children

were not staying up late, and therefore too tired to

attend school.

For full report click here

48. Money spent on learning difficulties services

does not improve lives

17 May 2006 – Community Care

For full report see Learning Disabilities—item 52

49. Mainstream schools can’t manage special

needs pupils, say teachers

17 May 2006 - The Times

For full report see Learning Disabilities—item 53

50. School 'is failing my daughter'

16 May 2006 – BBC News

A report commissioned by the National Union of

Teachers has highlighted problems that schools have

coping with children who have special education

needs. Michelle Chambers is in agreement, she feels

that her daughter’s school is not meeting her needs.

According to school records, six-year-old Jade has

been physically restrained numerous times this year

already, and they kept indicating that she was difficult.

Mrs Chambers called in the police who concluded

no criminal intent, and she is taking action

through a disability discrimination tribunal.

For full report click here

51. School inclusion 'can be abuse'

16 May 2006 – BBC News

John MacBeath of Cambridge University has said

that including children with special education needs in

mainstream classrooms could be classed as “a form

of abuse”. MacBeath co-wrote the report for the National

Union of Teachers, the Cambridge report,

called The Costs of Inclusion.

For full report click here

Learning Disabilities

52. Money spent on learning difficulties services

does not improve lives

17 May 2006 – Community Care

Carl Poll has challenged councils to be “more creative”

in the way they tailored services for learning difficulties

services. He argued that current learning difficulties

spending was "fantastically wasteful" when it

was used for residential care and out-of-area placements

that did not give people "quality of life".

For full report click here

53. Mainstream schools can’t manage special

needs pupils, say teachers

17 May 2006 - The Times

John MacBeath one of the authors of a report written

by academics at Cambridge University and issued by

The National Union of Teachers has described the

policy of inclusion of children with special needs in

mainstream education in some cases amounts to ‘a

form of abuse’ where they are placed in totally inappropriate

schools.

The report marks the dramatic reverse by the NUT of

decades of support for inclusion.

54. Interview with new learning difficulties

tsar Nicola Smith

15 May 2006 – Community Care

An interview with Nicola Smith, recently appointed as

a government learning difficulties tsar, her post is the

first of its kind for a person with learning difficulties.

She will work alongside Rob Greig, the current national

co-director for learning difficulties.

For full report click here

Legislation Update

Nothing to report

Mental Health

55. King's Fund responds to Department of

Health commissioned report on mental

health services

19 May 2006 – King’s Fund

The King’s Fund senior fellow in mental health Simon

Lawton-Smith adds his comments on the independent

report commissioned by the Department of

Health on investment in mental health services.

For full report click here

56. College faces fight on adult cuts

19 May 2006 – BBC News

Lecturers and students have combined forces to fight

against the withdrawal of college courses for people

with mental health problems in Cornwall. About 80

full and part-time jobs are to go after cuts in adult

and community learning.

For full report click here

57. Supporting People services need to

move on to meet needs of people with mental

health problems

18 May 2006 – Community Care

The Supporting People programme has been told

that it focuses too much on moving people on from

their supported accommodation, when the support

services that should be moved on instead. This

came to light on a programme session run by mental

health charity Rethink during Community Care Live.

For full report click here

58. Appleby calls for race equality assessment

on amended mental health act

18 May 2006 – Community Care

The government hasn’t yet decided whether it will

carry out a race impact assessment on the amended

mental health act or just the proposed amendments.

Mental health tsar Louis Appleby said he would prefer

a race equality impact assessment on the whole

amended act but added that "Whatever we do about

this issue mustn’t impact on the timetable for bringing

in new mental health legislation."

For full report click here

59. The 2005/06 national survey of investment

in mental health services

17 May 2006 – DoH

A report showing details of the level of investment in

adult mental health services in England for 2005-06

and compares it with the results reported in previous

years.

For full report click here

60. Policy briefing: NHS investment in mental

health services (2005/06)

17 May 2006 – DoH

A policy briefing outlining the key findings from a oneoff

survey of strategic health authorities carried out by

the Department of Health in December 2005. The

survey was undertaken to establish whether NHS

organisations had maintained their agreed investment

levels during 2005-06.

For full report click here

Miscellaneous

61. Hundreds wrongly dubbed criminals

21 May 2006 – BBC News

It has been revealed that nearly 1,500 people have

been wrongly labelled as criminals by the Criminal

Records Bureau. The mistakes had led to some people

being turned down for jobs or university places.

The Home Office stated that when personal details

were similar to a recorded conviction, errors arose,

but that it represented “a tiny proportion of cases”.

The Home Office also said it would not apologise for

“being cautious”.

For full report click here

62. Branded as criminals

21 May 2006 - The Mail on Sunday

21 May 2006 - BBC Radio news bulletins

Report that nearly 1,500 people have been wrongly

branded as criminals through the CRB Disclosure

procedure. The errors have led to people being refused

jobs and university courses.

Two individuals had their stories highlighted, Emma

Budd a 19 yr old who was Disclosure asserted she

had criminal convictions, after attending a police station

and having her fingerprints taken she was

cleared by the police, but, to her amazement, when

later she applied for another job, again her prospective

employers were told she had convictions. She

complained that police blamed CRB and CRB blamed

the police. ‘Nobody would take the blame’. It has

taken two years to clear her name.

David Mansfield’s story is that he was prevented

from working with learning disabled children because

of alleged convictions for selling hardcore pornography.

He said ‘you find you’re dealing with nebulous,

faceless bureaucracy…it was hard getting replies…

Eventually, the CRB admitted they had made a mistake

and sent me £150 as an ex-gratia payment, but

there was no apology’.

HANDY HINT: if one suffers quantifiable loss

(such as loss of wages) as a result of the negligence

of someone else (such as the Home Office)

one is entitled to compensation. In such

circumstances one can reasonably expect to recover

the amount of the loss itself. In an employment

context this is likely to far outstrip the

amount of the ex-gratia payment which Mr Mansfield

recovered.

63. Goldsmith Appeal over discredited expert

20 May 2006 - The Daily Telegraph

The Attorney General is seeking to challenge the

decision overturning the finding by the General Medical

Council of misconduct against Prof Sir Roy

Meadow whose error led to the wrongful conviction

of Sally Clarke for the murder of her children.

Mr Justice Collins judgement in relation to Meadow

was that an expert giving evidence in court should be

immune from disciplinary proceedings initiated by

anyone other than the trial judge – the Attorney General

is seeking to challenge that principle.

For BBC report click here

64. Errors block benefits to disabled

20 May 2006 – BBC News

A Radio Five Live investigation has found that nearly

80,000 sick and disabled people a year are being

denied benefits because some medical reports are

unreliable or inaccurate. As a result, many have had

to challenge the decisions to obtain benefits to which

they are entitled.

For full report click here

65. May 2006 - BMJ

Heart failure is a common cause of illness and death

among the elderly, they say. “Even a small increase

in the risk can translate into a significant disease burden

in the general population,” they conclude.

66. New inquiry into Scottish 'tsars' amid

concern over rising costs

16 May 2006 – The Scotsman

Scotland has now launched an investigation into the

ever-growing number of powerful and expensive

“tsars” being appointed. Five more ‘tsars’ are in the

pipeline, but a new ‘tsar’s tsar’ will be appointed to

tackle the problem of what to do about all the other

‘tsars’. The new appointment will also investigate the

country’s expanding list of quangos, inspectors and

others.

67. Do you show entertainment videos and

DVDs within your Care Home?

15 May 2006 - MPLC

If you show home entertainment videos or DVD films

without a proper licence, you may be infringing the

Copyright, Designs & Patents Act 1988. Films shown

within communal lounges, staff rest-rooms or waiting

areas for tests or treatment, are considered ‘public

performance’ as defined in the Copyright, Designs

and Patents Act 1988.

Please note:

Videos/DVDs viewed at a residential location, within a

resident’s own private room, are seen as home use

and would not require a licence.

The MPLC can also be found on The Patents Office

website at www.intellectual-property.gov.uk as a

recognised supplier of the MPLC Umbrella Licence®,

the simple, economical copyright solution.

For further information go to www.mplcuk.com, or

Tel:01323 649 647 for a licensing quotation.

68. Changes to Sex Discrimination Legislation

: explaining the Employment Equality

(Sex Discrimination) Regulations 2005

15 May 2006 – Gov.uk

A general explanation of the changes to sex discrimination

legislation in Great Britain, which came into

effect on 1 October 2005. It is aimed at employers,

providers of vocational training and those with responsibility

for office holders. However, it may also be

helpful to individuals, employee representatives and

advisers.

For full report click here

69. Sack the officials, not ministers

15 May 2006 - The Times

The left-wing think tank, Public Policy Research is

due to publish a report in July 2006 saying ministers a

frustrated the performance of the Civil Service and

the way it ‘ducks accountability’. Top civil servants

should be more accountable for their performance,

such as in the NHS.

70. Agency promotes healthy eating for

young and old

FSA News Issue 57, May 2006

The Food Standards Agency Northern Ireland is continuing

to develop new initiatives as part of an ongoing

campaign to promote healthy eating messages to

young and old people across Northern Ireland.

One strand of this is a grants project, run by

ESANP’s Consumer Choice and Food Standards

Division, to support local initiatives designed to inform

older people.

One project that recently benefited from an FSA

Northern Ireland grant was a healthy eating event

run by Antrim Borough Council. More than 200 people

attended a cookery demonstration by celebrity

chef Jenny Bristow who provided some great ideas

for simple, nutritious one-pot cooking.

The chef also held a raffle for a lucky winner to take

home a full meal that she cooked in front of the audience.

Andrea Marnoch, FSANI Senior Policy Officer Diet

and Nutrition, said: ‘The importance of eating well for

the over 60s cannot be emphasised enough.’

‘This message is being given a particularly strong

focus in Northern Ireland and events such as these

provide not only an enjoyable day out for local senior

citizens but help to put across the message that eating

a healthy diet needn’t be too complex or costly.’

Keeping with the theme of healthy eating, FSANI

Nutritionist Cheryl White recently visited the Baby

Café in Bushmills to give a talk to mothers attending

the group on healthy food for their children.

NHS

71. Tory A-lister urges well-off to avoid burdening

NHS

21 May 2006 - The Sunday Times

Adam Rickett, former Coronation Street star,

and prospective Parliamentary candidate said he

does not want to burden the NHS and has health

insurance. He encourages those who can afford private

medical insurance to do so.

Editor: one hopes that the Tory leadership agrees

with Mr Rickett and that as part of the review of their

manifesto they will undertake to give tax relief to

those who effect private medical insurance.

72. PFI hospitals face huge overspend

19 May 2006 – BBC News

The government is set to ‘rein in’ spending on some

of the biggest hospital building schemes as they

threaten to run £4bn over budget. Two projects have

already been abandoned and three reviews have

made £297 of savings bringing the expected overspend

from delays to under £3bn. The Times newspaper

reported that it had figures showing the 18 biggest

schemes were running over £4bn at one point.

For full report click here

73. Review over demand for Herceptin

19 May 2006 – BBC News

In spite of a sit-in protest by campaigners, Shropshire

Primary Care says that it will not change its policy

regarding the funding of the drug Herceptin. The

trust will not fund the use of Herceptin for the early

stages of breast cancer unless there are "exceptional

circumstances" to do so.

For full report click here

74. NHS trust to axe up to 150 posts

19 May 2006 – BBC News

St George’s Healthcare NHS Trust in Tooting, South

London looks set to cut 150 jobs after it was told to

balance its books by the Department of Health, to

make an additional £10m of savings. Services would

be “unaffected” by the cuts, as most will be among

administration staff, and consultants hours will be cut.

For full report click here

75. Private GP deal decision reserved

19 May 2006 – BBC News

United Health Europe, chosen as a the preferred bidder

in January to take over the provision of GP services

in Derbyshire has had a High Court bid against

the move by a local resident. The High Court has

reserved judgment and the deal has not yet been

finalised.

For full report click here

76. 'Targets' triggering NHS bullying

18 May 2006 – BBC News

The British Medical Association has said that bullying

is rife within the NHS after a culture of “survival of the

fittest” has developed. The British Medical Association

has stated that one in seven NHS workers have

been bullied by colleagues and a survey of medical

students has found that one in four has been bullied

by other doctors and 16% had been bullied by

nurses. The BMA are calling for “zero tolerance” of

bullying.

For full report click here

77. Funding boost for NHS dentistry

18 May 2006 – DoH

Health Minister, Rosie Winterton announced a capital

investment of £100m over two years for NHS dental

practices and their patients. The money will be used

to modernise premises and equipments to improve

services to patients and allow PCTs to give more financial

support to help dentists establish practices or

to upgrade existing ones.

For full report click here

78. Thousands denied eye drug over NHS

costs

18 May 2006 - The Times

Front page article about a new drug treatment,

Macugen, for age-related macular degeneration

which NHS is refusing to patients as it is not yet approved

by National Institute for Clinical Excellence

(NICE).

This story has echoes of the wrangle between patients

and the NHS over the prescribing of Herceptin.

79. Nigerian dies amid heart battle

18 May 2006 – BBC News

A Nigerian woman visiting the UK has died during a

fight to have her moved up the NHS heart transplant

list. Ms Alabi came to Britain in September while

pregnant with twins, but fell ill and had to give birth in

Britain. This meant her visa expired and she was

given lower priority as a non-EU citizen.

For full report click here

80. GP surgeries 'bursting at seams'

17 May 2006 – BBC News

A survey has found that three-quarters of GP practices

are literally “bursting at the seams” and will not

be able to add any more services, one surgery in

particular reported that it used the staff room to administer

vaccinations. Ministers said that the findings

did not present the full picture.

For full report click here

81. Trust could axe 600 health posts

17 May 2006 – BBC News

Oxford Radcliffe NHS Trust has been accused of

failing to manage its budget effectively by the health

secretary, and as a result, may have to cut 600 posts

to save money. The statement was made during a

briefing to four MPs about plans to “reduce costs in

non-clinical areas”.

For full report click here

82. NHS to merge three county trusts

17 May 2006 – BBC News

Three out of Wiltshire’s four health care trusts will be

merged into one. From October, South Wiltshire,

West Wiltshire, and Kennet & North Wiltshire Primary

Care Trusts will be combined and work has started

already to get the new PCT in place, including the

appointment of a chairman and chief executive.

More than 80 management and administration posts

are at risk because the combined debt of West Wiltshire

and Kennet & North Wiltshire trusts amount to

£15.7m. Swindon PCT will not be affected.

For full report click here

83. NHS savings plan handed to bosses

17 May 2006 – BBC News

Lincolnshire’s health bosses have received details of

planned cutbacks to tackle its worsening NHS debt.

The plans are expected to be made public after the

Spring Bank Holiday, however a memo leaked to

BBC News suggest that night-time emergency services

could be reduced at Boston and Grantham.

Unison warned that up to 1,000 health jobs could be

lost.

For full report click here

84. Hospitals' cuts 'could hit jobs'

16 May 2006 – BBC News

The Derby Hospitals NHS Foundation Trust running

the Derby City General Hospital, the Derbyshire

Royal Infirmary and Children's hospitals have announced

that it needs to make £15m worth of savings

this financial year. Future staff redundancies cannot

be ruled out, however, they want to try to keep it to an

absolute minimum.

For full report click here

85. Appointment Reminders

In the wake of the press reports on the wasted hospital/

doctor appointments due to non-attendance,

here’s something that’s possibly new – as well as getting

a reminder letter from hospital for my appointment,

2 evenings before the day, I got a phone call to

ask if I would be attending hospital for my appointment.

86. More patients to get even better treatment

as new Primary Care Research School

launches

17 May 2006 – DoH

Health Minister Andy Burnham has launched a new

School for Primary Care Research programme, to

enable patients to receive even better care in primary

care settings and allow research into the huge range

of areas of professional practice relevant to primary

care for example, looking at everything from the

medicines a patient is prescribed, what tests should

be run on patients to what general advice should be

given about a condition.

For full report click here

87. More jobs go with health cuts

17 May 2006 - The Times

A further round of NHS redundancies reported as the

number of NHS Primary Care Trusts is to be cut by

50% and NHS Direct (the 24 hr ‘pone service) also

announced sweeping changes.

The Minister announcing the reorganisation, Andy

Burnham, said the changes would save £250m pa,

but that the initial cost of redundancies will be £320m.

From July the 29 ambulance trusts are to be merged

into 12.

88. Unhealthy Law

17 May 2006 - The Times

The editorial says that at face value the European

Court of Justice’s decision in Watts (see Case Reports—

item 10) seems simple enough and patients

win – if there is undue delay in a patient’s treatment

the patient can seek. Treatment overseas and recoup

the cost from the NHS. However, it heralds a

warning, that the court has expressed itself in such a

‘woolly’ way that it will be fertile ground for lawyers.

89. NHS told to fund treatment abroad

16 May 2006 – BBC News

The European Court of Justice has ruled that the

NHS must refund costs if patients were forced into

Europe as a result of being forced to waiting longer

than they should. The court ruling was for the case

of Yvonne Watts, 75, of Bedford, who paid £3,900 for

a hip operation in France. However, the court said in

her case, the UK courts would have to decide if she

got a refund.

For full report click here

90. Reorganisation of primary care and ambulance

trusts

16 May 2006 – DoH

This webpage gives information on how primary care

trusts (PCTs) and ambulance trusts are to be reorganised.

It also provides maps of current and new

PCTs for each region of England.

For DoH press release click here

For DoH webpage click here

For BBC report click here

91. Hundreds face axe at NHS direct

16 May 2006 – BBC News

NHS Direct has proposed to close 12 of its smaller

call centres, expand others and cut nearly 800 posts

to help balance its books. It will be consulting staff

over the next three months and is aiming to save

£15m through the measures. NHS Direct currently

deals with 25,000 calls every day, and was set up in

1997 to help give medical advice to people on how to

deal with symptoms and to direct them to the correct

place in the event of an emergency.

For full report click here

92. Chocolates are the latest measure of satisfaction

with the NHS

16 May 2006 - The Times

Article on the new patient satisfaction survey

launched by The Royal Cornwall Hospital NHS Trust

of nurses recording gifts they receive from grateful

patients. The new audit was described by Howard

Catton, head of the Royal College of Nursing as

‘about as useful as a chocolate teapot’.

93. Ex-health boss justifies new firm

15 May 2006 – BBC News

Trevor Molton, a former health chief accused of defrauding

the NHS out of £250,000 has defended his

decision to set up a company recruiting overseas

nurses, stating that he registered the potential conflict

of interest with his employers and never hid his involvement

with the company. Mr Molton told the

court that he set up the Trust Professionals agency

quickly to bring in nurses from overseas because of

pressure from the government and that was

“essential” that the said nurses had somewhere to

stay in the UK.

For full report click here

94. New dental practice opens doors

15 May 2006 – BBC News

A dental surgery will open on Monday 22 May in Carlisle

after another Carlisle surgery stopped offering

NHS treatment last year. Patients will be taken on

only by invitation through the Dental Direct register.

For full report click here

95. Hospital trust 'spending to save'

15 May 2006 – BBC News

Leeds Teaching Hospitals NHS Trust has spent

£100,000 a month on advisers to tell it how to save

cash, whilst it is cutting hundreds of jobs in a bid to

save £25m. 430 posts are due to be cut as part of a

plan to save £84m over the next three years. Trust

Chief Executive Neil McKay has defended the expenditure

saying the advisers were specialists and

helped firms in the past to make substantial savings.

For full report click here

96. MRSA spread

15 May 2006 - The Times

Figures show that, since 2003, 230 children have

caught MRSA while staying at Scottish hospitals.

97. Sack the officials, not ministers

15 May 2006 - The Times

For full report see Miscellaneous—item 69

98. The chocolate audit

15 May 2006 - Daily Mail

The Royal Cornwall Hospital NHS Trust which is £8m

in debt has instructed staff to notify what gifts they get

and the value. This is not to prevent corruption but is

the new way to measure patient satisfaction – apparently!

Nursing

99. Nurses face pay cuts in NHS plan

17 May 2006 – BBC News

Barnsley Hospital is proposing to regrade nurses’

posts, and as a result around 200 nurses could see

their pay being cut. According to a survey at the

hospital, not enough nurses were providing hands-on

care and too many working at a high level. The

move was more about improving the strength of the

workforce and not about saving cash – staff have

until 14 June to comment on the proposals.

For full report click here

Older People

100. WOMAN, 80, TAKES NO CHANCES

20 May 2006 - The Times

Mrs Mary Wohlford of Iowa, USA who is excellent

health has made a ‘living will’, however, she has

gone further than most in having the words ‘DO NOT

RESUSCITATE’ tattooed on her chest. She said

‘sometimes the nuttiest ideas are the most advanced’.

101. Welcome to Britain’s new dying rooms

20 May 2006 - The Daily Telegraph

A two page article by Damian Thompson on the new

phenomenon of NHS discharging elderly patients at

the end of life. Hampshire, the first county council to

employ its own nurses has spent £60m on state of

the art, ‘spanking new’ care homes, one, Willow

Court, Andover, has 53 beds and has had admissions

of 100 in only two months. Ken Thornber, Tory

leader of the council believes that the NHS is ‘silently

but in very significant numbers releasing older people

from hospital too soon’.

The manager of the home, Mary Critcher, a former

district nurse and hospice manager, reports that she

is asked to assess patients for discharge from hospital

into the care of a home when they are so ill, as

she puts it ‘they are about to go to heaven’ yet someone

in the hospital has assessed the individual as fit

for discharge.

102. Protection of Vulnerable Adults scheme

in England and Wales for adult placement

schemes, domiciliary care agencies and care

homes: A practical guide

17 May 2006 – DoH

A practical guide for implementing the protection of

vulnerable adults (POVA) scheme, it is accompanied

by the following documents: overview of POVA implementation

flowchart; pre-employment checks for domiciliary

care providers and managers; preemployment

checks for adult placement scheme providers

and managers; and pre-employment checks

for care home providers and managers.

For full report click here

103. POVA

17 May 2006 – Social Care Institute

This guide aims to support people making referrals to

the POVA list under the Care Standards Act 2000. It

will help employers and managers to make effective

referrals that can be processed efficiently, leading to

accurate and timely decisions on POVA listing by the

Secretary of State for Health.

For full report click here

104. Silver Surfer Week

Silver Surfer Week runs from 22 May 2006 to 26 May

2006, it is a promotion of the internet to those over 55

years of age who have little or no knowledge of the

internet and the way in which it can enhance the lives

of older people. Age Concern, in partnership with

Microsoft has the ‘Silver Surfer Safari Bus’ visiting a

number of town on the south coast of England to promote

awareness.

For further info click here

Parliament (continued…)

24 May 2006 – Private Members Debate – Laura

Moffatt on nursing training & practice.

24 May 2006 – Safeguarding Vulnerable Groups Bill,

Report.

25 May 2006 – House of Commons – Adjournment,

Health services in the Forrest of Dean and Gloucestershire.

Scotland

105. Child protection scheme trialled

20 May 2006 – BBC News

For full report see Children—item 12

106. Executive admits it must do better over

delays in cancer care

18 May 2006 – The Scotsman

For full report see Social Care —item 114

107. £300m PFI superhospital

17 May 2006 – The Herald

For full report see Business News—item 6

108. Regulator‘s Summit with Nursery Chain

in E-Coli Outbreak

17 May 2006 – Care Commission

For full report see CSCI, CSIW, HEALTHCARE COMMISSION

AND SCOTTISH CARE COMMISSION – item 43

109. New inquiry into Scottish 'tsars' amid

concern over rising costs

16 May 2006 – The Scotsman

For full report see Miscellaneous – item 66

110. First National Report on the Quality of

Childminding in Scotland

15 May 2006 – Care Commission

For full report see CSCI, CSIW, HEALTHCARE COMMISSION

AND SCOTTISH CARE COMMISSION – item 46

Social Care

111. Department of Health calls for social

workers' views

18 May 2006 – Community Care

The Department of Health is seeking social care

staff’s experiences and views on the treatment of

older people in the care system as part of its campaign

to promote dignity.

To respond, visit www.dh.gov.uk/dignityincare

For press report click here

112. Treasury highly unlikely to fund

Wanless's call for a guaranteed free minimum

level of service for all older people

18 May 2006 – Community Care

The Treasury is examining a more modest version of

the funding proposal put forward by the Wanless so

cial care review and how it may work in practice. Under

the version currently being considered, the system

would be geared to producing less ambitious

outcomes than those originally proposed by Wanless.

For full report click here

113. Tony Blair slammed for continually moving

social care ministers

18 May 2006 – Community Care

Peter Beresford has slammed Prime Minister Tony

Blair for constantly moving ministers from their social

care posts to other departments so they do not have

time to get to grips with the portfolio. Liam Byrne was

Care Services Minister for less than a year before he

was moved to the Home Office to oversee policing,

with Ivan Lewis taking his place at the Department of

Health. The professor of social policy and director of

the Centre for Citizen Participation at Brunel University

also said: "Byrne’s predecessors were all soon

promoted out of social care because they were good.

Are the government waiting until they get a bad one

for him or her to stay in post? Is social care a third

division football club waiting for the first division to

poach our stars?"

For full report click here

114. Executive admits it must do better over

delays in cancer care

18 May 2006 – The Scotsman

The Scottish Executive has admitted that it must do

better as it emerged that cancer treatment waiting

times have worsened. The Executive had originally

aimed to ensure that all cancer patients started treatment

within two months of an urgent referral from

their GP. Statistics published from the last three

months of 2005 showed that only 74% of all cancer

patients started treatment within two months, compared

with 75% of the previous quarter.

115. Over 400 social workers referred to

GSCC for alleged misconduct

17 May 2006 – Community Care

It has been discovered that more than 400 social

workers have been referred to the General Social

Care Council for misconduct. 161 of the referrals

were assessed as not amounting to its complaint of

misconduct, 50 have been referred to the regulator’s

preliminary proceedings committee and 191 are still

being investigated.

For full report click here

116. Social care employers need to support

staff who are carers or face problems

17 May 2006 – Community Care

Nearly one in five of the workforce are also carers,

and called for Social care employers to support staff

who are carers or they will face major recruitment and

retention issues.

For full report click here

117. Lewis: social care needs to lose victim

mentality

17 May 2006 – Community Care

Ivan Lewis spelled out his hopes for social care by

citing his transformation of the Department for Education

and Skills to a top government priority, and that

he hoped to do the same turnaround for social care.

He has been in the job for just 12 days, and stated he

would like to bring social care “from the margins to

the mainstream”.

For full report click here

118. Dignity in care

17 May 2006 – DoH

This webpage provides information on the Dignity in

Care initiative, it has been set up to ensure all older

people are treated with dignity when using health

and social care services.

For full report click here

119. ECCA welcomes new Care Home Minister

16 May 2006 – ECCA

The English Community Care Association (ECCA)

has welcomed the appointment of Ivan Lewis MP

and said it looked forward to fostering good links with

him.

For full report click here

120. DRC launches first formal investigation

into public sector fitness standards

16 May 2006 - Community Care

Monday 22 May heralds the beginning of part of a

12-month Formal Investigation being undertaken by

the Disability Rights Commission. Regulations and

procedures governing entry to, and work in, teaching,

nursing and social work are to be subjected to the

first detailed legal review of their compliance with the

Disability Discrimination Act.

The review will form part of a Formal Investigation

being undertaken by the Disability Rights Commission

which begins on Monday 22 May 2006.

The investigation will look into how training, qualifying

and working practices within these professions

may be posing challenges to the entry and progress

of disabled people.

In October 2005, an approved social worker successfully

appealed against the GSCC after it imposed

conditions on his registration after he disclosed

he had bipolar affective disorder.

For full report click here

121. Funding vital for registration scheme to

work, ECCA warns

15 May 2006 – Community Care

The ECCA has warned that without significant government

funding, plans to register all residential and

home care staff will fail. ECCA has also said that

plans to register service managers is simply duplicating

the existing requirement for them to register with

the CSCI.

For full report click here

122. Speech by Ivan Lewis MP, Parliamentary

Under Secretary of State for Care Services,

15 May 2006: CSIP White Paper Implementation

Event

15 May 2006 – DoH

A transcript of the speech made by Parliamentary

Under Secretary of State for Care Services Ivan

Lewis at the Care Services Improvement Partnership

White Paper Implementation Event on 15 May 2006.

He talks about social care and the Director of Adult

Social Services guidance.

For full report click here

123. ECCA’s Response to Consultation on

the Registration of Social Care Workers

15 May 2006 – ECCA

The English Community Care Association (ECCA)

has responded to the General Social Care Council’s

consultation on the registration of social care workers.

For full report click here

124. Skills for Care chief highlights inequalities

15 May 2006 – Community Care

Skills for Care chief executive Andrea Rowe has attacked

the much greater investment in developing new

roles in the NHS than in social care. Rowe said the

NHS received £32m in 2005-6 to develop new roles,

while Skills for Care received just £3m for the same

purpose in social care, despite the comparative size of

the workforces.

For full report click here

Staff, employment and

disciplinary

125. Over 400 social workers referred to GSCC

for alleged misconduct

17 May 2006 – Community Care

For full report see Social Care—item 115

Wales

126. New dental practice opens doors

15 May 2006 – BBC News

For full report see NHS—item 94

© Brunswicks LLP 2006 http://www.brunswickslaw.com Page 17

The impact of regulation

and future plans for inspection

Speech by David Behan—Chief Inspector,

Commission for Social Care Inspection

Ceretas Annual Home Care Conference

10 May 2006

Thank you for inviting me. You have asked me to talk

about the Commission’s plans to modernise the way

we regulate social care services, in the context of the

vision that is set out in the White Paper and I am delighted

to do so.

Let me just say first that the home care sector provides

vital support. The provision of home care and

other simple services help people maintain the independence

that we know is important to them. Home

care was delivered to almost 600,000 people in

2004/05, 98,000 of whom received intensive support.

Some 30% of home care is provided by councils.

Councils spent £2.3bn in 2004/05 on home care.

Hours of home care delivered increased by 6% in

2005/06. We also know that people are receiving

intensive packages of support in their own homes is

increasing and the numbers of people in residential

care has fallen. However we also know that the number

receiving simple services has fallen as threshold

or eligibility criteria have increased.

What makes services improve?

I believe there are 5 influences on the quality of services:

1. People’s views and expectations – will people

accept the quality of services on offer

2. How providers run services – providers are responsible

for the quality of services;

3. How councils and PCTs commission services

– are they clear what they are commissioning in

terms of quality and outcomes as well as price and

volume;

4. How the market operates – how the money flows

into the sector;

5. How the regulator operates – what do we do to

assure the quality of services.

All 5 influences need to operate together effectively to

improve quality. At the moment we have strong regulation

– but we need to further develop commissioning

and provider responsibility for quality.

What do people want?

People who use social care services have told us

what matters most to them.

Our recent report Real Choices, Real Voices highlighted

these – and this is the order that people put

them in:

Choice

Flexibility

Information

Being like other people and taking risks

Respect and being heard

Fairness and non-discrimination

Cost and value

Safety

People have told us:

“The main point is that you should be able to make

your own decisions depending on what level you feel

safe at. You spend your whole life making decisions

about things, your work, your relationships, your children,

you don’t want to suddenly give up that responsibility

because you’re older.

“Social services don’t see you as an individual. They

tell you what you want, but don’t listen to what you

really want.”

In the next few years peoples’ ‘voice’ and their expectations

will be a significant driver of the way services

are commissioned and provided. The baby

boomers who are now entering ‘old age’ will bring

with them a range of expectations which will be more

demanding than previous generations. They will undoubtedly

assert their rights in 2010 as they did in

the 1960s.

What people say they want from services should be

the starting-point for providers and commissioners.

Providers are responsible for quality. It is essential

they are clear about their responsibility. As regulator

our role is to encourage improvement and challenge

services which don’t meet standards. We are not an

improvement agency. Our job is to identify where

improvement is required and then to judge that improvement

has taken place.

If personalised care is to be made a reality, as set out

in the care services White Paper and other policy

documents, current ways of commissioning services

will need to change. The challenge now facing councils

is how to take a strategic, long-term view of what

sort of services need to be developed, based on individual

preferences. Councils do of course face the

dilemma of having to be efficient – which can indicate

block-purchasing arrangements – at the same time

as purchasing individualised services. In resolving

this, they will need to develop better ways of listening

to people and taking their views into account to encourage

new services and new ways of contracting.

Crucially, they will need to take a broad view of commissioning.

This should include local economic development

strategies to encourage the local market for

care, and develop more sophisticated IT systems,

which can track changes in service preference.

Above all, commissioners must recognise that they

are responsible for the whole community they serve.

They will have to find ways to include those groups

who find it hard to participate, that have profound and

complex needs and whose services might so easily

be left behind in this complex change agenda.

They will need to rise to the challenge of ensuring

that there is a sufficiency of provision for all their local

community; not just those whose care they expect to

fund, but also for those who pay for their own care.

The best councils understand that they should com

mission to meet the needs of the whole population

they serve, and they have undertaken a thorough

analysis of what these needs might be. But many

councils are still commissioning services on the basis

of incomplete knowledge of what is required.

Turning to the operation of the market – social care

has been a pluralist market for over a decade. But

two recent reports have highlighted a number of issues

that we need to pay attention to.

The Office of Fair Trading in their report published

last year fundamentally challenged current expectations

of the care offered to older people in homes. It

raised serious questions about how inadequate information

and a lack of transparency erodes older people’s

rights as economic consumers and as citizens.

More recently the King’s Fund published ‘The Business

of Caring in London’ and identified the absence

of market development and market management as

an influence on the quality of care.

The focus of our work at the Commission therefore

needs to be not only the quality of services but also

the operation of markets in meeting people’s diverse

needs. Councils will need to encourage innovation

through new models of care and new ways of providing

it – we are seeing a small increase in user-led

and managed services, and social enterprises. Increasingly

of course developing the market will involve

commissioners from different sectors. Commissioning

will need to involve housing as well as health

and social care – our forthcoming publication on

Supporting People emphasises the importance of

Health and Housing and Social Care undertaking

joint commissioning of services to meet local needs.

Inspecting for better lives

In recent years there has been an important debate

on regulation in both the public and private sectors.

The debate has focused on the role, purpose and

function of regulation together with a challenge as to

its costs and benefits.

Central to this modernising inspection approach is

what we believe to be a more intelligent approach to

inspection. Turning up at a home for a few days

twice a year doesn’t tell us much. It gives only a

snapshot of the reality of people’s lives in that home.

Our new system will bring together different types of

evidence in the way we form our judgements about

the quality of services.

Our intention is to focus more strongly on the experience

of the people using care services, and on how

providers are building in quality.

The changes affect:

The style and frequency of inspections;

The introduction of a quality rating for all services;

Our reports on services;

How care providers tell us about their plans to

improve;

The information providers submit to us;

How people who use services are involved in

our work;

How providers register with CSCI.

The Department of Health has announced changes to

the statutory regulatory framework for adult social

care.

Previously, Government regulations stipulated that

the Commission must inspect most adult services at

least twice a year. Under the new regulations, we will

be able to inspect any adult social care service at any

time – as long as every service is inspected at least

once every three years. This means we will be able to

focus more attention on services that need the most

support.

In future there will be three types of inspections:

Key inspections,

Random inspections, and

Thematic inspections.

Key inspections are thorough, unannounced inspections.

Our intention is that all adult social care services

will receive at least one key inspection between

April 2006 and June 2007.

We will look at all the information we already have on

services – such as complaints, incidents and previous

reports, to see how well the service has performed in

the past and how well providers have improved their

service. We will talk to people who use services and

to people who are involved in other ways – such as

families, and care professionals.

Then we will visit and see for ourselves how well the

service works, and we’ll make a judgement on the

quality of the service based on all this information.

We will discuss this judgement with providers before

it is finalised, and it will help us to decide how often

we need to inspect a particular service.

Random inspections will be short, targeted inspections.

We will do these if we want to check out a specific

issue about a particular service. For example –

we may wish to follow up a complaint or see for ourselves

the progress on addressing an issue identified

in an earlier inspection.

We will also carry out a number of random inspections

each year without a specific reason and without

notice – to provide reassurance to the public and

people who use services, as well as to ourselves.

In addition, we will carry out a number of thematic

inspections each year to follow up on national or

regional issues. For example, we might decide to

look at meals, or how medication is managed. (Wwe

have recently published reports on medication, and

meals.both of these themes). Our findings will feed

into a national report on specific themes. If there are

issues of good or poor practice in a particular service,

we will put these in a letter to the service provider.

We’ll also put this letter on our website for the

public to see.

The regulatory changes bring a new legal requirement

for registered providers to produce an Annual

Quality Assurance Assessment. This will reinforce

the need for good quality assurance, which we believe

is a vital part of maintaining a service that works

well for the people who use it and puts the responsibility

for high quality care where it needs to be – with

the providers. The assessment will take the place of

the current pre-inspection questionnaire. Our expectation

is that providers will give an assessment of:

How well they believe they deliver good outcomes

– such as those listed in the recent

community services White Paper – for people

using the service;

How they have used the views of people who

use the service to shape what they do; and

Where they believe they need to improve the

service and what action they will take.

In 2005 we introduced a new style for our reports,

making them more accessible for people, and we

have had a positive response from the people who

use them.

We intend to introduce a new quality rating system

for adult services in April 2007 linked to the White

Paper outcomes. For providers, this means that we

will use clearer criteria to say how we judge their performance

against outcomes. For the public, it means

that our judgements will be presented in a way that

helps them better understand the strengths and

weaknesses of a particular service. We will use descriptors

setting out whether performance on each

outcome is ‘excellent’, ‘good’, ‘adequate’ or ‘poor’. It

will be very clear what a provider needs to do to

achieve an ‘excellent’ rating.

A major element of our new approach to regulating

social care is a new emphasis on service improvement.

We all know that even the best care services

have room for improvement. Providers are responsible

for driving improvement in services. The Commission

plays a part in improvement but we are not an

improvement agency. Our job is to identify where improvement

is required and then to assess that im

provement has taken place, consequently, the Government

has included in the new regulations a requirement

that providers of adult care services produce

a plan about how they will make the improvements

that they and the Commission agree are

needed.

Each year at about the anniversary of the first key

inspection, the Commission will review all the information

we have about a particular service. We will

pay particular attention to new information or service

changes. A summary of the annual care service review

will go on our website for the public to see.

We will show:

Any changes in registered provider or manager;

Notable good things in the service that have been

brought to our attention;

Complaints that have been investigated and upheld;

The main findings of any random or thematic inspections;

Recent views of people using the service.

We will then consider if there are risks to people using

the service, on the basis of the available information.

If so, we may decide to bring forward our key

inspection or carry out a random inspection.

Our new approach to inspection can be summarised

as: collect, assess, think, act. Collect information.

Assess the evidence, and put it through our riskassessment

process. Think – what is this information

telling us? What is going on at this service? Is

this the true picture? Why are these things happening?

And act – decide how and when we will inspect

the service in future and how we will work with the

provider to encourage improvement.

What will success look like?

We are confident that the new regulatory system I

have described has the potential to drive real improvement

in services across the board. We will

know that things have improved when:

We have moved to a culture of improvement

not ‘compliance’.

People who use social care services will have

a better experience and a stronger voice to

influence the services they use.

Innovation will be rewarded and encouraged.

The sector will grow to meet increasing and

changing demands.

People will be better able to plan their own

services using the Commission to inform and

support their decisions.

I also want to say something briefly on assessing the

performance of councils. We have begun work on the

Performance Assessment Framework for measuring

council’s performance in 2006/07. We are moving,

in graduated steps, towards an outcomes based

performance framework. Not only should the indicators

better reflect the policy initiatives but also they

should reflect the work that councils deliver in partnership.

We are working to have in place a revised performance

assessment framework for 2008. This will be

based on the 7 outcomes described in the White Paper.

The focus of this work will be on how councils commission

services. At present there is no correlation

between councils assessed as excellent and the

quality of local regulated services. How councils commission,

and the impact on the market, will be part of

their performance assessment in future.

As we move our assessment processes to looking at

outcomes, commissioners will also become aware of

alternative services that may work better to meet people’s

needs. Councils have a critical role in assessing

needs and commissioning services to help people

live their lives to the full – but too often the emphasis

is on what people can’t do, not what they can.

The White Paper has a bold and ambitious vision for

adults who require help support and care. At its heart

is a change in the nature of the relationship between

those who need help and those who deliver it. Choice

and control are the key. The regulatory framework

can help to ensure the vision and ambition of the

White Paper is delivered.

I don’t under-estimate the challenge of achieving the

necessary change to ensure that we provide the best

possible services to the people who depend on social

care. It requires us all to work together as partners

more effectively than ever before. I am confident that

we will rise to the challenge – and I look forward to

working with you.

Thank you.

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