Editorial
There is much that could be said this week; however,
sometimes ‘less is more’ – as they say.
So, to all our readers - from Lin, me and all our
colleagues in Brunswicks we take this opportunity to
wish you and yours the compliments of the season.
Thanks to all of you who have been kind enough to
contact us during 2006 with thoughts, views and
comments on this publication. Thanks also to the
many individuals who have contributed articles for
inclusion and those who have ‘tipped us off’ about
information which the authorities sometimes would
prefer not to have aired, except at a time of their
choosing.
We are now taking a break and the next issue of
BHCR will be published in the New Year.
Have a very happy, peaceful and rewarding 2007.
.
Parliament
19 December 2006 – House of Lords – Corporate
Manslaughter and Corporate Homicide Bill, Second
Reading
20 December 2006 – Parliamentary Recess until 8
January 2007.
Next
Abuse
1. Huntley defends sex allegation
15 December 2006 – The Times
Soham killer, Ian Huntley, has succeeded in having a
civil default judgement set aside in a claim brought
by a woman who says he sexually assaulted her
when she was aged nine.
2. Claims of abuse in care homes up by a
third
14 December 2006 – icWales
Complaints about abuse of vulnerable people in Cardiff
has risen by a third in the last year.
496 complaints were made about abuse of older
people over the last 12 months.
The allegations related to incidents in care homes,
hospitals, supported housing and the victims' own
homes.
That figure has risen from 373 in 2004/05 and only
158 the year before, according to the annual report
of Cardiff Area Adult Protection Committee.
3. 'Most wanted' sex offender found
12 December 2006 – BBC News
Paul Turner, a convicted child sex offender who had
gone missing in 2004 has been tracked down thanks
to a new website set up to track missing convicted
paedophiles. The Child Exploitation and Online Protection
(CEOP) website published the names, ages
and pictures of the men. Turner was located in
France and will be returned to Dorset to face
charges.
For full report click here
Business News
4. Coalition wanted to bury BUPA news
16 December 2006 – Irish Independent
The newspaper is full of items about BUPA (including
two full page adverts from BUPA itself) explaining its
withdrawal from healthcare insurance in Ireland. A
decision taken following an Irish High Court judgement
which would require BUPA pay about a million
euro every week to its competitor VHI under the Irish
risk equalisation scheme.
5. Nursing home aim
12 December 2006 – The Times
Southern Cross is said to be considering a £200m
acquisition of Life Style Care.
6. Southern Cross Healthcare Group PLC
11 December 2006
Southern Cross has entered into a management
agreement with Alpha Care Services (UK) Limited for
the management of five elderly care homes containing
a total of 197 beds. Four of the five homes are
based in Norwich (totals 166 beds) and one home is
based in Durham (31 beds). Southern Cross, as part
of the management agreement, has an option to acquire
the shares of Alpha, currently holding the leasehold
interest, business and trading assets of the five
homes.
7. Competition Commission requires clinical
waste sell off by Stericycle International
12 December 2006 – GNN
A clinical waste firm will be required to sell off at least
part of a competing business it had acquired, following
a ruling by the Competition Commission (CC).
In its final report published today at http://
www.competition-commisssion.org.uk the CC concluded
that Stericycle International LLC's completed
acquisition of Sterile Technologies Group Limited
(STG) may be expected to result in a substantial reduction
in competition in the market for healthcare
risk waste requiring high temperature treatment in
northern England, the North Midlands, north Wales,
the West Midlands and south-east Wales. As a result
of the merger, customers face the risk of higher
prices for incineration of healthcare risk waste.
Stericycle will be required to sell all or part of the STG
business to a suitable purchaser. The CC will assess
the suitability of purchasers according to their ability
and incentive to act as an effective competitor. Initially,
Stericycle will be allowed to pursue its own proposal,
which involves selling STG's incinerators at
Salford, Redditch, and its incinerator and alternative
technology plant at Wrexham.
If Stericycle fails to do this within an agreed period,
then the CC will have the right to appoint an independent
divestiture trustee, who will be authorized to
sell all or part of the STG business excluding Northern
Ireland.
The case was referred to the CC on 28 June 2006.
8. BUPA acquires home healthcare specialist
Clinovia
BUPA has acquired Clinovia for £87.8 million from
Lyceum Capital. Clinovia is a home healthcare specialist
and will give BUPA new opportunities to expand
the out of hospital care market. Clinovia also
has a strong network among NHS hospitals and
PCTs and is a growing business an in area identified
by the government as a priority.
9. BARCHESTER SECURES TGI FRIDAY
BOSS
10 December 2006 – Sunday Telegraph
Tim Hammond, the former managing director of TGI
Friday's, the restaurant chain, is swapping burgers
for bedpans by becoming the Managing Director of
Barchester.
Hammond, who is starts in the new role tomorrow, is
likely to continue Barchester's ambitious expansion
plans. The company has made over 40 acquisitions
in its 13 year history, and is one of Britain's fastest
growing companies. The move follows the appointment
of Mike Parsons, Barchester's incumbent Managing
director, to the position of chief executive of
Grove Limited, Barchester's Jersey-based parent
company.
10. Life Style Care ready to sell as investors
hunger for homes
10 December 2006 – Independent on Sunday
Investment bank NM Rothschild will conduct the auction
of Life Style Care, a privately held nursing-home
operator with 23 sites in London and the Southeast,
for a price of up to £150m.
Prospective bidders, include Barchester Healthcare
and Three Delta, the investment firm set up earlier
this year by Paul Taylor with the backing of the Qatar
government. "We're interested. We will bid on it,"
said Mr Taylor of Three Delta, owner of Four Seasons
Healthcare.
Southern Cross Healthcare, which buyout firm Blackstone
Group floated earlier this year and BUPA,
which has on the mergers and acquisition trail all
year, may also make a bid.
Care Homes
11. Do older people in care homes get a fair
deal?
13 December 2006 – CSCI
For full report see CSCI, CSIW etc… - item 36
12. Deck the halls
Caring Business, issue no. 204—page 19
Article giving ideas on how to keep service users entertained
over the Christmas period and how to make
the most of the festive season of goodwill.
13. A helping hand
Caring Business, issue no. 204—page 24
An article looking at how smaller care home providers
can survive in a market where larger groups are increasingly
monopolising the sector.
Case Reports
Law Reports
14. Giblin V Huntley
H successfully applied to set aside a default judgment
brought by G, now aged 20, who says H sexually assaulted
her nine years ago.
15. Tweed V Parades Commission for Northern
Ireland
This is a case concerning conditions which were attached
to an Orange Lodge march. Its relevance to
health and social care is that the House of Lords has
held that in judicial review proceedings, while the disclosure
of documents would be ordinarily unnecessary,
the court should adopt a more flexible, less prescriptive
approach. Accordingly, those involved in
judicial review cases can expect to have a greater
involvement in preparation of documents for disclosure.
Disciplinary cases
16. Police probe 'cheating' optician
14 December 2006 – BBC News
An optician is being investigated after allegations that
he cheated the health board out of £110,000. The
locum optician who has a practice in Scotland examined
the eyes of elderly people in NI care homes, but
seemed to check on an unusually high number in any
given day. NI’s four health boards re-tested hundreds
of people and many people had been given unnecessary
glasses.
The optician was fined £1,000, struck off the NI ophthalmic
list and reported to the General Optical Council.
For full report click here
Cases in the news
17. Regina V Arthurworrey
Ms A, the social worker sacked for failing to spot the
abuse of Victoria Climbie was given a conditional discharge
by Enfield Magistrates Court after pleading
guilty to one count of harassment.
Children
18. Children & Young Peoples Plans: Childrens
Commissioner report
14 December 2006 – NCVCCO
A report has been published by the Children’s Commissioner
for England, a review of the first year of
Children and Young People’s Plans. The report
evaluates the mechanisms used to pull together the
Plan and has analysed the creation and implementation
of it also.
For full report click here
19. Councils should be aware of childcare
obligations
12 December 2006 – Community Care
The National Children’s Bureau has warned that local
authorities should be aware of their legal obligation
to ensure staff who are parents and entitled to
childcare should receive it. The charity has produced
a guide to help professionals be aware of their
obligations under the Childcare Act 2006.
For full report click here
Conferences & Courses
To follow next week
Consultations
20. NHS Emergency Planning Guidance 2005
- Mass Casualties Incidents: A Framework
for Planning - Best Practice Guidance: A
consultation
Closing date: 31 December 2006
A consultation that calls for comments of this set of
general principles to guide all NHS organisations in
planning for incidents that produce mass casualties.
This is based within the context on the NHS Emergency
Planning Guidance 2005.
For full report click here
21. Consultation on the Draft Employment
Equality (Sexual Orientation) (Religion or Belief)
(Amendment) Regulations 2006
Closing Date: 2 January 2007
These new regulations will be introduced to update
the Employment Equality (Sexual Orientation) Regulations
and the Employment Equality (Religion or Belief)
Regulations to ensure they are in line with EU
Directives for employment and vocational training.
For consultation click here
22. Childcare Act 2006: Section 12 Duty to
Provide Information, Advice and Assistance
Closing Date: 3 January 2007
A consultation on regulations and guidance supporting
the information duty as set out in clause 12 of the
Childcare Act 2006. It is aimed at local authorities,
children's information services in England and other
interested organisations.
For consultation click here
23. Direction of travel for urgent care: A discussion
document
Closing date: 5 January 2007
People's expectations of health and social care are
changing and the DoH is seeking views on the range
of services available in each health and social care
community.
For consultation click here
24. Childcare Inequalities Targets: consultation
on regulations
Closing Date: 31 January 2007
A consultation from the DfES is seeking views on a
draft of regulations. The regulations referred to are
for the Childcare Act 2006 allowing the Secretary of
State to set statutory targets for English local authorities
to improve the wellbeing of young children and
reduce inequalities between them.
For full report click here
25. Amendments to regulations under Section
142 of the Education Act 2002 and the
childcare disqualification regulations which
apply to applications for registration made
under Part XA of the Children Act 1989
Closing Date: 2 January 2007
This consultation is inviting comments on amendments
to the Education (Prohibition from Teaching or
Working with Children) Regulations 2003 and proposals
for changes to the Day Care and Child Minding
(Disqualification) (England) Regulations 2005.
For consultation click here
26. Communication from the Commission -
Consultation regarding Community action on
health services
Closing date: 8 January 2007
The European Commission has published a Communication
on health services, the document forms a
consultation on health services that will run until the
end of January 2007.
This Communication is a response to the removal of
health care from the scope of the Services Directive,
and recent developments in European Court of Justice
case law on cross-border patient mobility.
For full report click here
27. Care Matters: transforming the lives of
children and young people in care
Closing Date: 15 January 2007
Care Matters sets out a radical package of proposals
for transforming the lives of children in care. Despite
the fact that outcomes for these children have improved,
they have not kept pace with other children
which is unacceptable.
For consultation click here
28. Government launches discussion on Professional
Executive Committees
Closing Date: 7 February 2007
A review of professional executive committees
(PECs) has now concluded and the outcomes of that
review have informed a consultation document and
supporting annexes. The consultation document is
seeking views from the NHS and stakeholders on
roles and functions of PECs in the new primary care
trust landscape.
For consultation click here
29. Guidance on non-emergency patient
transport services: consultation
Closing date: 16 February 2007
A consultation seeking views on draft eligibility and
finance guidance for non-emergency patient transport
services in accordance with the white paper Our
Health, Our Care, Our Say commitment.
For full report click here
30. Reviewing the Care Programme Approach
2006: A consultation document
Closing date: 19 February 2007
A consultation setting out a range of proposals and
questions about the review of the Care Programme
Approach (CPA), introducing values and principles
that should underpin implementation of the CPA.
Comments on the proposals and examples of positive
practice are invited.
For full report click here
31. Bearing Good Witness: Proposals for reforming
the delivery of medical expert evidence
in family law cases - A consultation
Closing date: 28 February 2006
The Chief Medical Officer's report Bearing Good Witness:
Proposals for reforming the delivery of medical
expert evidence in family law cases has now been
published for a period of public consultation, from
30th October 2006 - 28th February 2007.
The report was originally commissioned in 2004 by
Ministers Dr Stephen Ladyman MP and Mrs Margaret
Hodge MP after some very high profile court cases
calling into question the quality of medical expert witnesses
in certain types of case. The report makes 16
proposals.
For consultation click here
32. Social care and health inspection merger
to go ahead
Closing Date: 28 February 2007
A Department of Health consultation paper published
today proposes that the Commission for Social Care
Inspection (CSCI), the Healthcare Commission and
the Mental Health Act Commission merge to form a
single regulatory body by 2008.
For consultation click here
33. The code of practice for promotion of
NHS services
Closing date: 28 February 2007
A document setting out the context within which providers
may wish to consider promoting their services.
It outlines proposals for a self-regulatory approach to
promotion of NHS services, underpinned by a Code
of Practice.
This aims to ensure that: information patients receive
is not misleading, inaccurate, unfair or offensive; the
brand and reputation of the NHS is protected; and
expenditure of public money on advertising and promotion
is not excessive.
For consultation click here
CSCI, CSIW, Healthcare
Commission &
Scottish Care Commission
34. Healthcare watchdogs call for consistency
in drug treatment throughout country
15 December 2006 – Healthcare Commission
The Healthcare Commission and the National Treatment
Agency for Substance Misuse (NTA) has issued
a joint press release to call for action on inconsistent
standards of care provided by substance misuse services
across England. The findings were released via
a joint national report revealing the overall findings of
a review carried out by both Healthcare Commission
and the NTA.
For full report go to http://www.healthcarecommission.org.uk//
newsandevents/pressreleases.cfm?
cit_id=4889&FAArea1=customWidgets.content_view_1&useca
che=false
35. Commissioners Approve New Star Ratings
for Care Services
13 December 2006 – CSCI
The new star rating system for all social care providers
in England will begin in January 2007. People
who use such services, social care providers and
local councils will be invited to work with the CSCI to
make sure the new system works.
For full report click here
36. Do older people in care homes get a fair
deal?
13 December 2006 – CSCI
The CSCI is launching an investigation to find out if
older people looking for a care home are given
enough information to make the best choice for
themselves. The CSCI, as a result, will be carrying
out unannounced inspections specifically to look at
this issue. See the link for more details on what they
will be looking for.
For full report click here
37. Older people want real choices about
their care
12 December 2006 – CSCI
The CSCI has issued a new report which reveals that
older people want real choices and responsibility to
choose the best possible lifestyle for them. The report
looks at experiences of older people and carers
who need care providers to help the adjust to their
life changes associated with getting older, not just to
arrange care services.
For full report click here
Making choices: taking risks report
38. Older people want a life, not just services,
says new report
12 December 2006 – CSCI
For full report click here
Education
Nothing to report
Ireland, Scotland & Wales
Ireland
Nothing to report
Scotland
39. Executive responds to NHS Grampian
proposals
14 December 2006 – Scottish Executive
NHS Grampian has been given approval to develop
its diagnostic and older people’s services. However,
it has been asked to do more work on its plans for
maternity services, which is expected to be completed
and re-submitted to Health Minister, Andy Kerr
before the end of January 2007.
For full report click here
40. Scots consider limit to children numbers
13 December 2006 – Community Care
The Scottish Executive is currently considering limiting
the number of children placed with individual carers,
a move welcomed by foster care charities. The
Executive had previously indicated it was reluctant to
do this due to a shortage of foster carers, but are now
asking whether a maximum number of three children
should be looked after by a foster carer at any one
time. This is the limit in the UK.
The news was published in the Executive’s draft National
Fostering and Kinship Care document.
For full report click here
For document go to http://www.scotland.gov.uk/
Publications/2006/12/07091551/0
41. New NHS team to tackle depression
13 December 2006 – BBC News
NHS Highland has launched a new team designed to
relieve pressure on GPs by helping patients suffering
from mild to moderate depression. The health authority
stated that the scheme is aimed at cutting waiting
times for increasing numbers of patients. The
team will take referrals from doctors.
For full report click here
42. Child safety rules 'scare' adults
13 December 2006 – BBC News
MSPs have been told that adults are scared of working
with youngsters because of strict child protection
rules. Prof. Kathleen Marshall has urged them to address
the issue, which currently leaves children open
to neglect. The children’s commissioner told Holyrood’s
education committee that the measures were
putting “absolutely ridiculous” pressure on adults.
For full report click here
43. Intensive care post numbers cut
11 December 2006 – BBC News
Three Lothian hospitals are reducing their nursing
post numbers in intensive care and high dependency
units. The health board stated that the equivalent of
36.5 posts will be “reallocated” to elsewhere within
the service and the changes followed an independent
review of staffing.
For full report click here
44. Patients become NHS bug busters
11 December 2006 – BBC News
NHS Lothian are rolling out new plans which aims to
ask hospital patients to become hygiene inspectors.
The new “patient environment monitoring teams” will
be made up of staff, an infection control manager
and a patient nominated from the hospital patient
representative group. This follows the scheme being
successfully piloted at St John’s in Livingston, Roodlands
and Herdmanflat Hospitals in East Lothian.
For full report click here
45. Minister backs plan to downgrade A&E
department
16 December 2006 – The Herald
Andy Kerr, the Health Minister has approved proposals
to downgrade the A&E department at Ayr Hospital,
stating that the NHS “cannot stand still” in the
face of massive local opposition. There were also
warnings that the longer journey times needed to
reach an emergency department would cost lives,
and the reform means that the number of emergency
hospital departments serving south-west Scotland is
reduced from three to two. Ayr is the sixth A&E department
out of 15 in West and Central Scotland to
be selected for downgrading.
46. NHS board's finance gap revealed
15 December 2006 – BBC News
A Scottish Executive-appointed task force sent to
resolve problems at Western Isles Health Board has
found its spending plans ran at £4.5m more than the
authority’s income. The team have implemented
cuts with immediate effect such as a freeze on vacancies
and reducing the number of staff allowed to
place orders from 52 to six.
For full report click here
47. Obesity 'could bankrupt the NHS'
15 December 2006 – BBC News
The British Medical Journal has warned that current
rising levels of obesity could bankrupt the NHS if left
unchecked. Experts said obesity treatment currently
took up 9% of the NHS budget but warned that it
would rise as the number of obese adults rose from
one in five to one in three by 2010.
For full report click here
Wales
48. 14 December 2006
No. 3251
(W.295) The Care Standards Act 2000 and the
Children Act 1989 (Regulatory Reform and Complaints)
(Wales) Regulations 2006
For full legislation see Legislation Update—item 55
49. A Director Designate is being sought by the
Welsh Assembly Government at £95,000 a year to
lead the Care and Social Services Inspectorate for
Wales (CSSI) which will be established to receive the
merged entities of Care Standards Inspectorate for
Wales and Social Services Inspectorate for Wales in
2007.
For an application form visit www.wales.gov.uk/
recruitment
50. Older people want real choices about elderly
care
Craegmoor News (press release) - UK
A report carried out by the Commission for Social
Care Inspection (CSCI) has revealed that the older
generation wants to be offered "real" choices when it
comes to their own care.
Learning Disabilities
51. Day centre closes to save money
14 December 2006 – BBC News
East Sussex County Council has announced that all
users of a day centre catering for 45 people with
learning difficulties will be offered alternative ways of
receiving their usual services. The centre is closing
in order to save £231,000, but will not close immediately.
For full report click here
52. Two councils severely criticised over care
of young person with learning difficulties
12 December 2006 – Community Care
Two councils have faced severe criticism by the Local
Government Ombudsman after they failed to adequately
care for a looked-after young person with
learning difficulties. Essex Council was found at fault
for moving the John Moore (not his real name) to
Kent even though it was told there was no suitable
education available. Kent Council was criticised for
failing to provide appropriate education for the teenager
during his stay in the area.
Tony Redmond, Ombudsman, said both councils
blamed each other instead of fulfilling their duties to
the teenager.
For full report click here
53. Compensation for council failures
12 December 2006 – BBC News
For full report click here
Legislation Update
54. 15 December 2006
NORTHERN IRELAND
The Health (Miscellaneous Provisions) (Northern
Ireland) Order 2007
For full legislation click here
55. 14 December 2006
No. 3251
(W.295) The Care Standards Act 2000 and the
Children Act 1989 (Regulatory Reform and Complaints)
(Wales) Regulations 2006
For full legislation click here
Mental Health
56. Mental health is soft target for NHS cuts,
say MPs
13 December 2006 – Community Care
The health select committee report has found that
mental health services are “soft targets” for savings
being made in the NHS. The report noted that deficits
were the “main reason” for reducing spending in
mental health trusts in 2006-7 which meant there
was a “significant step back” in the provision of mental
health services. It also meant a reduction in the
number of mental health acute beds.
For full report click here
For the health select committee report go to http://
www.publications.parliament.uk/pa/cm200607/cmselect/
cmhealth/73/7302.htm
Miscellaneous
57. Lord Warner announces retirement
15 December 2006 – Community Care
Health Minister, Lord Warner, has announced his
intention to retire next year to spend more time with
his family.
Warner has a wealth of experience in health and social
care, including a spell as director of social services
at Kent county council and time as a senior policy
adviser to the home secretary. In 1992, he also
chaired the national inquiry into selection, development
and management of staff in children’s homes in
1992.
For full report click here
58. Good practice guidance on managing the
introduction of new healthcare interventions
and links to National Institute for Health and
Clinical Excellence (NICE) technology appraisal
guidance
14 December 2006 – DoH
Good practice guidance responding to a number of
requests, received by the Department of Health, to
update guidance originally issued in 1999 (HSC
1999/176) and to further clarify guidance on Directions
to Primary Care Trusts and NHS Trusts concerning
the funding of Technology Appraisal Guidance
issued by the National Institute for Health &
Clinical Excellence (“the funding Directions”).
For full report click here
59. How Red Cross can relieve mental and
physical scars
13 December 2006 – The Times
As part of its Christmas Appeal The Times article focuses
on the sole UK provider of skin camouflage
advice, Red Cross, which helps 7,500 people each
year with a range of skin disfigurements from those
who self harm to people coping with surgical scarring.
www.redcross.org.uk/timesappeal
60. The CRB Christmas Opening Hours
11 December 2006 – CRB
The CRB has published its opening hours over the
Christmas period.
For full report click here
61. Rankin’s Grilling
Caring Business, issue no. 204—page 20
An interview with celebrity chef, Paul Rankin who has
been working with the Barchester Group...gives his
views on how to improve food quality in care homes.
Includes a recipe for Irish stew.
62. In the bleak midwinter
Caring Business, issue no. 204—page 22
Advice on how to keep residents warm as the cold
weather starts to bite.
NHS
63. Why does a hard-hearted old Right-wing
Tory have to tell a Labour Government the
NHS should not be privatised by half-baked
schemes
17 December 2006 – The Mail on Sunday
Lord Norman Tebbit weighs into the debate following
the headline ‘World Famous Nuffield Faces Closure’
(see other items on this topic in this issue of
BHCR). Lord Tebbit talks from personal experience
following the paralysis of his wife, Margaret, in the
IRA bombing of the Grand Hotel, Brighton in 1987.
64. Doctors told to cast off ties
17 December 2006 – The Sunday Times
Brighton and Sussex University Hospitals Trust has
told consultants that even bow ties are now banned,
together with all neckwear as a potential source of
MRSA and that they face disciplinary action if they
repeatedly were a tie.
The memos can be seen in full at: www.timesonline.co.uk/
doctorsites
65. Fears over children's care staff
16 December 2006 – BBC News
Jane Dudeney has expressed her fears that her
daughter Annie, 11, will have nurses withdrawn from
caring for her. Annie suffers from Edward’s syndrome
which affects her heart and lungs, and Mrs
Dudeney said she believes funding for the care team
at the Royal Alexandra Children's Hospital in Brighton
will be axed.
A hospital spokeswoman said that a decision was
currently in progress as to how the service would be
best provided for the future.
For full report click here
66. Electronic care records go ahead
16 December 2006 – BBC News
The go-ahead has been given for the controversial
electronic medical records system. The government's
patients' tsar Harry Cayton will say the system,
which will hold records for 50m people in England,
is needed to modernise the NHS, and so only
people who prove that the system will cause them
substantial mental distress will be exempt. Doctors
warned that creating the record without a patient’s
consent could harm the doctor-patient relationship.
For full report click here
67. Specialist hospitals vital to modern NHS
16 December 2006 – The Daily Telegraph, Letters
to the Editor
Prof. Paul Wordsworth of the Nuffield Department of
Orthopaedic Surgery complains about the lack of
joined up thinking in the DoH in the planning of
healthcare provision in the NHS and the potential for
adverse impact on the education and training provided
by current centres of excellence.
68. Drive to improve patient safety
15 December 2006 – BBC News
Due to the failure of current safeguards, the government
has announced a shake-up to improve patient
safety. The chief medical officer’s report has called
for a blame-free culture for staff to report, plus
quicker and simpler reporting systems and that serious
incidents should be reported within 36 hours.
For full report click here
69. Safety first: a report for patients, clinicians
and healthcare managers
15 December 2006 – DoH
This report was commissioned by Sir Liam
Donaldson, Chief Medical Officer, to reconsider the
organisation arrangements currently in place to ensure
that patient safety is at the heart of the healthcare
agenda.
For full report click here
70. Report of the National Patient Choice Survey,
England - July 2006
15 December 2006 – DoH
A report giving the results of around 70,000 responses
to the second national patient choice survey
commissioned to assess the implementation of
choice at PCT level. The surveys were conducted by
Ipsos MORI on behalf of the DoH, as part of a series
of surveys planned to monitor patient awareness of
choice and recall of having been offered a choice of
hospital for their first outpatient appointment.
For full report click here
71. Results of the Patient Choice Survey,
England - July 2006
15 December 2006 – GNN
Link:
http://www.dh.gov.uk/PublicationsAndStatistics/Publications/
PublicationsStatistics/PublicationsStatisticsArticle/fs/en?
CONTENT_ID=4141309&chk=vfv/vq
The Information Centre for Health and Social Care
released the following statistics:
• Summary of the Public Service Agreement
(PSA) target on Home Care, 2005-6; which
shows The national PSA value has continued
to rise, increasing to 33.8 per cent in 2005-06
from 32.0 per cent in 2004-05.
• Community care statistics 2005-06: Referrals,
Assessments and Packages of care for adults,
England: national summary is said to show that
there was estimated to have been 2 million
contracts for 'new clients' and that 37,000 people,
in total were receiving direct payments.
• Personal social services survey of Home Care
users in England aged 65 or over: 2005-
06 which shows 59% of service users were
satisfied with the services they receive; 86%
said their care workers always or usually came
at times that suit the service user; 10% said
that they were never kept informed of changes
to their care.
71. Results of the Patient Choice Survey,
England - July 2006 (continued…)
• HES Outpatient Data Quality Report
Links:
* http://www.ic.nhs.uk/pubs/psahome
* http://www.ic.nhs.uk/pubs/ccs0506
* http://www.ic.nhs.uk/pubs/psshceng0506
• http://www.ic.nhs.uk/pubs/outpatientdq
72. Doubts over orthopaedic hospital
15 December 2006 – BBC News
A report has called into question the future of the
renowned Nuffield Orthopaedic Centre (NOC), in
Headington by stating its existence as “not viable as
a separate organisation”. The report was commissioned
by the former Thames Valley Strategic Health
Authority – now called the South Central Strategic
Health Authority (SHA).
The NOC has nearly completed its new £42m treatment
and diagnostic centre, due to open in February
2007. Bosses at the NOC insist that the centre will
not close but may have to merge.
For full report click here
73. Care and resource utilisation: ensuring
appropriateness of care
14 December 2006 – DoH
Document setting out for commissioners using practice-
based commissioning (PBC) and primary care
trusts (PCTs) some techniques to help identify areas
where services can be redesigned, thereby freeing
up resources to focus on clinically needy patients.
The Care and resource utilisation (CRU) is all about
giving the patient the right treatment in the right place
at the right time.
For full report click here
74. Diagnostic tests waiting times
13 December 2006 – GNN
Diagnostic test waiting times data were released for
the month ending October 2006
The data is claimed to show NHS progress in tackling
the waiting times for diagnostic tests like scans. The
monthly data published today gives the waiting times
for 15 key diagnostic tests carried out in the NHS.
More information, including a diagnostic data Q&A, is
available via the 18 week website.
Link - 18 week website: http://www.18weeks.nhs.uk
The following statistics were released today by the
Information Centre for Health and Social Care:
- Hospital Episode Statistics (admitted patient care),
England 2005-06
Link - http://www.ic.nhs.uk/pubs/hesapc
75. 'NHS-wide faults' led to deficits
13 December 2006 – BBC News
The Commons Health Select Committee has found
that mismanagement at all levels of the NHS in England
has led to the current multimillion pound deficit.
The committee also said that existing deficits have
been made worse by new staff pay deals and the
expense of meeting NHS targets.
For full report click here
76. NHS 'pride of Britain' says Blair
13 December 2006 – BBC News
Tony Blair has fought back against criticism of the
NHS saying that it was getting better under his party.
For full report click here
77. Mental health is soft target for NHS cuts,
say MPs
13 December 2006 – Community Care
For full report see Mental Health – item ??
78. Equality and Human Rights in the NHS: A
guide for NHS Boards
12 December 2006 – DoH
A guide designed to help NHS Board members understand
and comply with their obligations under
equality and human rights legislation. Every NHS organisation
as a public body, needs to assure itself of
legal compliance.
For full report click here
79. Health merger consultation starts
12 December 2006 – BBC News
A consultation has begun on the proposed merger
between Good Hope Hospital NHS Trust and Heart of
England NHS Foundation Trust. Patricia Hewitt has
approved the consultation and the merger is expected
to take place on 1 April 2007.
For full report click here
80. 43 maternity units 'under threat'
12 December 2006 – BBC News
The Conservatives have warned that forty-three maternity
wards across the UK are under threat. The
party also said that most wards are in England, and
two-thirds are in Conservative, Liberal Democrat or
Independent seats.
The Department of Health has challenged the figures
saying that safety and quality demands dictated that
services have to change.
For full report click here
81. Information Regarding Publication of Local
Choosing Your Hospital Booklets and the
National Menu Supplement
12 December 2006 – DoH
Letter announcing publication of the second editions
of the choosing your hospital booklets and the national
menu supplement.
For full report click here
82. 12 December 2006 – GNN
The reform of specialist medical training is the next
stage of the Modernising Medical Careers (MMC)
initiative, designed to improve the quality and safety
of patient care through better education and training
for doctors and ensure fully trained specialist doctors
deliver more NHS services in 2007.
Health Minister Lord Warner said:
"A guaranteed minimum of 18,000 additional training
places is excellent news as it represents a significant
number of training opportunities - and many more
than the alarmist predictions that came from some
quarters earlier in the year.
"Doctors in training in England should consequently
be pretty confident about securing a training post. Of
course, as recruitment is competitive not everyone
will be able to have their first choice specialty or location,
but this has always been the case. The number
of vacancies in each specialty and location is ultimately
decided by the needs of patients and the
NHS. We anticipate that there will be around 16,000
- 17,000 doctors currently in training in England eligible
to apply for these positions, but we do not yet
know how many doctors will apply from the EEA and
overseas."
Provisional data based on the specialties within the
Royal Colleges are shown below. These show, for
example, there will be over 5,800 places in General
Practice, 2,235 for surgery, 1800 for Psychiatry and
1390 vacancies for doctors who want to be paediatricians.
More detailed figures by specialty, level of entry and
deanery will be placed on the MMC website (http://
www.mmc.nhs.uk) on 21 December 2006.
Final figures will be available as the recruitment process
commences on 22 January. At that stage applicants
will be able to register with the new national
electronic Medical Training Application Service (http://
www.mtas.nhs.uk) and view the detail of the programmes
available.
Approximate specialty training numbers by Royal Colleges:
Anaesthetics 1485
Emergency Medicine 870
General Practice 5800
Medicine 2980
Obstetrics & Gynaecology 835
Ophthalmology 290
Paediatrics 1390
Pathology 130
Psychiatry 1800
Public Health 50
Radiology 135
Surgery 2235
Doctors wishing to find out more about the changes
to postgraduate medical education and the transitional
arrangements should visit: http://www.mmc.nhs.uk
83. NHS child units spared bed cuts
12 December 2006 – BBC News
Hospitals at Hastings and Eastbourne will not now
see a reduction in children’s services. A planned cut
to two 15-bed units to 10 were decided against because
demand was higher during the winter. A
spokesman said that bed numbers could still be reduced
in the spring.
For full report click here
84. Londoners say NHS needs improving
11 December 2006 – BBC News
A poll has suggested that three-quarters of Londoners
believe that their local NHS services need to improve.
A poll of more than 7000 people found that
only 6% in total believed that the NHS did not need to
improve at all. The survey was part of a major report
into the London’s NHS services to be released in the
New Year.
For full report click here
85. Trust to lead medical research
11 December 2006 – BBC News
Oxford Radcliffe Hospitals will receive a £11.5m grant
to become one of five new centres for biomedical research
across the UK. The hospital will work in partnership
with the University of Oxford and research will
be carried out in areas such as vaccines, diabetes,
stroke, cancer and heart disease. The National Institute
for Health Research are setting up the centres.
For full report click here
86. The NHS in England: Operating framework
for 2007-08
11 December 2006 – DoH
Document setting out the specific business and financial
arrangements for the NHS for 2007/08. As an
update to the 2006/07 operating framework, it describes
the delivery priorities, the payment by results
and tariff details and expectations on the development
of commissioning and practice based commissioning.
For full report click here
87. Target for £250 million budget surplus
must not come at expense of high-quality
services to patients, says King's Fund
11 December 2006 – King’s Fund
The King’s Fund has welcomed the government target
to restore financial balance to the NHS but
warned that the quest to achieve the £250 million
budget surplus must not be at the expense of high
quality care.
For full report click here
88. NHS Chief Executive publishes 2007-08
operating framework
11 December 2006 – DoH
The operating framework for 2007-8 has been published
by NHS Chief Executive, David Nicholson. It
sets out a number of significant changes in the way
the NHS will conduct its business by bringing greater
rigour and transparency to the service. It also marks
a deliberate move towards a more rules-based system
allowing greater autonomy for local NHS organisations.
For full report click here
89. NHS Chief Executive releases podcast
11 December 2006 – DoH
NHS Chief Executive David Nicholson has recorded
a video podcast to explain the importance of the new
NHS operating framework for 2007-08 (more details
above).
For full report click here
90. NHS 'must make surplus next year'
11 December 2006 – BBC News
The NHS in England has been told that it has to
achieve a £250m surplus next year, despite the latest
predictions showing that it will have a £94m
shortfall. NHS chief executive David Nicholson has
set out new targets for tackling hospital infections
and meeting the 18-week waiting time target.
For full report click here
91. New edition of 'Immunisation against Infectious
Disease'
11 December 2006 – Department of Health
(National)
The ‘Green Book’ officially called 'Immunisation
against Infectious Disease,' is now being distributed
free to primary care health professionals. It’s a valuable
reference guide on the latest UK immunization
recommendations and information on vaccinations
and its procedures.
92. Revealed: the 13 bankrupt NHS trusts
11 December 2006 – The Guardian
Front Page. A dozen NHS hospital trusts are technically
bankrupt and 103 expect to end the year with
accumulated deficits of £1.6bn.
93. How new rules caught one hospital in
debt trap
11 December 2006 – The Guardian
Analysis of Queen Elizabeth Hospital in Woolwich;
the hospital is regarded within the NHS as being well
run. However, it is moving towards building the largest
deficit within the NHS. Why? In short, it is because
of the PFI deal which locked it into a deal
which added £9m to the costs that were met by an
equivalent hospital built with traditional funding -
money from the Government and locked into payments
which are particularly onerous.
Nursing
Nothing to report
Older People
94. Care cuts mean fewer old folk are being
helped to live at home
16 December 2006 – Daily Mail
Figures from the national Patient Survey demonstrate
that thousands fewer are receiving the help they need
to in order to stay at home. 493,000 older people
received home care in 2003/04 and 489,000 in
2005/06.
Ed. Making the short-term savings now will be
shown to be misguided and ill-judged in the long
term as the cost of caring for older people who
enter care homes will increase as their care needs
become more severe and they become more frail
at the point of entering into care homes.
95. Survey of home care users aged 65 and
over finds they feel more in control
15 December 2006 – Community Care
The Information Centre for health and social care has
published a survey of 84,000 home care users showing
that over a third said they were always kept informed
by their home care service providers and 10
per cent felt they were never kept informed. 46 per
cent currently receiving home care services say that
the report they receive helps them feel more in control
of their lives.
For full report click here
For more information go to http://www.ic.nhs.uk/
96. When the laughter has to stop
14 December 2006 – Community Care
Tony Robinson, comedian, and campaigner for older
people has given an interview to Community Care,
Robinson is best known for playing Baldrick in TV
comedy Blackadder. During the interview he speaks
about his dream to get care for older people improved
in the UK.
For full report click here
97. New slippers given out to elderly
13 December 2006 – BBC News
Nursing staff at Leicester’s hospitals have been
handing out new slippers in a bid to cut falls for the
over-65s. According to the University Hospitals of
Leicester, 24,000 over-65s in the UK fall over at
home every year because of poorly fitting footwear
and Leicester have mounted a campaign to ban dangerous
“sloppy slippers” from homes.
For full report click here
98. GPs' concerns over bed closures
13 December 2006 – BBC News
GPs at Honiton Surgery in Devon have stated their
concerns about cuts which mean that more elderly
people may have to stay in big general hospitals as a
result of bed closures in community hospitals. The
PCT has responded by saying that it must return to
financial balance and the measures are only short
term, with no loss of service.
For full report click here
99. Older people want real choices about
their care
12 December 2006 – CSCI
For full report see CSCI, CSIW etc…- item 37
100. Older people want a life, not just services,
says new report
12 December 2006 – CSCI
For full report see CSCI, CSIW etc…- item 38
Social Care
101. Peers debate funding shortfall in adult
social care
8 December 2006 – Community Care
In a debate on adult care funding, Essex Council
leader Lord Hanningfield joined parties’ calls that the
sector faced both an immediate and long-term funding
crisis. Chancellor Gordon Brown was criticised
for “missing an opportunity” to address the significant
funding shortfall.
For full report click here
102. New kid in the dock
Caring Business, issue no. 204—page 12
Full length article examining Care Minister, Ivan
Lewis’ background and looks at his challenge in the
social care sector.
Staff, employment and
disciplinary
103. Social worker sent inappropriate text to
service user, conduct committee hears
15 December 2006 – Community Care
Eric Charlesworth, a social worker, is fighting allegations
that he formed inappropriate relationships with
service users sent a text message to a client saying
that he was lining up some “top totty” for him. The
General Social Care Council hearing is taking place
in Birmingham this week.
For full report click here
For another report click here
104. Danger from 'untrained' staff
11 December 2006 – HD24
Research by the Royal College of Nursing has revealed
that the NHS is letting people work as healthcare
assistants without giving them any training. This
means that patients could be at risk because the
healthcare assistants provide essential nursing care,
often having to make intimate contact with patients.
Apparently nurses are also unsure of what tasks
healthcare assistants should be given so decisions
are being made on how well the nurse knows the individual
rather than their level of training. The study
surveyed healthcare assistants and 35 ward managers
at two acute trusts followed up by interviews in
focus groups.
Healthcare assistants are currently unregulated. The
RCN plan to address this by developing a set of competency
standards, welcomed by NHS Employers.
105. Right from the start
Caring Business, issue no. 204—page 48
How to ensure you induct staff properly and how to
implement the Common Induction Standards (CIS)
within the induction as the recognised standards in
adult care.
Protecting Adults from
Abuse – everyone’s business
Community Care Conference
30 November 2006
Paul Snell
Chief Inspector, Commission for Social Care
Inspection
‘The role of regulation and inspection in protecting
vulnerable adults’
Introduction
Thank you for inviting me to deliver a session at this
event on what is a very important topic. The title of
the conference ‘Protecting Adults from Abuse – everyone’s
business’ is well-chosen – not only the key
agencies but people using services themselves, their
relatives and carers, and staff, can all act in ways
that help safeguard themselves and others. We
need to work together to ensure that services and
systems that are designed to safeguard adults work
as effectively as possible.
There is a growing awareness in England of the phenomenon
of elder and adult abuse, and it is now accepted
that mistreatment, neglect, or outright abuse
of people by professional or informal carers does
take place. We must now however ensure that it is
treated with the same seriousness as child abuse
has been over the last decade. People need to know
that they will be safe and well cared for and that, if
there are any incidents of abuse and neglect, trained
staff will respond appropriately.
An effective system for responding to abuse and neglect
is part of broader ‘safeguarding adults’ work,
which promotes respect for the dignity, independence
and well-being of all people who require the support
of social care services. However, the chances of
abuse occurring can be minimised in services which
are well-managed and led, which have the right policies,
and a combination of appropriate support, training
and supervision of staff.
In the Commission, we are prepared to get tough with
organisations that fail to do everything they can to
keep people safe. Where our inspectors come across
abuse or poor practice they will not hesitate to act.
But I also want to argue that developing high quality
services responsive to the needs and wishes of people
who use services will prevent abuse and enhance
their quality of life.
What do people tell us they want?
People have told us told us what matters to them in
services. They want:
• Choice
• Flexibility
• Information
• Being like other people and taking risks
• Respect and being heard
• Fairness and non-discrimination
• Cost and value
• And of course to be safe from abuse or neglect
The starting-point for providers and commissioners
must be what people have said they want. Services
for people need to preserve their dignity; individuality;
and privacy. They need to treat them with respect;
offer them choice and promote independence. Where
these qualities are not in place we will say so in our
reports and require services to improve.
What the Commission does
You have asked me to talk on the role of regulation
and inspection in protecting vulnerable adults. Inspection
is an important component of the system of accountability
that runs through the way we organise
public services in this country. The function of the
regulator is to provide independent scrutiny and report
publicly on what we find.
We have a statutory duty to promote improvement in
social care services in England, across both adults’
and children’s services. We combine regulation, the
performance assessment of local councils and inspection
to ensure that national standards are met.
This means we can give a single, overall picture of
the quality and efficiency of social care services in
England, including the performance of local councils
in meeting the social care needs of their local population.
What have we found about services and safeguarding?
In ‘The state of social care in England 2004-05’ we
reported that there were serious concerns in services
for adults which were failing to ensure the proper
level of protection for people using them. In particular,
it was identified that care homes for older people
and younger adults needed to:
• improve their recruitment practices to ensure
that staff are suitable for the job,
• work in a safer way to protect the health and
safety of people who live in the home, and
• put better systems in place for managing
medication.
It is the National Minimum Standards that identify
what a registered person needs to do in order to
meet their legal obligations. These include having:
• Clear written policies concerning abuse.
• Robust procedures for responding to suspicions
of abuse.
• Policies, practices and procedures that ensure
that the restraint of residents is used as a last
resort by staff and in accordance with government
guidance.
• Arrangements for safely managing residents’
finances and valuables
• Finally where staff are unsuitable to work with
vulnerable adults they are referred for consideration
for inclusion on the Protection of Vulnerable
Adults (PoVA) list.
Whilst it is important to have robust procedures in
place to safeguard adults, procedures alone will not
keep people safe. It is how the procedures are used
and, most importantly, the interactions between people
living in care homes and those trained to care for
them which will help keep people safe.
Earlier this month we published a report called ‘Better
Safe than Sorry’. This describes the performance of
care homes for older people and councils in relation
to their policies and procedures for safeguarding
adults and identifies areas in which these agencies
could make improvements.
What were our key findings?
As at 31 March 2006, some 75% of care homes met
the national minimum standard for safeguarding
adults. Of the 25% who failed to meet the standard,
just over 4% of homes scored the lowest mark and
gave cause for concern. 20% of homes just failed to
meet the standard but need to address the necessary
shortfalls. Whilst there was a considerable improvement
against this standard between 2003 and 2004 –
23% more care homes met the standard between
these two years - further improvement is required.
We found that the most common reasons why some
care homes do not meet the safeguarding standard
were:
• Policy and procedures were not clear or specific
enough about all of the necessary steps a
provider or staff member should take in the
case of suspected abuse or neglect.
• Staff members were unaware of the policy.
• Staff members did not know how to recognise
signs of abuse or neglect.
• Training on adult protection procedures and on
recognising abuse was not being made available
to all staff.
• Incidents of abuse were poorly recorded or not
reported to the council’s safeguarding adults
services.
• Providers were unaware of the local council’s
safeguarding adults procedures or did not link
their own care home procedures into the council
procedures, in effect keeping the two systems
separate.
Where we found good practice:
• care homes had comprehensive policies and
procedures on adult protection.
• The manager and staff had undertaken adult
protection training.
• Staff could demonstrate that they could tell the
difference between expressions of dissatisfaction
about the quality of the service and an
incident of a more serious nature.
• Staff and residents felt safe in expressing their
concerns to the manager.
• A self-assessment process has been put in
place for staff to identify gaps in their skill development.
• Managers acted promptly to address any concerns.
Overall it was the quality of leadership and management
in the care home that was fundamental to the
running of a good home. The manager must create
an environment and culture of professionalism and
openness, so that staff, people living in care homes
and their families feel able to raise concerns, complaints
or allegations of abuse.
What did we find about councils?
Whilst almost all (97%) had established multi-agency
procedures by 2004, there is more work to do to ensure
that the procedures work as well as they should.
In the past three years, councils’ performance in relation
to safeguarding adults improved from 63% in
2004 to 82% performing well against this standard in
2006. However again here more needs to be done to
ensure that:
• Training for staff in assessing the risk of abuse
and in the multi-agency procedures needs is
made more widely available. In 2005/6, the
average percentage of relevant council social
care staff receiving safeguarding adults training
was only 51%.
• Councils also need to improve the systems for
monitoring referrals concerning the safeguarding
of adults. In 2005, 66% of councils produced
an annual report on work relating to vulnerable
adults, although only 56% of councils
• produced a report that contained the number of
referrals received and investigations undertaken.
This clearly needs to improve.
Finally, members of the multi-agency partnerships
including health organisations must be are aware of
and carry out their roles and responsibilities effectively.
Roles and responsibilities of the organisations
should be clearly set out. These arrangements did
not work well in the case of Cornwall – and I will talk
more about this in a minute.
So what is our role in safeguarding adults
We receive information from a range of people
(including staff, other agencies, residents, family
members and advocates) on the performance of services
through the process of inspection or through our
Concerns and Complaints procedure. Sometimes
information is disclosed to us directly, rather than to
the care home manager, because people find it difficult
to raise their concerns directly with the care home
manager for a variety of reasons.
Our inspectors may also find direct evidence of concerns
when inspecting a care home. We have increased
the number of unannounced inspections now
over 90%, placing a greater focus on the views of
people using the service and resources are focused
on poor performing care services.
The legislation places specific responsibilities and
duties on us and in working to safeguard adults we
need to work within that legal framework. Our role is
as a regulator and not an investigation agency. As a
result the responsibility for investigation of individual
cases within safeguarding adults procedures rests
primarily with other partners including the local authority.
There are three significant levels of engagement for
CSCI in response to a safeguarding alert or referral:
Where the safeguarding alert suggests serious risk
to a person’s life, health or well-being then we will
consider what immediate regulatory action is needed
in addition to the investigation/assessment undertaken
by partner agencies or the care provider. On
occasion this can include the urgent closure of a service.
Where the safeguarding adults referral received by
the local council suggests breaches of regulations
and standards we will undertake a random Inspection
as part of the multi –agency strategy.
Where there are no indications of serious risk requiring
immediate regulatory action, the outcome of any
investigation undertaken by partner agencies or the
care provider will inform our decision making about
further inspection or enforcement action.
And we will take action if care providers are placing
adults at risk. What action we take will depend on
how seriously the care service is failing to protect and
safeguard people, what effect this is having on the
people using the service and the response of the care
service provider.
Cornwall Partnership NHS Trust
I want to talk now about the Cornwall Partnership
NHS Trust case. The official investigation into learning
disability services provided by Cornwall Partnership
NHS Trust began in May 2005 and was sparked
by concerns raised by East Cornwall Mencap Society.
The subsequent investigation jointly undertaken
by CSCI and the Healthcare Commission examined
services at the Budock Hospital near Falmouth, which
is a treatment centre for 18 inpatients. The investigation
also looked at two other treatment centres, 4 children’s
units and 46 houses occupied by groups of up
to four people with learning disabilities.
The report of our investigation described many years
of abusive practices at the trust and the failure of senior
Trust executives to tackle this. We found that institutional
abuse was widespread, preventing people
from exercising their rights to independence, choice
and inclusion.
Some examples were a person who spent 16 hours a
day tied to their bed or wheelchair, for what staff
wrongly believed was for that person’s own protection.
One man told investigators that he had never
chosen any of the places he had lived as an adult.
More than two-thirds of the sites we visited placed
unacceptable restrictions on people living there. For
example, we found that some internal and external
doors were kept locked by staff to restrict the movement
of people from the services, instead of seeking
alternative methods to address perceived problems.
In one home, taps had been removed and, in another,
light fittings were taken out. Arrangements to manage
the finances of people in supported living services,
such as the apparent pooling of their money to a
shared household account and the use of people’s
money to purchase communal goods and pay for improvements
to homes, were also a concern.
As a result of the investigation 40 people were referred
to the County Council under the procedure for
the Protection of Vulnerable Adults.
More than two thirds of the 46 supported living
houses visited by the investigation team placed unacceptable
restrictions to the people living there. We
also found that the houses were run as unregistered
care homes, which did not meet accepted standards.
Following our investigation, we made a number of
recommendations for action including that:
• The key agencies should ensure effective systems
and processes to protect people with
learning disabilities from abuse were implemented
• the Council should carry out community care
assessments and provide ‘person centred’
plans for people who may require social care
and ensure that the results of assessments
are used to shape the redesign of the service
• The views of people using services and their
carers should be included as part of the annual
planning cycle for learning disability services.
• the trust should make immediate applications
to register homes where indeed they are care
homes!
• the provision of personal care should be delivered
in accordance with the regulations and
national minimum standards for care homes or
domiciliary care agencies
• the trust should ensure that people with learning
disabilities are allowed to exercise choice
and control over their care and development,
supported by the availability of information in a
format that is easy to read.
• the trust must review its systems, policies and
practice for managing the finances of people
who use its services.
We continue to monitor the CPT & SSDs action plan
to ensure that the redesign of the new placements for
all services users with LD is compliant with the Care
Standards Act.
What conclusions can we draw in order to learn from
what happened in Cornwall?
• Listening to people who use services and their
families remains a vital element in uncovering
abuse and in helping to ensure high quality services;
• Training staff, (many of whom were caring and
well-meaning in Cornwall) must encompass the
very best practice, not simply learning from peers
in other local services;
• Services provided in community settings must be
subject to the scrutiny of independent regulation;
• As regulators we could effectively work in partnership
to look at the needs of people using services
in health and social care settings.
Risk and independence
Finally I want to say something briefly about risk and
independence. Our guiding principle is to judge services
by how well they reflect the qualities that people
value, and to be guided by people’s experiences and
aspirations. It is our job, as a modern inspectorate,
within the framework we are given, to make sure that
care services are relevant to the people who use
them – and that services give people choice, voice
and dignity.
When we have talked to people who use services, we
have sometimes been challenged specifically about
our approach to balancing risk and safety, and balancing
risk with the duty to care. These are not easy
judgements to make. Risk must be managed but not
to the point that creativity is managed out of care and
it must not be confused with abuse or lack of care.
Worries about risk – by other people, organisations,
wider public perceptions and media- can affect the
personal choices that individuals calling upon support
from social care are able to make and the amount of
control they have over their everyday lives. Rather
than encouraging independence this can make older
people more dependent; it can prevents them from
leading fulfilling lives and achieving the outcomes
they want.
Conclusion
The function of regulators is to provide independent
scrutiny and report what they find. I believe that the
inspection, performance assessment and regulatory
functions of CSCI and of other regulators have
helped achieve improvement in services and protection
of people from abuse - an aim we all share. Policies
and procedures which are well understood by
well led and trained staff have an important part to
play in ensuring effective safeguards. Where we find
poor practice, we will act on it.
For the providers of services, the message is that
striving for, and achieving, excellence in the quality
of services will go a long way to ensuring people are
also safeguarded.
Reproduced with the kind permission of the
Commission for Social Care Inspection.
For online speech, please click here:
http://www.csci.org.uk/default.aspx?page=1814&key=
Paul Snell
Chief Inspector
Commission for Social Care Inspection