Tag Archives: Care Inspectorate

The Future of Elderly Care Homes CQC to prosecute

“CQC to prosecute providers without warning for serious care failings under government plans.”

CQC chief executive David Behan said: “Those who run health and care service are accountable for the quality and safety of the care they provide.  People have a right to expect that care homes and hospitals meet basic standards of care.”

Delivering care to anyone brings with it huge responsibilities for the service providers, which as a service provider I am happy to accept. 

The focus of legislation and regulation is to protect vulnerable people, and that is without doubt correct. 

Inspection and regulation of Care Homes is extremely in depth and relies too heavily on written evidence.

Trust in nurses and nursing care has gone. 

This has been replaced with the ethos Care Homes are guilty until they can prove themselves innocent, and even with written proof, the balance of judgement lies solely with the inspector appointed by the Care Inspectorate. 

The days of the long term elderly care wards where the patients had access to Geriatricians and highly skilled nursing staff are in the distant past.

Now Care Homes are caring for elderly people with extremely complex health care needs. 

Instead of the experience and personal attention of a Geriatrician, it is the responsibility of the General Practitioner to provide the medical support to the elderly. 

Instead of the trained nursing staff of an elderly care hospital, Care Homes can employ in some cases quite inexperienced, newly qualified trained nurses to provide the nursing care. 

The trained nurse to care assistant ratio is also vastly diluted.

Nursing Care 

Excellent care is what every care home provider wants to give but I believe Care Homes need more support than they presently receive.

New regulation and standards brings with it more paperwork and documentation and a constant need for development of its services.

Most Care Homes care for their residents in a respectful and dignified manner, but the shift and emphasis is now on complex management systems, paper trails, and not evidence based on practice. 

Very few nurses in a management role have the required extensive management training or expertise. 

Their main aim is to ensure the delivery of excellent practical care. Whilst modern management methods are to be welcomed a balance needs to be struck and that is sadly missing.

Guidance

It is vitally important that Care Homes are inspected regularly and any complaints are investigated thoroughly but that must be in a fair manner to everyone involved in the process. 

Every inspector has their own opinions on what systems should be in place. 

The Care Inspectorate do not accept the responsibility for giving guidance to service provider. It is up to the Care Home manager to read the mind of the inspector.

Failing to have this gift leaves the Care Home very much at a disadvantage and the mercy of their inspector. 

The system which was adopted by the Health Board regulators and inspectors was a role of inspection but also support to the Care Homes in achieving excellence.

Any new legislation would be introduced to each home by way of a memo and if the new legislation involved a shift of focus or change in practice the Health Board hosted a seminar to introduce the changes which were being suggested.

Patient care is everyone’s priority, the young people of today will be the elderly of tomorrow.

Is elderly care improving and progressing as it should?

What is the best way forward? 

Cargenholm and Inverness care home services rated ‘weak’

Two Scots care homes – one near Dumfries and the other in Inverness – have been told to make improvements after being rated “weak” by inspectors.

The Care Inspectorate visited the Cargenholm Care Centre in December and the Fairfield Care Home in January.

It found that the quality of care and support provided was “weak”, the second lowest possible grade.

Inspectors have said they would revisit both sites soon and take further action if improvements had not been made.

At the Cargenholm Care Centre on the outskirts of Dumfries, inspectors raised concerns about staff vacancies, staff practice and environmental issues and have made a number of requirements for improvement.
Required improvements

“We were disappointed to find in this inspection there were very poor levels of hygiene and cleanliness, particularly in service users’ own private space,” they noted.

“We recognise that there is a considerable level of commitment needed from the provider and management team to ensure that the deficits identified at this inspection are addressed and positive outcomes are achieved.

“Through discussion and submission of an immediate action plan the management team conveyed an intention to make the required improvements.”

A spokesman for the Care Inspectorate said it continued to have concerns about the service and would be monitoring it closely to ensure action was taken to meet required standards.

A spokesperson for the the south of Scotland home, run by Canterbury Care, said: “The feedback from the Care Inspectorate was taken very seriously and a comprehensive and robust action plan is in place.

“We are working closely with the Care Inspectorate, social services and the commissioners and are confident that our actions will meet the requirements within the prescribed timescales.”

Inverness inspection

At the Inverness site – run by another operator – a previous inspection had graded the quality of care and support as “unsatisfactory”.

A formal improvement notice remains in effect at the service, and some concerns raised in an earlier inspection had not been addressed, inspectors said.

In their most recent report, inspectors noted: “We have maintained the improvement notice and given extended timescales for those requirements that have not been fully addressed.

“At this inspection we found that the service had not sufficiently addressed the seven requirements and five recommendations that were highlighted within the inspection report of August 2014.

“The service had not addressed the requirements that were made from three complaints, which were made to us and which were upheld.

“Furthermore they had not provided us with an action plan within the given timescales, as highlighted within the complaint reports.”

Source BBC News

Care homes should be ‘civilised’ by filling them with personal posessions and furniture, the care minister has said

Care homes must furnish residents’ rooms with their own curtains, bedspreads and furniture in an effort to “civilise” institutions which can be “austere and alien”, the care minister has said.

Norman Lamb warned that that many care home residents, particularly those suffering from dementia, can be left feeling confused and unhappy if they are “plunged into” a completely different environment.

He told The Telegraph that under a “robust” new inspection regime, which comes into force in October, care homes will be assessed on whether they are creating a “real sense of an individual’s home”.

Campaigners warned that too many care homes have small rooms with low ceilings and staff fail to get to know their patients beyond ensuring that they follow a set “regime”.

Mr Lamb said: “The whole focus needs to be on personalising care as much as possible. For everyone, but particularly with dementia, it is particularly important to focus on things that are familiar and enable people create a link back to their life before entering a care home.

“A willingness to take bit of furniture, bedspreads, curtains, whatever it might be that creates that link can be incredibly important in civilising care homes and making them a real home for someone, rather than an austere alien environment.

“Having your own possessions can be critical in reassuring someone with dementia and in making them feel at home. Flexibility has to be the key – and whatever works for that individual that’s what the care home ought to focusing on.

“We are introducing these much more robust inspections and ratings of care homes and I think those care homes that create a real sense of an individual’s home will be the ones who get the great ratings.”

From October, 25,000 homes and homecare providers will be subject to a new inspection regime which will rate them. The worst homes can be put on special measures, giving them a limited time to improve or close.

The Care Quality Commission, the watchdog, admitted earlier this month that it has in the past failed the elderly and vulnerable because it feared legal threats from the owners of privately-run care homes.

Lesley Carter, the policy programme manager for social care at Age UK and former nursing manager, said: “Putting things that are familiar around a person’s room, not necessarily photographs but things they can touch, that they can look at, something like a bedspread that they have always had.

“They might not recognise it as their own but it would feel familiar as they touched it and it would evoke memories.

“Rooms should be made to suit the person in it, coloured the way the person likes but you will never know what they like if you don’t know them. Care homes often have no idea what makes that person tick.

“Quite a lot homes have done a lot of work and have the things you want, but we go to the homes maybe run by independent people they have very small rooms, very low ceilings people in a regime rather than about the patient experience.”

It came after a government-backed report from the Dementia Centre at Stirling University made a series of suggestions about how to improve care homes.

They include allowing people to paint their bedroom doors whatever colour they want, surrounding themselves with personal photographs and ensuring rooms have plenty of natural light.

Alison Dawson, one of the research fellows who produced the report, said that people with dementia can become confused and forget where they are and “live in a different moment”.

She said: “The more you are able to reassure people by having things that are familiar to them, the more comfortable they are likely to feel.

“The care home environments are quite sterile, its improving, and there is a greater knowledge about how to make things more homely and friendlier environments but there is still lots to do.

“Sometimes people with dementia live in a different moment, they may occasionally feel they are in a different time-frame, so to have photographs and other memorabilia around that reminds them of the times and places where they were happy and comfortable and they are likely to go back to outside of the current moment tends to have a calming influence.”

Source The Telegraph