Tag Archives: CQC

NHS ‘TripAdvisor’ to let families check care home quality: Site will allow reviews from other families and show ratings that inspectors have given

Families will be able to check the safety and quality of every care home in the country on a new TripAdvisor-style website run by the NHS.
They will be able to see if homes have been rated good or inadequate by inspectors and read critical reviews from other relatives.
The site is being launched by the Government amid concern that as many as a third of care homes in England fail to meet basic standards.
At the worst, inspectors have found patients calling for help, left severely dehydrated or with ‘worrying’ bruises.
From today, the details of all 17,000 care homes in England will be published on a section of the NHS Choices website.
Each will have an overall rating of outstanding down to inadequate, based on the most recent inspection by the Care Quality Commission.
But relatives will also be able to award their own scores out of five and write reviews, similar to those on the TripAdvisor website for hotels and restaurants.
There will be nothing to stop care home managers giving themselves glowing reviews under the guise of members of the public. Staff or relatives with a grudge against a home could also post bad reviews unfairly.
However, officials at the Department of Health say comments will be checked before they go online to ensure they are not offensive and the website will be constantly monitored.
Ministers hope the site will drive up standards by encouraging the worst-rated homes to improve, or relatives will be unlikely to choose them.
 The Mail has repeatedly exposed failings in residential care as part of our Dignity for the Elderly campaign.
Health minister Alistair Burt said: ‘This is a victory for those who are worried about care. With a click of a button, the public will be able to make an informed choice about care.
‘This data will show clearly the difference in quality across care homes and will help drive up standards by highlighting poor performers, which will mean they have to shape up their services or lose out.’
The Government claims the website will make England the first country in the world to provide families with so much information about care homes.
Figures from the CQC show 36 per cent of residential care homes inspected so far have been graded as inadequate or requiring improvement.
The situation is even worse for nursing homes caring for frailer patients, with 55 per cent deemed inadequate or requiring improvement based on recent inspections.
The CQC’s chief inspector of adult social care, Andrea Sutcliffe, has admitted that ‘week in, week out, our inspectors discover some truly awful care’. At the worst homes, they have found residents with ‘worrying bruises’ or dementia sufferers with ‘malnutrition or life-threatening dehydration’.
In an interview earlier this year, she said there was a ‘shocking lack of respect for people’s dignity’ in the worst homes.
‘Sometimes it is abuse – older people treated roughly, worrying bruises that have no explanation,’ she said. ‘Sometimes it is neglect …It can all add up to a thoroughly miserable and frightening experience for people often in the most vulnerable of circumstances.’
At one, the Old Village School Nursing Home in Bedfordshire, inspectors uncovered such appalling neglect they sought a court order to close it immediately. But this was granted only at 5pm and some frail residents were still being moved out on to the street in wheelchairs at midnight before being transferred.
The new website will also state the hygiene rating of homes, based on inspections by the Food Standards Agency, and the number of beds.
It will give the staff turnover, as a percentage of those who left in the last year, and whether there is a registered manager.
Beth Britton, a campaigner whose father spent nine years in care homes after being diagnosed with dementia, said: ‘Anything that helps families to be more informed when making these decisions is to be welcomed.
‘I very much hope this new resource will provide more transparency about quality of care and give families increased insight at what is a hugely challenging time.’
Source Mail Online

Four in 10 care homes below standard – CQC watchdog

The health regulator has warned that 40 per cent of care homes for the elderly are below standard.

Andrea Sutcliffe, the Care Quality Commission’s chief inspector for adult social care, said that a third of social care facilities require improvement, with as many as seven per cent providing “inadequate” services.

Writing for The Telegraph, Ms Sutcliffe said: “There are concerns about safety and leadership and many nursing homes are struggling.

“There is too much variation – yes, nearly 60 per cent are good or outstanding, but a third require improvement and seven per cent are inadequate.”

She added: “In this climate it is critical that responses from local services to financial pressures do not increase risks to people’s health, safety and well-being.”

Ms Sutcliffe was writing ahead of the Government’s spending review, which will set department budgets for 2016-20.

While funding for the NHS will be protected, there are fears that councils will see their grants substantially cut, putting increased pressure on funding for social care services that are paid for by local authorities.

Local authorities say £4.6bn has been cut from social care budgets in the last five years and that George Osborne’s decision to raise the minimum wage to £7.20 an hour, and £9 by 2020, will add to the crisis by increasing the cost of delivering care.

Her remarks follow a stark warning from Guy Hands, chairman of Terra Firma, the private equity firm which owns Four Seasons, Britain’s biggest chain of care homes, about the future of the sector.

• Care system ‘crumbling’ after broken promise on fees cap – inquiry chair

He warned, in an interview with The Guardian at the weekend, that care homes will start closing down or being put up for sale next spring of George Osborne does not ease the financial pressure on the sector.

He said a quarter of his company’s homes are making at a loss and some would “inevitably” have to close.

“For the last three years, we have assumed the Government would look at the economic effect of their policy and make a decision,” he said.

“I don’t think the effects will be felt this winter, but next April or May is when you will see care homes closing or for sale.”

Meanwhile the head of a major independent review into the social care system warned ministers will face a growing “public outcry” when the full implications of the current crisis are felt.

Dame Kate Barker, told the Telegraph, that thousands of elderly people risk being condemned to a “miserable” end to their lives following a Government u-turn capping the cost of care.

Ms Sutcliffe warned that cuts in funding, rising costs and increased demand for care from an growing elderly population have already placed a huge strain on care homes and adult care services.

“Providing good quality care needs adequate investment and funding. Adult social care should be valued by society in the same way as the NHS and other public services are,” she said, adding:

“At its very best adult social has the potential to completely transform a person’s life, but at its worst it can damage people’s lives forever.”

• Andrea Sutcliffe: My brother’s suicide spurs me on to end the care crisis

• Elderly at risk at hundreds of care homes

Ms Sutcliffe’s warnings follow a growing number of scandals about the shockingly poor standards of care endured by vulnerable elderly people in a number of nursing and residential homes.

The CQC has been criticised in recent years of acting too slowly or not coming down hard enough in cases where elderly people in care homes are being maltreated.

The commission has the power to order the closure of care homes who fall below certain standards, but only uses this power sparingly – aware that the residents in these homes would still have to be found places elsewhere, in what is already a struggling sector.

In December last year the CQC ordered the closure of two care homes in Surrey run by the same couple, businessman Soondressen Cooppen and his wife Maleenee, after it found “significant failings in safety and quality of care”.

It took the urgent action after concluding that the 27 elderly residents at Merok Park Nursing Home, in Banstead, and 19 others at Grantley Court Nursing Home, in Sutton, were at “significant risk of harm”, despite repeated warning to Mr and Mrs Cooppen.

A care home in Surrey has been shut down after inspectors found residents were “at significant risk of harm”

Residents were being washed with cold water, not given sufficient support to eat meals and the understaffed home smelt of urine, while some workers had not had any criminal records checks.

Ms Sutcliffe, who joined the Care Quality Commission (CQC) in 2013, has previously said that she draws upon personal experience when making decisions.

That has led her to use what she calls the “Mum Test” when assessing institutions, asking the question: “Would I put my own mum in here?”

She said: “As the regulator I am determined that CQC lives up to its promise of being on the side of people who use services. To do that we will continue to speak up when there are challenges for the sector and continue to provide reliable and transparent information about the quality of care we find.”

Source The Telegraph

CQC issues sepsis deaths warning in NHS trust report

Too many patients are still dying at an under-performing NHS trust, with double the national average rate of sepsis deaths, the Care Quality Commission (CQC) has warned.

The situation is so serious at Sherwood Forest Hospitals NHS Foundation Trust that Professor Sir Mike Richards, the chief inspector of hospitals, has written to Health Secretary Jeremy Hunt with his concerns.

In a new report, the CQC rated the trust as i nadequate and said it should remain in special measures, where it has been for the last 18 months.

Inspectors found major concerns, including resuscitation equipment not being on trolleys which would leave patients suffering a cardiac arrest in crisis.

The trust has also failed to take adequate action to cut its high death rates, with warnings on sepsis since 2010. Sepsis is a deadly bloodstream infection.

The CQC report said: ” There have been long-standing concerns about the management of patients with sepsis.

“In 2010 and 2012 we raised mortality outlier alerts with the trust when information showed there were a higher number of deaths than expected for patients with sepsis.

“The trust had identified a third mortality outlier for patients with sepsis in the period April 2014 to January 2015.”

Inspectors found 88 deaths from sepsis between April 2014 and February 2015. Some 32% of all patients diagnosed with septicaemia died, almost double the England rate of 17%.

The trust provides services for people across north and mid-Nottinghamshire as well as parts of Derbyshire and Lincolnshire.

Both Kings Mill Hospital and Newark Hospital were rated as inadequate overall while medical care at Mansfield Community Hospital required improvement.

The trust was placed in special measures two years ago by NHS medical director Sir Bruce Keogh because of concerns about death rates and standards of care.

Executive leaders at the trust were also found to regard some of the CQC’s concerns as not being significant.

Prof Richards said inspectors had “found a number of serious problems” since a 2014 inspection and the findings were “extremely concerning”.

He added: “Rather than getting better, our latest inspection shows a noticeable decline in ratings.

“The trust’s special measures action plan had 18 high level action points to be completed by March 2015.

“Only one of these areas had been completed by the June inspection, although there has been some progress in other areas.”

At the time of the inspection, death rates continued to be above expected limits, Prof Richards said.

“A particular concern was the trust’s management of patients with sepsis, with just 17% of inpatients receiving care and treatment in accordance with national guidance.”

Karen Fisher, acting chief executive at the trust, said: “We are extremely disappointed about the shortfalls the Care Quality Commission has identified. We are sorry we have let down our patients by not meeting the high quality standards they rightly expect.

“We have made a new start and are working hard to make the necessary improvements.

“The CQC recognised our staff are caring, hard-working and compassionate. Our staff continue to deliver this compassionate care to the hundreds of patients who use our services every day.”

She said the trust has already made improvements in some areas, including ensuring that patients with sepsis are managed according to national standards.

All life-saving equipment is in place and is spot-checked daily, she added.

The regulator Monitor said it had agreed with the CQC that the trust needed a close long-term tie-up with another trust.

Monitor has made a number of appointments in the meantime to help the trust, including a former NHS chief executive and two improvement directors from other trusts.

Frances Shattock, regional director at Monitor, said: “The findings of this inspection are deeply disappointing.

“Local people expect a much better service from their hospitals. We’ve agreed with the CQC that the trust will need more than a sticking plaster.”

Source Mail Online

NHS and care sector: Safety a ‘big concern’ in England

Safety across the NHS and care sectors in England is a “significant concern”, with particular problems in hospitals, inspectors are warning.

The Care Quality Commission review found three-quarters of hospitals visited under its new inspection regime so far had safety problems.

Over 40% of care and nursing homes and home care services and one in three GP services also had problems with

Lack of staff was identified as a major issue in hospitals and care services.

The way medicines were managed and how mistakes were investigated and learnt from were also highlighted.

‘Kept on trolleys’

Among the individual cases flagged up were:

  • A&E patients being kept on trolleys overnight in a portable unit without proper assessment
  • Staff at a GP surgery not undergoing basic life-support training in the past 18 months
  • Medication mistakes at a care home – including delays giving drugs and signs of overdoses

The findings – contained in the CQC’s annual report – are effectively a mid-term update of the new tougher Ofsted-style inspection regime.

They cover the first 14 months of the inspection programme, which was launched in April 2014 and is expected to be largely completed by April 2016.

So far more than 5,000 organisations have been inspected – nearly half of hospitals, 17% of care services and 11% of GP surgeries and out-of-hours providers.

However, those deemed most at risk have been predominantly targeted first, so the level of failure is not necessarily representative of the overall sector.

During the inspections, CQC experts look at a range of different issues, including:

  • The quality of management
  • Whether staff are caring
  • Safety

Each organisation – from GP surgery to hospital – gets a rating for each, resulting in an overall rating of inadequate, requires improvement, good or outstanding.

The results of these are widely published throughout the year, whereas this report looks at some of the common problems identified during the whole process.

Of all the issues looked at, the CQC said most concerns had been raised about safety.

Some 13% of hospitals were judged unsafe, 10% of social care services and 6% of GP services.

Once those judged to be not safe enough are included, it brings the numbers with safety problems to 74% for hospitals, 43% for social care services and 31% for GPs.

The report said improving leadership was the key to tackling the problems.

David Behan, CQC chief executive, told Radio 4’s Today programme: “What we know from our report and from other research is that the leadership of an organisation sets the culture of that organisation.

“If the leadership says the important things around here are quality and safety, then that’s what people attend to.”


Royal College of Nursing general secretary Janet Davies believes financial problems are a major factor – last week it was revealed trusts had already racked up a deficit of nearly £1bn in the first three months of this financial year, greater than the overspend for the whole of 2014-15.

She added: “Whether nursing care is delivered, in hospitals, care homes or the community, it depends on having the right number of staff with the right skills and support. There must be more investment in training nurses, keeping nurses and listening to nurses.”

Mr Behan said money was “important”, but added that hospitals with similar amounts of money achieved different results.

Katherine Rake, chief executive of Healthwatch England, the patient watchdog, said it was vital to learn from mistakes, describing the problems highlighted as “unacceptable”.

“We would now like to see all services operate with the right culture of openness and transparency when things go wrong,” she said.

But Rob Webster, of the NHS Confederation, which represents trusts, warned the financial pressures and negative publicity was creating a “toxic environment”, which in turn had caused a “revolving door of NHS leadership”.

“[This] is bad for the health service, and bad for patients,” he said.

Source BBC News

“Inadequate” dementia care home ordered to improve by CQC

A CARE home in Poole for dementia sufferers has been deemed “inadequate” after one nurse was left to look after 23 residents.

Delph House, based on Upper Golf Links Road in Broadstone, has been told it is “not safe”, “not effective”, “not responsive” and “not well led” in a Care Quality Commission report published on July 29.

Among the “serious shortfalls” identified by inspectors, who visited unannounced in May, were concerns over the staff’s “skills and ability to provide safe care”.

Inspectors, who identified 11 areas where the home failed to meet legal requirements, said despite there being a sufficient number of carers to meet basic personal needs there was only one nurse on duty for 23 people with nursing needs.

The Royal College of Nursing recommends that one nurse per six patients be present during daytime hours.

Inspectors raised concerns about a resident who had lost the top set of their teeth. They said no action had been taken to refer them to a dentist. The report said: “The lack of a top set of dentures had not been considered a contributing factor to this person’s lack of nutritional intake and subsequent weight loss.”

Another resident left “upset and agitated because of pain” was given sedatives instead of the painkillers they had been prescribed, the report said.

The inspectors said care plans included “contradictory information”, singling out an inaccurate assessment of a resident’s skin the night before their visit. The report said: “We saw the person’s skin was dry, their skin was very thin and they had a dressing on their left arm from a skin tear…. The care plan review stated the person’s skin was intact.”

The report said “people were being deprived of their liberty without lawful authority”, that residents’ “nutritional and hydration needs were not being met” and there were “shortfalls in operating an effective complaints system”.

Inspectors described how they were contacted by a concerned relative prior to their visit who went on to complain directly to the home. Despite the manager acknowledging this complaint had been lodged, no record of it had been made.

Inspectors found ripped and stained chairs used by the residents, medicines being stored in communal cupboards and found controlled drugs had gone missing.

The following day the report said the home was able to demonstrate this was an administrative error and that the drugs had not gone missing.

The CQC has served the home with a warning notice to comply with regulations by August 14.

At the time of the inspection the registered manager was listed as Janice Jenkins and the responsible individual as Jacqueline Lesley Haigh.

When the Daily Echo phoned the home for comment, we were told Janice Jenkins has left and that Delph House is now under new management.

Source The Daily Echo

Care home abuse allegations increasing under ‘strained’ system

Allegations of abuse in care homes are being made at almost double the rate they were four years ago, with an average of 150 now being reported every day, according to figures from the Care Quality Commission.
In 2011, around 30,000 allegations were reported to the regulator by providers of adult social care. More than 27,000 of those came from care homes.
In the first six months of this year, just over 30,000 abuse allegations were already reported to the CQC. Nearly 24,000 occurred in care homes.
The data was released following a Freedom of Information request by The Observer newspaper, which also interviewed the CQC’s chief inspector of adult social care, Andrea Sutcliffe.
Ms Sutcliffe told the paper that the figures showing more allegations being reported were indicative of care providers and those using the services being increasingly aware of the need to notify authorities about potential abuse.
But she did say she was concerned by the “kind of increase there has been, the numbers of people directly affected”, and that 125 more CQC inspectors were now being recruited to help tackle the issue.
Cuts in funding and a lack of political leadership had helped to create a sector that was now under “stress and strain”, said Ms Sutcliffe.
She noted the poor pay and long hours often found in adult social care settings and warned of healthcare workers who felt undervalued and demoralised, which led to some providing sub-standard care.
Andrea Sutcliffe
“That potentially means that they may leave, and we do see turnover, but it also may mean that they end up being the sort of care worker that you wouldn’t want them to be, because the system around them isn’t supportive,” she said.
She pointed to the role that local authorities and clinical commissioning groups play in ensuring enough money is provided to organisations offering quality care.
“There is an important responsibility in the role of those funding care – local authorities or clinical commissioning groups – to really understand what the true cost of care is, what true quality looks like and to make sure they are commissioning services that meet those standards and providers are given the appropriate funding to enable then to do that,” she said.
In response, a Department of Health spokesman said: “Abuse and neglect are completely unacceptable at all times, and whatever the cause, we are determined to stamp them out.
“We need to understand what lies behind these figures – an increase in awareness and reporting of abuse is to be welcomed, so that proper action can be taken,” he told Nursing Times.
He added: “Treating someone with dignity and compassion doesn’t cost anything. We’re making sure we recruit people with the right values and skills by introducing a ‘fit and proper person’ test for directors and a care certificate for front-line staff.
“The CQC’s new tougher inspection regime will also help to make sure that if abuse does occur, it’s caught quickly and dealt with,” he said.
In recent months there have been warnings about a nurse recruitment crisis facing the care home sector, with managers struggling to compete with the NHS for staff amid a national workforce shortage.
Meanwhile, at the Royal College of Nursing’s annual conference this year, union members voted to lobby the government to make changes to the way care home providers are funded in a bid to help tackle issues such as low pay.
Source The Nursing Times

Elderly care crisis after complaints soar to 160 every day: Number doubles in just four years as inspectors also find care home staff are ignoring residents in distress

More than 160 complaints a day about the care of elderly and vulnerable adults are being lodged with the watchdog, figures reveal.

Inspectors at the Care Quality Commission are also turning up at nursing homes to find residents crying out in distress, ignored by staff.

Yesterday the chief inspector of social care at the CQC warned that increasing pressure on cash-strapped services was turning ‘good people into bad carers’.

Andrea Sutcliffe said that some employees ‘end up being the sort of worker that you wouldn’t want them to be’.

Councils across England are having to slash their budgets for social care, which includes nursing homes and home help, just when demand is growing as the population ages.

Figures from the CQC released under the Freedom of Information Act reveal that the number of complaints concerning social care doubled between 2011 and 2015.

A total of 30,222 were lodged in the first six months of this year – the equivalent of 166 a day – and the majority involved care homes for the elderly. This compares to 30,911 for the entire 12 months of 2011.

Officials said the rise was partly down to increased public awareness following high-profile reports of abuse in homes.

Meanwhile harrowing reports from inspectors at the CQC reveal that some elderly residents are being left in their beds in care homes for hours after waking up.

One published last week into the Birdsgrove Nursing Home, near Bracknell in Berkshire, reads: ‘We spoke with a person who was still in bed in night clothes.

‘It was mid-morning and they told the inspector they had been awake since 7am and were waiting for staff to help move them to their chair, wash them and help them get dressed.

‘We left the room and shortly afterwards heard them shouting for help. The person was in very obvious distress and their shouts for help were loud enough for any staff nearby to hear them. No staff responded to the calls for help.’

Mrs Sutcliffe, who became chief inspector of adult social care in 2013, said that much good work was being done in the system ‘despite the cuts’. But in an interview with The Observer, she said staff were increasingly feeling undervalued and demoralised.

‘That potentially means that they may leave, but it also may mean that they end up being the sort of care worker that you wouldn’t want them to be because the system isn’t supportive,’ she added.

‘The social care sector is certainly under stress and strain. And it is a combination of all sorts of factors – the increased number of people who need support, the increased complexity of their needs.’

The Daily Mail has long called for an improvement to the care of older people as part of our Dignity for the Elderly campaign.

A Department of Health spokesman said: ‘Abuse and neglect are completely unacceptable, and whatever the cause we are determined to stamp them out.

‘We need to understand what lies behind these figures – an increase in awareness and reporting of abuse is to be welcomed so that proper action can be taken.’

Source Mail Online

Why are nursing homes worse than care homes?

Social care has changed dramatically in the last two decades: now care homes have residents who would previously have been in nursing homes – and nursing homes look after people who would have required hospital care.

As demographics have changed, people are living for longer with more complex conditions – most notably, dementia.

“The job that we’re expecting nursing homes to do is ever more complex and ever more difficult,” says Andrea Sutcliffe, chief inspector for regulator the Care Quality Commission (CQC). Homes with nursing are expected to care for people with acute needs, while also ensuring a community aspect to the care.

The distinction between care homes and nursing homes is simply that the latter offer nursing care, with nurses on site who provide this, while both are residential facilities for older or disabled people.

But findings from the 2014 CQC State of Care report suggest that there is also a quality distinction to be made between the two and that nursing homes provide poorer care than care homes.

Less that 80% of nursing homes inspected met CQC standards for safety, compared to 85% of residential care homes.

The increased complexity of care is one explanation for the problems faced by nursing homes. Another is the difficulties recruiting nurses.

The State of Care report found that 20% of nursing homes do not have enough staff on duty to ensure that residents received good and safe care and their turnover and vacancy rates are among the highest in social care.

This affects the nurses already working in social care.

Claire Phillips, a registered nurse in a Cumbrian nursing home, says: “We’ve been begged to do extra [work] because there’s not enough nurses to cover all the shifts. So there’s been periods where we all work more than our contracted hours and that can be hard … It’s a lot of pressure, I’ve got a young family.”

Frank Ursell, chief executive of the Registered Nursing Homes Association (RNHA), says that one reason for the shortage is that the NHS has been hiring many more nurses since the Mid Staffs scandal and “sucking them out of our sector”.

Phillips echoes this, saying that nurses leaving “seems to come in waves, especially with the NHS recruiting so heavily – that’s been an issue certainly in the last year”.

The Conservative party’s manifesto promised 6,900 more nurses for the NHS, suggesting that homes will be further mined for their nurses.

In a recent Guardian interview, the head of Health Education England, Ian Cumming, said: “We’ve got a significant problem with nursing, and the inability to recruit nurses.” Nurses are not just in short supply in social care.

Nursing homes have limited control over the number of nurses trained each year and as a registered profession, this is in the hands of the government. “The Department of Health is not good enough at determining how many nurses we need,” says Ursell.

In April, the Royal College of Nursing revealed that there are fewer nurses now than in 2010, because of a cut in student nursing commissions. While 50,000 people applied to be nurses in 2014, there were only 21,000 places available.

The poor reputation of the social care sector compared to the NHS is often cited as a reason for the shortage of nurses in social care.

Care and nursing homes are not seen as attractive places to work, despite the fact that nursing in a residential home can be much more relationship-based.

“I like going in and knowing the faces I’m going to see,” says Phillips. “My strengths lie in communication, the building up of the relationship.” The continuity of patients in a nursing home gives nurses the chance to get to know the residents and their families.

“There’s a difference between nursing inside the NHS, which is prominently episodic, as opposed to working in our sector where it’s more relationship based”, says Ursell. This is a key strength of social care and is what so many people working in the sector love about it. But it can be overshadowed by the harsh media criticism and poor public image of the sector.

The RNHA is making strides to try and improve the recruitment situation and is exploring partnering with universities to offer nurse training courses.

Students would have to pay for these themselves, rather than being covered by an NHS bursary, but would be guaranteed a job in a nursing home at the end of it.

While many students may not be overly keen to pay for a degree they could get for free, the over-subscription for places on current nursing degrees may nevertheless lead to demand for this course.

And there are steps that nursing homes could take themselves, such as paying a higher rate for night shifts and improving their pension offering in line with the NHS.

A problem that affects the whole of social care, and one that the sector skills agency Skills for Care is attempting to address, is the actual or perceived lack of a career pathway.

Care assistants can feel that there is no way to progress unless they take time out to get a nursing degree, and registered nurses find that they cannot move up the career ladder without going into management and losing the hands-on nature of their role.

Making it easier for care assistants to get a nursing degree while staying in their job could be a longer term solution, as would enabling registered nurses to specialise in particular areas of care within the nursing home.

Tracy Paine, registered nurse and operations director at care provider Belong, says: “I think we need to really sell the great news stories, the opportunities available in adult social care, the training and investment.” Nursing in social care does have some advantages over the NHS, but the sector needs to shout loudly about them. Phillips, who has worked in a nursing home for two years, says: “I can’t imagine now working in a hospital even though I did my training there. I think this job gives me what I need.”

Source The Guardian

Mental health crisis care ‘inadequate’

People who need urgent mental health care in England are receiving inadequate support, regulators say.

The Care Quality Commission reviewed the help given to people in mental health crisis, which includes people who are suicidal, having serious panic attacks or psychotic episodes.

The regulator said the system was “struggling to cope”.

Its report also highlighted what it described as a “lack of compassion” from A&E staff.

The CQC carried out its investigation following the signing of a Crisis Care Concordat between the government and the sector last year which promised round-the-clock support to those who needed it.

This includes help from dedicated mental health staff, intensive support at home or telephone advice.

‘Wake-up call’

But the review – based on surveys of patients, analysis of national data and inspections of services – found that 42% of patients did not get the help they needed.

Patients were also asked about the attitudes of staff towards them. Staff working for charities and volunteers received the most positive ratings, while staff in A&E received the worst.

Just over a third of patients who ended up in A&E thought they had been treated with compassion and warmth and a similar proportion said their concerns had been taken seriously.

The dedicated crisis-resolution teams that are there to help those in trouble did little better with fewer than half answering positively to each question.

The report also highlighted the experiences of a number of patients. One said: “It was approximately seven hours before I got crisis support and that was only a call not a visit, which would have been more useful. As my crisis worsened, I took a small overdose as I was not coping or getting any immediate help.”

Dr Paul Lelliott, the CQC’s mental health lead, said while there were some excellent examples of care, the findings must “act as a wake-up call”.

“Worryingly many people told us that when they were having a crisis they often felt the police and ambulance crews were more caring and took their concerns more seriously than the medical and mental health professionals they encountered.”

Paul Farmer, chief executive of Mind, the mental health charity, said: “The report will not come as a surprise to anyone who has found themselves in crisis or who is involved in supporting people when they are at their most unwell.

“We take for granted that when we have a physical health emergency we will get the help we need urgently. It should be no different for mental health.”

Care Minister Alistair Burt said the government was trying to tackle the problems in mental health with its new treatment targets and extra funding that were both announced before the election.

“Improving mental health care is my priority,” he added.

Last year 1.8m people sought help for a mental health crisis.

Source BBC News

Regulators to take over NHS services in three English regions

NHS regulators are to push through major changes to how hospitals and GP services are run in whole parts of England where services have been beset by major problems for years.

The unprecedented move will see three key national NHS bodies intervene to dictate how all local services tackle longstanding problems such as understaffing, financial trouble and poor care.

The new “success regime” will be applied first to three areas of England – Essex, North Cumbria and North, East and West Devon – where previous efforts have failed to produce improvements.

But it is understood that it may be extended to other places, including Kent and Staffordshire, where hospitals in particular have racked up mounting debts, struggled to cope with rising demand for care and had difficulties in delivering key waiting time targets, such as for A&E and cancer patients.

Simon Stevens, the chief executive of NHS England, outlined the move on Wednesday in a speech to 3,000 local NHS leaders gathered in Liverpool for the NHS Confederation’s annual conference.

The new scheme is different to the “special measures” regime that Jeremy Hunt, the health secretary, introduced for individual failing hospitals after Robert Francis QC’s landmark report in 2013 into the Mid Staffs scandal.

What the NHS is calling “whole-systems intervention” is needed because often problems besetting one hospital are part of wider problems in their locality, Stevens said. The various acute hospitals in Essex are understood to be about £150m in deficit, for example.

Previous efforts to turn around individual hospital trusts – such as repeated financial bailouts, regular replacement of chief executives and inspections – have not done the job, he said.

“We are going to both nationally and locally bring to bear a full range of flexibilities and say what is our holistic diagnosis as to what needs to change in this individual health economy, not just go and inspect individual institutions or set individual cash limits,” Stevens said.

An extraordinary series of recent lapses in patient safety at Broomfield hospital in Chelmsford, Essex, some of which have resulted in serious harm to patients and even death, illustrate why the new regime has been created.

Surgeons there operated on the wrong hip, ear and part of the scalp in three separate incidents, a delayed diagnosis resulted in another patient losing an arm and unregistered nurses were passed off as being fully qualified registered nurses – a serious lapse which the Care Quality Commission, the NHS care regulator, says is the first incident of its kind at any English hospital.

NHS bodies have also criticised the trust over other failings, including a number of patients whose condition deteriorated after receiving “sub-optimal care”, including a child; several unexpected deaths; a patient in a wheelchair sustaining injuries after their wheelchair collided with a van; two unexpected deaths of newborn babies; a string of drug errors, including an incorrect dose of chemotherapy to a cancer patient; and lapses in safeguarding of children and vulnerable adults.

NHS England said: “The aim is to improve care and sustainability of services for patients. The three areas are facing some of the most significant challenges in England. They will begin work to make improvements this summer and further areas may enter at a later point.”

The new approach will see NHS England working in partnership with Monitor and the NHS Trust Development Authority, which both regulate England’s 160 acute hospital trusts. They will draw up radical plans to overhaul how all the different types of local NHS organisations across large areas are run and deliver care.

Working with local NHS care providers, they will push through determined action to ensure hospitals, GP surgeries and other NHS service providers work together much more closely to tackle deep-seated problems which previous initiatives have failed to banish.

Previously failing hospital trusts have been placed in special measures – 23 in all so far – but this is the first time that this type of takeover across multiple trusts spanning whole regions has been enacted. It will reignite the debate about the current state of the NHS and its funding.

The move is part of the NHS Five Year Forward View, the blueprint for the service’s future, which Stevens and fellow bosses of other key NHS bodies published last year.

An NHS background briefing on the move published on Wednesday explains: “The problems in these health and care economies are often deep-rooted, longstanding and spread across the whole system as opposed to individual organisations. Local and national organisations may have worked hard for some time to improve services for patients and the public, but not made the required progress.

“Transformation is therefore now required, and this will only be achieved if national and local leaders take a different approach to those taken previously, which has not yet delivered the expected improvements for patients and the public.”

The British Medical Association said that more areas would start to fall under the “success regime” if ministers continued to push the NHS to deliver even greater efficiencies.

Hunt warned the NHS in an article in the Daily Telegraph this week that, with ministers having pledged to give it the £8bn extra funding by 2020 that Stevens has requested, the health service needed to to press on with making £22bn of “substantial and significant efficiency savings” in return.

Dr Mark Porter, chair of council at the doctors’ union, the British Medical Association, said: “This unprecedented move underscores the abject failure of the Health and Social Care Act 2012 to address the underlying pressures on NHS services.

“The expensive and unnecessary reorganisation diverted attention away from the real problems facing the NHS such as the service coordination and chronic funding pressures.

“The need for this sort of dramatic intervention is likely to increase if the government continues to pursue its drive for yet more ‘efficiencies’, instead of properly addressing inadequate NHS funding in the face of rising demand for health and care services.”

Source The Guardian