Showing posts with label CQC. Show all posts
Showing posts with label CQC. Show all posts

Friday, 4 October 2013

CQC official Anna Jefferson cleared over 'cover-up'

CQC official Anna Jefferson cleared over 'cover-up'

Furness General HospitalInvestigations had focused on maternal and infant deaths at Furness General Hospital in Barrow

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One of the officials at England's health regulator accused of a cover-up has been cleared of wrong-doing in an internal inquiry.
The Care Quality Commission said media manager Anna Jefferson had not supported an alleged decision to delete a critical report.
It had been suggested the CQC tried to conceal failings in its investigation at Furness General hospital in Cumbria.
Ms-Jefferson said she was "relieved that her name has now been cleared".
She added that it had been "an extremely difficult time".
Baby deaths
The spotlight fell on the CQC when it published a review in June by consultants Grant Thornton which looked at how the organisation had investigated Furness General Hospital in Cumbria.
This review had been ordered by the CQC's new chief executive, David Behan, after he took over the regulator in 2012.
The CQC had given Morecambe Bay NHS Trust, which runs the hospital, a clean bill of health in 2010 despite problems emerging in relation to its maternity unit - since then more than 30 families have taken legal action against the hospital in relation to baby and maternal deaths and injuries from 2008.
In 2011 - with more concerns arising - the CQC ordered an internal review into how those problems had been missed.
But when this report was finished, officials decided not to make the findings public and the author was allegedly been told to "delete" it, the Grant Thornton review said.
The officials alleged to have been involved in this decision were initially not named by the CQC.
No disciplinary action
The organisation came under immediate pressure from ministers and the information commissioner, who accused them of hiding behind the Data Protection Act.
Within a day the identities of the three - former chief executive Cynthia Bower, her deputy Jill Finney and media manager Anna Jefferson - had been revealed.
All three strongly disputed the allegations made against them.
Ms Jefferson is the only one of the three to still work for the CQC - she is now its head of media - and therefore the only one subject to an internal investigation.
The CQC says no disciplinary action will be taken.
In a statement, it added Anna Jefferson had "not used 'any inappropriate phrases' as attributed to her by one witness quoted in the Grant Thornton report" and "had not supported any instruction to delete an internal report prepared by a colleague."
It added: "The CQC regrets any distress Anna Jefferson has suffered as a consequence of this matter and is pleased to welcome Anna back to the organisation following a period of maternity leave."
The independent report had suggested that Ms Jefferson had said of the critical internal review: "Are you kidding me? This can never be in the public domain."
A spokesman for Grant Thornton said it fully supported and stood by its findings.

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Saturday, 1 June 2013

Monitoring the use of the Mental Capacity Act Deprivation of Liberty Safeguards in 2011/12

Monitoring the use of the Mental
Capacity Act Deprivation of
Liberty Safeguards in 2011/12


Purpose of the Safeguards
The Safeguards came into effect in 2009. They are part of a legal
framework set out in the Mental Capacity Act 2005 (MCA). The MCA
is a very important mechanism for protecting the rights of people who
do not have the ability (mental capacity) to make certain decisions for
themselves. It provides guidance to people who need to make decisions
on behalf of someone else. It sets out the principles that should guide
such decisions, including the need to act in the person’s best interests
and to achieve the desired outcome in ways that put the least restriction
on the person’s rights and freedom of action.
The Mental Capacity Act is primarily concerned with people who have
mental disabilities. The Safeguards are particularly relevant for those with
severe learning disabilities, dementia, or people who have brain injuries.
The Mental Health Act focuses on people who have mental illnesses. In
practice, the same person may be covered by both Acts, depending on
individual circumstances.
The reason the Safeguards were introduced was to address the problem
that arises if a person does not have the mental capacity to make an
informed decision about care or treatment. This problem was brought
to light in the late 1990s by the case of Mr L and became known as
‘the Bournewood Gap’. 1The reason the Safeguards were introduced
The case of Mr L
Mr L was profoundly mentally disabled and
unable to consent to medical treatment.
He was admitted to hospital by a psychiatrist
without the use of the Mental Health Act, as he
was thought to be fully in agreement with this
course of action.
His carers challenged this admission because of the
restrictions on his liberty that were applied to him
once in hospital and because Mr L did not have the
capacity to disagree with the restrictions. The reality
was that he was not free to leave.
The case went to the European Court of Human
Rights, which agreed that Mr L had been deprived
of his liberty within the meaning of Article 5 of the
European Convention on Human Rights.2
The ‘gap’ that was identified was in the lack of
safeguards for the admission and detention of people
who appeared to agree but in fact lacked the capacity
to consent or disagree.
There were no stated grounds for such action, no
statement of purpose, no limits of time or treatment
and no requirement for continuing clinical assessment.
It was this gap that the Deprivation of Liberty
Safeguards were designed to address.
1 HL v United Kingdom (2005) 40 EHRR 761
2 Article 5(1) Everyone has the right to liberty and security of person. No one shall be deprived of his liberty save in the following cases and in accordance with a
procedure prescribed by law:… (e) the lawful detention… of persons of unsound mind.
4 Monitoring the use of the Mental Capacity Act Deprivation of Liberty Safeguards in 2011/12
There have been high profile failures in health and social care, which
include deprivation of liberty. The Winterbourne View Serious Case Review
highlighted the unlawful nature of restrictions imposed on people with
learning disabilities in that service. It found that individual patient records
gave rise to concerns because they did not accurately reflect the person’s
legal status under the Mental Health Act (MHA); nor did they give any
indication as to whether the Safeguards had been considered.3
The decisions of the courts continue to develop mental capacity law, the
meaning of ‘deprivation of liberty’ and practice. The health and social care
system is currently changing. NHS primary care trusts will be abolished
in April 2013, when local authorities will assume responsibilities as
supervisory bodies for hospitals as well as for care homes.
How the Safeguards work in practice
The Safeguards must be considered in care homes and hospitals when the
restrictions on a person’s freedom, imposed in their best interests, may
mean that they are deprived of their liberty. In addition to protecting the
person’s rights, the Safeguards can provide reassurance to staff that they
are acting appropriately within the framework of the MCA, in a way that is
proportionate to the risk of harm to the person. The following
two examples illustrate this point.
Case study
Mrs A, care home resident
Mrs A has severe dementia and lives in a care
home. She makes persistent and purposeful
attempts to leave the home.
Staff are concerned for her safety if she was to leave,
but also concerned not to restrict her rights and
freedom any more than the minimum necessary for
her safety.
The care home (managing authority) decides to ask
the local social services authority (supervisory body)
to consider whether Mrs A should be ‘detained’
in the care home under the Deprivation of Liberty
Safeguards.
The local authority carries out a series of independent
assessments (looking at the person’s best interests
and medical needs and including the person’s family)
and notes that Mrs A’s medication is not being
administered correctly – which could be exacerbating
her anxiety.
The assessor recommends that the GP should review
the medication and look into an alternative medication
plan. The local authority agrees to authorise
deprivation of Mrs A’s liberty for a short period to
allow time for these aspects of the care plan to
be changed.
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Friday, 11 January 2013

the CQC had still failed to grasp its primary role to ensure patient safety.


Health regulator problems 'persist'

By Nick TriggleHealth correspondent, BBC News
Surgeons operatingThe commission monitors hospitals and care homes

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The health and care regulator for England has yet to win the public's confidence, according to a report by a committee of MPs.
The Care Quality Commission (CQC) was only created in 2009 but has been under fire virtually ever since.
The House of Commons' Health Select Committee said the CQC had still failed to grasp its primary role to ensure patient safety.
Previous reports have found recruitment problems have meant the quantity and quality of inspections have suffered.
Now the new review by the cross-party group said despite some recent improvements it was was not yet back on track.
Eighteen months ago the committee had produced a report which said the CQC had developed a "tick-box culture" and lost sight of its main role - to protect patients.
The report prompted Prime Minister David Cameron to criticise the organisation and this was followed by another attack by the National Audit Office a year ago and an official performance review by the Department of Health.
Its work also came under scrutiny after abuse at the Winterbourne View residential home near Bristol came to light.
Since then the CQC has lost its chief executive, while its chair is due to leave soon.
Public confidence
The MPs acknowledged the organisation was now aware of the changes it had to make, while new inspectors have been taken on.
But the committee said the CQC had not yet successfully defined its core purpose or earned public confidence.

“Start Quote

We will ensure that openness and transparency are at the heart of the way we develop”
David BehanCare Quality Commission
It suggested its inspections needed to be more challenging and that when problems were identified ensure providers of care were addressing them rapidly.
Committee chairman Stephen Dorrell said: "The CQC's primary focus should be to ensure that the public has confidence that its inspections provide an assurance of acceptable standards in care and patient safety.
"We do not believe that the CQC has yet succeeded in this this objective."
David Behan, the CQC's new chief executive, said the regulator had carried out a strategic review and was in the process of making changes.
"We will ensure that openness and transparency are at the heart of the way we develop.
"We are focused on protecting and promoting the health, safety and welfare of people who use health and care services."
Mike Farrar, chief executive of the NHS Confederation, which represents health managers, said feedback from his members showed many did not have confidence the CQC would be fit for purpose this year.
But he said the new leadership at the regulator had brought "strong expertise" for the future.
"It is in everybody's interest to have a strong and respected regulator for health and social care in place," he added.

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Saturday, 8 September 2012

Dame Jo Williams: Care regulator chair to resign


Dame Jo Williams: Care regulator chair to resign

She said it had been a "privilege" to work at the Care Quality Commission, but it was now "time to step aside".
The CQC came under attack last year over the exposure of abuse of residents at the Winterbourne View care home.
Jo Williams
The Department of Health said she was "tireless and dedicated" to her role.
She will step down once a replacement has been found.
Last year scathing reports by the health select committee of MPs and the National Audit Office suggested the organisation was struggling to cope.
Her own position has come under close scrutiny after she tried, and failed, to have a board colleague sacked over criticism of the CQC's leadership.
Kay Sheldon had given evidence to the public inquiry into failings at the Mid Staffordshire trust which is due to deliver its report to the government in mid October. The recommendations from the inquiry could have far reaching implications for the regulation of healthcare.
'A privilege'
In a statement Dame Jo said: "I am proud of the progress we have made.
"It has been a demanding and complex role, and there have undoubtedly been challenges as we registered 40,000 providers and brought the entire health and social care system under one set of standards.
"But there is now clear evidence that our regulation is beginning to have an impact on the care that people receive, and it feels as if the organisation is moving into the next stage of its development.
"It has been a privilege to hold this important role but I now believe it is time to step aside and for a new Chair to lead CQC into the next stage."
She will still give evidence as planned to the Health Select Committee on Tuesday. The committee has previously criticised the CQC for taking on too many responsibilities and failing to concentrate on its core role of ensuring minimum standards.
Earlier in the year Cynthia Bower resigned as chief executive of the organisation.
Una O'Brien, permanent secretary at the Department of Health, said: "I would like to thank Jo for her tireless and dedicated service in leading the CQC as Chair since 2010, and before that as a Non-Executive Director from its inception in 2008.
"Jo has shown sustained loyalty and commitment to the organisation, and to the patients and the public its serves. She is leaving the CQC well prepared for the next phase of its development
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