Showing posts with label care. Show all posts
Showing posts with label care. Show all posts

Sunday 5 May 2013

Essential standards of quality and safety


Essential standards of quality and safety
The essential standards of quality and safety consist of 28 regulations (and associated outcomes) that are set out in two pieces of legislation: the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and the Care Quality Commission (Registration) Regulations 2009.

 For each regulation, there is an associated outcome – the experiences we expect people to have as a result of the care they receive.

 When we check providers’ compliance with the essential standards, we focus on the 16 regulations (out of the 28) that come within Part 4 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 – these are the ones that most directly relate to the quality and safety of care. Providers must have evidence that they meet the outcomes.

 These 16 regulations are set out below. (Note that the outcome numbers are different to the regulation numbers because we have grouped the outcomes into six overall themes. See our Essential standards of quality and safety publication for full details.)

 Regulation* Outcome Title and summary of outcome
9 4 Care and welfare of people who use services
People experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.
10 16 Assessing and monitoring the quality of service provision
People benefit from safe, quality care because effective decisions are made and because of the management of risks to people’s health, welfare and safety.
11 7 Safeguarding people who use services from abuse
People are safeguarded from abuse, or the risk of abuse, and their human rights are respected and upheld.
12 8 Cleanliness and infection control
People experience care in a clean environment, and are protected from acquiring infections.
13 9 Management of medicines
People have their medicines when they need them, and in a safe way. People are given information about their medicines.
14 5 Meeting nutritional needs
People are encouraged and supported to have sufficient food and drink that is nutritional and balanced, and a choice of food and drink to meet their different needs.
15 10 Safety and suitability of premises
People receive care in, work in or visit safe surroundings that promote their wellbeing.
16 11 Safety, availability and suitability of equipment
Where equipment is used, it is safe, available, comfortable and suitable for people’s needs. 
17 1 Respecting and involving people who use services
People understand the care and treatment choices available to them. They can express their views and are involved in making decisions about their care. They have their privacy, dignity and independence respected, and have their views and experiences taken into account in the way in which the service is delivered.
18 2 Consent to care and treatment
People give consent to their care and treatment, and understand and know how to change decisions about things that have been agreed previously.
19 17 Complaints
People and those acting on their behalf have their comments and complaints listened to and acted on effectively, and know that they will not be discriminated against for making a complaint.
20 21 Records
People’s personal records are accurate, fit for purpose, held securely and remain confidential. The same applies to other records that are needed to protect their safety and wellbeing.
21 12 Requirements relating to workers
People are kept safe, and their health and welfare needs are met, by staff who are fit for the job and have the right qualifications, skills and experience.
22 13 Staffing
People are kept safe, and their health and welfare needs are met, because there are sufficient numbers of the right staff.
23 14 Supporting workers
People are kept safe, and their health and welfare needs are met, because staff are competent to carry out their work and are properly trained, supervised and appraised.
24 6 Cooperating with other providers
People receive safe and coordinated care when they move between providers or receive care from more than one provider.
* Regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010
The other 12 regulations relate more to the routine day-to-day management of a service. The information we receive in respect of these helps us to check that the service is being run appropriately and responsibly, and to monitor generally the provider’s compliance with the essential standards of quality and safety. However, we will make checks where concerns are raised with the 12 regulations.

 Regulation Outcome Title and summary of outcome
4* 22 Requirements where the service provider is an individual or partnership
People have their needs met because services are provided by people who are of good character, fit for their role, and have the necessary qualifications, skills and experience.
5* 23 Requirement where the service provider is a body other than a partnership
People have their needs met because services are managed by people who are of good character, fit for their role, and have the necessary qualifications, skills and experience.
6* 24 Requirements relating to registered managers
People have their needs met because services have registered managers who are of good character, fit for their role, and have the necessary qualifications, skills and experience.
7* 25 Registered person: training
People have their needs met because services are led by a competent person who undertakes the appropriate training.

12** 15 Statement of purpose
People know that the Care Quality Commission is kept informed of the services being provided.
13** 26 Financial position
People can be confident that the provider has the financial resources needed to provide safe and appropriate services.
14** 27 Notifications – notice of absence
People can be confident that, if the person in charge of the service is away, it will continue to be properly managed.
15** 28 Notifications – notice of changes
People can be confident that, if there are changes to the service, its quality and safety will not be affected.
16** 18 Notification of death of a person who uses services
People can be confident that deaths of people who use services are reported to CQC so that, if necessary, action can be taken.
17** 19 Notification of death or unauthorised absence of a person who is detained or liable to be detained under the Mental Health Act 1983
People who are detained under the Mental Health Act can be confident that important events that affect their health, welfare and safety are reported to CQC so that, if necessary, action can be taken.
18** 20 Notification of other incidents
People who use services can be confident that important events that affect their health, welfare and safety are reported to CQC so that, if necessary, action can be taken.
19** 3 Fees
People who pay for services know how much they are expected to pay, when and how, and what service they will get for the amount paid.
* Regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010
** Regulation of the Care Quality Commission (Registration) Regulations 2009
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Staff should help residents to eat


06 February 2009 today there is a crisis @ Ivybank care home ,lack of food,and the staff have problems with the 
heating and they have not got the keys nor anyone to deal with the problem,i.e. it is very cold today.
John a member of staff @ Ivybank expressed that to me on the phone today, to help he is going to on my
request try and get my mother a take away meal delivered to her she will pay. 
I was unable to obtain a reply from 0117 956 7890 begbrook office , however I have spoken to your office and 
the lady I spoke to is aware of the above and was setting about dealing with this matter , I myself will
be doing all that is neccesary to help the situation within Ivy bank House.

  Living in a Care Home 
Food & mealtimes 
Food preparation and the rituals of eating are important elements of cultural identity. Involving residents in planning and preparation and helping residents to enjoy their food wherever possible is a sign of a home that takes the concept of holistic care seriously – caring for the whole person rather than a collection of ailments and illnesses. 
Food is, of course, essential to physical wellbeing and enabling residents to eat well is an important part of the job of care staff. Residents should have access to three meals a day and drinks and snacks in between. Thought should be given to the timing of meals with care taken to avoid big gaps particularly between supper and breakfast. If the evening meal is quite early then what is offered for supper would have to be quite substantial to take the resident comfortably through to breakfast. And it is important that residents are offered snacks and drinks. Staff should not rely on residents to ask as shyness, confusion or not wanting to bother staff may leave residents hungry or thirsty. 
A helping hand 
Staff should help residents to eat. They should not feed residents. The difference may be difficult to judge but it is an important one. Sitting next to the resident, maintaining eye contact, talking to the resident and going at their pace are all indications that the carer is helping rather than feeding. Carers should never be helping more than one resident at a time. Nor should they be talking to a co-worker or watching TV while they are doing it. 
Going alone 
After perhaps years of living alone or with a partner, getting used to communal eating may be difficult. It is common for residents to withdraw to their rooms and take all their meals there. Staff may try to 
persuade your relative to join their fellow residents in the dining room. Although it is good to encourage residents out of their isolation, and try to address any reasons why residents may be reluctant to eat with others, ultimately the wishes of the resident must be respected. Residents must not be forced or coerced into changing their behaviour. 
Private space 
Eating with other people may become something of an endurance test and source of anxiety that could lead some people to withdraw from being with others as the only way of maintaining their dignity. When residents exercise their choice to stay in their room, for meals they have previously taken in the dining room with other residents, it may be worth thinking about what has caused this. It may have been an embarrassing episode – difficulty in eating, a row with another resident or member of staff, or failure to get to the toilet in time – that has caused a change in behaviour. 
Remember 
• A resident’s likes and dislikes should be recorded in their care plan and reviewed regularly. 
• Food should be attractive, even if is liquidised. 
• Discuss any problems your relative is having with eating with their key worker, the cook or the home manager 
• If food is prepared or served in an unusual way ask why such steps are necessary and how the decision was reached. 
• When helping a resident to eat, staff should sit, maintain eye contact and go at the resident’s pace. 
• Drink should never be withheld from a resident in response to incontinence. It is likely to make matters worse. 
At the care meeting nobody except Michelle Totanes spoke about mothers food and the filth she has been served, she is vegetarian, when I stated this at the meeting
Michelle Totanes stated that my mother was not a vegetarian , why,?First incident with michelle I received call
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Sunday 4 November 2012

Liverpool Care Pathway: Relatives 'must be informed


Liverpool Care Pathway: Relatives 'must be informed'Elderly man's hands

There will be a 12-week consultation on the proposed changes to the NHS constitution

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Relatives of terminally-ill patients would have to be consulted before a decision to withdraw food or water is taken, under new government proposals.
It comes after some patients were placed on the Liverpool Care Pathway - designed to relieve suffering - without their relatives' knowledge.
The government wants to ensure families are told of life and death decisions.
The instruction will be included in a number of proposed changes to the NHS Constitution to be unveiled on Monday.
The Liverpool Care Pathway was developed at the Royal Liverpool University Hospital and the city's Marie Curie hospice to relieve suffering in dying patients, setting out principles for their treatment in their final days and hours.
Supporters say it can make the end of a patient's life as comfortable as possible and the method is also widely backed by doctors and many health charities.
However, critics argue it can be inhumane.
The government has now said that the rules needed to be stricter, meaning relatives of patients are always consulted before the technique is applied.
'New right'
A Department of Health (DoH) spokesman said the proposed changes would set out a "new right" under the NHS Constitution, which was established by the Health Act 2009, but he stopped short of describing the move as a "legal requirement".
However, the spokesman added: "Anybody providing NHS services is required by law to take account of it [the NHS constitution] in their decisions and actions."
Some reports suggested health trusts that failed to involve patients and families in decisions could be sued, while doctors could face being struck off.
The DoH spokesman said it was unlikely policy had been developed on this as the proposal was still at an early stage.
Health Secretary Jeremy Hunt will launch a 12-week consultation on the proposed changes to the constitution - the formal statement of patients' rights - on Monday.
Health minister Norman Lamb said this week that it was "completely wrong" for terminally-ill patients to be put on a "pathway" to death without relatives being consulted.
Mr Lamb has called a meeting of doctors and patients to discuss worries about the pathway.
Meanwhile, Conservative peer Baroness Knight called for an inquiry into claims some people might have survived had they not received this treatment.
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Monday 29 October 2012

Care homes given five star ratings fail key standards


Care homes given five star ratings fail key standards

But critics say this is a "cheque book system" open to any home prepared to pay for a rating.Care homeCare homes with five-star ratings are receiving premium fees despite not meeting essential standards set out by the care regulator.
Local authorities pay higher fees to care homes awarded top ratings.
The Care Quality Commission advises people to visit homes and check their most recent CQC inspection report before making a decision on care.
Care regulator the Care Quality Commission (CQC) stopped issuing its own star ratings in 2010 and now some homes pay independent ratings companies and consultants to assess them instead.
Gwenda Dunn was surprised to find that her aunt's care home had been awarded five stars by such a company.
"This is not a complaint against the home - it's a complaint as to how the home could be given five stars when it patently was not," she told the BBC's 5 live Investigates.
5 star failures
Mrs Dunn says her aunt's room was often cold and calls from her aunt for a commode during the night were sometimes ignored by staff.
Also, her aunt was frequently disturbed by another patient with dementia who often entered her room uninvited.
"I was there when the inspection was done. I spoke to the inspector and raised a fair amount of issues and then we found out within a week that the home had got five stars again," says Mrs Dunn.
"People who aren't in the know would take it as face value, not recognising the reality."
The home was rated by David Allen, an independent consultant who trades under Prestige Quality Ratings (PQR).
Mr Allen says the issues raised with him lacked substance and were misplaced. He also says other people at the home spoke very highly of the care provided and he saw no reason to downgrade the home.
PQR is one of three independent ratings companies recognised by Sefton Council. The others are RDB Star Rating Limited and Assured Care.
With the top five-star rating attached, families might believe a home is providing an outstanding level of care.
But the BBC has found that out of 80 homes given a four or five-star rating in the Sefton area, 14 are failing to meet one or more of the essential standards set out by the CQC.
This includes standards of staffing, standards of treating people with respect and standards of caring for people safely and protecting them from harm.
A day centre for the elderlyAll of the homes had been rated by either RDB Star Rating, Assured Care or PQR.
The CQC is taking action against two of the highly-rated homes, demanding immediate improvements be made - although it is not known which company provided their rating.
All three ratings companies have defended their awards system.
"I always take account of what the CQC have to say… but the CQC doesn't have to be right every time," says Frank Watts of Assured Care.
David Allen of PQR insists that his company's ratings are "accurate reflections of the quality of the care provided at care homes at the time of the assessment".
RDB Star Rating told the BBC its assessments were "comprehensive and reliable".
Higher fees for homes
Sefton Council pays a quality premium to homes given a high rating by the companies - a residential or nursing home with five stars receives an additional £40 per week on top of the basic fee paid for each person in its care.A spokesman for Sefton Council said: "All the companies providing quality ratings use assessment criteria linked to outcomes in care home provision.
An old lady sits at a table"We work closely with the CQC to ensure quality standards are closely monitored. If either party feel standards have reduced, through their own monitoring activity or inspections, we will decline or even suspend a particular rating and work with CQC in relation to this."
Sefton council is not the only one to pay a quality premium to homes awarded a four or five-star rating.
Redcar and Cleveland Borough Council says that since it introduced the RDB rating scheme in 2001, standards of care homes across the borough have improved.
But the BBC has learned that a quarter of its highly rated homes are failing to meet all the essential standards set out by the CQC.
"The council does feel that a new quality assessment tool would help to continue the drive to improve the quality of provision and therefore the RDB scheme will cease to be used at the end of this financial year," a council spokesperson said.
While the old Care Quality Commission rating system did have problems, critics say it was at least a system which was nationally recognised, independent, and easy for the public to understand.
"We maintain it is the responsibility of CQC as the regulator to assess the quality of care homes," says Nadra Ahmed, chair of the National Care Association which represents care homes.
"When the star rating system was scrapped by the CQC they consulted on the introduction of a system whereby assessments would be carried out by organisations independent of the CQC, which would be selected through a tendering process.
"The process was voluntary, so providers would pay to be assessed. The National Care Association felt strongly that this would be a cheque book rating system which enabled those who could afford it, to purchase a rating."
Bupa, the UK's second-largest care home group, is also critical of the CQC for abolishing its rating system:
"We would like to see them [star ratings] back so people can identify excellent care homes," said a company spokesperson.
"Other organisations, such as local councils and independent companies, are creating their own systems - but this could be confusing because there is no consistency."
The CQC warns people not to rely on ratings from outside companies when choosing a home.
"We do not endorse any external ratings systems," CQC operations director Amanda Sherlock told the BBC.
"We would recommend people look at a range of information includingour website to get the latest reports into care homes, nursing homes, hospitals and other care providers."
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Sunday 23 September 2012

Care funding reform failure blamed on Treasury


Care funding reform failure blamed on Treasury

Paul BurstowThe former care services minister lost his job at the recent reshuffle

Social care

The Treasury is to blame for a failure to reform care funding in England, a former Lib Dem minister has said.
Paul Burstow said the Treasury saw no need for change and was happy to "kick the can down the road".
Care groups have backed a proposal that the state cover elderly and disabled people's care costs over £35,000.
The government, which is continuing to look into cheaper options, said the Treasury had played a major part in getting care back onto the agenda.
Ministers have said they support the principle of a cap, proposed by the independent Dilnot Commission - but as yet there is no commitment to finding the money to pay for it.
The Dilnot package would cost the Treasury almost £2bn a year.
'Historic opportunity'
The government is expected to include its plans on paying for the cost of care in the next spending review, to begin next year.
Writing in the Daily Telegraph, Mr Burstow - a former care services minister - said there was a "historic opportunity" to change the system for the better but feared that the government would put it "back in the too difficult drawer".
"The coalition made a good start, setting up the Dilnot Commission within two months of taking office. But sustaining that pace has been tough," he said.
One of the reasons behind this was, he said, reluctance from the Treasury to back the reforms.
"The Treasury's view is simple, kick the can down the road despite our rising elderly population. No sense of urgency. No recognition that left unreformed there is no incentive for families to plan and prepare.
"In the view of mandarins there is no need for change, and certainly not yet. That has been the Treasury line every time a reform plan has popped its head above the parapet."
Mr Burstow, who lost his job in the recent reshuffle, said he had received more correspondence from MPs about care costs than any other topic.
"The good news is so far the Treasury has failed to smother the latest plan, a cap on lifetime care costs," he added.
"Ending the scandal of people forced to sell their homes to pay for care would be a legacy for this government felt for generations."
'Reaching consensus'

Who gets what care

social care promo image
He later told BBC Radio 4's Today programme that the government had made "a lot of progress" on the issue but urged Mr Osborne to show the "political will" to go the final step.
"The division, I think, is between the Treasury and everyone else. Both the prime minister and deputy prime minister have signalled over the summer their determination to see this now happen but that does require the Treasury to actively engage with the Department of Health to work through how you pay for it and actually deliver this reform...
"In the end, it does require the chancellor of the day to actually say 'this has to be a priority and this is now what we are going to deliver'."
A coalition spokesman branded Mr Burstow's remarks as "rubbish".
"Unlike under the previous government, the Treasury has played a major part in getting Dilnot back onto the agenda, not least by working to ensure we have the sustainable public finances that are necessary if it is to be delivered."
Labour said there were "no simple solutions" to the rising cost of caring for the elderly and cross-party co-operation was essential to agree a way forward.
"Labour has been warning for months that the government is kicking long-term care funding into the long grass," Liz Kendall, shadow minister for care and older people, said.
"All the parties must now come together to try and reach consensus about how we tackle the immediate care crisis and develop a better, fairer system for the future."
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Wednesday 29 August 2012

Personal care costs rise by 150% in seven years


Personal care costs rise by 150% in seven years

Generic image of pensionersAbout 77,000 people now receive help in their own homes and in care homes

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The cost of providing free personal care to people in their own homes has risen by more than 150% in seven years, according to the Scottish government.
Helping people with personal care such as washing and dressing cost £342m in 2010-11, up from £133m in 2003-04.
The government said the rise reflected the fact that an increasing proportion of older people were cared for at home rather than in hospital or care homes.
Personal care costs for people in care homes rose by 25%, from £86m to £108m.
Personal or nursing care payments are available to self-funding care home residents who have assets, including property, worth more than £23,500.
The number of people receiving these payments to help pay their care home fees increased steadily in the first few years of the policy. Currently, just under a third of all older people in care homes receive the payments.
The number of people receiving free personal care at home has also increased by 42% over the same period, from 32,870 in 2003-04 to 46,720 in 2010-11.

“Start Quote

A responsible government in Scotland cannot ignore the facts, kidding everyone on that everything and anything is affordable”
Jackson CarlawScottish Tory health spokesman
Free personal care was introduced by the Scottish government in 2002, and the policy was reviewed in 2008.
About 77,000 people in Scotland now receive help in their own homes and in care homes compared with 64,000 when the policy was first introduced.
Jackson Carlaw, Scottish Conservative health spokesman and deputy leader MSP, said: "If the SNP wants to continue funding free personal care, then it has to be far less casual in extending other entitlements and refusing to find ways to make them more sustainable.
"That is why we opposed free prescriptions, and why we want to align free transport to the pensionable age in future.
"A responsible government in Scotland cannot ignore the facts, kidding everyone on that everything and anything is affordable. We all know that there is an unprecedented demographic challenge waiting around the corner."
Jackie Baillie, Scottish Labour's health speaker, said her party was fully committed to the policy.
But she added: "My fear is the quality of care we provide for people will be compromised as a result of the strain on finances and the elderly and the vulnerable will pay another kind of price in a drop in standards of care.
"We have previously suggested creating a National Care Service to join up budgets and set a minimum standard of care but are open to working with the Scottish government to look at ways to ensure personal care is sustainable in the long-term."
'Greatly valued service'
Health Secretary, Nicola Sturgeon, said: "These figures show that each year an increasing number of older people continue to benefit from free personal and nursing care.
"This reflects the Scottish government's focus on more intensive support to frail older people at home or in a homely setting, as well as the continuing shift in the balance of care towards providing care at home.
"We are fully committed to the funding of free personal care for the elderly, a service greatly valued by the people of Scotland.
"The challenges posed by an ageing population demonstrate why we want to see health and social care for adults delivered in an integrated way by NHS.

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