Monday, 7 October 2013

'Disgraceful" short care visits on rise, says charity

'Disgraceful" short care visits on rise, says charity

Richard Stapely, who has Multiple Sclerosis, says his 30-minute visits are not long enough

Related Stories

Short care visits to elderly and disabled people are "disgraceful" and on the rise, a charity has claimed.
In England, 60% of councils use 15-minute visits, which are not long enough to provide adequate care, Leonard Cheshire Disability says.
The charity says such visits can "force disabled people to choose whether to go thirsty or to go to the toilet".
The government said the Care Bill would prevent "inappropriate" short visits but would not outlaw 15-minute visits.
Leonard Cheshire wants a ban on what it calls the "scandal of flying 15-minute visits", lobbying the government to prevent the practice in England.

Case study

Tracey Currey, from Swindon, was a care worker for two years but left because her employer would not let her do more than the "bare minimum" for clients.
She said: "I was forever in trouble with my company because I always went over my time.
"There was usually a care plan in place telling you what was needed at each visit but there was always more to do. I would stay and do everything that was needed.
"What is a carer to do on arriving for a 15-minute call to find the client soiled, confused and extremely distraught?
"What would the priorities be? To administer the medication as instructed, or to clean and change the client, or to make a hot drink and try to calm and reassure the client? All three in my book, but the present times do not allow for this.
"It is simply atrocious how this has gone on for so long. Care companies, agencies and councils getting away with this, money having become top priority and the compassion, love and care that should be shown to each and every elderly person has long gone, been thrown out of the window."
'Ridiculous split'
Care minister Norman Lamb said the government "can't ban these short visits completely" because they are useful in some circumstances, such as when a carer visits to give someone medicine.
But he told the BBC a 15-minute visit was "completely inappropriate" when people needed things like feeding or bathing.
"We're actually introducing an amendment to the Care Bill this week which will require councils to focus on an individual's wellbeing when they're organising care on their behalf, and so this sort of very short visit for personal care would not meet that standard," he said.
He also said the government plans to "force" the NHS and local government to work better together and end the "ridiculous split" between health and social care.
A report published by Leonard Cheshiresaid short visits "simply do not allow enough time to deliver good-quality care".
It said data from 63 local authorities pointed to a 15% rise in such visits in the last five years, and said some in councils more than 75% of care visits were carried out in less than 15 minutes.
The charity's latest research looks at England alone, but in August Unison accused many councils in Scotland of providing "care on the cheap" by arranging 15-minute home visits, and in June the union said 83% of Welsh councils were doing the same.
Research by the UK Homecare Association published last year suggested 87% of home visits in Northern Ireland lasted 30 minutes or less, the highest proportion in the UK (73% in England and 42% in both Scotland and Wales).
Separate care bills are currently going through the Scottish Parliament and the Welsh Assembly.
Sandie Keene from the Association of Directors of Adult Social Services: "We're all committed to making sure that we all continue to get it right"
Chief executive Clare Pelham said visits should be at least 30 minutes long.
"It is disgraceful to force disabled people to choose whether to go thirsty or to go to the toilet by providing care visits as short as 15 minutes long," she said.
Ms Pelham said most people need 40 minutes to get up, washed, dressed and have breakfast.
"We are treating disabled and older people as if they are robots to be serviced, rather than real people who deserve to be treated with kindness and consideration," she added.
But the Association of Directors of Adult Social Services (Adass), which represents care managers, argued it was "totally wrong" to suggest all caring tasks require more than 15 minutes.
Sandie Keene, the association's president, said some short visits were "fully justified and fully adequate".
It was "frankly naive to believe that simply by abolishing 15-minute slots a magic wand will have been waved, and improvements automatically achieved in our care services," she added.
Ms Keene said social workers and their managers had to make "horrendously difficult choices" every day to give the best possible care with limited resources.
Leonard Cheshire wants peers to back a ban on short visits by amendingthe government's Care Bill when it is debated in the House of Lords on Wednesday.
Care manager Tina Blake: "It's very difficult, it's very stressful for the person, and it's certainly stressful for the care worker as well"
Time pressure
Speaking to BBC Radio 5 live, Rosaleen, a Thames Valley care worker who gave only her first name, said 15-minute visits usually overrun.
But she said the short time available still forced carers to make choices such as whether to leave someone alone with a hot drink which they might spill on themselves, or sit with them while they drink but fail to get them ready for bed.
Asked if people's safety was being compromised by visits being too short, she replied: "Their safety, their independence, their dignity."
Another care worker told the BBC that travel time was not included in her pay, so she would work unpaid time every day travelling between appointments.
Sally Lubanov, 83, who is house-bound, said even in 30-minute visits "nothing got done" because carers would take some time booking in, checking what the previous visitor had done and preparing for whatever tasks needed doing.
She said 15-minute visits might be fine for giving someone medicine, but for people living alone it was "wonderful to see someone" and short visits allowed no time for conversation.
The Local Government Association (LGA), said social care was "substantially underfunded" and councils were under increasing pressure.
"Significant cuts to council funding mean local authorities are struggling to meet the rising demand for home care visits," said Katie Hall, chairwoman of the LGA's community and wellbeing board.
She said 15-minute visits "should never be the sole basis for care", but added: "In some circumstances such as administering medication they can be appropriate, but only as part of a wider comprehensive care plan involving longer one-to-one visits."
Leonard Cheshire Disability said a survey of 2,025 people found 93% of those who expressed an opinion agreed 15 minutes was "not long enough to support a disabled or older person to do everyday things like wash, dress and get out of bed in the morning"

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

Related Stories

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.

More on This Story

Related Stories

to be sentenced over Hamzah Khan killing

Amanda Hutton to be sentenced over Hamzah Khan killing

Hamzah KhanThe prosecution said the cause of Hamzah Khan's death was "blindingly obvious"
A mother who allowed her four-year-old son to starve to death and left his decomposing body in a cot for nearly two years is to be sentenced later.
Alcoholic mother-of-eight Amanda Hutton was found guilty of manslaughter after a jury heard her son Hamzah Khan died due to severe malnutrition.
Police found Hamzah's mummified remains in squalid conditions at the family's home in Bradford in September 2011.
Hutton, 43, will also be sentenced at Bradford Crown Court for child neglect.
She admitted a charge of neglect in respect of each of Hamzah's siblings, who were aged between five and 13 in 2011.
Hutton and her eldest son Tariq, 24, one of five other siblings living at the house, will also be sentenced for preventing the burial of Hamzah's body, a charge they admitted before Hutton's trial.
The court heard Hamzah had a "grossly inadequate" diet, suffered osteoporosis and was so small he still fitted in a baby grow for a six-month-old infant when he died.
Returning the guilty verdict on Thursday, after almost five hours of deliberation, the foreman of the jury made it clear they had convicted Hutton on the basis that she was grossly negligent by not providing adequate nourishment for her son.

More on This Story

Related Stories

From other news sites

The BBC is not responsible for the content of external Internet sites

Thursday, 3 October 2013

'Serious errors' caused patient's death

David Sellu trial: 'Serious errors' caused patient's death

David SelluDavid Sellu has been a surgeon for four decades
A patient died because of "serious errors in judgment" by a senior doctor at a private hospital in north-west London, the Old Bailey has heard.
James Hughes received "exceptionally bad" care from David Sellu after routine knee surgery at the Clementine Churchill Hospital, jurors were told.
The operation, in 2010, went well but afterwards his bowel ruptured.
Mr Sellu, who denies gross negligence manslaughter, "simply ignored" the urgency of the case, the court heard.
After the initial operation on 5 February at the hospital in Harrow, Mr Hughes, a 66-year-old retired builder from County Armagh, developed abdominal pain and was transferred to the care of Mr Sellu.
The surgeon, of Croft Close in Hillingdon, west London, has been a surgeon for four decades and specialises in colorectal surgery.
Death 'avoidable'
Prosecutors told the court Mr Sellu suspected there had been a rupture, which is a potentially life-threatening condition that requires surgery.
But instead of immediately performing surgery he ordered a CT scan for the next day.

Start Quote

Had (Mr Sellu) operated earlier Mr Hughes would have had a very good chance of survival”
Bobbie Cheema QCProsecutor
The scan confirmed the medic's suspicions but he "failed" to carry out the surgery immediately and instead carried on with his own clinic, prosecutor Bobbie Cheema QC said.
Mr Hughes was sent to the operating theatre at 9pm on 12 February after being in pain for 40 hours, however, by this point, his condition had deteriorated so badly that intensive care specialists had to work to stabilise him, the court heard.
Ms Cheema told the jury that Mr Hughes was transferred to the intensive care unit after surgery but died the following day.
"That death was avoidable," she said.
"Had (Mr Sellu) operated the night before, or even earlier on February 12, Mr Hughes would have had a very good chance of survival."
Perjury charge
She added: "There was a series of missed opportunities and serious errors in judgment in the care of this patient and they combined to cause Mr Hughes' death.
"The standard of care was exceptionally bad."
Ms Cheema told the court that Mr Hughes felt he was not getting sufficient help from hospital staff and phoned a doctor friend who told him to call the surgeon who had operated on his knee.
That surgeon, John Hollingdale, visited Mr Hughes and examined him.
"He was concerned something was wrong... unrelated to his knee surgery and asked for an X-ray to be completed urgently," Ms Cheema said.
Mr Hollingdale was "surprised" to learn the test was to be delayed until the next day as the hospital had the facilities to perform the tests around the clock, Ms Cheema told jurors.
Mr Sellu is also accused of perjury in relation to allegations he lied at under oath Mr Hughes's inquest, which he also denies.
The trial continues.

More on This Story

The BBC is not responsible for the content of external Internet sites

Tuesday, 17 September 2013

New hospital inspection regime targets poor care

New hospital inspection regime targets poor care

Hospital wardBy the end of 2015 the CQC aims to have inspected all acute hospitals

Related Stories

A new hospital inspection regime for England is getting under way, with the chief inspector promising to "expose poor and mediocre" care.
The Care Quality Commission agreed to overhaul its inspections following the Stafford Hospital scandal.
Inspectors will visit Croydon Health Services NHS Trust, in south London, later - the first of 18 inspections taking place before the end of 2013.
Mike Richards, the new chief inspector of hospitals, is leading the process.
The inspection teams are larger and more specialised than before - about 30 people are taking part in the Croydon visit, including a surgeon, senior nurses, a student nurse and members of the public.
There will also be a public meeting held in Croydon on Tuesday evening - something that will be happening during the other inspections too.
Another crucial difference is that the inspections will focus on the "whole patient experience".
Clearer picture
Each inspection will cover eight key services areas: A&E; medical care; surgery; critical care; maternity; paediatrics; end-of-life care and outpatients.
The inspections will be a mixture of announced and unannounced visits and they will include inspections in the evenings and at weekends.
That contrasts with the previous inspections which were grouped around essential standards so hospitals would find themselves inspected for issues such as nutrition and infection control rather than the entire system.
Sir Mike said: "These inspections are designed to provide people with a clear picture of the quality of the services in their local hospital, exposing poor or mediocre care as well as highlighting areas of good and excellent care.
"We know there is too much variation in quality in the NHS - these new in-depth inspections will allow us to get a much more detailed picture of care in hospitals than ever before."
The launch comes amid heightened focus on the performance and regulation of hospitals.
The public inquiry into the poor care at Stafford Hospital, published in February, identified failings in the way hospitals are monitored.
Weaknesses were once again highlighted in July when the government's Keogh Review led to 11 hospitals being placed in special measures. Only two of them were facing regulatory action from the CQC, suggesting problems were slipping under the radar.

Hospital inspection

Old systemNew system
Inspections focused on themes rather than looking at whole hospital. Meant sites inspected for individual issues such as nutrition and dignity.
Inspectors will now spend at least two days looking at the whole hospital, with a special focus on key services such as A&E.
Inspections resulted in hospital either meeting or failing 16 essential standards.
School-style ratings of "outstanding", "good", "requires improvement" and "inadequate".
Inspection teams limited to four or five people, often not specialists in care.
Practising doctors and nurses invited on to panels along with patients to create 20-strong teams.
Regulator uses 1,200 indicators to identify which trusts need repeat inspections.
Indicators trimmed to about 150 to give more weight to key measures such as surveys and death rates.
Health Minister Norman Lamb said: "Our priority is to make sure that people get better care. That's why we asked the CQC to appoint a new Chief Inspector of Hospitals to shine a spotlight on quality and drive up standards across the board."
The programme of inspections continues on Thursday when inspectors go into Airedale NHS Foundation Trust followed by inspections at Taunton and Somerset NHS Foundation Trust and The Royal Wolverhampton NHS Trust next week.
By the end of 2015 the CQC aims to have inspected all acute hospitals.
Results will be published about a month after each inspection.

More on This Story

Related Stories

The BBC is not responsible for the content of external Internet sites

Featured post

More patients in Scotland given antidepressants

More patients in Scotland given antidepressants 13 October 2015   From the section Scotland Image copyright Thinkstock Image ca...