Thursday, 14 June 2018

ADASS Raises Serious Concerns About Social Care Funding and Market Failures


The Association for the Directors of Adult Social Services (ADASS) has published its annual budget survey.

The report highlights the increasingly fragile state of the social care system and the importance of investing in social care.  

ADASS recognise the importance of the government's emergency funding in keeping the system working, contributing to a significant and sustained reduction in delayed transfers. But the organisation warns that the need for both short and long-term funding is urgent, and that without it, there will be fewer older and disabled people receiving support.

Funding for adult social care now makes up 37.8 per cent of total council budgets. This shows that councils are continuing to do their best to protect adult social care and yet despite this, social care continues to have to make savings.

ADASS is urgently calling on the Government to:
  • Make sure that short-term protected funding to shore up social care continues so that emergency need can be met until the Green Paper is implemented; 
  • Find a way to deliver long-term, adequate funding in the upcoming green paper that enables meeting people’s needs effectively is a reality, not an aspiration; 
  • Help councils support the care market and value the skilled staff that works within it, and putting providers on a firm financial footing 
The survey has also revealed serious concerns about the impact of funding reductions on providers and the care market. Three-quarters of councils believe that providers will experience financial difficulties over the next year, with two thirds concerned that those pressures could impact on the quality of care over that period and directly affect thousands of people who need those services.

A staggering 78 per cent of councils are concerned about their ability to meet the statutory duty to ensure care market stability within their existing budgets. 48 councils say they have seen home care providers closing or cease to trade within the last six months, and 44 councils had contracts handed back by providers – affecting 2,679 people in care – over that period.

Recruitment and retention remains the most significant worry. The skilled social Care workforce delivers essential care yet they are amongst the lowest paid in the economy. It’s, therefore, no surprise that Directors have highlighted being able to increase salaries as the most important factor in recruitment and retention.

Glen Garrod, President of ADASS, said: “It is of serious concern that we have such a fragile social care market, where 48 councils across the country have seen care providers close or cease to trade in the last six months – this means that people do not have the choice over the care that they should have and the potential to transform lives is being lost. It’s also worrying that despite social care’s contributions to reducing pressures on hospitals, NHS pressures continue to have serious impacts on the provision of social care.

“There is an undeniable, urgent and imperative requirement on the Government to act to ensure interim funding continues until the green paper is implemented, that the social care workforces receives the wages and esteem it deserves, that the care market is safeguarded, and that the long-term funding solution that social care desperately needs is finally delivered.

“We cannot go on like this. How we help people live the life they want, how we care and support people in our families and communities, and how we ensure carers get the support they need is at stake – it’s time for us to deliver the secure future that so very many people in need of social care urgently need.”

Responding to these findings, Andrea Sutcliffe, CQC Chief Inspector of Adult Social Care, said  "Over the last two years the Care Quality Commission has raised concerns in its State of Care report that the adult social care sector is precarious with mounting pressures continuing to push the sector towards a tipping point. The ADASS budget survey reinforces our concerns and lays bare the financial pressures Directors are facing which we know can have a direct and detrimental impact on the quality of care and support people receive."

Wednesday, 13 June 2018

Public Lending Rights (PLR) Extended to All Forms of E-Lending

The Government has announced that it is committed to extending Public Lending Right (PLR) to all forms of e-lending following its recent consultation on the matter.

Provisions to extend PLR to e-books and e-audiobooks were originally contained in the Digital Economy Act 2017, but further secondary legislation was required before the changes could be implemented. After many months of silence from the government and pressure from the writing and publishing worlds,  a consultation on the proposals was launched at the start of May this year.

The Department of Digital Culture, Media and Sport (DCMS) has now released the results of the consultation and the Minister for DCMS has already signed the necessary statutory instruments required to extend PLR to include remote lending of e-books and e-audiobooks. 

The changes will come into force from the beginning of July, in line with the start of the new PLR year (1 July to 30 June). This means that e-lending will be reflected in the PLR for 2018/19 year onwards.

Nicola Solomon, Chief Executive of the Society of Authors, said “We are thrilled that the extension of PLR to e-lending has finally been given the green light. PLR is a vital source of income for many authors, and it is only right that the same rules apply to e-lending as to the lending of physical books.

“Today’s announcement follows years of lobbying and campaigning alongside authors, booksellers, libraries, agents and publishers. All this work has finally reached fruition, and I know that authors will be delighted by the news.”

Tuesday, 12 June 2018

CQC Issues Warning Notice to Hospice Over Staffing and Management Issues

The Care Quality Commission has told Prospect Hospice in Swindon that it must make significant improvements following an inspection in February.  Prospect Hospice’s provides care and support for people living with, and dying from, advanced and progressive life-limiting illnesses. The 16-bed in-patient facility provides respite care, symptom control and care at the very end of life. 

The CQC inspectors made an unannounced visit in response to concerns about low staffing numbers, out of date staff competencies, increased safety incidents, low staff morale and allegations of bullying by senior staff.

Following the inspection the CQC issued a Warning Notice requiring the hospice to improve its management oversight systems and to ensure that staff received appropriate training, support and appraisal to carry out their roles.

Inspectors found risks to patient safety as systems and processes for recording, monitoring and reviewing significant safety issues were ineffective. This was recognised by the provider but there was no evidence that the systems being implemented would improve their processes.

The inpatient unit had a high number of vacancies, and nursing staff described low morale and increasing levels of fatigue and sickness. In six months there had been 53 recorded medicine errors.

Although CQC did not observe unsafe practice during the inspection - staff training was out of date, and the provider could not demonstrate that all staff were competent to carry out all clinical procedures. There was no formal induction for temporary staff.

In response to a number of complaints about bullying the senior leadership instigated four workshops with staff. Whilst these sessions were well-intentioned, staff said that the workshops made them feel uncomfortable and in some cases humiliated.

The board and senior leadership team did not always seem to be aware of what was happening within the inpatient unit. Key information on staffing and other risk areas were not reported regularly and the board was therefore unsighted and unable to support and challenge the leadership team. Omissions included information about delayed admissions and seven complaints about a member of the senior leadership team.

The CQC’s Head of Hospital Inspection, Mary Cridge, said "Prospect Hospice provides a much-needed service to people nearing the end of their lives. While there is clearly a commitment to provide a good service on all sides – it is troubling to report on the cultural issues and divisions that we found within the team as a whole.

“Since our inspection in February, the hospice has taken some steps to address our main concerns. The safety issues must be addressed as a priority. By the time we return to re-inspect, we hope to see a real improvement for the benefit of the patients and their families. In the meantime we are in regular contact with the leadership at Prospect Hospice and we will continue to monitor this service closely.”

Friday, 8 June 2018

CQC Report Staffing Levels and Quality of Staff Key to Providing Good Services

The CQC has published its latest report, exploring how adult social care services awarded 'inadequate' ratings have turned their services around.

‘Driving Improvement’concludes that the recruitment and retention of capable, valued and supported staff has never been more critical to achieving the high-quality care everyone has a right to expect.

The report focuses on the work of nine adult social care services and provides an honest insight from a wide range of people – including those who use services, their families and carers, staff, managers, directors, chief executives and other professionals – describing how it felt to be rated as inadequate, what impact this had, the challenges they had to overcome and how they got back on  track.

Key Themes


Leadership
The value of a good leader cannot be underestimated. In most of the case studies, a new manager had come into the service to deliver the improvements. They engaged with staff, people who use services and their families and were open to suggestions, but set parameters and took tough decisions where necessary.

Cultural change
Failing organisations tended to have cultures in which staff were afraid to speak out. Involving staff is one of the best ways to drive improvement.

Person-centred care
Typically, when a new manager took up the reins, they wanted to see care plans. In most cases these were lacking in detail and did not show that the care being provided was person-centred. It is not possible to provide good care if the care staff do not understand the needs of the person being cared for.

Staffing
The report concluded that the recruitment and retention of capable, valued and supported staff has never been more critical to achieving the high-quality care everyone has a right to expect.

Working with partners
Most of the services featured received support to help them improve – mainly from the corporate provider, if there was one, or commissioning bodies.

Commenting on the publication, Andrea Sutcliffe, CQC’s Chief Inspector of Adult Social Care, said: “As the independent quality regulator, we know the devastating impact inadequate adult social care has on people, their families and carers. That’s why it’s vital that the people in charge of providing care tackle the problems our inspections identify so improvement can be achieved. Our Driving Improvement publication shares the experiences of those who have been able to transform the care they deliver to explain how that journey of improvement can happen. My hope is that people running or working in care services rated as inadequate or requires improvement can use these case studies as practical guidance to improve for the benefit of the people they support and care for.

“Key lessons we have seen from the case studies include understanding and accepting that problems exist; creating a clear vision to improve and putting that into action; appointing strong leaders who can establish an open and transparent culture where improvement can truly thrive; and focusing on developing a workforce that is valued, well trained and supported to deliver safe, effective person-centred care.

“But we’re not saying that improvement is easy. Pressure on resources, increasing demands and workforce shortages mean these are challenging times for adult social care. Providers and their staff have a responsibility to deliver good care – but commissioners, funders and national bodies and the health and care system as a whole has a responsibility to work together to help create the environment that makes this possible.”

Thursday, 7 June 2018

Women's Prize for Fiction 2018 Winner Announced!

Home Fire by Kamila Shamsie has been named as the winner of the £30,000 Women's Prize for Fiction.  

The Women’s Prize for Fiction is the UK’s most prestigious annual book award for fiction written by a woman. Founded in 1996, the Prize was set up to celebrate excellence, originality and accessibility in writing by women throughout the world.

Home Fire, follows Isma, a young woman now free from the responsibility of raising her twin siblings in the wake of their mother’s death. She resumes a dream long deferred – studying in America. But she can’t stop worrying about Aneeka, her beautiful, headstrong sister back in London, or their brother, Parvaiz, who’s disappeared in pursuit of his own dream – to prove himself to the dark legacy of the jihadist father he never knew.

Then Eamonn enters the sisters’ lives. Handsome and privileged, he inhabits a London worlds away from theirs. As the son of a powerful British Muslim politician, Eamonn has his own birthright to live up to – or defy. The fates of these two families are inextricably, devastatingly entwined in this searing novel that asks: what sacrifices will we make in the name of love?

Kamila Shamsie is a Fellow of the Royal Society of Literature and was named a Granta Best of Young British Novelist in 2013.  She grew up in Karachi and now lives in London and has written seven novels:
  • In the City by the Sea (shortlisted for the John Llewellyn Rhys Prize)
  • Salt and Saffron
  • Kartography (also shortlisted for the John Llewellyn Rhys Prize)
  • Broken Verses
  • Burnt Shadows (shortlisted for the Orange Prize for Fiction) 
  • A God in Every Stone, which was shortlisted for the Baileys Prize, the Walter Scott Prize for Historical Fiction and the DSC Prize for South Asian Literature.
  • Home Fire (winner of this award, longlisted for the Man Booker Prize 2017 and Costa Novel Award 2017)
This year’s judges were Sarah Sands (Chair), Anita Anand, Katy Brand, Catherine Mayer and Imogen Stubbs. 
2018 Chair of Judges Sarah Sands, said: “This was a dazzling shortlist, it had depth and richness and variety. We were forcibly struck by the quality of the prose. Each book had its champions. We loved the originality of mermaids and courtesans, we were awed by the lyrical truth of an American road trip which serves as a commentary of the history of race in America, we discussed into the night the fine and dignified treatment of a woman’s domestic abuse, we laughed over a student’s rite of passage and we experienced the truth of losing a parent and loving a child. In the end we chose the book which we felt spoke for our times. Home Fire is about identity, conflicting loyalties, love and politics. And it sustains mastery of its themes and its form. It is a remarkable book which we passionately recommend.”

Wednesday, 30 May 2018

Strong and Evolving Policies and Procedures Lead to Outstanding Rating from the CQC

The CQC has found North Shore Nursing home, in Blackpool, to be Outstanding following an inspection in March 2018.

At the time of the inspection North Shore Nursing home was at capacity, providing accommodation and nursing care to 25 people.

North Shore Nursing home is rated Outstanding in all categories.

Report Highlights

  • The registered manager was proactive in ensuring people accessed healthcare services quickly. 
  • Their pioneering techniques greatly improved people's lives because they assisted staff to implement treatment before problems deteriorated. 
  • The management team had exceptional procedures for the preparation of meals, delivery of nutritional support and monitoring of associated needs. 
  • People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. 
  • Staff maintained up-to-the-minute documentation to assure they continuously met the person's changing capacity and support requirements. 
  • The registered manager had an exceptional initiative for training and to assist staff to apply their learning in practice. They used team meetings, handovers, supervision and group discussions to follow training up with observation, question and answer sessions, competency testing and role-play. 
  • Staff had a very good grasp of the Human Rights Act 1998 and implemented this in their work. They had relevant training and demonstrated an in-depth awareness of inclusion, discrimination, diversity and prejudice. 
  • Staff continuously kept people and their representatives fully informed and involved, which helped them to take ownership of their treatment. 
  • Staff frequently evaluated care documents to ensure they were updated to people's changing wishes and health to optimise their end of life experiences. 
  • The management team promoted an authentic culture of transparency at North Shore through extensive quality assurance audits and feedback systems. 
Debbie Westhead, Deputy Chief Inspector of Adult Social Care in the North, said “The service engaged in effective staffing levels and skill mixes, this supported them in delivering the high quality care and attention the residents deserve. The proficient communication in the home meant that people’s needs were well known and documented efficiently, which ensured people’s continuity of care.

“Our inspectors were told many times, by residents and their relatives, about how much their health has improved whilst at the service. One resident’s relative told us it ‘should be an example to other homes’ – I agree. The compassion and dignity we witnessed was reinforced by strong and evolving policies and procedures, implemented by devoted and knowledgeable staff.

“We were impressed by the organised, proactive and dedicated management of the service. It was clear that safe high quality person-centred care was the priority. We saw a commitment to continually improving the care being provided by engaging with the residents and their families.

“It is wonderful to see a service embrace innovation and continually develop improvements to enrich people’s lives in care. This service is absolutely Outstanding, well done.”

FSB Campaigning to End Culture of Late Payments In Support of SMEs

Big business has been put on notice by the Federation of Small Businesses (FSB) and warned that they must do more to end late payments, poor payment practice and supply chain bullying that is damaging the UK economy.

A letter from FSB National Chairman, Mike Cherry, to all FTSE 100 companies urges Chairman and CEOs to take immediate action by agreeing to lead the way in stamping out poor payments for good. In the letter FSB National Chairman, Mike Cherry, calls on these companies to work with small businesses to help foster a new payments culture in the UK.

Research from FSB shows the hugely damaging impact these practices have on small firms within supply chains with our data showing that the vast majority (84%) of small firms report being paid late, with a third (33%) saying at least one in four payments they’re owed arrives later than agreed.

A similar proportion (37%) state that agreed payment terms have lengthened in the past two years, hampering cash flow. Only four per cent say payment terms are improving.

The pressure from small business comes after the release of Parliamentary Joint Select Committee report on the collapse of Carillion published last week. The report laid bare the substantial failures at the company including the squeezing of its suppliers, and the frailty of the Prompt Payment Code.

The FSB is calling for a non-executive Director on Boards to be given a specific responsibility for good supply chain practice including making sure the firm is opting to follow best practice and lead the way, not just doing the absolute minimum or the best it can get away with, and so still squeezing suppliers to improve the firm’s cash-flow.

FSB National Chairman Mike Cherry, said: “The poor payment practices that run rampant through UK supply chains is a national disgrace with the country falling behind almost all other industrialised nations in our ability to pay small businesses on time.

“These practices are putting small businesses at risk forcing many to turn to personal credit cards or overdrafts just to survive. Sadly, we estimate late payments lead to 50,000 small businesses a year closing their doors, costing the economy £2.5 billion annually.

“We can only end the late payments crisis and poor payment practices when we see a fundamental cultural shift in the boardrooms of big business, with those at the very top showing a willingness to address the issue and be accountable for their payment practices.”