Thursday, 13 December 2018

CQC Rate Somerset GP Surgery Outstanding for Second Time

The Care Quality Commission has found the quality of care provided by Dunster Surgery, Minehead in Somerset to be Outstanding again following an inspection in October. This is the second time the service has been rated Outstanding overall.

Inspectors rated the care at the surgery Outstanding for being caring and well-led, and Good for being safe, effective and responsive to people’s needs.

Practice Strengths

  • The practice delivered safe and quality care with innovative systems in place to identify and minimise risks to patients.
  • The practice had an open culture to the reporting of, and learning from safety concerns raised by patients. 
  • The practice had a clear vision which had quality and safety as its top priority. High standards were promoted and owned by all practice staff with evidence of team working across all roles.
  • The service had a strong focus on continuous learning and improvement to ensure that high-quality, sustainable care was provided.
  • Leadership was compassionate, inclusive and effective. They prioritised compassion and support towards their staff and other health professional’s well-being.
Ruth Rankine, Deputy Chief Inspector of General Practice, said;“It is with pleasure that I am again delighted to highlight the exceptional service at Dunster Surgery. This practice is an excellent example of what outstanding care looks like. The service had clear vision to promote safe and quality care with high standards being promoted by all staff.

“There was a strong focus on continuous improvements to its services and valued the concerns raised by staff and people.

“This dedication and commitment pays off in making a real difference for their patients – which is why we have again found the practice to be Outstanding. I hope other practices will see this service as a model for excellent care.”

Monday, 10 December 2018

CQC Launches a Review into the Management of Patients with Mental Health Problems, a Learning Disability and/or Autism

The Secretary of State for Health and Social Care, Matt Hancock, has asked the CQC to review the use of restrictive interventions in settings that provide inpatient and residential care for people with mental health problems, a learning disability and/or autism.

Interim findings and recommendations are expected in May 2019, with the full report scheduled for release by March 2020.

Concern has been raised over the use of physical restraint, prolonged seclusion and segregation
in wards for people of all ages with a learning disability and/or autism and in secure and rehabilitation mental health wards.

The review will consider whether seclusion and segregation should be used in registered social care services for people with a learning disability and/or autism and how they should be used.

Dr Paul Lelliott, Deputy Chief Inspector of Hospitals (lead for mental health), said:  “There is understandable public concern about the use of restraint, prolonged seclusion and segregation for people with mental health problems, a learning disability or autism. It is vital that services minimise the use of all forms of restrictive practice and that providers and commissioners work together to find alternative, and less restrictive, care arrangements for people who are currently subject to seclusion or segregation. Failure to do this has the potential to amount to inhuman and degrading treatment of some of the most vulnerable people in our society.

“We welcome the Secretary of State’s commission for CQC to undertake a thematic review of this important issue. The review will examine the range of factors that lead to people being subject to restraint, prolonged seclusion or segregation, and will assess the extent to which services follow best practice in minimising the need to use force. The experience and perspective of the people affected by these practices, either as a patient or as a carer, will be central to this work. It is vital that society protects the rights, welfare and safety of children and adults with a mental illness, learning disability or autism and that they receive the safe, high quality care that they deserve.”

Thursday, 6 December 2018

Universities Urged to do More to Support Students at Risk of a Crisis

Higher education representatives have been told to take another look at their approach towards involving a student's family and friends (those listed as emergency contacts) when it is clear that the student is at risk of a mental health crisis.

Education Secretary, Damian Hinds has written to Julia Buckingham, who is chairing a roundtable on student mental health, asking the sector to maintain the focus that has been built up in recent months following the Student Mental Health Summit that was held at the University of the West of England in June 2018.

The event, hosted by Universities UK (UUK), will aim to develop advice for universities on consent for the disclosure of information about severe student difficulties to third parties. Giving universities clear guidance on this issue will ensure young people struggling at university will have every possible chance of receiving help from someone in their domestic support network. This is particularly important for students studying away from home, who may have a reduced support group.

Damian Hinds said "Ensuring that university students, many of whom will be leaving home for the first time, are supported is a key challenge for my department and the higher education sector as a whole.

Our universities are world leading in so many areas and I want them to be the best in the world for support and pastoral care as well. Ensuring that universities get better at reaching out to family members if a student is struggling with mental health is a big step along the road to delivering that ambition.

I’ve made clear to the sector how important this issue is and now I want them to work together to find a clear way forward so young people can get support from every person and organisation best able to give it.

In a recent Higher Education Policy Institute (HEPI) survey, 75% of applicants to higher education expected universities to contact a parent or guardian in situations where they are faced with serious challenges relating to their mental health.

The new UUK advice will need to build on this by giving 100% of students every possible opportunity to choose to receive care from families and trusted friends alongside the support they get from student welfare teams and the NHS."

Thursday, 29 November 2018

Ambulance Service Placed into Special Measures by the CQC

England’s Chief Inspector of Hospitals has rated SSG UK Specialist Ambulance Service – South as Inadequate and placed the service into special measures following its latest inspection by the Care Quality Commission.

A team of inspectors from the Care Quality Commission visited SSG UK Specialist Ambulance Service – South at Wickham Road, Fareham, Hampshire during August and September 2018 in response to concerns received relating to medicines, staffing, overall management of the service and one of the provider’s ambulances being involved in a road traffic collision.

SSG UK Specialist Ambulance Service – South provides both emergency and urgent care and patient transport services throughout the south-east. These services are commission by local NHS trusts.

Key Concerns 

  • Inspectors found that the overall management of medicines was not safe or line with legislation. Controlled drugs were not managed safely and as there were no regular audits SSG 
  • Records of medicines that were destroyed were incomplete and the provider could not provide any assurance that this was undertaken in line with legal requirement and the service’s guidance. 
  • The service could not provide an accurate count of staff who were employed or worked as bank staff, but thought there were around 650 staff recruited with 300 of these working on a regular basis.
  • There was no assurance that all staff working for the provider held a current disclosure barring service check and active professional registration.
  • Not all managers had the necessary skills, knowledge or experience to lead and develop the service. There was limited evidence they understood the challenges to service quality and overall sustainability of the service.
  • One of the secure vehicles used for the transport of mental health patients was not fit for purpose. The area that was used to transport patients, had a metal bench with no padding on the seat, this was rusty and patients had to sit directly on the metal.
  • There was limited evidence on how there was assurance that staff followed the restraint policy and protected patients from the risks of harm. The nine records for secure patients where restraint had been used showed that staff did not follow the full process.
  • There were no risks assessments completed and staff did not record a clear rationale for the use of restraint.
CQC Deputy Chief Inspector of Hospitals, Dr Nigel Acheson, said "“We are all well aware that our ambulance services are under a tremendous amount of pressure and scrutiny. However, when we inspected SSG UK Specialist Ambulance Service – South in August, we were extremely concerned at the disconnect we identified between the senior team and the staff working on the frontline. We saw no sign of a clear vision and strategy and a lack of response to the concerns we had previously raised."

“On the basis of this inspection, we have placed this provider into special measures. That means that SSG UK Specialist Ambulance Service – South will be inspected again within six months. We are currently engaging with the provider and monitoring the service very closely. If insufficient improvements have been made, we will take action in line with our enforcement procedures.”

Wednesday, 28 November 2018

New Government Funding Released to Support Electronic Prescribing

13 NHS trusts will receive a share of a £78 million fund to support electronic prescribing and medicines administration (ePMA) to improve patient safety.

New electronic systems will help hospital trusts move away from handwritten prescriptions:
  • reducing potentially deadly medication errors by up to 50% when compared with the old paper systems 
  • building up a complete electronic record 
  • ensuring fast access to potentially lifesaving information on prescribed medicines 
  • reducing duplication of information-gathering 
The 13 NHS trusts have been chosen because they provide a mixture of acute, mental health and community services. They will receive a share of £16 million funding for 2018 to 2019.

The roll-out of full ePMA across healthcare organisations is designed to improve efficiency in the healthcare system by:
  • making the most effective use of medicines 
  • increasing the use of digital systems to generate additional data sets 
This will help clinicians gain a greater understanding of the management of diseases.

Andrew Davies, Director of Hospital Pharmacy, NHS Improvement said "There is evidence that electronic prescribing and medicines administration systems will improve safety for patients, reducing the risk of harm and ensuring high-quality efficient patient care which is as safe as possible.

I’m delighted so many trusts have submitted successful bids to accelerate the introduction of these systems to provide safer, better quality patient care. We are now looking for more trusts to bid for funding by the end of January."

The first regional allocations are as follows:
  • Bolton NHS Foundation Trust - £1,020,000 
  • The Rotherham NHS Foundation Trust - £750,000 
  • Mid Yorkshire Hospitals NHS Trust - £1,600,000 
  • Humber NHS Foundation Trust - £300,000 
  • Northern Lincolnshire And Goole NHS Foundation Trust - £940,000 
  • Kettering General Hospital NHS Foundation Trust - £820,000 
  • University Hospitals of North Midlands NHS Trust - £2,190,000 
  • Barts Health NHS Trust - £1,700,000 
  • East London NHS Foundation Trust  - £740,000 
  • East Kent Hospitals University NHS Foundation Trust - £1,450,000 
  • Frimley Health NHS Foundation Trust - £1,170,000 
  • Buckinghamshire Healthcare NHS Trust - £1,620,000 
  • East Sussex Healthcare NHS Trust - £1,700,000 

Tuesday, 27 November 2018

Small and Medium Size Businesses Offered Free Support to Grow Their Digital Exports

Baroness Fairhead, Minister of State at the Department of International Trade, has announced a new partnership between the Exporting is GREAT campaign and Google, which will see the Digital Garage deliver an exporting education series for 2000 SMEs in 2019.

Focusing on helping businesses grow their digital export operation, the events will be hosted in Manchester, Edinburgh and on university campuses around the UK. The training will be split into three modules which focus on:
  • finding new global opportunities, 
  • setting up new export operations,
  • and marketing.
Ronan Harris Google MD UK and Ireland said "We firmly believe everyone should be able to benefit from the opportunities that technology brings and we want to give people the skills they need to grow their confidence, career or business.

Looking forward to 2019, there is tremendous potential to envisage what we can achieve from working with the Department for International Trade to roll out a brand new training offering to small and medium enterprises providing valuable insight to support their export operations."

A recent Google business survey found that 70% of SMEs said that they lacked the skills needed to find the best overseas markets to enter.

The new partnership builds on an existing relationship which saw the Department for International Trade and Google working together to build a new online ‘Market Finder’ tool which allows companies to find overseas opportunities at the click of a mouse.

Thursday, 22 November 2018

Care Home Fined £30,000 by CQC For Failing to Protect People in its Care

A care home provider has been fined £300,000 for allowing a man in its care, with a history of sexual assaults, the freedom to prey on vulnerable people.

The Care Quality Commission brought the case against Hillgreen Care Limited for not providing the constant, one-to-one supervision required for the man, failing in its duty to protect people in its care and exposing them to the risk of sexual abuse.

Highbury Corner Magistrates’ Court was told that on 1 November 2015, an autistic man was assaulted at Hillgreen’s care home at Colne Road, in Enfield, north London. At the time there were only two care staff on duty to look after six people.

One of the residents, who was described as non-verbal, with limited mental capacity, was followed up to his room and, allegedly, raped. The incident was eventually reported to the police, but partly because of the alleged victim’s mental capacity and a lack of evidence, no prosecution ensued.

The alleged perpetrator had been under the care of Hillgreen Limited for 10 years. Mr Paul Greaney QC, representing CQC said that: “XX is a predatory and opportunistic sex offender” and was a risk to both sexes. Numerous allegations involving vulnerable adults and children had been made against XX dating back to his childhood.

The court heard from expert witness, Chartered Clinical Psychologist, Dr Neil Sinclair, who said that it should have been apparent to Hillgreen Care Limited that there was an extremely high risk of XX committing sexual offences. XX needed to be monitored at all times.

Dr Sinclair said that if that monitoring been carried out, the alleged attack would probably never have happened. Residents at Colne Road were exposed to potential and actual harm.

A number of care workers who had worked at Colne Road gave evidence - although nobody from the senior Hillgreen management team.

A support care worker, who said she had not been given any instructions about watching XX, said that she walked in on XX while he was assaulting another service user, described as YY, on 1 November 2015.

Following the alleged sexual assault Colne Road Home Manager, said that the home was no longer a place he wanted to work after the incident. He said that staffing levels were inadequate and that he had raised the matter with senior Hillgreen management, but that nothing had been done about it.

Paul Greaney QC said: “YY plainly needed to be protected from abuse. One only needs to think for a moment about the situation that existed in that care home, a vulnerable man, in an environment in which a predatory sexual offender was largely free to roam, to realise that YY needed protection.”

Andrea Sutcliffe, CQC's Chief Inspector of Adult Social Care, welcomed the judgment and sentence: "As the judge has made clear, Hillgreen Care Limited utterly failed in their duty of care for the people they were responsible for supporting. YY should never have been exposed to the potential of sexual abuse from XX and the impact on him and his family is heartbreaking. My thoughts are with them today.

"It has taken a long time to bring this prosecution to a conclusion but the outcome proves that it has been worth the effort and dedication of CQC's inspection and legal teams. Providers should be clear that if people are exposed to harm through their failure of care we will take every step we can to hold them to account."