Sunday, 28 December 2014

Just what does the Information Governance Alliance do?

The Information Governance Alliance has been established this autumn with a view to create one, distinct voice which can direct the way in which Health and Social care providers tackle issues relating to Information Governance, Information Sharing, Data Protection and Confidentiality. To find out more about the role of the Information Governance Alliance, check out our article on the subject matter, which can be downloaded from our website.

Friday, 26 December 2014

West Yorkshire Care Home is rated inadequate

The Care Quality Commission (CQC) has told Hollycroft Care Home in Ilkley, West Yorkshire that it must make improvements or face enforcement action. During an unannounced inspection in October 2014, inspectors found that the home was failing to provide care which was safe, effective, caring, responsive or well led. A full report of this inspection has been published on the CQC website today. Under CQC’s new programme of inspections, all adult social care services are being given a rating to help people choose care. Overall Hollycroft Care Home has been rated as Inadequate. The report identifies a number of areas in which improvements are required: Care plan documentation was incomplete and did not always reflect people's individual needs. There were not enough qualified, skilled and experienced staff to fully meet people's needs. This was particularly evident during the morning and at lunchtime. Inspectors found evidence of safeguarding incidents having occurred at the home that had not been notified to the local authority safeguarding team or CQC as required by law. Staff were not always provided with sufficient training and supervision. People's capacity to make decisions was not assessed in line with the requirements of the Mental Capacity Act 2005. Some audits were undertaken, however the provider did not have an effective system in place to regularly assess and monitor the quality of service that people received, or to identify and manage risks to the health, safety and welfare of people using the service. Debbie Westhead, Deputy Chief Inspector of Adult Social Care in the North said: "We found that the care provided at Hollycroft Care Home fell a long way short of what we expect services to provide. We have told them they must take action to resolve the issues we identified. "While we did see some caring interactions between staff and people living in the home, and that in some ways people were well supported, the safety issues we identified needed urgent attention. "We have made it clear that we will return to the home to check that the necessary improvements have been made. If not – we will take further action to make sure that people living there receive care which is safe, effective, caring and responsive to their needs."

Care Home in Warwickshire rated as adequate

The Care Quality Commission (CQC) has told Haven House Residential Home in Warwick it must make improvements or face enforcement action. During an unannounced inspection in October, inspectors found that the home was failing to provide care which was safe, effective, caring, responsive or well led. A full report of this inspection has been published on the CQC website. Under CQC’s new programme of inspections, all adult social care services are being given a rating to help people choose care. Overall Haven House Residential Home has been rated as Inadequate. The report identified a number of areas where improvements are required: The provider must ensure appropriate arrangements are in place to cover unplanned staff absences. The home needs to operate an effective quality assurance monitoring system. The provider must ensure premises are maintained to provide a suitable and safe environment. Resident and staff records need to be stored more securely. The provider must ensure an effective system to prevent and control the risks of infection is put in place. Improvements regarding the home’s management of medicines are required. An effective staff recruitment process needs to be implemented to ensure staff are suitable and of good character. Sue Howard, Interim Deputy Chief Inspector of Adult Social Care, said: “We found that the care provided at Haven House Residential Home fell short of what we expect services to provide. We have told the home they must take action to resolve the issues we identified. "Although many people said staff treated them with kindness and compassion, we found examples where people’s needs had not been met and where people had not been protected against risks associated with cleanliness and infection control. We also found that the service’s recruitment processes and record keeping needed to be improved. “We have made it clear that we will return to the home to check that the necessary improvements have been made. If not, we will take further action to make sure people living there receive care which is safe, effective, caring and responsive to their needs.”

NHS's plan for the year ahead

On the 19th December 2014, plans have been outlined for what commissioners and providers of NHS care will do in 2015/16 to deliver on the Five Year Forward View for the NHS, which published earlier this year. The planning guidance has been produced by NHS England, Public Health England, Monitor, the NHS Trust Development Authority, Health Education England, and the Care Quality Commission. Commenting on its publication, David Behan, Chief Executive of the Care Quality Commission said: “The Five Year Forward View sets out an exciting vision for the future. CQC has an impartial role to play to make sure services provide people with safe, high quality and compassionate care.” Download the NHS Forward View into Action: partnership and planning for 2015/16 from their website.

Government to review parts of the Mental Health Act

Section 135 of the Act gives police officers powers to enter private premises – with a warrant – to remove a person suspected of being in urgent need of a mental health assessment. Section 136 gives them powers to remove someone from a public place to a 'place of safety', where they can be detained for up to 72 hours, pending a mental health assessment. What changes does the report propose? The review highlights areas where the use of these sections of the Act is working well, as well as areas that could be improved. Changes proposed by the report include: Outlawing the use of police custody as a place of safety for people under 18 who are detained under the Act. Extending the use of Section 136 to anywhere apart from a person's home (for example, a railway station). Shortening the length of time a person can be detained under sections 135 and 136. It also includes proposals for changing the use of the Act, including improved commissioning of places of safety and faster arrangements for the use of Section 135. Dr Paul Lelliott, the CQC Deputy Chief Inspector of Hospitals and lead for mental health, said: "The joint Home Office and Department of Health review of the use of Section 135 and 136 detention under the Mental Health Act is an excellent piece of work. "We were pleased to see that the recommendations made in the report build on those that we made in our report, A safer place to be, earlier this year – and also welcome the call for legislative change designed to end the unacceptable practice of children and young people ending up in a police cell when they experience a crisis." The Centre for Mental Health has also published a report, commissioned by the Department of Health and the Home Office, as part of the Government's review of police powers under Sections 135 and 136 of the Mental Health Act in England and Wales. The centre's report explores people's experiences of the two sections and their views about how they should be changed. Its conclusions call for changes to the use of police powers under the Act.

Special measures in adult social care

At the Public Board meeting on the 17th of December 2014, an update on how the CQC plans to tackle inadequate care across all adult social care services in England was shared with board members. The CQC are proposing that where adult social care services fail to improve within a year of being rated as Inadequate overall, they will face closure. Today's update follows the announcement from the Secretary of State for Health in July that asked us to develop a special measures regime for adult social care in England. Since then, the CQC have been developing what this could look like with people using services and their carers, providers and their representatives, commissioners, CQC staff and national partners. The CQC are now seeking further views from anyone who wishes to have their say on the latest proposals before final policy is agreed. To learn more about special measures for adult social care and have your say, visit the CQC website. The deadline for feedback is Friday 30 January 2015. The CQC's Chief Inspector of Adult Social Care, Andrea Sutcliffe, said: "A critical part of our role as the regulator is to hold providers of adult social care to account and ensure they are providing the standards of safe, caring, effective, responsive and well-led care that are good enough for my mum or anyone else's loved one. "Since the launch of our new ratings system in October, our reports are showing many adult social care services are providing Good care. However, where we identify services to be delivering Inadequate care, we know the effect on people's lives can be awful. "Today's proposals set out our thinking about when a provider is placed into special measures and the timescale they will have to improve. "Above all, I want to help the adult social sector improve so that people can get the high-quality care they expect and deserve. But if providers do not or cannot improve, then we will take action that will lead to closure. "We are now in the final stages of developing the special measures policy and I would like to thank everyone who has been involved so far and encourage anyone who has an interest to share their views with us." Care and Support Minister Norman Lamb said: "Whilst it is never an easy decision to close down a care home that must not be an excuse for allowing poor care to continue. It is right that where providers are not able to make improvements CQC takes action to protect vulnerable people from harm." It is expected that the final special measures policy for adult social care will be published in March 2015. Source: CQC website

Sunday, 14 December 2014

The team raise money for SMA Support UK and Save the Children

The Words Worth Reading Ltd team took part in the 2014 Christmas Jumper Day on Friday 5th December. We were raising money for SMA Support UK, a charity which supports families and individuals who are affected by the genetic disease, SMA. As we are a small team we thought we'd involve all the little people in our lives too! We are delighted to say that we raised £52 for the charity. We then made the same donation to the charity Save the Children.

Information Sharing to improve patient care

A new agreement to help drive improvements to patient care has been formalised between the Care Quality Commission (CQC) and the General Medical Council (GMC), the regulator for doctors.
Although the two regulators have different responsibilities, they have a shared goal - to ensure patients receive the best possible care and are protected from harm.

The joint operating protocol (JOP) makes it official that relevant information will be shared between the two organisations.

Any information given by GMC will support CQC in preparing for its inspections of hospitals and general practices. CQC will alert GMC to anything non-routine such as information about a potentially serious emerging or urgent concern.

Ted Baker, Deputy Chief Inspector of Hospitals, said:

“This is one of a number of agreements we have with a wide number organisations. While each relationship is different, they are all aimed at ensuring health and social care services provide people with safe, effective, compassionate, and high quality care.

“Making these relationships work is therefore critical for CQC to fulfil our regulatory role and for us to play our part in supporting the improvement of care.”
Anthony Omo, Director of Fitness to Practise at the GMC, said:

“By sharing information - especially concerns about patient safety – we can both build a bigger and sharper picture of what is happening inside organisations. That means we can target our action more effectively where there are problems.

“Ultimately that means we can be more effective in the improvements that we drive in medical practice and the care that patients receive.”

The current JOP was published in July 2013. CQC regularly reviews agreements with partner organisations to make sure they are always relevant, up to date and effective.

The revised agreement aligns with CQC’s new approach to inspections, and is set out in a Memorandum of Understanding (MoU).

CQC Supports Human Rights Day

The CQC are proud to have supported Human Rights Day (Wednesday 10 December) and to have celebrated how people who use services are at the forefront of their regulation of health and adult social care in England.

The annual occasion honours the adoption of the Universal Declaration of Human Rights (UDHR) by the United Nation’s General Assembly on 10 December 1948.

Within CQC, it is an opportunity for the team to reflect on the changes they have made to how they inspect care services and how they are implementing our three-year strategy to integrate human rights into the way they work.

Malte Gerhold, Director of Policy and Strategy for CQC, said: “The Care Quality Commission has a crucial role in making sure care providers protect the human rights of people using their services. People who use services are at the heart of our new inspection model. As the quality regulator for health and adult social care, we have an important role to promote equality, diversity and human rights as part of services that are safe, effective, caring, well-led and responsive to people’s needs. This is why CQC has developed a human rights approach for its new model of regulating quality in health and social care. It is based on the human rights principles of fairness, respect, equality, dignity, autonomy, rights to life and rights for staff.”

The theme of UN Human Rights day this year is “Human Rights 365”. It celebrates the fundamental proposition in the Universal Declaration that each one of us, everywhere, at all times is entitled to the full range of human rights. So, the CQC will consider human rights principles wherever we inspect. CQC’s role is particularly important for people that may face greater risk to their human rights or greater barriers to self-advocacy – such as detained patients and many people living in care homes.

Further details about their human rights approach are available here.

Care Home in Surrey to close

The Care Quality Commission has taken urgent action to close a failing care home in Banstead, Surrey, after serious failings were identified which presented a significant risk to the safety of residents.

Inspectors visited the home on 28 November and 1 December in response to concerns raised by Surrey County Council to find that people were not receiving care which was safe, effective, caring, responsive to their needs or well-led.

Inspectors found that residents – many of whom were living with dementia – were being washed in cold water and had a high risk of developing pressure sores due to inappropriate beds. The home was dirty and had an overpowering smell of urine. A broken lift had left some people unable to get downstairs in the home for several weeks.

Staff were not supporting people to eat, and inspectors saw incidents of poor manual handling. Some staff working in the home had not had criminal records checks, and staff were working up to 60 hours a week. There were not enough staff on duty, and relevant training had not been provided.

CQC worked with the local authority and the local Clinical Commissioning Group to ensure as smooth a process as possible as a result of the closure.

Adrian Hughes, Deputy Chief Inspector of Adult Social Care in the south for CQC, said: "CQC sincerely regrets the disruption and distress that the residents of Merok Park have experienced. However, moving the residents to new homes was the right thing to do because we were extremely concerned about the impact living in the home was having on their health and wellbeing. The owners of Merok Park were providing substandard care and we had no confidence in their ability to correct the serious failings we found. I was pleased to be told today that those who were moved are now safe and well in their new homes.

"We have worked with the responsible local authority and the local Clinical Commissioning Group and confirmed with both agencies last Friday (5 December) that we would be serving the notice requiring the immediate closure of the home on Tuesday (9 December) to allow time for people to move.

"Our understanding is that while the local authority had ensured that new accommodation was ready for all those they needed to move, an issue arose on the 9 December regarding the attendance of the transport services arranged by the CCG which delayed transfers until later in the day. This of course caused additional distress for the residents and their families which everyone involved would have wished to avoid."

CQC say that North West Ambulance Trust are focused on quality

England's Chief Inspector of Hospitals has published his first report on the quality of care provided by North West Ambulance Service NHS Trust.

Overall the CQC inspection found that the trust provided safe and effective services which were well-led with a clear focus on quality.

North West Ambulance Service NHS Trust is the first ambulance trust to be inspected under radical changes which have been introduced by CQC to provide a more detailed picture of healthcare than ever before. A full report of the inspection is available here.

The inspection team included CQC inspectors, doctors, nurses, paramedics, patient experts by experience and senior managers. The team spent four days visiting the trust’s three emergency operations centres covering Cheshire and Merseyside, Greater Manchester, and Cumbria and Lancashire, and shadowing ambulance crews and paramedics during August. They visited 50 of the 100 ambulance stations within the trust. They also visited local A&E and Outpatient departments to talk to patients and staff about their experience of the ambulance service.

Inspectors examined the care and treatment provided by the trust, reporting in detail on access to the service, emergency and urgent care and patient transport services.

Patients who met inspectors were overwhelmingly positive about the quality of their care, and inspectors saw staff treating patients with compassion, dignity and respect. Staff showed a caring, committed and compassionate manner, whatever the environment or challenges they faced.
In comparison with England’s nine other regional ambulance services, inspectors found that the performance of NWAS varied in some areas of clinical quality:

This year 71.9% of the trust’s patients who had suffered a stroke, arrived at a hyper acute stroke centre within 60 minutes of the original 999 call; this performance was the second best of all ambulance trusts.

But a significant number of people who dialled 999 hung up before they got through and compared with all other trusts, NWAS was the most likely to send an ambulance rather than deal with an emergency caller by finding alternative solutions.

Over the whole year, the trust was better than the national average in responding to 75.9 per cent of patients with immediate life threatening conditions within eight minutes.

The inspection team found several areas of good practice.
  • Patients who called more than twice in seven  days or four times in 28 days were recognised as frequent callers, and helped by a specialised team that  liaised with the caller, their GP and other social care providers to ensure that the person’s health and social care needs would be met.
  • Clinical staff performance was monitored and all paramedics’ results were published within the team so that each of them could compare their performance against their colleagues. At the time of the inspection, 55% of staff had completed their training in ‘Prevent, which is part of the UK government’s counter-terrorism strategy.
  • The trust encouraged the ongoing education of their staff at all levels. The commitment and enthusiasm for the use of volunteer community first responders and their support was evident. They received a comprehensive 6-month package of training, and then continuing training and support.
There were also areas for improvement:
  • Getting the most appropriate vehicle to the patient –whether it be, community first response, Paramedic rapid response or air ambulance. The trust aimed to achieve this 60 percent of the time. However, this had only been achieved in 40 percent of cases from July to September 2014.
  • The service took a high number of patients to hospital when alternative services may have been more appropriate in meeting their needs. The trust was the worst performing nationally in this area.
  • The trust needs to make sure its staff receive appropriate supervision and appraisal.
Professor Sir Mike Richards, Chief Inspector of Hospitals, said:

“We rely on our ambulance services to be there whenever we need them – but there is so much more to a good service than simply arriving on time.  The key to providing an excellent ambulance service is in first managing all the calls that come in to ensure that patients in need  get the best possible service – whether it is from a paramedic at the scene, or in being advised to attend a walk in centre, if that’s appropriate.

“Overall, we found services provided by North West Ambulance Service NHS Trust were safe, well led with a focus on quality.

“Although it did achieve all key national ambulance targets for response times last year, I note that the picture has been mixed so far this year. In terms of clinical quality, and patient outcomes, I am sure that NWAS will keep a close watch on its performance against the other ambulance trusts, to understand how it can improve its service to patients.

“While I can only commend the staff for their dedication and effort, I will continue to watch their progress in these areas.”

Tuesday, 9 December 2014

Terror and Wonder: The Gothic Imagination Exhibition

The British Library is hosting Terror and Wonder: The Gothic Imagination. The exhibition presents an intriguing glimpse of a fascinating and mysterious world. Experience 250 years of Gothic’s dark shadow. The exhibition runs until the 20th January. 
Experience the dark shadow the Gothic imagination has cast across film, art, music, fashion, architecture and our daily lives. Including iconic works, such as handwritten drafts of Mary Shelley’s Frankenstein, Bram Stoker’s Dracula, the modern horrors of Clive Barker’s Hellraiser and the popular Twilight series. 

You can book curator led tours, or download the free podcast which accompanies the exhibition. There are even workshops for students. 

Find out more by visiting the British Library website here

Image:, Flickr

Letter from CS Lewis to be auctioned off this month

A letter from CS Lewis discovered inside a secondhand book sees the author writing about how real joy feels. 
Believed to be previously unpublished, the letter to a Mrs Ellis was written by Lewis on 19 August 1945, and sees the author explaining his concept of joy. Three years later, Lewis would expand on the subject in his memoir Surprised by Joy: The Shape of My Early Life, the account of his conversion to Christianity. 
Before he began work on the memoir, however, Lewis tells Ellis in this letter that “real joy … jumps under ones ribs and tickles down one’s back and makes one forget meals and keeps one (delightedly) sleepless o’ nights”
The handwritten letter had been enclosed within a copy of A Problem of Painbought from a secondhand bookshop, and is set to be auctioned later this month. “A private owner bought the book some years ago, and some time later discovered the letter inside it. As far as we know it’s unpublished,” said Chris Albury of Dominic Winter Auctioneers. “We haven’t been able to discover who Mrs Ellis is – there’s no envelope, because the owner just found it in the book.”
The letter will be auctioned on 18 December, with a guide price of £1,200 to £1,500. “We’ve only had a handful of good CS Lewis letters before and they’ve all attracted strong interest,” said Albury. “CS Lewis letters don’t come up very often.”
Source: The Guardian

Tuesday, 2 December 2014

The November edition of the Words Worth Reading Ltd newsletter is now available to download

The November edition of the Words Worth Reading Ltd newsletter is now available to download.

There may be another month to go, but we love Christmas here at Words Worth Reading Ltd, that's why we will be getting into the festive spirit and taking part in the SMA Support UK Christmas Jumper Day on the 5th December. Meanwhile, in the WWRL office this month, we have begun working towards Information Governance Toolkit submissions for our healthcare clients.

To get the latest news about business, healthcare, jobs, writing, student life, and to find out what the Words Worth Reading Ltd team have been up to, download this month's newsletter from our website by clicking here

Monday, 1 December 2014

Consultation on Records Management Code of Practice

 The Information Governance Alliance have commissioned a revision of the Records Management Code of Practice. A working group from the IG Alliance, Department of Health, NHS England and the Health and Social Care Information Centre will work together to redraft the Code of Practice. Comments and suggestions for change are invited. Further more specific consultation will take place with professional groups and other organisations directly impacted by any changes to the Code. At the moment the consultation is open to anyone interested in records management in health and social care.

If you wish to make any comments and suggestions for change about the current Code please can you send them to the mailbox listed below:

Copies of the current Records Management Code of Practice can be found at the website below;

Comments should be sent in by 31 January.


IG Toolkit Version 13 - Requirements review

The HSCIC External Information Governance (IG) Delivery Team is now beginning work on the development of the IG Toolkit version 13, due for release by the end of June 2015. The intention is to make some changes to the Requirements to reflect current thinking on Cyber Security, to provide additional guidance on implementation of the Caldicott2 recommendations, and the NHS Number requirement is under review by NHS England. Other changes are likely to be minimal, e.g. correction of errors, new guidance that people need to be made aware of, etc.
The HSCIC External Information Governance (IG) Delivery Team is now beginning work on the development of the

You can submit requests for change in relation to the IG Toolkit Requirements (e.g. Guidance,
Knowledge Base Resources - not the technical functionality). To submit a request for change, please complete the online change request form which is available via the ‘change requests’ option on the left-hand menu of the IG Toolkit, where detailed guidance in relation to the process is also available.

The form will then be submitted to the HSCIC External IG Delivery Team and your change will go through the process for consideration.

Please ensure that you submit any requests for change by no later than Wednesday 31 December 2014 in order to allow these to be considered as part of the version 13 development cycle; and note that any major changes you propose are likely to be deferred to version 14 for which we intend to carry out a comprehensive review of the Toolkit.

Please note: This request for feedback relates to only amendments to the Requirements or Knowledge Base Resources. It does NOT include functional / technical improvements or enhancements to the IG Toolkit website.


CQC warns Sage Care Homes (Jasmin Court) Limited that they must improve standards of care at Jasmin Court Nursing Home

The Care Quality Commission (CQC) has formally warned Sage Care Homes (Jasmin Court) Limited that that it must make urgent improvements at Jasmin Court Nursing Home in Sheffield.

This warning follows an unannounced visit to the home in September 2014 which was carried out to check they had made improvements in response to the breaches of regulations we identified at our last inspection that we carried out on 9 and 15 April 2014.

Visiting inspectors found that the nursing home was failing to provide care which was safe, effective, caring, responsive or well led; and four of the five national standards reviewed by the inspection team were not being met.

Following the inspection, CQC issued three warning notices requiring Sage Care Homes (Jasmin Court) Limited to make improvements in order to protect the health, safety and welfare of the residents:

A full report detailing the findings from the inspection has been published on the CQC website this week.

Inspectors identified a number of concerns including:
  • The privacy, dignity and independence of people living at the home were not always being respected by staff.
  • Practices that were being followed at the home did not support the people’s right to safe care and treatment.
  • Inspectors found poor standards of cleanliness throughout the home, many materials and surfaces were visibly dirty posing an infection risk to residents and staff.
  • Improvements required following a previous CQC inspection with regard to assessing and monitoring the quality of service provision had not been implemented and systems to monitor quality remained ineffective.
Debbie Westhead, CQC’s Deputy Chief Inspector of Adult Social Care in the North said:
"We have told Sage Care Homes (Jasmin Court) Limited that they must take action to protect the health, safety and welfare of the people who live there.

“It is unacceptable that the provider has allowed the service at Jasmin Court to deteriorate in this way. The people for whom they are providing a service are entitled to services which are safe, effective, caring, well led, and responsive to their needs.

“The provider should have systems in place to monitor the quality of the service, and it is of significant concern that Sage Care Homes (Jasmin Court) Limited did not have such systems in place to prevent the deterioration in the service

"We have shared our findings with the Local Authority Safeguarding Team, and we have told the provider very clearly where they must take action to address our concerns.

"We are monitoring the home very closely in liaison with the local authority to ensure that people receiving care are not at risk of immediate harm, we will return shortly to ensure improvements have been made."

Improvement needed at specialist cancer trust

A joint report by the Care Quality Commission (CQC) and Monitor has found no evidence of serious failings in the organisational culture at The Christie NHS Foundation Trust, but has highlighted areas in need of improvement.

The regulators acted after concerns were raised by former staff members suggesting a culture where staff felt inhibited to raise issues or highlight problems with the senior team.

The review team included senior staff from both organisations, CQC Specialist Advisors and an experienced Medical Director. The team spent three days at the trust and analysed a range of documentation, interviewed key personnel and carried out focus groups with a variety of staff groups.
Today’s report concludes that there was no evidence of serious failings of governance or widespread cultural issues at the trust and that staff were committed to providing patients with high quality care and treatment.

However, both CQC and Monitor have identified some areas where the trust should seek to improve its performance, particularly in relation to its quality assurance processes and staff engagement.

The team have made a number of recommendations including:

The trust should continue to improve staff engagement and support.
  • The trust should consider whether any further changes are required to Human Resources processes to help improve engagement with non-clinical staff groups, and if so implement improvements.
  • The trust should consider whether any further improvements are required in the way it communicates and engages with staff to promote an open learning culture.
  • The trust should review the processes for measuring waiting times in the outpatient department to ensure accuracy of information and timely scheduling of appointments.
  • The trust should take into account the findings of this joint review when focusing the scope of its planned internal governance review.
Miranda Carter, Executive Director of Provider Appraisal at Monitor, said:
“We take all concerns raised by whistleblowers seriously. That’s why we wanted to work closely with the CQC to find out if there were problems with how The Christie was being run.”

“Our work did not highlight that there are currently serious failings of governance or culture at the trust.”

Ann Ford, Head of Hospital Inspections at CQC, said:
“If a trust is well-led we expect it to encourage an open and transparent culture. We found evidence of a strong commitment to delivering good outcomes for patients at The Christie, but also identified some concerning issues regarding team leadership that the trust must address.

“Further work is needed to improve communication with staff and strengthen the trusts quality assurance processes.”

Monitor also announced today that formal regulatory action at the trust has ended. The sector regulator has issued compliance certificates to recognise the progress that has been made.


CQC seeks views on its new approach to regulating dental, independent healthcare and ambulance services

The Care Quality Commission (CQC) is asking people who run and use health and care services for views on the regulator’s plans for inspecting primary care dental services, and inspecting and rating ambulance and independent healthcare services.

Following the earlier roll-out of CQC’s new inspection approach for general practice, out-of-hours GP services, adult social care and in NHS acute hospitals, three consultations are launched today (Friday 28 November) to seek views on CQC’s plans for inspecting dental, ambulance and independent healthcare services.

CQC Chief Executive David Behan said:

"We have been carrying out new style of inspections in hospitals, mental health and community health services, adult social care services and GP practices over the past year.
“Now we are setting out the changes we are proposing to make to the way we regulate dental services, ambulance services and independent healthcare services that will help us to make sure that they provide safe, high-quality care.
“We want to hear what professionals, clinicians and members of the public think of these proposals."

Due to the view that people using primary care dental services are less likely to experience poor care, CQC proposes to inspect 10% of providers using random and risk-based inspections as well as inspecting in response to concerns. CQC does not intend to rate primary care dental services in 2015/16.

The consultation asks for views on these elements of the new approach and if people think that the approach will help dental practices to improve, for example by reporting on good practice.

The CQC propose to divide the independent acute healthcare sector into three distinct groups which are ‘hospitals’, ‘single-specialty services’ and ‘non-hospital acute services’.

The approach they are proposing for the hospitals group closely follows the model used for NHS acute trust hospitals, with some modifications to take account of the differences between them.
They are proposing other, tailored approaches for the single-specialty services and non-hospital acute services. The CQC are asking whether the sector agrees with these approaches.

They are also asking for views on whether special measures should be introduced into the independent healthcare sector and whether there should be a rating at corporate provider level for independent healthcare providers.

For ambulance providers (both NHS and independent services) the CQC will also take a similar approach to that of acute services to check if the services are safe, effective, caring, responsive to people’s needs and well-led. This will help us to give NHS ambulances a rating of either outstanding, good, requires improvement or inadequate.

NHS regulations improve openness and transparency

The 27th November was the first day that the Care Quality Commission started enforcing two new regulations for the NHS.

This follows their announcement last week about the publication of guidance for NHS organisations to help them meet the requirements of the duty of candour and fit and proper persons requirement.
The duty of candour and fit and proper persons requirement for directors come into force today for NHS Trusts, Foundation Trusts and some special health authorities that provide care and treatment that are regulated by the Care Quality Commission (CQC).

The introduction of a statutory duty of candour for providers is an important step towards ensuring there is an open, honest and transparent culture; particularly when things go wrong.

This is separate from the draft guidance for a 'duty of candour' that has been produced by the General Medical Council and the Nursing and Midwifery Council – the regulators for individual health professionals. This will support doctors, nurses and midwives in fulfilling their professional duty to be open and honest about mistakes.

During CQC inspections, the CQC assess whether a provider is delivering good quality, safe care. As part of their approach, they ask whether lessons are learned and improvements made when things go wrong, including whether people who use services are told when they are affected by something that goes wrong, given an apology and informed of any actions taken as a result. Where they find that the provider is not delivering good quality care, they consider whether a regulation has been breached.
The fit and proper persons requirement for NHS board members is to make sure that providers have robust systems in place to carry out appropriate checks before a job offer or appointment is made. This would include whether the person is of good character, is physically and mentally fit and has the necessary qualifications, skills and experience for the role.

During registration, the CQC will check that the provider understands the requirements of this regulation and ask them what systems they have in place so that they can meet it. It is not for CQC to identify that NHS board members are 'fit and proper persons', that is the responsibility of providers.
The duty of candour and fit and proper persons requirement for directors are part of new fundamental standards. The remaining fundamental standards will come into force from April 2015.

The duty of candour and the fit and proper persons requirement for directors will also be extended to all other providers from April via additional regulations, still subject to Parliamentary approval.