Jun
29
Have the Care Quality Commission got things wrong?
The new Essential Standards of Quality and Safety Regulations, published by the Care Quality Commission (CQC), set out the Regulatory Activities responsible for indicating Registration and Inspection by the Care Quality Commission.
In short, the Regulatory Activities define weather a service requires to be registered with CQC. Under these new regulations, Domiciliary Care Agencies have a Regulatory Activity of “Personal Care “. If personal care is undertaken, you must register, simple enough so far!
Now, for the first time ever, we have a true definition of “Personal Care” within this new legislation, but surprisingly there seems to be something missing from this! The new Definition does not include Medication Administration or Prompting; it also does not include shopping or any other form of Financial Management. Huge mistake here!
Let me explain why:
As an agency, if I am providing services of a Personal Care nature, then any other aspect of my care service must adhere to the Regulations specific to those areas. This is because I provide Personal Care services which are a Regulatory Activity. Any regular additional service such as Shopping, Financial Management or indeed Medication Administration will automatically fall under my inspection and compliance requirements within the Essential Standards of Quality and Safety Regulations.
So for example, if I am tasked with assisting with feeding a Service User, in addition to administering Medication, the Feeding element dictates registration under the new legislation, and the Medication element is automatically required to be delivered in accordance to the new regulations as a part of the whole care delivery.
However…..If I am only looking to oversee Service Users Finances’, their shopping, or even their entire Medication needs, providing there is no Personal Care duties delivered, I am exempt from registration as an organisation. I have no guidance to follow, no regulations to adhere to and no legal responsibilities to meet whatsoever.
I can see this, in addition to the promotion of Personal Assistants, creating a whole lot of Safeguarding Issues across the industry! My worry is that with so much opportunity for unsupervised care in the community, how will we even know when these potential Safeguarding incidents do take place?
From my experience, it’s not often the Abuser reports themselves…….
May
27
Personalisation…..Inevitable Abuse?
The government’s Personalisation Agenda is currently under way, and at a swift pace I must add! But what exactly does this mean for us all? And perhaps more importantly, how does this affect the safety of Service Users in the community and the standards of care being delivered?
Notwithstanding the above, do I see a potential safeguarding issue on the horizon? Yes – and I don’t think I am the only one.
The personalisation agenda offers an opportunity to make home care (and other services) more responsive and flexible so that it is actually doing what people who use services want and need, rather than being constrained in rigid tasks and time specifications. There are, however, some unintended consequences for service providers, especially home care providers, which could spell large-scale destruction of the sector.
Let me be clear, I believe in the overall approach, but in my opinion, the speed of implementation and lack of control on spending are simply out of tune with the needs of the service users. Personalisation is a way of promoting choice within the provision of care services, but when choice allows service users to employ friends, family members, strangers, or to even spend the funds on non-care related items or activities, suddenly the overall picture of homecare changes. Targets mean rapid changes, and capacity issues within Regulated Services due to this pace, will no doubt force more unregulated care provision in the community.
Opinions vary. Mine are without prejudice and quite simply I have huge concerns over the speed of uptake of personalisation, the huge targets set for the individual Councils regarding the implementation of the personalisation agenda, and of course, what this spells out in the short, medium and long term.
Community care for the elderly is without question cheaper to deliver than residential care. The average costs for the delivery of homecare vary dramatically dependant of individual needs, however the abundance of “pop in calls“ provides a cheap way of meeting the “ Basic “ care needs of the Service User, but shouldn’t a care service offer more than this? In my experience, cheaper does not necessarily mean better.
I believe the fundamental ideas behind personalisation are correct: personal choice is without doubt an important improvement to the delivery of care in the community. But this must not come at a price where quality and safety is concerned.
There are a significant number of carers working as personal assistants through the personalisation agenda, without relevant training, supervision or CRB disclosure checks to validate suitability! Are risk assessments, ELP’s and care needs assessments becoming a thing of the past? With no CQC regulations to adhere to, this is likely to be the case. Standards are achieved because consequences exist for non compliance, poor performance and lack of value for money. It goes without saying; if rules and regulations do not apply…..they simply will not be adhered too.
So does personalisation really mean choice? If choice promotes the deterioration of Quality, is it really a positive outcome? Indeed does it highlight some real issues surrounding potential abuse through unsupervised care provision by non-regulated services and personal assistants?
Domiciliary care agencies with sufficient management structures, supervisory support and clinical experience still have difficulties surrounding capacity and safeguarding in the community. Are we simply passing on the inevitable issues of Financial Abuse, Safeguarding Incidents and poor practice to the service users themselves by pushing the agenda at such a pace? I’m inclined to believe that rapidly introducing a system, where quality benchmarks, supervision procedures, adequate training and suitability checks are no longer required, indeed spells out trouble, not choice.
If choice and responsibility is shifted away from the Council services, and placed in the hands of the individuals at such a pace, where will the advocacy service’s that are needed to assist with these decisions come from, and who will pay for it?
Charities such as Action On Elder Abuse that provide such services are having funding withdrawn, not increased!
Food for thought in my opinion, but what do you think? Have I missed something?
Jan
21
” 247 Search & Selection ” is launched
Gowing rapidly seems to be on the cards this year. What a great start to 2010 so far!!!
247 Nursing is thriving, 247 Homecare is experiencing an explosion of demand from all areas of the sector and to top it off due to increased demand, we have launched our Permanent Pecruitment Division 247 Search & Selection
We have been asked to recruit Specialist Management and Deputy Management staff for one of the largest Healthcare Providers in the UK. Starting with the North-West, we are actively seeking the best of the industry.
What are we looking for:
People with talent, experience, and a commitment
Managers with opinions, ideas and enthusiasm
Deputy Managers, the future leaders
We are interviewing now, what are you doing?
If you have the experience, and want to know more call:
Joe Willis
07500 927 247
Jan
21
247 Nursing is on the move!
247 Nursing is on the move!
Due to the development of 247 Professional Health over the last 12 months, we are enjoying the benefits of a fantastic reputation accross the Merseyside and Manchester areas in particular. Our Nursing division ” 247 Nursing ” is rapidly expanding we are recruiting rapidly to meet demand.
Our clients are expressing an increased need for Qualified RGN’s andRMN’s and we are planning on delivering on these requirements in our own unique way. We are looking for the best Nursing staff around, and we are commited to rewarding our staff for their hard work and commitment.
2010 is looking exciting, business is booming and if you have the right experience then don’t hesitate in contacting us! You will enjoy the following:
- Immediate start
- Full Mandatory Instruction
- Ongoing Support
- Fantastic Rates of pay
- Holiday Entitlement
- Flexible Working Hours
Contact us now on: 01704 883 864
Jan
14
247 Homecare – fastest growing provider in the area!
The New Year has brougth with it an exciting challenge for 247 Professional Health.
A big welcome to Gareth who has recently joined us, to inject a wealth of knowlege and experience into the company. With a background of over 10 years in the provision of care services, 247 Professional Health is lucky to have yet another valuable and professional resource to offer support and growth to an already succesful organisation.
Our CQC Registered Domiciliary Care Service ” 247 Homecare ” is making waves, and in a great way too!
We are quickly gaining a reputation within the area for our ability to respond to the changing and diverse needs of our clients. We are being called upon by Social Services, Hospital Discharge Teams and indeed Private Individuals, to deliver a bespoke care service. As a result the business is steadily building into a true competitor within Sefton and the surrounding area.
We are launching into the delivery of Children Services, an area where our Management experience is profound and deliberate. This sector of the industry requires a unique commitment to compliance driven standards, and an approach based upon new ideas, providing Service Users with an alternative to the standard care service currently available.
Learning Disability, Mental Health, Elderly Services and Childrens Services, we are able to offer a package that suits the needs of the individual. Well done to the team behind making this a success so far, 2010 is an exciting year for us indeed!
www.247professionalhealth.com #in
Jan
07
New year and a new opportunity – 247 Professional Health
Whats about to change?
Business is booming, 247 Professional Health is swiftly taking its place in the staffing world of Health and Social Care.
Southport is where we hang our hat and its about time we really pushed our brand and excellent service across the area.
We now have two CQC registered services:
247 Nursing
247 Homecare
We are really driving forward and our clients are feeding back excellent reviews on our 24/7 approach to quality and accessibility.
Preston is doing fantastically well, Northampton is gaining speed and Darlington is progressing nicely indeed. More offices to follow shortly and our Domiciliary Care Division is gaining ground daily.
Watch this space!
www.247professionalhealth.co.uk
Sep
08
137,000 NHS posts must go in next five years
A consultancy firm has suggested the NHS in England will have to cut 137,000 jobs if it is to make savings of £20bn by 2014.
McKinsey and Company made the recommendations to the Department of Health in a confidential report that would mean the NHS losing 10% of its workforce.
The document has already been circulated among senior NHS manages, though the DH has moved to say that the report is purely advisory and “does not constitute government policy.”
However, the McKinsey document does make wide-ranging suggestions for cuts with clinical staff and administrators sharing the burden.
The proposed cuts include: 30,800 non-clinical posts, saving £600m; saving £3bn by increasing staff productivity in NHS hospitals; saving £1.9bn by cutting external contracts and supply costs such as waste and food; saving £1.3bn from unneeded appointments and procedures; selling hospital estates to raise £8.3bn.
HSJ reports that the analysis was presented to the DH in March this year and was shared with senior managers at strategic health authority level.
McKinsey indicates acute providers will be hardest hit, with cuts equivalent to up to 38% of their 2008-09 spending by 2013-14, while primary care spending would fall by 13% and community care budgets by 28%.
However, health minister Mike O’Brien played down the significance of the report.
He said: “Advisers advise but minsters will decide after taking a range of advice. The McKinsey work… is not in any sense an NHS plan of action. They are just making some suggestions which will be looked at with many other ideas.”
Aug
20
NHS staff illness 1.5 times higher than private sector
New figures have shown that on average NHS workers are taking 10.7 sick days every year.
The findings in the interim NHS Health and Wellbeing report show that NHS absences are higher than the public sector average and 50% above the private sector which is 6.4 days.
The document suggests that the health service should do more to tackle staff illness and it shows that if NHS managers followed private sector models, up to 15,000 staff absences a day could be avoided.
The government-commissioned study said the NHS should act as an exemplar for the rest of the economy.
The most common problems included stress, mental health difficulties and musculoskeletal problems.
Dr Steve Boorman, who led the review, said there was evidence that trusts which improve the health of their staff perform better.
He said: “Trusts that take health and wellbeing seriously perform consistently better on measures of quality, patient safety and efficiency.”
Dr Boorman will draw up his final report later this year after consulting NHS staff and government officials.
Health workers union Unison said the nature of NHS work saw staff placed at higher risk of injury and infection.
Head of health, Karen Jennings, said the NHS had a patchy occupational health system and that managers should take a more responsible approach to the health and wellbeing of their staff.
Sian Thomas, director at NHS Employers, said: “As health is our core business we must put the health issues of our own staff at centre stage so that we all become role models for our communities.”
Aug
17
NHS attack ‘unpatriotic’
A Tory MEP who attacked the NHS on American TV has been accused of being unpatriotic by health secretary Andy Burnham.
Daniel Hannan made his comments after stepping into the debate raging in the US over President Barack Obama’s planned health bill.
Mr Hannan has appeared on American television in recent weeks, describing the NHS as “60 year mistake” and saying that he “wouldn’t wish it on anyone”.
However, Conservative leader David Cameron described Mr Hannan’s view as “eccentric” and distanced himself from them as Labour and the Liberal Democrats questioned the Tory party’s commitment to the NHS.
He said: “The Conservative Party stands four square behind the NHS.
“We are the party of the NHS, we back it, we are going to expand it, we have ring-fenced it and said that it will get more money under a Conservative government, and it is our number one mission to improve it.”
The Leader of the Conservative group in the European Parliament, Timothy Kirkhope said Mr Hannan should be disciplined for his comments.
Mr Burnham has hit back at criticism that the government had not done enough to defend the NHS from attacks in the US.
Of Mr Hannan’s comment he said: “I would almost feel… it is unpatriotic because he is talking in foreign media and not representing, in my view, the views of the vast majority of British people and actually, I think giving an unfair impression of the National Health Service himself, a British representative on foreign media.”
Aug
14
High number of adverse reactions to Tamiflu
Drug safety monitors say there have been more than 400 reports of suspected adverse reactions to Tamiflu in the UK since April.
Figures from the drug safety monitoring body, the Medicines and Healthcare products Regulatory Agency (MHRA), are expected to show that within the last few days there have been as many as 125 events reported.
MHRA data reveals that between April 1 and August 6 there have been a total of 418 reports of 686 suspected adverse reactions to Tamiflu.
Two of the suspected cases were fatal.
The most common side effects were stomach, intestine and skin disorders, vomiting and nausea.
In children, the most common side effect was vomiting – seen in 15% of cases – along with reports of headaches when Tamiflu was used to prevent rather than treat swine flu.
Children who had asthma reported a worsening of their asthmatic symptoms.
The MHRA is also monitoring reports that suggest a possible interaction between Tamiflu and warfarin and also reported adverse reactions reported in people taking a second flu antiviral, Relenza.
A spokesperson for the MHRA said: “A report of a reaction does not mean it has been caused by the drug in question. Tamiflu and Relenza are acceptably safe medicines and most people will not suffer any side effects.
“The MHRA will continue to monitor the safety of Tamiflu and Relenza as their use increases during the swine flu pandemic and we will take appropriate action should any new risks come to light. The balance of risks and benefits for Tamiflu and Relenza remains positive.”
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