Thursday, 5 October 2017

Mistaken Beliefs



EDITH ELLENIn the Foundation’s opinion it is not an acceptable answer to unsafe care, to simply close down services and move people out. Within the Foundation’s own core values, it has to stand up to challenge any philosophy that appears to support care by punishing people who have been abused, but not the people that have carried out the abuse.
To extract people who have been abused and neglected out of their care service, and to move them into others, having no guarantees that these care standards are any safer, is surely not the right directions for improving the protection of our frail and vulnerable people. Particularly if at a later date that care service is deemed unsafe and requires closure.

Neither, in such circumstance, should good care workers be punished by having their reputations tarnished when they have done no wrong, and for them to find themselves jobless, when their services are closed.

In care today, it is not enough to simply rely on current systems of Legislation and Regulation to improve care, as they do little to address the many conflicts of interest that exist, and merely promote systems that are not fit for purpose.

Therefore, robust safeguards, not unproven platitudes of “Lessons will be learnt” and “Our services have improved” are a must for protection, respect and dignity to be restored to all, (including staff), who suffer abuse, and are being victimised.

All services are duty bound to cherish the people in their care. Yet Health and Social Care, in its current configuration, does little to stop leaving people living in care fearful of facing their own fate, alone and frightened.

It is a sad indictment that within in Social Care today and Social Care Partnerships, people and families in care have no confidence in its role as the Guardians of People’s Protection when people approach them with concerns of the abysmal atrocities in care.

Complainants, who bring these crimes to the attention of those in authority have done nothing wrong, and simply required genuine reassurance, actions and outcomes. They need to know people’s suffering will be taken seriously and stopped. But little is in place which reflects a genuine desire to act with openness and transparency, and for honesty and integrity to prevail in any matters of genuine support and improved outcomes.

If anything, current systems appear to condone the dynamics of fear, bullying and suppression when potential risks to life are reported, as the abuse and neglect is mostly ignored, and merely continues to escalate out of control or until urgent admission to hospitals is required.

If ever there was the need of radical reform on how to address and stamp out abuse and neglect, it is now.

Before our whole care system slips over the very precarious cliff of misconception that closing care homes, and bring all care into the community, is the preventative answer to better care.

It is support for improved training in humane attitudes and approaches that will see the truly effective measures and outcomes.

Tuesday, 3 October 2017

The Care Quality Commission


The CQC (Care Quality Commission) state on their website
“We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage them to improve.”

They are the ‘regulators’ who monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and they publish what they find, including performance ratings to help people choose care.

Like Ofsted in its relation to education, the CQC has a remit across all social care – providers and statutory commissioners.

Not so long ago we had the Healthcare Commission which was a non-departmental public body sponsored by the Department of Health.  The Healthcare Commission was set up to promote and drive improvement in the quality of health care and public health in England and Wales in 2004.  It aimed to achieve this by becoming an authoritative and trusted source of information by ensuring that this information is used to drive improvement.  It was abolished in 2009 and its responsibilities in England broadly subsumed by the Care Quality Commission.

The Care Quality Commission (CQC) is an executive non-departmental public body of the Department of Health.  It was established in 2009 to regulate and inspect health and social care services in England.  It was formed from 3 predecessor organisations
·         The Health Care Commission
·         Commission for Social Care Inspection (CSCI)
·         Mental Health Act Commission (MHAC)

The CQC's stated role is to make sure that hospitals, care homes, dental and general practices and other care services in England provide people with safe, effective and high-quality care, and to encourage them to improve. It carries out this role through checks it carries out during the registration process all new care services must complete, inspections and monitoring of a range of data sources that can indicate problems with services.

Part of the CQC’s remit is protecting the interests of people whose rights have been restricted under the Mental Health Act (MHA).

It is also imperative to remember that non-departmental public body (NDPBs) are not an integral part of any government department and carry out their work at arm's length from ministers. In the CQC’s bio its classed as an Execitive this means – they usually deliver a particular public service and are overseen by a board rather than ministers. Appointments are made by ministers following the Code of Practice of the Commissioner for Public Appointments. They employ their own staff and are allocated their own budgets.

But no one seems to monitor or regulate them.  What is more disturbing is that even the inspectors employed to monitor and inspect services seem to be all working from different worksheets.

It will not surprise anyone therefore that inspectors are not consistent in their Reports and Inspections.

By simply looking on their website I found two Inspections from two ends of the Country, both Services are “Celebrated” as Leaders in their Field, both services work with dementia care and both reports are near identical except for 1 is a charity and the other a fairly new organisation having only been operational for a year.  However, 1 is rated as Outstanding by the CQC and the other merely Good!

This is a clear demonstration of inconsistency within the CQC.

In a 3rd report on a service rated as Good, I found in the Summary of Findings that the Service was described as Safe and rated Good for “Is the Service Safe”.  Yet further in the report the Inspector noted that some Services users were left in Bed over 8 hours a day and with no drink or means to hydrate – how then is this safe? How then can this Inspector honestly rate the Safety of this Service as Good?

Monday, 2 October 2017

When did we stop caring about care?



When did we stop caring about people?

When did it become unfashionable to care?

These questions are something I have been thinking over this week.

Over the last few years I have witnessed some care that has been excellent, but some has been shocking.

When did it become unfashionable to care?

We stopped caring when it became easier not to care in the first place. People are not impediments to profit. The best Care Companies celebrate employees and Service Users as the reasons for profit. Integrity is non-negotiable, and transparency and kindness are worthy investments.

Care Homes, hospitals and even the individuals own home is no longer a place of safety

Some of the care workers I have personally met are ignorant, apathetic or both. There is no proper continuity between the different people who care, or clarity about who has overall responsibility. 

But note it is possible to build something lasting and good without hurting people? And yes, be profitable. Companies need to stop behaving badly and realise that honest people are not impediments to profit — they are instruments of it.

Identifiable as one of the major causes of our failing care system is the lack of joined-up help when caring for an older person.  Just a few more staff in homes with a bit more time would go a long way.