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Transcript of Personalisation, Quality & Safeguarding Julie Bateman Assistant Director of Personalisation, Quality...
Personalisation, Quality & Safeguarding
Julie Bateman
Assistant Director of Personalisation, Quality & Safeguarding
February 2013
“ A nation’s greatness is measured by how it treats its weakest members”
Mahatma Ghandi
Quality & Safety- A Wake Up Call
Winterbourne View Inquiry
ECHR
Enquiry into Older People &
Home Care
Francis Report- Enquiry into Mid
Staffordshire Hospital
Is this a Watershed Moment?
Why do things go wrong?
• Dignity Agenda• Caring with Compassion• Person Centred Practice• Family and Friends Test• Valuing People Now…
What doesn’t work
• QA systems alone do not Safeguard People• Clauses in contracts do not Safeguard People• Comprehensive policies and procedures do not
Safeguard People• Monitoring in itself does not necessary improve
the quality of care
Common features of a failing/unsafe service
• Culture of fear• Culture of secrecy• Lack of recognition of peoples human rights• Culture of rules and inflexibility• Poor training and workforce development• Acceptance of poor standards• Lack of consistency and continuity• Over focus on time and task
What does work
• Listening to, involving and engaging with families• Involvement of local communities• Active collation of autobiographies and stories• Maintaining identity• Relationship centred care• Recognition of emotional and physical demands
of work• Experienced and well trained staff• Managers as role models and leaders
What do we know about Quality & Safety in Suffolk?
Nursing Care 55
Home Care providers 78
Very Sheltered Housing (VSH) 22
Supported Housing Providers 32
Residential Care 155
Contract & Quality Monitoring Information
Formal Suspensions Voluntary Suspensions
Currently suspended 2 Currently suspended 1
Reaccredited since April 2012 16 Suspension ended since April 2012
2
Home closed 1 Homes closed 0
Flagged Services CQC
32 providers (of which 16 are res care, 11 are nursing homes and 4 Dom care) currently have multiple non compliance issues (non compliant in 2 or more areas
Currently flagged 2
Flag removed since April 2012 6
Homes Closed 0
Top Ten Concerns Through CQM Visits/Feedback
1. Care plans
2. Risk Assessments
3. PEEP
4. End of life
5. Staff numbers
6. MUST/Nutrition
7. Recording
8. Money and handling
9. DoLs/MCA
10. Environment/H&S
1. Inconsistent visit times
2. Missed visits
3. Too many different carers
4. Carers not staying full time
5. Visits too early
6. Visits too late
Safeguarding Referrals
Reason for Concern
288
0
526
563
3
45
11
0
374
700
12
186
0
2997
0 500 1000 1500 2000 2500 3000 3500
Care Issues
Dis-criminatory Abuse
Emotional
Financial
Institutional Abuse
Mal-administration of Drugs
Manual Handling
Medical Procedural Error
Neglect
Physical
Psychological
Sexual
Unexplained Injuries
Welfare
February 2012 to January 2013
In % breakdown
Reason for Concern
5.0%
0.0%
9.2%
9.9%
0.1%
0.8%
0.2%
0.0%
6.6%
12.3%
0.2%
3.3%
0.0%
52.5%
0% 10% 20% 30% 40% 50% 60%
Care Issues
Dis-criminatory Abuse
Emotional
Financial
Institutional Abuse
Mal-administration of Drugs
Manual Handling
Medical Procedural Error
Neglect
Physical
Psychological
Sexual
Unexplained Injuries
Welfare
Location of abuse
0
5
10
15
20
25
30
35
40
45
residential
own home
public place
Outcome by area
105
206
134
5065
49
330
717
283
132
271
83
0
100
200
300
400
500
600
700
800
J OINT NFA SCS SAP E
Strategy Outcome - County
WEST
SOUTH
NORTH
DoH Survey 2011-12 Findings
Question 1 All - Overall, how satisfied or dissatisfied are you with the care and support services you receive?
I am extremely or very satisfied
I am quite satisfied
I am neither satisfied or dissatisfied
I am quite dissatisfied
I am extremely or very dissatisfied
ENGLAND 62.8 27.3 6.3 1.9 1.7
EASTERN 60.5 29.7 6.3 2.2 1.3
Suffolk 60.9 30.3 5.8 1.6 1.5
Question 7a - Which of the following statements best describes how safe you feel?
I feel as safe as I want
Generally I feel adequately safe, but not as safe as I would like
I feel less than adequately safe
I don’t feel at all safe
ENGLAND 63.8 29.2 4.9 2.0
EASTERN 67.2 27.3 4.0 1.6
Suffolk 71.3 23.4 3.6 1.7
Question 8a - Thinking about how much contact you’ve had with people you like, which of the following statements best describes your social situation?
I have as much social contact as I want with people I like
I have adequate social contact with people
I have some social contact with people, but not enough
I have little social contact with people and feel socially isolated
ENGLAND 42.3 34.6 17.35.8
EASTERN 41.3 36.2 17.25.4
Suffolk 41.0 37.6 17.0 4.4
I don’t do anything I
value or enjoy with
my time
56.6EASTERN
7.526.633.932EASTERN
2
1.91031.5
Suffolk 57.5 29.2 11.3
1.5ENGLAND 57.1 31.2 10.2
6.8
Question 10 - Which of the following statements best describes how having help to do things makes you think and feel about yourself?
Having help make me
think and feel better about
myself
Having help does not affect the way I think
or feel about myself
Having help sometimes
undermines the way I think and
feel about myself
Having help completely
undermines the way I think and
feel about myself
Suffolk 30.5 35.6 27.1
7.3ENGLAND 31.5 33.5 27.7
Question 9a - Which of the following statements best describes how you spend your time?
I'm able to spend my time as I
want, doing things I value
or enjoy
I'm able to do enough of the things I value or enjoy with
my time
I'm do some of the things I
value or enjoy with my time
but not enough
Raising the Bar
• What will make the biggest impact?
• What can CQC do?
• What can Healthwatch do?
• What can the local authority do?
• What can the care sector do?
Crisis in Care
Loss of confidence in Care Sector
Lack of trust and support
Defensiveness, stress & anxiety
Focus on control, tasks, orders to prevent mistakes
Creates environment we want to avoid
Shift our focus to….
• Promoting Relationship Based Practice• Support & Supervision, space to reflect• Excellent managers and leaders• Great training & development
opportunities
ASPIRE VALUES
• Shift from Enforce to Enable and EMPOWER• RESPECT your own ability and motivation to
continually improve• Focus more of our resources and energies on
the offer of SUPPORT to help you ACHIEVE and be the best you can be
The Way Forward……?
• GEM awards and Dignity Ambassadors• My Home Life• Progress with Providers• iPlanit• Provider Forums
• Does it sound like the right direction?• Are the right things on the list?• What might be more helpful?• What will the sector do itself?
?