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?

Julie.Bateman@suffolk.gov.uk

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