Transcript Slide 1
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 ReportEnquiry 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?
Supported Housing
Providers 32
Very Sheltered
Housing (VSH) 22
Residential Care
155
Home Care
providers 78
Nursing Care 55
Contract & Quality Monitoring
Information
Formal Suspensions
Currently suspended
Reaccredited since April 2012
Home closed
Voluntary Suspensions
2
16
1
Flagged Services
Currently suspended
1
Suspension ended since April
2012
2
Homes closed
0
CQC
Currently flagged
2
Flag removed since April 2012
6
Homes Closed
0
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
Top Ten Concerns Through CQM
Visits/Feedback
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Care plans
Risk Assessments
PEEP
End of life
Staff numbers
MUST/Nutrition
Recording
Money and handling
DoLs/MCA
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
February 2012 to January 2013
Reason for Concern
2997
Welfare
0
Unexplained Injuries
186
Sexual
12
Psychological
700
Physical
374
Neglect
0
Medical Procedural Error
11
Manual Handling
45
Mal-administration of Drugs
3
Institutional Abuse
563
Financial
526
Emotional
0
Dis-criminatory Abuse
288
Care Issues
0
500
1000
1500
2000
2500
3000
3500
In % breakdown
Reason for Concern
52.5%
Welfare
Unexplained Injuries
0.0%
3.3%
Sexual
Psychological
0.2%
12.3%
Physical
6.6%
Neglect
Medical Procedural Error
0.0%
Manual Handling
0.2%
0.8%
Mal-administration of Drugs
Institutional Abuse
0.1%
9.9%
Financial
9.2%
Emotional
Dis-criminatory Abuse
0.0%
5.0%
Care Issues
0%
10%
20%
30%
40%
50%
60%
Location of abuse
45
40
35
30
25
20
15
10
5
0
residential
own home
public place
Outcome by area
S t r a t e g y O u t c o me - C o u n t y
800
717
700
600
500
WE ST
400
SOUT H
330
NORT H
283
271
300
206
200
134
132
105
100
50
65
83
49
0
JOI NT
NFA
SCS
SA P E
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
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
I am extremely or
very dissatisfied
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 don’t feel at
all safe
I feel less than
adequately 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
ENGLAND
42.3
34.6
17.3
EASTERN
41.3
36.2
17.2
Suffolk
41.0
37.6
17.0
I have little
social contact
with people and
feel socially
isolated
5.8
5.4
4.4
Question 9a - Which of the following statements best describes how
you spend your time?
I don’t do
I'm able to
anything I
spend my I'm able to do I'm do some of
value or
time as I enough of the
the things I
enjoy with
want, doing things I value value or enjoy
my time
things I value
or enjoy with
with my time
or enjoy
my time but not enough
ENGLAND
31.5
33.5
27.7
7.3
EASTERN
32
33.9
26.6
7.5
30.5
35.6
27.1
6.8
Suffolk
Question 10 - Which of the following statements best describes how
having help to do things makes you think and feel about yourself?
Having help
Having help
completely
Having help
Having help
sometimes undermines
make me does not affect undermines the
the way I
think and feel the way I think way I think and
think and
better about
or feel about
feel about
feel about
myself
myself
myself
myself
ENGLAND
57.1
31.2
10.2
1.5
EASTERN
56.6
31.5
10
1.9
Suffolk
57.5
29.2
11.3
2
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
Creates
environment we
want to avoid
Loss of
confidence in
Care Sector
Focus on control,
tasks, orders to
prevent mistakes
Lack of
trust and
support
Defensiveness,
stress & anxiety
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?
[email protected]