What’s going on at BUPA?

February was a busy month for me, and I didn’t get to the keyboard often. So I’m having an office day catching up with this blog.

Fist thing first check on the bad care reports for February

It may take a while, because it looks like there are a lot. Yes CQC are rolling out their new inspection model, yes they have raised the bar, but I don’t see that as an excuse for any responsible provider. Clearly those that are good and outstanding have been rated as such.

So first week in Feb, two BUPA homes in trouble.

What’s that about, when BUPA clearly have resources, don’t they?

I can guess at the answers, having experience of working for large organisations, but I wouldn’t like to post them here without a lot more evidence to back up any claims and avoid a libel case.

So in general my experience in large organisations would suggest that maybe these areas need looking into-

1-Priorities of the organisation. What is the balance between providing good care and making money?

2-Central focus. Does the centre know whats happening on the floor and vice versa?

3-Branding. Are these BUPA homes or homes that BUPA run?

Happy New Year!

I hope that everyone has had a happy and restful break. I certainly did, but have had to cram a couple of weeks work into five days in order to catch up!

Hence the lateness of the greeting.

One of the things that makes Christmas for me is the BBC.

It all starts with the Christmas Radio Times, and then Carols From Kings, The Reith lectures, The Royal Society Christmas Lectures and delightfully this year Terry Pratchett and Neil Gaiman’s Good Omens!

The Reith Lectures by Professor Atul Gawande were a huge pleasure this year and I can highly recommend them.

Click here to go the BBC website to listen to them

The first lecture explores the topic of why doctors fail, and explores the factors which affect medicine, Ignorance (lack of knowledge) and Ineptitude (failure to use existing knowledge).

The second lecture is titled the century of the system,  and interestingly describes some simple systems that care and nursing homes would do well to copy.

Lecture three is about the problem of hubris and looks at the issues of aging and death and how society has a problem recognising the limits of what professionals can do.

The final lecture the idea of wellbeing is for me the highlight, and explores ideas around end of life care and assisted dying.

If nothing else, for me, the whole series re enforces the importance of the fact that people providing care need to care. A simple concept,but one that’s often overlooked.

CQC State of Care report Video!

Sorry for those reading offline, but I will be covering this in print next week.

For now though here’s the video from CQC.

CQC Sandwich Generation Survey

I covered this story briefly earlier in the month when it was featured on BBC Radio Four’s You and Yours.
It’s a really useful piece of work though, so I thought I would cover it in further depth.

CQC commissioned Mumsnet and Gransnet to carry out a survey of the users of their sites. They were in particular looking for those that are described as the Sandwich Generation.

These are people who described as juggling caring for children and older relatives.

Eight out of ten people surveyed identified choosing care as major source of stress. Going as far as describing it as more stressful than divorce, separation, choosing a school, getting married or buying a house!

I have always described the process of finding good quality care as minefield. This survey clearly re enforces this.

Whilst I take no satisfaction in the fact that finding good care is so hard, clearly all care should be good! It is refreshing to see the CQC tasking steps to gain views and improve the information they provide. The infographic they provide shows what people want to now about care providers. All of which are included in one of my reports.

www.scotting.org/services.html

If you need some help and advice call my freephone line 0800 0016694 always happy to help .

sandwich-generation-survey-infographic-011014

Heres a link to the report on CQC website.

http://www.cqc.org.uk/content/sandwich-generation-carers-say-choosing-care-one-lifes-most-stressful-events

 

 

 

CQC to publish guidance on using CCTV in care homes

There has been a lot of noise about this issue in the press for some time, and last week it blew up again with CQC announcing the possibility of publishing of guidelines on the use of CCTV in care homes.

Here’s the headline from The Daily Mail 6th October:

Families given official green light to spy on care home staff if they fear their elderly relatives are being abused

I think the CQC position is more nuanced than that, but in effect will sanction families and employers using cameras to spot abuse.

I have made my thoughts on this clear several times since it was first mooted. In a nutshell they are-

1-CCTV will not prevent abuse.
2- CCTV is useful in gaining convictions where abuse is suspected.
3-Better recruitment, retention, training and pay will reduce abuse.

My views are echoed elsewhere, The Guardian on the 8th October ran a piece with the title

CCTV in care homes: secret cameras are not the way to improve care

Rather than allow covert filming, the Care Quality Commission should focus on driving up standards

The main thrust of the article is about the underlying causes of bad care, and I would agree, these need to be addressed as opposed to using CCTV to spot the symptoms.

The full article can be found here-

http://www.theguardian.com/social-care-network/2014/oct/08/cctv-care-homes-secret-cameras-improve-care

The CQC statement can be found at-

http://www.cqc.org.uk/content/statement-about-use-cameras-monitor-care

Local Government Ombudsman finds council top up fee policy to be illegal

The subject of third party top up fees is one I’m often asked about.
More often than not the people involved in working out who owes what to who, do not have enough information and experience to work it out correctly.
This story shows how one council got it wrong, by effectively requiring a lady to top up her own fees, which is against the law. (National Assistance Act 1948)
Underpinning the argument here is the basis of funding for health and social care. Health care-Free at the point of delivery. Social care-Means tested. This political hot potato is one that the political parties have been juggling at their conferences in recent months.

http://www.communitycare.co.uk/2014/10/03/ombudsman-criticises-council-forcing-resident-pay-unlawful-care-home-top/ For the full story

http://www.scotting.org for more on paying for care

You and Yours 7th October 2014

You and Yours have been producing some good coverage of the care sector for some time now. I particularly liked todays episode as it repeats one of my key messages to people. Always get good advice when looking for care. Odd to see CQC taking this position, but also refreshing to see them taking a real world view of the whole picture.

How easy did you find it to get good quality care for your elderly parents or relatives? The Care Quality Commission says it is one of the most stressful things we’ll face in life.

We’ll ask why is it so difficult and what can be done to make it better.

Guests will include the Care Quality Commission and Carers UK.

Web users click here for full story

For those reading in print the programme can be found at- http://www.bbc.co.uk/programmes/b04kbjhx

And don’t forget advice, help and information is available on my website-www.scotting.org

Elderly woman died after suffering burns in nursing home bath

This is a very sad story, and my heart goes out to this ladie’s family.

However I can’t help feeling it further shows up the defficiencies in care and nursing home regulation.

The story has been reported by the Health and Safety Executive, after a now dissolved company was found to be negligent.

http://press.hse.gov.uk/2014/elderly-woman-died-after-suffering-burns-in-nursing-home-bath/?ebul=hsegen&cr=15/29-sep-14

The worrying element is that highlighted by the magistrate. The directors of the company have walked away from this with a £5,000 fine. Which may or may not be paid by the company, as its now dissolved.

So what is to stop these clearly unsuitable people starting up a new home, if they haven’t already done so?

NOTHING!

My Care Service Report and Select-a-Home service will always look into the Directors of care companies and their past. www.scotting.org

 

 

 

No Kidding Sherlock!

http://www.lep.co.uk/news/care-homes-the-truth-care-home-staff-feel-undervalued-union-1-6672816

This is a great article, but does state the what’s been obvious to those of us in the business for many years.

Reduced funding from whatever source, has brought margins crashing down. Managers and shareholders aren’t going to let their earnings fall, so its the people who actually provide the care who bare the brunt.

Training in particular has been hit. Yes e-learning has its uses, but as a trained educationalist and nurse mentor, I can only recommend thorough training, with professional trainers in a classroom as the best way to ensure a skilled and motivated workforce.

With regards to pay and other rewards, it’s been clear for some time that the standard of candidates applying for care work has changed. When the terms and conditions working on supermarket tills are better than providing care, what can we expect?

What’s the solution?

If I was commissioning care services, I would ensure the contract contained terms that limited profits for the company and pay for staff who do not provide direct care.

And of course make sure more money went into the system.

You pay peanuts you get monkeys.

 

The Good, The Bad and The Ugly

After much thought I have added the final section to my blog site, “The Ugly”.

I have written before about how I monitor the various media channels for stories of good and bad care. I do this so that when clients come to me looking for care I can take a more longitudinal view of a care service. This is a better way of looking at the quality of care provided than other more snapshot methods, that look only at the present.

I have always found that care service have a history and this informs the culture of care provided in the present. So the history cannot be ignored. Alongside this though it shines a light on individuals and organisations who shouldn’t be involved in the care of vulnerable people. However these people do seem to somehow manage to avoid prosecution and penalty.

I personally had one such unsavoury individual on a staff team that I took charge of. He had wriggled out of the grasp of police and social services three times, avoiding disciplinary measures from three employers. One of whom was on NHS trust, another BUPA. I am proud to say he didn’t work a day in the service when I was manager, and whilst it took two years to bring him to justice he was eventually struck off the nursing register.

So I would rather report on the good care stories, and keep the bad stories to those services who are failing, but with work and investment could be recovered.

But the Ugly does exist, in living memory the big ones like Winterbourne View, Orchid View and Parkside nursing home, stand out.

I feel it a duty to those seeking quality care to make sure these stories aren’t forgotten, and are available for reading. As well as my services to help people avoid these horror stories.

The net effect of this since I started reporting on bad care stories is that the bar has constantly been raised at one end and lowered at the other, not for the best. Good care stories are few and far between and usually end up being promotional items for individual homes. The bad care stories are about homes failing inspections,a dn as mentioned the ugly tend now be very ugly.

So please don’t lose sleep, but please be aware.