The latest edition of the Social Care e-magazine – Driven by Health with Care – is now available at https://www.drivenbyhealth.co.uk/magazine/carpe-diem/
Brexit and it’s effect on Social Care
Brexit has finally arrived, and with it comes the year long process of reprising our country and our laws from the EU, raising yet more concerns for the sector. It has been advised that the Government’s Migration Advisory Committee carers will be considered ‘low skilled EU workers’. Currently EU nationals make up 104,000 carers working in the UK, with this number still looking to grow. Free movement will cease to end in 2021, therefore ending the increase for our staffing numbers.
Here at Driven By Health with Care would like to urge the committee to review this statement, as carer’s although low paid, are not low skilled and with social care in crisis this will only be adding to the worries of all within this sector.
IOM UNITED KINGDOM
The International Organization for Migration (IOM) is the UN Migration agency. Established in 1951, IOM works with migrants, governments and other partners to provide humane responses to
the growing migration challenges of today. With nearly 400 offices and 11,000 staff worldwide, IOM promotes international cooperation and dialogue on migration issues, to assist in the search for practical solutions to key issues facing migrants and societies alike.
In the UK, key areas of IOM’s work include resettlement and integration, community cohesion, combatting human trafficking and modern slavery, diaspora and development, migrant assistance,
supporting migrant children and migration policy and research.
SUPPORTING VULNERABLE PEOPLE TO ACCESS THE EU SETTLEMENT SCHEME
These documents (below) offer much useful data and links, including where to get more information and agncies with grant funding to help
The Trading Standards Chartered Institute has published Care Home Complaints:
Business Guidance, this is a consultation document, please take the time to respond
You have only until January 3rd 2020 to do this.
The overall document contains useful information about how social care providers can effectively manage and learn from complaints.
Reviewing the case: The right to appeal in adult social care
The Independent Age report ‘Reviewing the case: The right to appeal in adult social care’ shines a light on a neglected but crucial aspect of adult social care: how people can challenge decisions about the care and support they receive. While the Government has previously acknowledged the importance of a robust appeals system for adult social care and consulted on this in 2015, no response to the consultation has been published to date.
New Freedom of Information research for this report confirms that as few as one in five local authorities have put in place a separate appeals process, with the majority instead relying on a complaints process which can be unfit for purpose. We are calling on the Government to introduce a statutory appeals process for adult social care and our report discusses the clear advantages this system would offer
CQC’s report: The state of health care and adult social care in England 2018/19, can be downloaded below
This is the accompanying press release.
Growing pressures on access and staffing risk creating ‘perfect storm’ for people using mental health and learning disability services
Growing pressures on access and staffing risk creating ‘perfect storm’ for people using mental health and learning disability services
The Care Quality Commission’s (CQC) annual assessment of the state of health and social care in England shows that quality ratings have been maintained overall – but people’s experience of care is determined by whether they can access good care when they need it.
Providing the right access to the right care at the right time is increasingly key to the sustainability of health and social care as services struggle to cope with increased demand. When people can’t access the services they need, the risk is that they are pushed into inappropriate care settings – ending up in emergency departments because they can’t access the care they need outside hospital, or in crisis because they can’t access community based mental health and learning disability services.
Difficulties in accessing the right care can mean that people with a learning disability or autism end up detained in unsuitable hospitals. CQC’s ongoing thematic review, which began in 2018, highlighted the prolonged use of segregation for people with severe and complex problems who should instead be receiving specialist care from staff with highly specialised skills.
This year’s State of Care considers the pressures faced by health and social care as a whole – but focuses particularly on inpatient mental health and learning disability services, the area where CQC is seeing an impact on quality.
While the overall quality picture for the mental health sector, which includes community mental health services, remains stable, this masks a real deterioration in some specialist inpatient services which has continued after 31 July 2019, the cut-off point for the data included in the report. As at 30 September 20191:
- 10% of inpatient services for people with learning disabilities and/or autism were rated inadequate, as compared to 1% in 2018
- 7% of child and adolescent mental health inpatient services were rated inadequate (2018: 3%)
- 8% of acute wards for adults of working age and psychiatric intensive care units were rated inadequate (2018: 2%).
Since October 2018, 14 independent mental health hospitals that admit people with a learning disability and/or autism have been rated inadequate and put into special measures. Two of these services have since improved, three are now closed and one service is still registered but is closed to new admissions with no people resident.
Although inspectors have seen much good and some outstanding care, they have also seen too many people using mental health and learning disability services being looked after by staff who lack the skills, training, experience or support from clinical staff to care for people with complex needs. In the majority of mental health inpatient services rated inadequate or requires improvement, a lack of appropriately skilled staff was identified as an issue in the inspection report. This reflects a national shortage of nurses in these areas of practice, with 8% fewer learning disability nurses registered with the Nursing and Midwifery Council in 2019 than 2015.
Access and staffing are presenting challenges across all care settings, with geographic disparities – as highlighted in last year’s State of Care – presenting particular barriers in some parts of the country. People sharing their experiences with CQC have described having to ‘chase’ care in order to receive basic services, or experiencing worsening health as they move from service to service, unable to access the care they need.
Where patients struggle to access non-urgent services in their local community, including GP and dental services, this can have a direct impact on secondary care services. Figures for emergency admissions after attending the emergency department are continuing to rise year-on-year. This peaked at 31.2% of attendances in December 2018, and in July 2019 it was 28.9% – the highest figure for July in at least the last five years. There has also been an increase in referral to treatment times over the last year, with 4.4 million people at the end of June 2019 waiting to start treatment – an increase of 40% since June 2014.
In adult social care, issues around workforce – including a lack of qualified staff – and funding continue to contribute to the fragility of the sector. 2018/19 saw providers continuing to exit the market and in 2018, CQC twice exercised its legal duty to notify local authorities that there was a credible risk of service disruption because of provider business failure. These were the first notifications of this type CQC has issued in four years of running its Market Oversight scheme.
Ian Trenholm, Chief Executive of the Care Quality Commission (CQC) said;
“In this year’s State of Care, we have highlighted mental health and learning disability inpatient services because that’s where we are starting to see an impact on quality – and on people. There has been a deterioration in ratings in these services – and our inspection reports highlight staff shortages, or care delivered by staff who aren’t trained or supported to look after people with complex needs, as a reason for this.
“Increased demand combined with challenges around workforce and access risk creating a perfect storm – meaning people who need support from mental health, learning disability or autism services may receive poor care, have to wait until they are at crisis point to get the help they need, be detained in unsuitable services far from home, or be unable to access care at all.
“We are strengthening our approach to how we look at these services, and how we use the information that people share with us, so that we can act more quickly to spot and act on poor care. But having the right staff to deliver good care is crucial to turning the tide – as are better integrated community services to prevent people ending up in the wrong place. We’ve seen some excellent care where services collaborate and we want to see more local services working together.
“While we’ll continue to call out staffing issues at provider level when these have an impact on care, we’re also calling for system-wide action on workforce planning which encourages more flexible and collaborative approaches to staff skills and career paths. The ambitious plans to expand the mental health workforce to meet an increase in demand must be accelerated.
“We’ll continue to celebrate the providers – like those highlighted in this report – who are thinking beyond barriers to work together in new ways that not only improve quality but give their teams more development opportunities and flexibility to work across different settings, supporting them to deliver great care.”
Peter Wyman, Chair of the Care Quality Commission, said:
“The fact that quality ratings across health and social care remain broadly stable – due to the dedication and hard work of staff and leaders – should be celebrated. But at the same time, we need to acknowledge that people’s experience of care is not always good – too many people are facing unacceptable challenges and cannot get the right care in the right place and at the right time.
“Last year we warned that the continuing lack of a long-term sustainable funding solution for adult social care was having a damaging impact on the quality and quantity of available care. There is an urgent need for this solution to be prioritised by Parliament and Government – the failure to find a consensus for a future funding model continues to drive instability in this sector. Organisations that represent people who use services are telling us that the challenges faced by people, their families and their carers in getting the care and support they need are strongly related to pressures on local authority budgets and a lack of social care funding.
“The impact of these pressures is being felt across all health and care settings. We head into winter after a summer which saw a record-breaking number of patients attending A&E. Staff continue to do an incredible job, but the strain is starting to show – emergency departments were the core service that our inspectors were most likely to rate as Inadequate or Requires Improvement.
“This report points to examples that show how providers are working together more effectively – often using technology to help – to ensure that people get the care they need when they need it. But their efforts must be supported by Parliament, commissioners and national and local leaders in order to deliver real change in how and where people are cared for, and how they are supported to stay well.”
This year’s State of Care draws on quantitative analysis of inspection ratings of almost 32,000 services and providers, in addition to other monitoring information including staff and public surveys, and performance. It also draws on qualitative analysis of interviews and focus groups with CQC inspection staff and voluntary organisations, secondary analysis of ‘Share Your Experience’ comments and inspection reports, and case studies of the experiences of people who use services and innovative providers.
1 Data cited here is 31 July 2018 – 30 September 2019.
The latest edition of Driven by Health with Care magazine is now available
Interesting and useful articles and links
Social care providers encouraged to unite to tackle health inequalities in learning disability
The health of people with learning disabilities is worse than that of the general population with common health problems including respiratory disease, heart disease and obesity.
People with learning disabilities die earlier than the general population. Many of the health inequalities experienced by people with a learning disability are preventable. Social care providers have a major role to play in helping people to access good healthcare and to support people to make decisions about their lifestyle.
VODG is committed to tackling health inequalities experienced by disabled people. With the support of NHS England and NHS Improvement VODG is organising a series of three national conferences for social care leaders who want to improve the health of people with learning disabilities. Social care providers are being encouraged to actively work alongside VODG and system partners to collectively make a difference to people’s lives.
Rhidian Hughes, chief executive of the Voluntary Organisations Disability Group said:
“Reducing health inequalities is an urgent matter. These events offer social care providers the opportunity to work together to collectively improve practice and to support system wide efforts to tackle health inequalities.”
VODG recently published in partnership with the Centre for Disability Studies at the University of Lancaster a good practice guide on food and drink provision when supporting people using care services. The report recognises that sustained change involves addressing organisational cultures and personal attitudes as well as embedding a focus on supporting people to eat high quality food.
The social media hashtag is #TakeAStandTackleHealthInequalities
Leading for better health is a conference for leaders who want to explore how to foster organisational cultures, systems
and practices that reduce health inequalities.
Date: Thursday 3 October 2019
Click here to register for London.
NAO report – Exiting the EU: supplying the health and social care sectors
UPDATED Free Flu Jab Information for Social Care Staff
The brand new flu vaccination campaign for health and social care workers launches for the coming 2019/20 flu season. “Time to get your flu jab” takes a new approach – created for use by all social care organisations by Public Health England and NHS England & NHS Improvement – the staff facing campaign focusses on the protective benefit of the flu vaccination using a “Shield” motif.
Campaign materials show social care, social worker and other community based care staff going about their work protected by the shield of flu vaccination and the message “Help protect yourself, your family and the people you support. Get your free flu jab”.
The campaign is available to all organisations to use and adapt to encourage the uptake of flu vaccinations by frontline health and social care staff – the resources available include:
- Social Care and community/mental worker posters (three variations)
- NHS Trusts posters (6 posters – featuring a Doctor, Porter, Nurse, Mental Health Nurse, Social Worker and Paramedic)
- Leaflets for health and social care audiences
- Sticker artwork
- Social media toolkits including static and animated images for Instagram, Twitter and Facebook
- Brand artwork
- Communications toolkit (including long and short copy)
- Email signatures
All materials, including adaptable artwork and social media tools, are available on PHE’s Campaign Resource Centre for colleagues to download or print locally. We would encourage organisations to localise these resources to suit their own local requirements – however please do use the brand guidelines which can be found here.
We are also keen to extend our photo-library to include a wider range of health and social care roles so do let us know if you have images you own that you are willing and able to share with colleagues across the health and social care system.
*To Note: There are a range of digital resources available – those targeting social care staff use the phrase “” and not “patients”.
NEW CQC PIR
Below along with guidance is the important new PIR from CQC
FLU Vaccination Update
NEW materials promoting the flu vaccination for social care workers available to download FREE from end of August
A brand new flu vaccination campaign for health and social care workers is launching this year, delivered by Public Health England (PHE) and NHS England and NHS Improvement.
“Time to get your flu jab” will take a new approach to encouraging the uptake of flu vaccinations by social care staff – emphasising the protective benefit of the flu vaccination with a “Shield” motif and the message “Take care of others by taking care of yourself. If you work in the community, it’s time to get your annual flu jab”.
Campaign materials have been designed to show social care staff going about their work protected by the shield of flu vaccination – all materials, including adaptable artwork and social media tools, will be live on PHE’s Campaign Resource Centre for colleagues to download or print locally by the end of August. Further communication will be sent to you as and when these are made available.
The resources available include:
- A4 posters featuring different social care professionals (alongside posters featuring healthcare workers in clinical settings for NHS Trusts, which are already available to download)
- “I’ve had my flu jab” Sticker artwork
- Social media tools including gifs and digital banners
- Brand artwork
- Communications toolkit (including long and short copy)
We encourage all social care settings to adopt this campaign and brand when encouraging staff to get their flu vaccinations.
For any queries relating to this campaign, please contact Partnerships@phe.gov.uk
Accessing NHS Mail
Welcome to your Entry Level ‘Data Security and Protection Toolkit’ workbook!
This workbook outlines the 14 steps you must complete for the ‘Entry Level Assessment’ This has been created for
social care providers and it allows you to sign up to and benefit from NHSmail
CQC PIR Changes
CQC are making improvements to the Provider Information Return (PIR) which includes some amendments to questions and a change to an annual collection. This month they will start to ask all providers to complete an updated PIR and then on an annual basis.
CQC have revised the PIR questions and process based on feedback and to allow them to expand how they use the information collected. Requests for PIRs will be sent during the anniversary month of a provider’s first site visit and CQC have already started to write to providers to highlight this date.
The annual PIR will help CQC to identify areas to explore in more detail as part of our continuous monitoring of a service and ahead of a site visit. They will continue to gather and review feedback to ensure continual development of the PIR and CQC keep you updated on this.
The amended questions can be seen here:
The Advocacy Project Healing Words
We’d like to tell you about this year’s Healing Words poetry competition which celebrates creativity as a means of supporting mental health. This competition was a huge success last time it ran and we hope you will support the 2019 competition.
At The Advocacy Project, we believe a healthy society supports people’s mental wellbeing. In times where 1 in 4 of us experience mental health problems, it’s something that affects us deeply on both an individual and collective level. There’s now increasing evidence to show creativity is beneficial to our mental health – and we want to actively promote this.
“Engaging in creative activities such as doodling, music or writing
just once a day can lead to a more positive state of mind.”
Can you help us get people involved?
We want to reach as many people as possible, to help inspire those affected by mental health problems to use their creativity to improve their wellbeing. Please take a minute to share the details on social media: retweet on Twitter or LinkedIn (please use #HealingWords2019 in all posts).
More about the competition
I’ve included below an overview of the competition for you to share with colleagues, contacts and communities. You can also watch actress Joanna Scanlan’s video introducing the competition.
If you’ve got any questions, call Jo Kay on 020 8969 3000
CEO, The Advocacy Project
Healing words… the journey to wellness and recovery
“Writing is a very cathartic experience. It’s a chance to express feelings I had always thought were indescribable” Sarah
We’re inviting you to enter a poetry competition, run by The Advocacy Project. If you’ve experienced a mental health problem, or you’re a family member or friend of someone who has, we welcome you to send us your poem.
Creativity can help people express themselves during the darkest days of mental illness and throughout recovery. We want to share this with as many people as possible to improve understanding of mental health.
Closing date: 8 Sep 2019, 5pm
-Darkest days: poems from before the dawn of hope
-Good days and bad days: poems from the road to recovery
-Being well: poems about more peaceful times
-Illustrated poems: poems with illustrations
-Spoken word: poems spoken by the writer
The poems will be judged by six people including Joanna Scanlan – actress and writer. All entrants will remain anonymous from the judges until the award ceremony.
More information and how to enter
Visit www.advocacyproject.org.uk/poetry or call Jo Kay on 020 8969 3000
Involved & informed: good community medicines support
The National Institute for Health and Care Excellence (NICE);
in collaboration with several other partner organisations, has launched a new initiative to encourage better medicines support for people who are receiving social care services in their homes.
The aim is to ensure the safe and effective use of medicines in the community, so people get the best possible outcomes with a reduced risk of medicine related harm.
To enable better multi-disciplinary working, the campaign encourages health commissioners and local authorities to have a written agreement that sets out clear responsibilities for home-based medicines support.
Understanding primary care networks
A report from the Health Foundation can be downloaded from https://www.health.org.uk/publications/reports/understanding-primary-care-networks
- From 1 July 2019, all patients in England will be covered by a primary care network (PCN) – the most significant reform to general practice in England in a generation.
- PCNs should help to integrate primary care with secondary and community services, and bridge a gap between general practice and emerging Integrated Care Systems.
- Since January 2019, practices have been organising themselves into local networks to provide care at greater scale by sharing staff and some of their funding.
- While PCNs offer huge potential to integrate care and improve services, there is a risk that the speed of implementation will undermine the best intentions of the policy.
This briefing places PCNs in the context of previous changes to general practice funding and contracting. It examines the rationale for networks, explores relevant evidence and draws out intended benefits and possible risks for the future of PCNs.
Additional prompts added to some
Statutory Notifications forms
Re: Additional prompts added to some Statutory Notifications forms
I am writing to let you know that we are making some changes to the way we ask you to report some incidents to us with the aim of reducing the amount of follow up work we need to do with you. These are interim changes, which form part of a larger piece of work.
Registered providers must notify us of certain changes events and incidents that affect their service or the people who use it, notifications are submitted through our portal or via completing a downloadable form and sending it to us by email.
To make it easier for you to understand what we need to know when you notify us and to help us capture additional, more detailed information we are adding additional prompts to the word versions of the following notification forms in the additional information field:
We ask you to continue to notify us, but to also consider the issues identified by these prompts. This change is intended to reduce the need for us to contact you to obtain more information by ensuring we have all relevant facts at the earliest opportunity.
We are currently working on a major project which is intended to improve statutory notifications forms and guidance in relation to:
We are making these interim changes to some of the existing notification changes whilst this larger project is underway. This project aims to reduce the impact on you telling us about incidents that do not meet the threshold for a statutory notification, and removes the need for us to ask for further information relating to an already submitted form. Improved intelligence at an earlier stage will ensure we are assessing risks within provider services appropriately.
Care Quality Commission
EU EXIT CONTINGENCY PLAN TEMPLATE FOR CARE PROVIDERS
This brief template has been developed to support care providers in preparing Contingency Plans for care services as the UK prepares to exit the EU. It is a working document and not intended to be exhaustive. Its key purpose is to help providers ensure continuity in delivering care and support through a record of actions that may be necessary to deal with any possible disruption. Quite simply a Contingency Plan involves preparing for a situation that may not happen but could have major impact if it did. Contingency planning is a crucial part of the routine Business Continuity Planning process.
It is not possible to produce a single guide to cover the full range of different care and support services in adult social care and so this template is intended to be used simply as a framework to developing individual service Contingency Plans. Government advice has been clear that the UK should prepare for all scenarios relating to EU exit – including the option of ‘no-deal’. Communications and information have been issued to businesses and the public, by various Government departments, in support of preparations for the UK exiting the EU. This information can be accessed at: https://www.gov.uk/government/brexit
Don’t forget changes to the NMW in April, details at the ACAS website
Solutions Social Care are running the event below on March 29th and those of you working in Learning Disability may be interested. Please contact the organisers directly with bookings and any queries.