CQC: ‘3 rehab facilities in same London road are Inadequate’
Local people in the London borough of Kensington and Chelsea will be dismayed to learn that three locations, all run by the same provider in Kendrick Mews, have been rated Inadequate by the Care Quality Commission (CQC). All the drug and alcohol rehabilitation facilities, run by PROMIS Clinics, have been placed into special measures following inspections in May 2019. No 11 Kendrick Mews is a three-bedded unit based in a mews house. It is run by PROMIS clinics, which has two other services on the same street at No 12 and No 4. While the three are registered separately, they operate as one service with the same manager and the same staff covering the three locations. CQC completed the inspection which reviewed the three registered locations. Fire protection was not adequate Clients in the three services use the same communal areas in No 11, including a kitchen and a living room. The clinic room for the three services is in No 11. There are some therapy rooms in No 12, which are used by clients across the services. The premises were not being properly protected from the risk of fire. The service provides medically monitored alcohol and drug rehabilitation services including a psychological therapy programme. CQC inspectors were concerned that the provider had not full taken account of a CQC briefing (supported by Public Health England) on the quality and safety of detoxification in residential substance misuse services. This was circulated to providers of all relevant services in 2017. The service did not provide safe care for clients undergoing alcohol detoxification. The provider accepted clients for alcohol detoxification who had a history of alcohol withdrawal seizures and delirium tremens. This carried a level of medical risk that was not fully assessed prior to admission. Clients did not have a comprehensive assessment before commencing alcohol detoxification treatment. There was no record that clients had a physical examination, including for clients with a reported physical health problem. This included clients with possible or actual liver disease. Clients’ medical and mental health history was not always obtained from other healthcare professionals prior to detoxification treatment. Lack of training for alcohol detoxification treatment One of the GPs prescribing for clients undergoing alcohol detoxification treatment had not had any specific training in treatment for substance misuse. However, at CQC’s last inspection, inspectors identified that physical health monitoring equipment had not been regularly serviced and staff were not aware of their duty of candour. At this inspection, these matters had been resolved. People were cared for in a clean and comfortable environment and there were enough staff to meet the needs of the client group. Clients were supported and treated with dignity and respect and were involved as partners in their care. Clients were supported to understand and manage their care and treatment. The service offered family interventions and post discharge support groups. At number 4 Kendrick Mews there were no clients in residence, but inspectors rated both safe and well-led categories as Inadequate. CQC could not gather sufficient evidence to answer the remaining key category questions. Dr Paul Lelliott, Deputy Chief Inspector at the CQC (and lead for mental health) said: “We have placed all three PROMIS Clinics in Kendrick Mews into special measures. “I am placing the three services into special measures due to their failure to follow best practice for the safe detoxification of clients withdrawing from alcohol, their failure to protect their premises from the risk of fire and the lack of management oversight of safety and quality. “The service will be kept under review and, if needed, we will take further enforcement action. We will conduct another inspection within six months, and if there is not enough improvement we will move to close the service.” Read the reports in full when they are published on CQC’s website at: No 11: cqc.org.uk/location/1-506886543 No 12: cqc.org.uk/location/1-507813693 No 4: cqc.org.uk/location/1-2673104638
Improving residential care through digital transformation
Colin Yates, chief support officer at WorkMobile – an award-winning mobile data capture solution – discusses the links between going paperless and the quality of residential care. Over the past few years, digital transformation has become an increasingly hot topic in business circles. There is a very good reason for this: done well, digital transformation drives efficiency and improves productivity, saving a business both time and money. Enterprises in almost all industries stand to benefit from their own digital transformation projects, and the residential care home sector is no exception. The question is, what would this look like? At its most basic level, digital transformation is the use of digital technologies to solve traditional problems. So, there is a need to identify which areas of a business have historically proved challenging and could be improved by incorporating new technology such as cloud computing, artificial intelligence and the Internet of Things. Residential care homes are often very reliant on paper-based processes. From care plans and risk assessments, to safeguarding reports and health assessments, there is inherently a lot of paperwork involved in the day to day running of a care home business, and given that there didn’t use to be an alternative to physical documentation, many have continued to operate with traditional processes. However, a heavy reliance on paper can cause significant problems. If essential paperwork is not completed and filed in a timely and correct manner, this can lead to standards of care slipping and concerns being raised by the CQC. As a result, some forward-thinking care home operators have begun their digital transformations by implementing cloud-based electronic care record software. This type of software has the ability to completely eliminate the need for paper, with all documents being completed digitally instead, often via an app on a mobile device or tablet. The information in these documents can then be saved automatically to a central reporting platform, that can be accessed instantly by all authorised members of staff, wherever they’re based. Modernising care home businesses by going paperless can have a host of wide-reaching benefits for all of those involved. Care workers For staff working on the front lines, outdated paper-based processes create an unnecessary administrative burden. Completing all paperwork by hand takes time, and each document must then be filed away carefully. In some cases, the information in this paperwork is also manually inputted into a digital database, taking up even more time and being open to errors. With digital alternatives, documents can be accessed much more easily and filled in much more quickly, with no need for any time to be spent on filing. Information can be recorded in real time as staff go about their duties, meaning that data held about residents is more likely to be complete and accurate. Where appropriate, certain sections can also be pre-populated to save time and unnecessary repetition. This means that care workers don’t have to worry about having to stay late after their shift to complete outstanding admin tasks, offering them a better work-life balance and giving them more time to concentrate on providing the best possible service to those in their care. Residential care home operators For care home operators, one of the main benefits is a significant reduction in operational costs. Relying on paper-based processes is expensive, with one study suggesting that it can cost even a very small business as much as £14,616 each year. Implementing a digital care record solution can greatly decrease ongoing expenses, by minimising or even eliminating the need for paper, printers and physical storage. One major problem caused by relying on paper-based processes is that it can be difficult to ensure the confidentiality of patient information. Digital solutions can allow management to set permissions dictating who has access to which levels of information saved on the system. For care homes that experience a high turnover of carers, or rely heavily on agency staff, this is an easy and effective way to protect patient confidentiality. It can also be extremely difficult to keep large amounts of paperwork organised. This makes it much more likely that important documents will be filed incorrectly or misplaced altogether. Missing paperwork puts patients at risk, and leaves care providers vulnerable to compliance issues which could negatively affect their CQC rating. Digital systems eliminate this issue, while also making it much easier for staff to interrogate previous reports and see any outstanding tasks. With this additional safety net, care home operators can feel confident that they are providing the best possible quality of care and meeting the CQC’s high standards. It’s clear that embracing digital transformation is a relatively simple way to overhaul a care business. Just by going paperless, it’s possible to improve working conditions for staff, reduce costs, and increase CQC compliance, making it worth serious consideration for care home operators looking to improve their excellent standards of care. For more information on Improving residential care through digital solutions, visit www.workmobileforms.com
