Hull care home closes as operator has CQC registration removed
A care home operator has had his Care Quality Commission (CQC) registration cancelled following a rating of “inadequate” in a recent inspection. The CQC took the action to cancel the registration of Mr Thurairatnam Nadarajah Prakash and he is now no longer legally allowed to provide care at his service Durham Care Homes in Hull, which has since ceased operation. The CQQ said in a statement: “The latest inspection, in February 2019, rated the service inadequate overall and it was placed into special measures. The inspection revealed a significant deterioration in the care being provided and inspectors began the process to take enforcement action. “Previously the service had been rated Requires Improvement in October 2017 and November 2018.” The latest inspection, a report on which can be found here, found that safeguarding policies and procedures were not being followed, and some residents’ nutritional and hydration needs had not been fully assessed and met. Staff skills, care of residents, staff interaction and the protection of privacy and dignity were also found to be sub-standard. The CQC added: “We received information from the local authority regarding an escalation of concerns about the service; they had been completing monitoring visits. We completed this inspection based on these concerns. At the time of the inspection, we were aware of incidents being investigated by another agency.” Durham Care Homes has since closed and the CQC added: “Shortly after the recent inspection the provider announced their intention to close the home. The decision to cancel the provider’s registration was completed on 25 April 2019, the provider did not appeal the decision. “Inspectors worked closely with Hull City Council who supported the safe relocation of the home’s 14 residents prior to CQC’s action and its closure.” A report on the latest CQC inspection at Hull Care Homes can be found here
Specialist Neurological Rehabilitation Service in Oxfordshire rated Outstanding by the CQC
A neurological rehabilitation centre in Oxfordshire has been rated ‘Outstanding’ by the Care Quality Commission (CQC). Orchard House, which opened in 2014 and is run by Christchurch Group, provides specialist community-based transitional rehabilitation in the village of Harwell in Oxfordshire. It supports adults with neurological conditions resulting from injury, illness or disease. The service offers accommodation for 9 residents and is a Headway Approved Provider. Inspectors praised the service for its exceptional care, its strong, values-led leadership and their person-centered approach displayed by the registered manager and staff, which provided clear therapeutic benefits for patients. The CQC also highlighted how the registered manager had ‘continually thought of initiatives to make improvements to enhance people’s lives and those of the staff.’ Alexandra Costa, Christchurch Group’s Registered Home Manager, commented: “We strive to ensure those we support are at the heart of life here at Orchard House and to create a friendly, welcoming environment, so I’m enormously proud to see that recognised. “Great credit must go to our fantastic team, including care, therapy, governance and support staff, who enable our patients to achieve positive outcomes. Without their diligence and genuinely caring approach this would not have been achieved.” As part of the inspection, a number of patients, staff and relatives were spoken to and encouraged to provide feedback on the support they received at the Harwell centre. One individual commented: “I feel I am safe and in a good place. I have been moved from home to home for a number of years. The people and staff are like a second family. I love it here.” A relative added: “I am absolutely amazed at the care my daughter receives. The staff are really good, they’re always there, anything you want you get.” Richard McKenzie, Christchurch Group’s Chief Executive Officer, added: “I am delighted that Orchard House has been awarded ‘Outstanding’ status. We are proud to deliver life-changing, evidence-based outcomes for adults with neurological conditions. “An ‘Outstanding’ CQC is testament to the hard work and dedication that the staff at Orchard House have put in over the past 12 months. We are passionate about providing high quality, person-centred care, so to find out this has been recognised through a formal inspection is very rewarding.” Christchurch Group was established in 1998 to provide high quality brain injury rehabilitation within a community setting. The organisation has since grown into a leading provider of specialist neurological rehabilitation that offers a range of specialist services across eight centres in York, Lincoln, Birmingham, Northampton, Bedford and Harwell in Oxfordshire.
Care homes getting worse in one in three local councils
Care homes getting worse in one in three local councils – urgent action needed to end inadequate standards of care, says older people’s charity The quality of care homes has worsened in the last year in more than a third of local authorities (37%) Independent Age has found. With over 2.6 million over-65s living in areas where an increasing number of care homes are rated ‘inadequate’ or ‘requires improvement’ by the Care Quality Commission (CQC) many older people and their families have no choice but to choose a poorly-performing care home. The older people’s charity analysed a snapshot of the CQC’s inspection data in January 2018 and January 2019, and found: · More than a third of local authorities saw a drop in performance between the two dates. This is an extremely concerning trend, and a stark increase on the 22% of local authorities where care home quality worsened between 2017 and 2018 · In Manchester local authority, 44% of care homes were rated ‘Inadequate’ or ‘Requires Improvement’ · There were 16 local authority areas where between 30%-40% of care homes attracted this rating. For a care home to receive a ‘Requires Improvement’ or ‘Inadequate’ rating, the service must be failing to deliver the minimum quality of care that is expected. Issues highlighted in poorly rated care homes have included residents not receiving medicine as they were prescribed, and their nutrition and hydration not being monitored. Today’s report compares the immediate action taken by Ofsted to address failing schools to the general acceptance of poorly-performing care homes. The charity believes lessons can be learned from the education sector’s approach to making improvements. Ofsted’s approaches to tackling failing schools have included a comprehensive improvement plan, such as management changes, arranging for expert help from other schools as well as regular re-inspections. These tactics are not consistently employed across the care home sector, but could be used to help tackle poor performance. Independent Age is also calling for urgent action to end the poor and inadequate quality of care. Residents and their families fund care homes, as well as taxpayers, but increasingly are not getting value for money. The charity is also calling on the government to finalise a sustainable long term funding settlement for social care now. Only with a substantial investment which puts social care on a sustainable footing, can the Government truly resource the sector so that it can tackle unacceptable variations in quality. George McNamara, Director of Policy and Influencing at Independent Age, commented: “These findings are truly alarming, and show thousands of vulnerable older people live in homes that are failing to deliver even the bare minimum. “Years of dithering by the government, and the failure to reform the social care system, is a main cause of increased pressures on the care home market and more areas with poor performers. Unless the forthcoming Green Paper is bold and ambitious, it will do little to address the crisis in care. “Essentially, the government continues to stand by and do nothing to address the quality of care suffered by older people, many of whom live with conditions such as dementia, and who are being robbed of their ability to enjoy life as much as possible. “As well as being dangerous, poor care is miserable, involving things like being woken up in the night to be dressed or taken to the toilet because of staff shortages. Care homes are where many of us will live out our final months. No life should end in misery.” Find out more
Care Home Support and Training
At Care Home Support and Training we work with Managers, Nominated Individuals and Providers to meet and exceed the regulatory requirements. Expectations on social care services mean that Managers and Providers can sometimes feel overwhelmed with what appears to be increasing demands and ever changing requirements. Care Home Support and Training work with you, offering professional support and expertise to find creative solutions to your challenges and problems. We have a small team, with over 45 years of experience in health and social care. We offer a personalised service, specific to your needs, whether that is training in the fundamental standards, how to improve your CQC rating, streamlining documentation or policies …. or any care home challenges that you may face. CQC are using their enforcement powers to effect change, placing restrictions on registration as well as closing services that fail to meet the regulations. We are just as passionate about the quality of social care services and how quality impacts on service users, but we will help you and your business to succeed. Being the Registered Manager is a pivotal role in health and social care. Does the Manager get the training, support and mentorship that they require? Is the service well-led because the Manager is continuously seeking to improve? Remember, we all know that mistakes will occur, but it is what the Manager does about it that affects the care home rating. Our training can be delivered at your premises or at one of the many venues across the country. If you want further details about any of the services that we offer, then please use the contact form on our website: http://carehomesupportandtraining.co.uk
Edinburgh man is crowned top care home chef in the country
Months of head-to-head heats and a showdown final have seen residential care home provider Care UK crown Graham Watson Care Home Chef of the Year. Catering sector experts joined a panel of judges to name the champion, in a multi-stage competition open to the hundreds of chefs from across Care UK’s 119 homes. The trophy was lifted, at the Residential Care Services (RCS) Stars awards ceremony, by Graham, the head chef at Lauder Lodge, in Edinburgh. Having worked in the hotel and leisure industry for much of his career, Graham has cooked for an impressive array of people, including wildlife campaigner and broadcaster Sir David Attenborough and Anne, Princess Royal. But judges say it was his willingness to challenge himself and set a new standard in the care home sector which truly tilted the balance in his favour in the hard-fought contest. Contestants were given a box of 15 ingredients to create a two course menu. Graham’s menu consisted of chicken supreme stuffed with chorizo and chili rice cracker powder, classic fondant potato, butternut puree and a fig and red wine jus followed by and Oreo crumb and chocolate torte with brittle sugar and pineapple salsa. Graham said: “I love working in care homes, it presents a unique set of challenges to a chef. We work in what is our residents’ home and there is nothing more personal than food – it allows people to express their preference, their past and their individuality and it is our job to cater to all of that. The favourite dishes of residents at Lauder Lodge are slow cooked. They love stews and roast dinners, with all the trimmings, and our homemade Yorkshire pudding. They also have a sweet-tooth and they love all the fresh cakes and desserts me and my team make for them.” Graham enjoys the challenges of supporting residents’ health and wellbeing. He said: “We work with care and nursing colleagues to ensure that all our residents nutritional and dietary needs are met, and we have developed excellent relations with local suppliers to ensure we use the best, seasonal produce available. Food is also an excellent way to promote reminiscence and help people keep up their life skills. Our home uses Activity Based Care to engage residents in activities that benefit their wellbeing and foster their Janeinterests and hobbies.” During the awards ceremony the team at Ferndown Manor, in Poole, were also presented with an award to mark their commitment to creating an excellent daily dining experience for their 75 residents. A recent CQC inspection report praised the home that is known for its five-star dining experience. Inspectors praised the attractive table settings, which take into account individual requirements, and the great attention to detail that ensures each residents has not just a choice but also a dignified choice. For more information about Graham Watson and the Care Home Chef of the Year award click here
CQC review – how local health and social care work together
The CQC has published its findings following a review of health and social care services in Staffordshire. The report is one of 23 targeted local system reviews looking specifically at how older people move through the health and social care system, with a focus on how services work together. The reviews look at how hospitals, community health services, GP practices, care homes and home care agencies work together to provide seamless care for people aged 65 and over living in a local area. During the review CQC sought feedback from a range of people involved in shaping and leading the system, those responsible for directly delivering care, as well as people who use services, their families and carers. Professor Steve Field, Chief Inspector of Primary Medical Services and Integrated Care, said: “Our review of health and social care services in the county found that older people had varied experiences of health and social care services. There were variations in what was available to them depending on where they lived, which meant that people’s experiences of care and the support they received were inconsistent. “While there was a shared vision from leadership in the county’s Sustainability and Transformation Partnership (STP), this did not transfer to those at an operational level. This was due to a number of significant recent changes within the system, which meant more time was needed to ensure people received high quality services wherever they went in Staffordshire. “Our review found many examples of good practice but also highlighted a number of areas where improvements are needed to ensure those responsible for providing health and social care services work better together. Some of these areas had already been recognised by the system’s leaders and plans were already being developed, or were in place, to ensure those improvements took place. “We have presented our findings to the health and social care system leaders in Staffordshire so that they can prioritise and continue to improve and work together in bringing joined up care to people living in the county.” Overall CQC reviewers found: Older people living in Staffordshire had varied experiences of health and social care services. There were local variations in what was available to people and consequently experiences of care and support were inconsistent. There were instances of people attending A&E because they couldn’t get GP appointments and A&E attendance for people over 65 living in care homes (January to March 2018) were higher than both national and comparator areas. A&E experiences were much improved at Royal Stoke Hospital. Person centered services for people with Dementia were very positively received. Although there had been recent improvements, people were still more likely to be delayed coming out from hospital. There were examples of people who experienced avoidable harm due to delays in their discharge from hospital. People still had a limited choice in respect of care homes rated good. There were good relationships between senior leaders in the Staffordshire and Stoke Sustainability and Transformation Partnership (STP) and there was good political support from the County Council for the STP. This review makes a number of suggestions of areas where the local system should focus on to secure improvement including: Though there was a clear vision and strong leadership at a senior level services delivered remained fragmented and dependent on the area of Staffordshire people lived in. A whole county joint commissioning strategy needs to be further developed so there is consistency of provision throughout Staffordshire. The Health and Wellbeing Strategy for 2018- 23 should be completely inclusive and refer to how all people, including those of different faiths, beliefs, gender, sexuality, or with physical and/or learning disabilities, will be included in the development of services. A whole county dementia strategy needs to be developed to ensure the needs of people with dementia are consistently supported across Staffordshire The system needs to develop a strategy to ensure services are developed with input from the people who will use them. Nationally validated models of GP support for care homes need to be rolled out more quickly to ensure they are ready for winter. People living in Staffordshire must have equal access to services; such as the intravenous antibiotics administered in their own home and falls prevention services. A system-wide approach is needed to find better solutions to manage patient discharge; such as the virtual ward, meaning people have a full range of services available to them by clinical professionals form home. eLearning from serious incidents and complaints should be shared across the system. The full report will be available on our website on Friday 14 December 2018 here: cqc.org.uk/localsystemreviews.
Care Home Celebrates Outstanding Report From CQC
Staff at a Plymouth residential care home are celebrating after the service was given the Care Quality Commission’s highest rating following a recent inspection. After its previous CQC inspection in January 2016, Restormel House was given an overall rating of good. But following its latest inspection, in September this year, it has been upgraded to outstanding. Carla Dearing, who has been manager of the service for four-and-a-halfyears, said: “I’m so pleased that the hard work, commitment and passion demonstrated by the staff here has been rewarded with the CQC’s highest rating. “I’m privileged to lead an excellent team here who put everything into providing the best possible care for the people we support, and the team thoroughly deserve to be recognised in this way.” Restormel House, a large, six-bedroom Victorian property in Restormel Terrace, is run by the Regard Group, the UK’s third largest care provider in its sector. It specialises in accommodating and supporting adults with learning disabilities, mental health issues and other complex needs, including autism and Asperger’s. Carla said: “The ethos here is to promote empowerment, and this means enabling an element of positive risk-taking, to help the people we support develop their independence. “We work with young adults who want to take risks and experience the same opportunities as other people their age. “For example, they sometimes want to go out drinking, so we sit and budget with them and provide support.” Over the past 18 months Restormel House has said goodbye to five people who have been able to move on to less-supported environments, increasing their independence. Carla said: “I like to lead by example, but this is not really a management and staff, them and us, kind of place, I try to be very inclusive, always inviting suggestions and ideas from the team. “I am so proud of the team, and it’s very satisfying to read comments like ‘staff said they loved their work’ in the CQC report. “We treat Restormel House as people’s home rather than a place of work, and work had as a team for the benefit of the people we support.” She said the team will not be resting on any laurels having achieved the top rating. “We are always looking for ways to improve what we do, and we will continue to do that because we are determined to keep getting better and better; it’s not good enough to reach a certain level and then just stand still. Kerry Libby, Regard’s Regional Director, said: “I am incredibly proud of Carla and her team at Restormel House on being given a well-deserved outstanding rating by the CQC. “It’s heartening that the CQC recognised the positive culture and can-do approach of the staff, who are clearly passionate about providing very high standards of care for the people they support. “This inspection report adds to our industry-leading quality ratings, of which we are immensely proud. “Currently, 95% of our services are CQC rated good or outstanding, compared to an industry average of 82%, and that’s due, in no small part, to the commitment of staff and the quality of their managers. “I would also like to thank Locality Manager Sarah Ghent and the wider management team, for the support they have provided to Carla and her staff at Restormel House; earning the outstanding rating has been a true collaborative effort.” The Regard Group supports more than 1,300 people, with a dedicated staff of more than 2,600 people at 168 sites throughout the UK. For more information about the group, visit www.regard.co.uk.
Hillgreen Care fined £300,000 – for not monitoring ‘sexual predator’
A care home provider has been fined £300,000 for allowing a man in its care with a history of sexual assaults the freedom to prey on vulnerable people. The Care Quality Commission brought the case against Hillgreen Care Limited for not providing the constant, one-to-one supervision required for the man, who was described in court as XX. CQC prosecuted Hillgreen Care Limited for failing in its duty to protect people in its care, exposing them to the risk of sexual abuse. District Judge Susan Williams also awarded CQC £141,000 in costs. The judge ruled that residents at the care home must not be identified. She added: “There was a failure to provide appropriate care and a high level of culpability because the risks were well known to the company.” She said there was a “woefully inadequate system of care” in place. The judge said that although Hillgreen was subject to insolvency proceedings, this should not affect the sentence and that the “fine would serve to mark society’s condemnation” of Hillgreen’s failure to protect vulnerable people in its care. The CQC brought the case against Hillgreen Care Limited, for failing in its duty to protect people in its care, exposing them to the risk of sexual abuse. Hillgreen Care Limited was not present in court at any time during the proceedings. Highbury Corner Magistrates’ Court was told that on 1 November 2015, an autistic man was assaulted at Hillgreen’s care home at Colne Road, in Enfield, north London. At the time there were only two care staff on duty to look after six people. One of the residents, who was described as non-verbal, with limited mental capacity, was followed up to his room by XX, and, allegedly, raped. The incident was eventually reported to the police, but partly because of the alleged victim’s mental capacity and a lack of evidence, no prosecution ensued. The alleged perpetrator had been under the care of Hillgreen Limited for 10 years. Mr Paul Greaney QC, representing CQC said that: “XX is a predatory and opportunistic sex offender” and was a risk to both sexes. Numerous allegations involving vulnerable adults and children had been made against XX dating back to his childhood. The court heard from expert witness, Chartered Clinical Psychologist, Dr Neil Sinclair, who said that it should have been apparent to Hillgreen Care Limited that there was an extremely high risk of XX committing sexual offences. XX needed to be monitored at all times. Dr Sinclair said that if that monitoring been carried out, the alleged attack would probably never have happened. Residents at Colne Road were exposed to potential and actual harm. A number of care workers who had worked at Colne Road gave evidence – although nobody from the senior Hillgreen management team. A support care worker, who said she had not been given any instructions about watching XX, said that she walked in on XX while he was assaulting another service user, described as YY, on 1 November 2015. Following the alleged sexual assault Colne Road Home Manager, said that the home was no longer a place he wanted to work after the incident. He said that staffing levels were inadequate and that he had raised the matter with senior Hillgreen management, but that nothing had been done about it. A statement was read out in court from YY’s mother in which she said she had no doubt that YY would have been incapable of providing informed consent to sexual activity, given the nature and extent of his disabilities. Paul Greaney QC said: “YY plainly needed to be protected from abuse. One only needs to think for a moment about the situation that existed in that care home, a vulnerable man, in an environment in which a predatory sexual offender was largely free to roam, to realise that YY needed protection.” CQC began the process to cancel the registration of the Colne Road service in February 2016. The registration of Hillgreen Care Ltd was cancelled altogether in September 2017. Andrea Sutcliffe, CQC’s Chief Inspector of Adult Social Care, welcomed the judgment and sentence: “As the judge has made clear, Hillgreen Care Limited utterly failed in their duty of care for the people they were responsible for supporting. YY should never have been exposed to the potential of sexual abuse from XX and the impact on him and his family is heartbreaking. My thoughts are with them today. “It has taken a long time to bring this prosecution to a conclusion but the outcome proves that it has been worth the effort and dedication of CQC’s inspection and legal teams. Providers should be clear that if people are exposed to harm through their failure of care we will take every step we can to hold them to account.” www.cqc.org.uk
CQC outlines proposed regulatory fees for providers from next April
The Care Quality Commission (CQC) has published its consultation on the fees that it proposes to charge providers in 2019/20. The proposals follow the plans CQC set out to continue to meet the Treasury’s requirement to recover its chargeable costs in full from providers. CQC will analyse the feedback from this consultation to prepare a response and a final fees scheme to recommend to the Secretary of State, whose consent is required to implement the scheme from 1 April 2019. CQC will continue to look carefully at its costs, and to demonstrate that it is fair, efficient, effective and proportionate. CQC’s budget, in relation to the overall spending on health and adult social care in England, remains at 0.16%. Ian Trenholm, Chief Executive of the Care Quality Commission (CQC), said: “Health and social care regulation makes a real and practical difference to people’s lives and there needs to be a strong, independent regulator who will always act on the side of people who use services. “Protecting the public in this way has a financial cost. The fees paid by providers enable us to fulfil our purpose of making sure health and social care services provide people with safe, effective, compassionate, high-quality care. “The consultation proposals we have published today follow the plans we set out to meet the Treasury’s requirement to recover our chargeable costs in full from providers. This consultation period gives providers and their representatives the opportunity to review, comment upon and plan for any changes that may affect them from April 2019.” The consultation runs until midday on 17 January 2019. www.cqc.org.uk
