We have closed 34 care homes and eight care agencies over the past 12 months to protect residents’ safety. These closures took place in the run up to the full licensing of all health and adult social care providers on the 1 October.
Six of these providers closed after we issued legal notices, whilst the others closed following our enforcement action.
Reasons for closures included:
• verbal and psychological abuse of residents
• medicines not being managed safely
• lack of medical and nursing care
• illegal staff members
• poor sanitary conditions
• lack of staff training
Residents at these services have now been moved to other care homes with better standards.
These closures only represent a small fraction of the 24,000 services in England. The majority of care homes and agencies provide good care and respond positively to areas where they should improve.
Care homes and agencies are now regulated under The Health and Social Care Act 2008, which comes into force on 1 October. The act introduces new essential standards of quality and safety that everyone can expect when they receive care.
The new system will, for the first time, bring the NHS, independent health care and social care providers under the same inspection regime and standards. Our range of enforcement powers include on-the-spot fines, warning notices, suspension of registration, prosecution and closure.
Wednesday 29 September 2010
Condition lifted at Heatherwood and Wexham Park Hospitals
We have removed a condition on Heatherwood and Wexham Park’s licence following significant improvements to the way it monitors medical equipment.
Our inspectors conducted interviews and checked equipment at the following locations:
• Ascot Birthing Centre at Heatherwood Hospital
• the A&E and coronary care units at Wexham Park Hospital in Slough
The results of the visits show that the trust has now:
• introduced systems to maintain, replace and repair older equipment
• established new committees and equipment co-ordinators to address risks
The trust now has one final condition remaining on its licence, relating to the way it assesses and monitors the quality of its services.
We have given Heatherwood and Wexham Park until 30 October to ensure they meet this condition.
Find out more
• Download the Review of compliance : http://www.cqc.org.uk/publications.cfm?fde_id=16256
Our inspectors conducted interviews and checked equipment at the following locations:
• Ascot Birthing Centre at Heatherwood Hospital
• the A&E and coronary care units at Wexham Park Hospital in Slough
The results of the visits show that the trust has now:
• introduced systems to maintain, replace and repair older equipment
• established new committees and equipment co-ordinators to address risks
The trust now has one final condition remaining on its licence, relating to the way it assesses and monitors the quality of its services.
We have given Heatherwood and Wexham Park until 30 October to ensure they meet this condition.
Find out more
• Download the Review of compliance : http://www.cqc.org.uk/publications.cfm?fde_id=16256
Tuesday 28 September 2010
Condition lifted at West London Mental Health
We have today lifted one of the three conditions imposed on West London Mental Health Trust.
Under the Mental Health Act (MHA), patients’ detention papers must be reviewed regularly to ensure their rights and needs are being met. According to our new report, the trust now has effective systems in place to ensure:
• documents are reviewed within set timescales
• treatment and care are continually reviewed
The report also reveals that the trust has:
• put in place an action plan that records feedback provided by Mental Health Commissioner visits, enabling managers to effectively act on them
• implemented a quarterly care plan audit which is to be reported to the Patient Experience and Recovery Group meeting led by the Head of Nursing
• created current care plans for detained patients, demonstrating that staff are conversing with patients about their condition
However, evidence shows that not all patients have current care plans in place.
We will continue to monitor West London Mental Health to ensure that progress is being made on patients’ care plans, and to check on the progress of the two remaining conditions relating to:
• staffing
• systems to assess and monitor quality and safety of service provision
Find out more
• Download the Review of compliance: http://www.cqc.org.uk/publications.cfm?fde_id=16220
Under the Mental Health Act (MHA), patients’ detention papers must be reviewed regularly to ensure their rights and needs are being met. According to our new report, the trust now has effective systems in place to ensure:
• documents are reviewed within set timescales
• treatment and care are continually reviewed
The report also reveals that the trust has:
• put in place an action plan that records feedback provided by Mental Health Commissioner visits, enabling managers to effectively act on them
• implemented a quarterly care plan audit which is to be reported to the Patient Experience and Recovery Group meeting led by the Head of Nursing
• created current care plans for detained patients, demonstrating that staff are conversing with patients about their condition
However, evidence shows that not all patients have current care plans in place.
We will continue to monitor West London Mental Health to ensure that progress is being made on patients’ care plans, and to check on the progress of the two remaining conditions relating to:
• staffing
• systems to assess and monitor quality and safety of service provision
Find out more
• Download the Review of compliance: http://www.cqc.org.uk/publications.cfm?fde_id=16220
Friday 24 September 2010
Conditions lifted at Basildon, but further improvements required
The removal of the conditions comes after an unannounced inspection in July that looked at how care was given. The inspection also involved interviews with patients, visitors, staff and senior managers.
The results show that the trust has addressed issues concerning:
• setting up appropriate systems for the supervision and appraisal of staff
• providing training to clinical staff who need to identify and manage patients whose health is deteriorating
However, the trust still needs to make further improvements, specifically covering how staff:
• inform patients of their discharge
• deal with violent and abusive behaviour
We will return to Basildon to assess whether its final condition, relating to reducing the risk of patients contracting legionellas, can be lifted.
Find out more
• Read the press release: http://www.cqc.org.uk/newsandevents/pressreleases.cfm?cit_id=36665&FAArea1=customWidgets.content_view_1&usecache=false
• Download the Review of compliance: http://www.cqc.org.uk/publications.cfm?fde_id=16202
The results show that the trust has addressed issues concerning:
• setting up appropriate systems for the supervision and appraisal of staff
• providing training to clinical staff who need to identify and manage patients whose health is deteriorating
However, the trust still needs to make further improvements, specifically covering how staff:
• inform patients of their discharge
• deal with violent and abusive behaviour
We will return to Basildon to assess whether its final condition, relating to reducing the risk of patients contracting legionellas, can be lifted.
Find out more
• Read the press release: http://www.cqc.org.uk/newsandevents/pressreleases.cfm?cit_id=36665&FAArea1=customWidgets.content_view_1&usecache=false
• Download the Review of compliance: http://www.cqc.org.uk/publications.cfm?fde_id=16202
Tuesday 21 September 2010
Two conditions removed on Sherwood Forest’s licence
The two conditions were imposed on the trust after we found that it had not investigated concerns raised in the Integrated Critical Care Unit (ICCU) at King’s Mill Hospital. This then indicated that the trust did not have an effective system to assess and monitor care.
Following an unannounced inspection in August, we found that King’s Mill Hospital now:
• holds weekly clinical governance meetings to assess effectiveness and risk management
• has developed a monitoring tool to measure the progress of care
• has set up a communications board to discuss incidents and near misses
Additionally, relatives of patients who were being treated in the ICCU provided positive feedback about the care they had seen.
We also found that the trust as a whole now ensures effective systems to assess and monitor all its services:
• All departments across the hospital have a lead clinician for clinical governance, and each directorate reports to the trust-wide clinical governance committee.
• Systems are in place to monitor the quality and safety of services to ensure action is taken when risks are identified.
• Accidents are reviewed and analysed, and results are communicated to staff.
• Mortality data is monitored, and the results are used to improve outcomes for patients.
We also received evidence that the staff take part in surveys, meetings and other forums where they are able to make their views heard.
Find out more
• Read the press release: http://www.cqc.org.uk/newsandevents/pressreleases.cfm?cit_id=36641&FAArea1=customWidgets.content_view_1&usecache=false
Following an unannounced inspection in August, we found that King’s Mill Hospital now:
• holds weekly clinical governance meetings to assess effectiveness and risk management
• has developed a monitoring tool to measure the progress of care
• has set up a communications board to discuss incidents and near misses
Additionally, relatives of patients who were being treated in the ICCU provided positive feedback about the care they had seen.
We also found that the trust as a whole now ensures effective systems to assess and monitor all its services:
• All departments across the hospital have a lead clinician for clinical governance, and each directorate reports to the trust-wide clinical governance committee.
• Systems are in place to monitor the quality and safety of services to ensure action is taken when risks are identified.
• Accidents are reviewed and analysed, and results are communicated to staff.
• Mortality data is monitored, and the results are used to improve outcomes for patients.
We also received evidence that the staff take part in surveys, meetings and other forums where they are able to make their views heard.
Find out more
• Read the press release: http://www.cqc.org.uk/newsandevents/pressreleases.cfm?cit_id=36641&FAArea1=customWidgets.content_view_1&usecache=false
Thursday 16 September 2010
Care regulator tells Devon Partnership NHS Trust to improve or face formal enforcement action
CQC inspectors find mental health trust failed to address all concerns raised by investigation into care and treatment of patients.
The Care Quality Commission has told Devon Partnership NHS Trust that it must improve its systems of staff supervision and appraisal - or face the prospect of formal enforcement action.
When CQC introduced a new registration system in April, Devon Partnership NHS trust was one of 22 NHS organisations that were registered with conditions because they were not meeting essential standards of quality and safety.
Devon Partnership NHS Trust had been subject to an in-depth investigation by CQC, which found that the trust’s failure to supervise and appraise staff had led to serious concerns about the inappropriate administration of medicines in one unit.
Today CQC has published its findings on progress made by the trust to meet the condition on its licence:
• The registered provider must ensure that there are systems in place by 31 March 2010 for the supervision and appraisal of staff and for the keeping of proper records of that supervision and appraisal. Evidence must be available to demonstrate this from 1 April 2010.
Inspectors made two unannounced visits in June to older people’s mental health units at Abbotsvale in Bideford and St John’s Court in Exmouth. They spoke to people who use services, and to relatives and staff.
Inspectors said there had been significant improvements since the investigation. These include higher staffing levels, changes to the environment to improve privacy and dignity for patients and safety improvements in the management of medicines and in end of life care.
However, CQC said the trust had failed to make all the improvements to supervision and appraisal of staff that were required under the condition.
It said that while arrangements for routine supervision have improved, the trust’s own records show that only 22% of their staff had been appraised in the previous nine months. Almost all staff working in older peoples mental health services interviewed by inspectors reported they had not received supervision or an appraisal in the last 12 months.
The regulator has demanded that the trust provides detailed plans within 28 days, outlining how it will implement all necessary improvements. CQC warned that if the improvements are not made, the next step is legal enforcement action.
CQC has also required detailed plans in relation to its concerns with nine other essential standards of quality and safety. Inspectors identified concerns with record-keeping, missing documentation, assessments which did not reflect individual people’s needs or preferences, limited choices of food, incomplete knowledge of safeguarding processes, and poorly-completed care plans.
CQC will closely review the trust’s plans and inspectors will return to the trust later in the year to undertake a full review of all 16 standards of quality and safety to check that improvements are made.
Ian Biggs, Regional Director of CQC in the South West said the regulator would take a flexible, but tough approach to using its new enforcement powers, which start with a warning notice and escalate to fines, prosecution, restrictions on activities or in extreme cases, closure.
He said: “In taking any kind of enforcement action our main consideration is the need to drive improvements which will benefit people who use services.
“We know that the problems over the inappropriate use of medicines in the Harbourne Unit stemmed from a history of inadequate supervision of staff, which allowed years of poor practice to go unchallenged. It was only when concerns were raised in 2008 that the trust managers intervened.
“If doctors and nurses aren't being properly supervised and supported, this can have a significant effect on the quality of care that people experience.
“Throughout this report, we have identified many different ways in which Devon’s services for older people have improved recently. It is clear that the staff have made real progress in a wide range of areas, from management of medicines to layout of wards facilities as well as day-to-day care.
“For this reason it is all the more disappointing that the trust has not taken the action which all agreed was required at the time of registration in April.
“We are now giving notice to the trust, as well as to the South West strategic health authority and to NHS Devon who commission their services, that we are on the verge of legal enforcement action. It is a decision we do not reach lightly.”
The Care Quality Commission has told Devon Partnership NHS Trust that it must improve its systems of staff supervision and appraisal - or face the prospect of formal enforcement action.
When CQC introduced a new registration system in April, Devon Partnership NHS trust was one of 22 NHS organisations that were registered with conditions because they were not meeting essential standards of quality and safety.
Devon Partnership NHS Trust had been subject to an in-depth investigation by CQC, which found that the trust’s failure to supervise and appraise staff had led to serious concerns about the inappropriate administration of medicines in one unit.
Today CQC has published its findings on progress made by the trust to meet the condition on its licence:
• The registered provider must ensure that there are systems in place by 31 March 2010 for the supervision and appraisal of staff and for the keeping of proper records of that supervision and appraisal. Evidence must be available to demonstrate this from 1 April 2010.
Inspectors made two unannounced visits in June to older people’s mental health units at Abbotsvale in Bideford and St John’s Court in Exmouth. They spoke to people who use services, and to relatives and staff.
Inspectors said there had been significant improvements since the investigation. These include higher staffing levels, changes to the environment to improve privacy and dignity for patients and safety improvements in the management of medicines and in end of life care.
However, CQC said the trust had failed to make all the improvements to supervision and appraisal of staff that were required under the condition.
It said that while arrangements for routine supervision have improved, the trust’s own records show that only 22% of their staff had been appraised in the previous nine months. Almost all staff working in older peoples mental health services interviewed by inspectors reported they had not received supervision or an appraisal in the last 12 months.
The regulator has demanded that the trust provides detailed plans within 28 days, outlining how it will implement all necessary improvements. CQC warned that if the improvements are not made, the next step is legal enforcement action.
CQC has also required detailed plans in relation to its concerns with nine other essential standards of quality and safety. Inspectors identified concerns with record-keeping, missing documentation, assessments which did not reflect individual people’s needs or preferences, limited choices of food, incomplete knowledge of safeguarding processes, and poorly-completed care plans.
CQC will closely review the trust’s plans and inspectors will return to the trust later in the year to undertake a full review of all 16 standards of quality and safety to check that improvements are made.
Ian Biggs, Regional Director of CQC in the South West said the regulator would take a flexible, but tough approach to using its new enforcement powers, which start with a warning notice and escalate to fines, prosecution, restrictions on activities or in extreme cases, closure.
He said: “In taking any kind of enforcement action our main consideration is the need to drive improvements which will benefit people who use services.
“We know that the problems over the inappropriate use of medicines in the Harbourne Unit stemmed from a history of inadequate supervision of staff, which allowed years of poor practice to go unchallenged. It was only when concerns were raised in 2008 that the trust managers intervened.
“If doctors and nurses aren't being properly supervised and supported, this can have a significant effect on the quality of care that people experience.
“Throughout this report, we have identified many different ways in which Devon’s services for older people have improved recently. It is clear that the staff have made real progress in a wide range of areas, from management of medicines to layout of wards facilities as well as day-to-day care.
“For this reason it is all the more disappointing that the trust has not taken the action which all agreed was required at the time of registration in April.
“We are now giving notice to the trust, as well as to the South West strategic health authority and to NHS Devon who commission their services, that we are on the verge of legal enforcement action. It is a decision we do not reach lightly.”
Wednesday 15 September 2010
Condition lifted at Peterborough and Stamford
We have lifted the remaining condition imposed on Peterborough and Stamford Hospitals NHS Foundation Trust.
Our latest review found a significant increase in staffing levels at the Peterborough Maternity Unit, ensuring that all women receive care from a registered midwife.
We checked the trust’s compliance through a range of measures including:
• meetings with senior management and staff
• reviewing the results of a survey conducted by the Strategic Health Authority (SHA) on the care women received during labour
The findings show that the trust has:
• successfully recruited a large number of permanent midwifes and additional staff
• put in place a risk escalation process to use when staffing ratios dip below the required level
• created a reserve list to use against future vacancies and bank staff recruitment
• allowed midwives to concentrate on clinical activities by increasing the number of maternity support workers and administration staff on duty
Additionally, according to the interim results from the survey, new mothers are highly satisfied by the care they received. All participants also commented that they received 1 to 1 care from a midwife whilst they were in labour at the maternity unit.
Find out more
• Read the press release:http://www.cqc.org.uk/newsandevents/pressreleases.cfm?cit_id=36625&FAArea1=customWidgets.content_view_1&usecache=false
• Find out about our essential standards:
http://www.cqc.org.uk/aboutcqc/whatwedo/monitoringessentialstandardsofqualityandsafety/whataretheessentialstandardsofqualityandsafety.cfm
Our latest review found a significant increase in staffing levels at the Peterborough Maternity Unit, ensuring that all women receive care from a registered midwife.
We checked the trust’s compliance through a range of measures including:
• meetings with senior management and staff
• reviewing the results of a survey conducted by the Strategic Health Authority (SHA) on the care women received during labour
The findings show that the trust has:
• successfully recruited a large number of permanent midwifes and additional staff
• put in place a risk escalation process to use when staffing ratios dip below the required level
• created a reserve list to use against future vacancies and bank staff recruitment
• allowed midwives to concentrate on clinical activities by increasing the number of maternity support workers and administration staff on duty
Additionally, according to the interim results from the survey, new mothers are highly satisfied by the care they received. All participants also commented that they received 1 to 1 care from a midwife whilst they were in labour at the maternity unit.
Find out more
• Read the press release:http://www.cqc.org.uk/newsandevents/pressreleases.cfm?cit_id=36625&FAArea1=customWidgets.content_view_1&usecache=false
• Find out about our essential standards:
http://www.cqc.org.uk/aboutcqc/whatwedo/monitoringessentialstandardsofqualityandsafety/whataretheessentialstandardsofqualityandsafety.cfm
Tuesday 14 September 2010
Assessments of quality in 2010/11
Earlier this year, we consulted on our proposals for the assessment of quality for health and adult social care in 2010/11.
The consultation provided a high level overview of our planned approach to carrying out periodic reviews and special reviews and studies, and how we plan to publish information about them. We described these three activities as ‘assessments of quality’.
The consultation ran from 2 February to 27 April 2010 and we received over 462 responses to our proposals.
We thank everyone who participated in the consultation, and are encouraged by the many positive responses to our general approach to assessments of quality.
Whilst reviewing the comments, we considered feedback on areas where we can further improve. We have amended our plans for assessments in light of the abolition of the Comprehensive Area Assessment, and the proposals for change in the Government’s white paper, published on 12 July 2010. The changes in the white paper relate to the way the NHS will operate and be regulated.
For more information go here: http://www.cqc.org.uk/newsandevents/newsstories.cfm?FaArea1=customwidgets.content_view_1&cit_id=36599
The consultation provided a high level overview of our planned approach to carrying out periodic reviews and special reviews and studies, and how we plan to publish information about them. We described these three activities as ‘assessments of quality’.
The consultation ran from 2 February to 27 April 2010 and we received over 462 responses to our proposals.
We thank everyone who participated in the consultation, and are encouraged by the many positive responses to our general approach to assessments of quality.
Whilst reviewing the comments, we considered feedback on areas where we can further improve. We have amended our plans for assessments in light of the abolition of the Comprehensive Area Assessment, and the proposals for change in the Government’s white paper, published on 12 July 2010. The changes in the white paper relate to the way the NHS will operate and be regulated.
For more information go here: http://www.cqc.org.uk/newsandevents/newsstories.cfm?FaArea1=customwidgets.content_view_1&cit_id=36599
Community mental health survey results
We have published the results of a survey looking at the experiences of more than 17,000 people who had contact with specialist community mental health services between July and September 2009.
According to the survey, the majority of respondents are generally very positive about the health and social care worker they had seen most recently for their mental health condition. However, the findings also show that some had not been involved as much as they would have liked in some aspects of their care.
The survey covered 66 NHS trusts. Participants included those referred to:
• psychiatric outpatient clinics
• local community mental health teams
• other community-based services
43 per cent of these respondents had their care coordinated under a framework called the Care Programme Approach (CPA). Find out more about the results here: http://www.cqc.org.uk/newsandevents/pressreleases.cfm?cit_id=36623&FAArea1=customWidgets.content_view_1&usecache=false
Key findings
The vast majority of participants said that the health and social care workers listened carefully to them, gave them enough time for discussion and took their views into account. Most people also said that they were treated with respect and dignity, and that they had trust and confidence in the health or social care worker.
However, many reported that they were not as involved in aspects of their care as they would have liked. Some respondents said they would have liked more explanation or more say in their treatment and support.
Find out more
• Read more about the key findings: http://www.cqc.org.uk/newsandevents/pressreleases.cfm?cit_id=36623&FAArea1=customWidgets.content_view_1&usecache=false
• Find out more about the survey: http://www.cqc.org.uk/aboutcqc/howwedoit/involvingpeoplewhouseservices/patientsurveys/communitymentalhealthservices.cfm
• Check how your local NHS Trust scored: http://www.cqc.org.uk/aboutcqc/howwedoit/involvingpeoplewhouseservices/patientsurveys/communitymentalhealthservices/mentalhealthservicessurvey2010a-zlist.cfm
According to the survey, the majority of respondents are generally very positive about the health and social care worker they had seen most recently for their mental health condition. However, the findings also show that some had not been involved as much as they would have liked in some aspects of their care.
The survey covered 66 NHS trusts. Participants included those referred to:
• psychiatric outpatient clinics
• local community mental health teams
• other community-based services
43 per cent of these respondents had their care coordinated under a framework called the Care Programme Approach (CPA). Find out more about the results here: http://www.cqc.org.uk/newsandevents/pressreleases.cfm?cit_id=36623&FAArea1=customWidgets.content_view_1&usecache=false
Key findings
The vast majority of participants said that the health and social care workers listened carefully to them, gave them enough time for discussion and took their views into account. Most people also said that they were treated with respect and dignity, and that they had trust and confidence in the health or social care worker.
However, many reported that they were not as involved in aspects of their care as they would have liked. Some respondents said they would have liked more explanation or more say in their treatment and support.
Find out more
• Read more about the key findings: http://www.cqc.org.uk/newsandevents/pressreleases.cfm?cit_id=36623&FAArea1=customWidgets.content_view_1&usecache=false
• Find out more about the survey: http://www.cqc.org.uk/aboutcqc/howwedoit/involvingpeoplewhouseservices/patientsurveys/communitymentalhealthservices.cfm
• Check how your local NHS Trust scored: http://www.cqc.org.uk/aboutcqc/howwedoit/involvingpeoplewhouseservices/patientsurveys/communitymentalhealthservices/mentalhealthservicessurvey2010a-zlist.cfm
Friday 10 September 2010
Working with children to prevent crime needs better evaluation, say inspectors
The work to turn children away from crime needs to be more focused and to be evaluated better, said independent inspectors who have today published a joint report on youth crime prevention.
Many adults in the criminal justice system began offending in their childhood or early teens at a time when a number of factors made their offending more likely. HM Inspectorate of Constabulary, HM Inspectorate of Probation, the Care Quality Commission and Healthcare Inspectorate Wales examined the approaches to child crime prevention, visiting seven local authorities and examining 75 individual cases where children aged 8 to 13 had been referred for interventions to prevent offending.
Inspectors confirmed that a number of factors in a child’s background can make that individual more likely to offend. The report emphasises that it is difficult to turn some of these children away from crime, but details many examples of prevention work that were having a positive impact on children’s lives.
Inspectors found impressive partnership working and considered approaches to youth crime. However, better coordination and improvement in identifying what works, both locally and nationally, is needed.
Inspectors were pleased to find that:
the quality of key workers was impressive, including their knowledge of and commitment to the children they were working with;
once a child had been identified and assessed, entry onto a prevention programme was generally swift; and
the scope of interventions varied widely and there were some very simple, inexpensive but successful interventions.
Inspectors believe some processes could be refined and better managed, and were concerned that:
there was little co-ordinated evaluation of interventions which have achieved longer term success;
a number of aspects of the underpinning processes and assessment frameworks were overly bureaucratic;
health services were not integrated to the same extent and did not always see themselves as key to prevention; and
the short-term nature of some funding and the different reporting requirements caused concerns about future continuation.
The inspectors said:
“The scope of interventions to prevent youth crime varied widely. Some work was very simple, inexpensive but successful. In some cases, however, it was difficult to understand why a particular intervention was made as it did not appear to address the issues raised at the child’s assessment. The quality of intervention plans ranged from those which were clear, time bound and reviewed to having no plan at all. A significant minority of these plans lacked detail, outcome milestones and an exit strategy. There was little evidence of any local evaluation either of individual interventions or of the longer term outcomes for children. Better evaluation would enable everyone to see what works and improve the ability of practitioners to turn young people away from crime.”
A copy of the report is available at www.hmic.gov.uk or from our website:
http://www.cqc.org.uk/aboutcqc/howwedoit/workinginpartnership/maternity,childrenandyoungpeoplesservices/youthoffendinginspections.cfm
Many adults in the criminal justice system began offending in their childhood or early teens at a time when a number of factors made their offending more likely. HM Inspectorate of Constabulary, HM Inspectorate of Probation, the Care Quality Commission and Healthcare Inspectorate Wales examined the approaches to child crime prevention, visiting seven local authorities and examining 75 individual cases where children aged 8 to 13 had been referred for interventions to prevent offending.
Inspectors confirmed that a number of factors in a child’s background can make that individual more likely to offend. The report emphasises that it is difficult to turn some of these children away from crime, but details many examples of prevention work that were having a positive impact on children’s lives.
Inspectors found impressive partnership working and considered approaches to youth crime. However, better coordination and improvement in identifying what works, both locally and nationally, is needed.
Inspectors were pleased to find that:
the quality of key workers was impressive, including their knowledge of and commitment to the children they were working with;
once a child had been identified and assessed, entry onto a prevention programme was generally swift; and
the scope of interventions varied widely and there were some very simple, inexpensive but successful interventions.
Inspectors believe some processes could be refined and better managed, and were concerned that:
there was little co-ordinated evaluation of interventions which have achieved longer term success;
a number of aspects of the underpinning processes and assessment frameworks were overly bureaucratic;
health services were not integrated to the same extent and did not always see themselves as key to prevention; and
the short-term nature of some funding and the different reporting requirements caused concerns about future continuation.
The inspectors said:
“The scope of interventions to prevent youth crime varied widely. Some work was very simple, inexpensive but successful. In some cases, however, it was difficult to understand why a particular intervention was made as it did not appear to address the issues raised at the child’s assessment. The quality of intervention plans ranged from those which were clear, time bound and reviewed to having no plan at all. A significant minority of these plans lacked detail, outcome milestones and an exit strategy. There was little evidence of any local evaluation either of individual interventions or of the longer term outcomes for children. Better evaluation would enable everyone to see what works and improve the ability of practitioners to turn young people away from crime.”
A copy of the report is available at www.hmic.gov.uk or from our website:
http://www.cqc.org.uk/aboutcqc/howwedoit/workinginpartnership/maternity,childrenandyoungpeoplesservices/youthoffendinginspections.cfm
Wednesday 8 September 2010
Final condition lifted at Surrey and Borders
We have found significant proof of good practice at Surrey and Borders Partnership Trust to lift the final condition imposed on its license.
The condition, which relates to the assessment of patients admitted under the Mental Health Act, required the trust to ensure that all patients were:
• informed about their treatment
• assessed on their capacity to consent to treatment
The trust was also required to document all outcomes relating to patients’ consent.
Our review, carried out in August, involved the inspection of 67 records from a variety of locations. The results showed that the trust has:
• introduced a new form that assesses patients’ ability to give consent and agree to treatment
• achieved 100 per cent compliance in completing the forms within required times
• updated 100 per cent of their patients notes
• effectively communicated to staff how the form should be filled out
We will continue to monitor the improvement of the trust, returning when necessary to check its compliance with the essential standards.
Find out more
• Read the press release: http://www.cqc.org.uk/newsandevents/pressreleases.cfm?cit_id=36581&FAArea1=customWidgets.content_view_1&usecache=false
• Download the Review of compliance: http://www.cqc.org.uk/publications.cfm?fde_id=16064
The condition, which relates to the assessment of patients admitted under the Mental Health Act, required the trust to ensure that all patients were:
• informed about their treatment
• assessed on their capacity to consent to treatment
The trust was also required to document all outcomes relating to patients’ consent.
Our review, carried out in August, involved the inspection of 67 records from a variety of locations. The results showed that the trust has:
• introduced a new form that assesses patients’ ability to give consent and agree to treatment
• achieved 100 per cent compliance in completing the forms within required times
• updated 100 per cent of their patients notes
• effectively communicated to staff how the form should be filled out
We will continue to monitor the improvement of the trust, returning when necessary to check its compliance with the essential standards.
Find out more
• Read the press release: http://www.cqc.org.uk/newsandevents/pressreleases.cfm?cit_id=36581&FAArea1=customWidgets.content_view_1&usecache=false
• Download the Review of compliance: http://www.cqc.org.uk/publications.cfm?fde_id=16064
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