The Care Quality Commission has told Mid Staffordshire NHS Foundation Trust that it must continue to make improvements to meet minimum standards of quality and safety.
In a report published today CQC concludes that services at Stafford Hospital are compliant with five of the 16 essential standards. The report identifies 11 standards where improvement is required.
The Commission says the trust has made considerable progress in the last two years. In some areas its concerns remain only because the improvements still need more time to bed in and for CQC to see the full benefit of those changes.
CQC has given the trust's managers 28 days to provide details of action they will take to achieve compliance with the standards where improvement is needed.
Inspectors will return to the trust to review whether the necessary improvements have been made and to decide whether further action is required.
The CQC team will also work closely with West Midlands Strategic Health Authority, South Staffordshire Primary Care Trust and Monitor to help the trust deliver long term improvements.
Today's report evaluates Stafford Hospital's overall performance against all 16 essential standards of quality and safety. By law, providers of health care services have a legal responsibility to make sure they are meeting all the standards.
Inspectors found that the hospital was fully compliant with standards relating to patient consent, meals, partnership working, keeping people who use services safe from harm and assessing and monitoring services.
But they also identified concerns around management of medicines, staff supervision and appraisals and handling of complaints.
Andrea Gordon, Regional Director of CQC in the West Midlands, said that her staff would continue to keep the trust under close review.
“I am satisfied that hospital is moving in the right direction, but the trust must not relax its efforts to improve. We believe that with the right support the management team at the trust has the capability to make the necessary improvements.
“The trust needs to take action to address the issues we have identified. The law says these are the standards that everyone should be able to expect when they receive care. Providers have a duty to ensure they are compliant – or face the possibility of enforcement action.
“Management of medicines is one of the areas that gives us most concern because there are inconsistencies on the wards and the trust’s own audits point to significant problems which must be addressed. Staff training has improved, but arrangements for regular supervision are still not satisfactory and need urgent attention.
“Handling of complaints is another area where we expect to see significant improvements. The trust’s complaints system is not effective because staff involved in complaints are not fully trained and investigations are not completed as quickly as they should be.
“People who depend on these services need to know that they are safe. If we had an immediate concern, we would step in quickly to protect the public.
"In the meantime we will follow up and monitor the improvements identified in this report, and we will take firm action to ensure that Mid Staffordshire NHS Foundation Trust comes up to standard."
-ends-
Notes to editors:
Today's report identified concerns with the following standards
• Management of medicines
• Supporting workers
• Complaints
• Respecting and involving people who use services
• Care and welfare of people who use services
• Safeguarding people who use services from abuse
• Safety and suitability of premises
• Safety, availability and suitability of equipment
• Requirements relating to workers
• Staffing
• Records.
The report finds that Mid Staffordshire is compliant with the following standards:
• Managing risks around patient consent
• Providing adequate meals
• Strengthening its approach to partnership working
• Keeping people who use services safe from harm
• Assessing and monitoring services.
• Download our latest Review of compliance on Mid Staffordshire: http://www.cqc.org.uk/publications.cfm?fde_id=16457
Friday 29 October 2010
Monday 25 October 2010
New consultation on our registration fees scheme
21 October 2010
We have today launched a new consultation on the fees we charge to providers of health and adult social care services.
The consultation sets out our proposals to simplify our fees to a single scheme for all providers. This scheme will cover our work both in registering providers and monitoring their compliance with essential standards of quality and safety. We hope to launch the scheme in April 2011.
This consultation will run until January next year.
• Read our full press release on the launch of the consultation: http://www.cqc.org.uk/newsandevents/pressreleases.cfm?cit_id=36785&FAArea1=customWidgets.content_view_1&usecache=false
• Download our consultation documents and find out how to take part:
• http://www.cqc.org.uk/yourviews/consultations/registrationfeesscheme.cfm
We have today launched a new consultation on the fees we charge to providers of health and adult social care services.
The consultation sets out our proposals to simplify our fees to a single scheme for all providers. This scheme will cover our work both in registering providers and monitoring their compliance with essential standards of quality and safety. We hope to launch the scheme in April 2011.
This consultation will run until January next year.
• Read our full press release on the launch of the consultation: http://www.cqc.org.uk/newsandevents/pressreleases.cfm?cit_id=36785&FAArea1=customWidgets.content_view_1&usecache=false
• Download our consultation documents and find out how to take part:
• http://www.cqc.org.uk/yourviews/consultations/registrationfeesscheme.cfm
Thursday 14 October 2010
More post offices for dental providers’ CRB checks
The Care Quality Commission (CQC) has worked with the Post Office to increase the number of post offices available to process Criminal Record Bureau (CRB) disclosures for providers of dental services.
The way health services are regulated is changing and as part of that change, providers of dental services need to be registered with the CQC by April next year.
The new system of registration will bring all the different elements of the health and adult social services sectors under a single system, which requires providers to meet new essential standards of quality and safety.
This regulation, as directed by the Health and Social Care Act 2008, means all providers of dental services and their registered managers now require an enhanced CRB check if they don’t already have one.
Many dental providers with an NHS contract should already have an enhanced CRB disclosure, approved by the primary care trust they have a contract with. It is estimated that more than 90 percent of the dental industry has an NHS contract. In these cases, no new CRB disclosure will be needed.
However, providers without a criminal records check now need to present proof of identification at a designated post office in England to obtain their mandatory check.
This can currently be carried out at 27 crown post offices where this service is offered but from 1 November, this network will be expanded to 100 post offices able to offer this service.
CQC director, Linda Hutchinson, said: ‘We have been working closely with The Post Office for some time to increase the number of branches available to dental providers obtaining a CRB check.
‘The majority of providers of NHS dental services are already required to have a CRB check countersigned by their local primary care trust and they just need to declare this on their application form to CQC. These dentists will not need to obtain new checks.
‘Obtaining a CRB check is without doubt in the best interests of patients and their safety.
‘CQC appreciates that applying for registration can be challenging as it’s the first time the dental industry has been subject to this form of regulation. We have been working with the dental sector for some time and have just completed a series of local events where we talked to local providers and listened and responded to concerns and queries.
For more information and a full list of post offices go to www.cqc.org.uk/crb.
The way health services are regulated is changing and as part of that change, providers of dental services need to be registered with the CQC by April next year.
The new system of registration will bring all the different elements of the health and adult social services sectors under a single system, which requires providers to meet new essential standards of quality and safety.
This regulation, as directed by the Health and Social Care Act 2008, means all providers of dental services and their registered managers now require an enhanced CRB check if they don’t already have one.
Many dental providers with an NHS contract should already have an enhanced CRB disclosure, approved by the primary care trust they have a contract with. It is estimated that more than 90 percent of the dental industry has an NHS contract. In these cases, no new CRB disclosure will be needed.
However, providers without a criminal records check now need to present proof of identification at a designated post office in England to obtain their mandatory check.
This can currently be carried out at 27 crown post offices where this service is offered but from 1 November, this network will be expanded to 100 post offices able to offer this service.
CQC director, Linda Hutchinson, said: ‘We have been working closely with The Post Office for some time to increase the number of branches available to dental providers obtaining a CRB check.
‘The majority of providers of NHS dental services are already required to have a CRB check countersigned by their local primary care trust and they just need to declare this on their application form to CQC. These dentists will not need to obtain new checks.
‘Obtaining a CRB check is without doubt in the best interests of patients and their safety.
‘CQC appreciates that applying for registration can be challenging as it’s the first time the dental industry has been subject to this form of regulation. We have been working with the dental sector for some time and have just completed a series of local events where we talked to local providers and listened and responded to concerns and queries.
For more information and a full list of post offices go to www.cqc.org.uk/crb.
Significant improvements at The Heart of England
We have lifted two of the three conditions imposed on The Heart of England NHS Foundation Trust.
The trust’s latest compliance report, released today, shows it has addressed our concerns relating to:
safeguarding people who use services
staffing
We inspected The Heart of England Trust on two separate, unannounced occasions. During these visits, we conducted interviews with staff and patients, and reviewed documentary evidence. The results show that the trust:
provides staff with training around safeguarding
encourages staff to make contact with external agencies to increase their understanding of safeguarding
documents safeguarding issues across the trust
The Heart of England now has until September to meet the third condition, which relates to supporting staff.
The trust’s latest compliance report, released today, shows it has addressed our concerns relating to:
safeguarding people who use services
staffing
We inspected The Heart of England Trust on two separate, unannounced occasions. During these visits, we conducted interviews with staff and patients, and reviewed documentary evidence. The results show that the trust:
provides staff with training around safeguarding
encourages staff to make contact with external agencies to increase their understanding of safeguarding
documents safeguarding issues across the trust
The Heart of England now has until September to meet the third condition, which relates to supporting staff.
Monday 11 October 2010
Criminal Record Bureau (CRB) checks
Under the Health and Social Care Act 2008, all health and adult social care providers as part of their registration with the Care Quality Commission (CQC) are required to undertake an enhanced Criminal Record Bureau (CRB) check.
Since 2006, primary dental care providers with an NHS contract were required to have a CRB disclosure countersigned by the PCT which manages the contract. To avoid duplication, CQC has adopted a policy of accepting PCT countersigned CRBs for primary dental care providers. This means that the majority will not need to obtain a new CRB disclosure in order to register with us. They can declare their current one, countersigned by the PCT.
For providers without an NHS contract, the disclosure must be countersigned by CQC. Registered managers must also obtain a CRB disclosure countersigned by CQC, unless the manager is the same person as the provider and already has a PCT countersigned CRB in that capacity (e.g. one of the partners in a partnership may also take on the role of manager).
In order for CQC to countersign the criminal records check, proof of identity is required. To undertake this arrangement, the Post Office is able to check identities on its behalf. This increases the number of places where this can be completed, making it more convenient for providers.
There are currently 27 national "crown" Post Offices which offer this service. From 1 November 2010, 73 additional offices will ensure a wider network is available to cope with the demand for this mandatory check.
We are constantly reviewing the service and will continue to work with the Post Office to increase the number of offices that offer this service.
Please visit www.cqc.org.uk/crb to find your nearest post office.
For more infomation on CRB and the CQC please go here: http://www.cqc.org.uk/contentdisplay.cfm?widCall1=customWidgets.content_view_1&cit_id=36436
Since 2006, primary dental care providers with an NHS contract were required to have a CRB disclosure countersigned by the PCT which manages the contract. To avoid duplication, CQC has adopted a policy of accepting PCT countersigned CRBs for primary dental care providers. This means that the majority will not need to obtain a new CRB disclosure in order to register with us. They can declare their current one, countersigned by the PCT.
For providers without an NHS contract, the disclosure must be countersigned by CQC. Registered managers must also obtain a CRB disclosure countersigned by CQC, unless the manager is the same person as the provider and already has a PCT countersigned CRB in that capacity (e.g. one of the partners in a partnership may also take on the role of manager).
In order for CQC to countersign the criminal records check, proof of identity is required. To undertake this arrangement, the Post Office is able to check identities on its behalf. This increases the number of places where this can be completed, making it more convenient for providers.
There are currently 27 national "crown" Post Offices which offer this service. From 1 November 2010, 73 additional offices will ensure a wider network is available to cope with the demand for this mandatory check.
We are constantly reviewing the service and will continue to work with the Post Office to increase the number of offices that offer this service.
Please visit www.cqc.org.uk/crb to find your nearest post office.
For more infomation on CRB and the CQC please go here: http://www.cqc.org.uk/contentdisplay.cfm?widCall1=customWidgets.content_view_1&cit_id=36436
Friday 8 October 2010
Nearly 1,000 care homes are without a registered manager, says regulator
The Care Quality Commission (CQC) said today (8 October) that nearly 1,000 residential care homes do not have a registered manager in place, despite this being a requirement of the new Health and Social Care Act 2008.
Although it does not present a direct risk to the safety of residents, care homes without a registered manager may be less able to identify potential concerns and address them quickly, said the commission. It has placed conditions on the operators of all the care homes in question requiring them to put managers in place.
Under the provisions of the Act that came into force from last Friday (1 October), many care homes must have a registered manager who is appropriately experienced and qualified. This was also a requirement under the old legislation, the Care Standards Act 2000.
CQC announced today that so far it had newly registered the care providers operating about 20,000 adult social care service locations under the Health and Social Care Act. Just over 15,000 of these locations are residential care homes. Most of the others are home-care agencies and nurses agencies. However, around 1,000 care homes (operated by more than 500 different providers) had a condition placed on them that they appoint a registered manager by 1 April 2011.
Not all care homes need to have a registered manager – CQC said that registered providers who manage their own services on a day-to-day basis do not need to also register as managers.
Cynthia Bower, CQC’s chief executive, said: “It has been recognised in the care sector for some time that there is a shortage of experienced and qualified managers. While we have been undertaking the enormous task of re-registering thousands of care services, the scale of this has become clearer.
“The lack of a registered manager does not necessarily mean that people are receiving poor care, but we know from experience that care services without leadership can struggle to address any problems that may arise. Good-quality care is led by good management.
“We know that some providers struggle to find suitably qualified people to take on this role. The sector as a whole needs to take a robust approach to seeking solutions to the shortage of registered managers. It cannot be allowed to continue indefinitely.
“We will use our enforcement powers in the best interests of people who use services. If a care provider is genuinely trying to appoint a registered manager and the quality of care is good, it might not be in the service users’ best interests for us to take enforcement action immediately. But if we find that people are being put at risk because there is no registered manager, then we will take action.”
Under the new Act, CQC has registered about 9,400 providers of adult social care (with a total of 20,000 different service locations), and 600 providers of independent healthcare (with 1,500 locations such as hospitals and cosmetic surgery clinics).
A further 600 providers across adult social care and independent healthcare are resubmitting their applications after their original applications were incomplete or it was unclear which registered activities they needed to register for. A further 430 have not yet been asked to apply, because they were registered near the end of the old system under the Care Standards Act 2000 and consequently are the last to transfer to the new one.
A further 1,300 providers have not yet applied for registration. CQC said they included those who had proved difficult to contact, some of whom may no longer be operating; all of them would be followed up to establish whether they needed to register or not.
In addition to the conditions relating to the lack of a registered manager, providers of about 200 adult social care and independent healthcare service locations have had conditions placed on their registration in relation to various other compliance issues.
The names of providers with conditions on their registration will be published in due course, after they have had the opportunity to exercise their legal right to make representations to the commission.
Ms Bower thanked care providers for their co-operation: “This has not been an easy process for providers or for CQC. We were set a very tough challenge by government to get everyone into the new system in a very short space of time. Now we can move onto the crucial and continuing task of monitoring the quality and safety of care across the sector.”
NHS trusts came into registration last April under the new Act, which CQC says is an important step forward in ensuring that people receive joined-up care. It is the first time that healthcare and adult social care services have been regulated under the same legislation and the same essential standards of quality and safety.
CQC has tough enforcement powers to drive improvements where it finds standards are not being met, including issuing a warning notice, carrying out a prosecution, and suspending or even closing a service.
Although it does not present a direct risk to the safety of residents, care homes without a registered manager may be less able to identify potential concerns and address them quickly, said the commission. It has placed conditions on the operators of all the care homes in question requiring them to put managers in place.
Under the provisions of the Act that came into force from last Friday (1 October), many care homes must have a registered manager who is appropriately experienced and qualified. This was also a requirement under the old legislation, the Care Standards Act 2000.
CQC announced today that so far it had newly registered the care providers operating about 20,000 adult social care service locations under the Health and Social Care Act. Just over 15,000 of these locations are residential care homes. Most of the others are home-care agencies and nurses agencies. However, around 1,000 care homes (operated by more than 500 different providers) had a condition placed on them that they appoint a registered manager by 1 April 2011.
Not all care homes need to have a registered manager – CQC said that registered providers who manage their own services on a day-to-day basis do not need to also register as managers.
Cynthia Bower, CQC’s chief executive, said: “It has been recognised in the care sector for some time that there is a shortage of experienced and qualified managers. While we have been undertaking the enormous task of re-registering thousands of care services, the scale of this has become clearer.
“The lack of a registered manager does not necessarily mean that people are receiving poor care, but we know from experience that care services without leadership can struggle to address any problems that may arise. Good-quality care is led by good management.
“We know that some providers struggle to find suitably qualified people to take on this role. The sector as a whole needs to take a robust approach to seeking solutions to the shortage of registered managers. It cannot be allowed to continue indefinitely.
“We will use our enforcement powers in the best interests of people who use services. If a care provider is genuinely trying to appoint a registered manager and the quality of care is good, it might not be in the service users’ best interests for us to take enforcement action immediately. But if we find that people are being put at risk because there is no registered manager, then we will take action.”
Under the new Act, CQC has registered about 9,400 providers of adult social care (with a total of 20,000 different service locations), and 600 providers of independent healthcare (with 1,500 locations such as hospitals and cosmetic surgery clinics).
A further 600 providers across adult social care and independent healthcare are resubmitting their applications after their original applications were incomplete or it was unclear which registered activities they needed to register for. A further 430 have not yet been asked to apply, because they were registered near the end of the old system under the Care Standards Act 2000 and consequently are the last to transfer to the new one.
A further 1,300 providers have not yet applied for registration. CQC said they included those who had proved difficult to contact, some of whom may no longer be operating; all of them would be followed up to establish whether they needed to register or not.
In addition to the conditions relating to the lack of a registered manager, providers of about 200 adult social care and independent healthcare service locations have had conditions placed on their registration in relation to various other compliance issues.
The names of providers with conditions on their registration will be published in due course, after they have had the opportunity to exercise their legal right to make representations to the commission.
Ms Bower thanked care providers for their co-operation: “This has not been an easy process for providers or for CQC. We were set a very tough challenge by government to get everyone into the new system in a very short space of time. Now we can move onto the crucial and continuing task of monitoring the quality and safety of care across the sector.”
NHS trusts came into registration last April under the new Act, which CQC says is an important step forward in ensuring that people receive joined-up care. It is the first time that healthcare and adult social care services have been regulated under the same legislation and the same essential standards of quality and safety.
CQC has tough enforcement powers to drive improvements where it finds standards are not being met, including issuing a warning notice, carrying out a prosecution, and suspending or even closing a service.
Thursday 7 October 2010
Breaches found at Scarborough and North East Yorkshire Trust
We have published two reports revealing serious concerns at Scarborough and North East Yorkshire Healthcare NHS Trust.
The reports show Bridlington Hospital is only compliant with six of our 16 essential standards, whilst Scarborough Hospital is compliant with just one.
Our concerns relate to:
• staffing levels
• buildings and maintenance
• patient records
• safeguarding arrangements
• systems for assessing and monitoring service quality
The trust has, however, complied with the following conditions to:
• complete a full risk assessment of its premises and put plans in place to make improvements to the environment
• employ more medical records staff
We have given the trust 14 days to produce plans on how it intends to comply with all our standards. Scarborough and North East Yorkshire faces tougher enforcement action if it does not address our concerns.
Read our press release: http://www.cqc.org.uk/newsandevents/pressreleases.cfm?cit_id=36747&FAArea1=customWidgets.content_view_1&usecache=false
The reports show Bridlington Hospital is only compliant with six of our 16 essential standards, whilst Scarborough Hospital is compliant with just one.
Our concerns relate to:
• staffing levels
• buildings and maintenance
• patient records
• safeguarding arrangements
• systems for assessing and monitoring service quality
The trust has, however, complied with the following conditions to:
• complete a full risk assessment of its premises and put plans in place to make improvements to the environment
• employ more medical records staff
We have given the trust 14 days to produce plans on how it intends to comply with all our standards. Scarborough and North East Yorkshire faces tougher enforcement action if it does not address our concerns.
Read our press release: http://www.cqc.org.uk/newsandevents/pressreleases.cfm?cit_id=36747&FAArea1=customWidgets.content_view_1&usecache=false
Wednesday 6 October 2010
Most conditions lifted on Milton Keynes’ licence
Conditions were originally imposed on Milton Keynes Hospital’s licence in response to concerns over its maternity services.
We found that the trust was not meeting four of our essential standards of quality and safety, and was required to make a series of improvements.
The report published today, shows that the trust has made significant changes to its maternity services, and is now better placed to cope with peaks in demand.
The trust has complied with conditions requiring:
• a revised action plan to address outstanding recommendations made by the Healthcare Commission in 2008.
• a new system that allows midwives to assess and monitor the quality of services provided by the maternity department.
• a revised audit programme that takes into account incidents and complaints.
• a clinical governance system to assess and monitor the quality of service provision across all services.
• that serious incidents and risks are reported to the board and healthcare governance committee.
• that midwives recruited since 1 January 2010 be given comprehensive training in promoting normal births, local maternity policies and procedures and escalation procedures.
• that recommendations made by the Oxford Deanery be reviewed.
We will return to Milton Keynes later in the year to ensure the remaining conditions are met, and we will be prepared to take further action if the trust has not demonstrated compliance with our standards.
We found that the trust was not meeting four of our essential standards of quality and safety, and was required to make a series of improvements.
The report published today, shows that the trust has made significant changes to its maternity services, and is now better placed to cope with peaks in demand.
The trust has complied with conditions requiring:
• a revised action plan to address outstanding recommendations made by the Healthcare Commission in 2008.
• a new system that allows midwives to assess and monitor the quality of services provided by the maternity department.
• a revised audit programme that takes into account incidents and complaints.
• a clinical governance system to assess and monitor the quality of service provision across all services.
• that serious incidents and risks are reported to the board and healthcare governance committee.
• that midwives recruited since 1 January 2010 be given comprehensive training in promoting normal births, local maternity policies and procedures and escalation procedures.
• that recommendations made by the Oxford Deanery be reviewed.
We will return to Milton Keynes later in the year to ensure the remaining conditions are met, and we will be prepared to take further action if the trust has not demonstrated compliance with our standards.
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