Councils have kept up the high quality of their social care services for adults in the past year, the Care Quality Commission said today (25 November).
Outcomes for local people who use services continued to improve in 2009-10 in key areas such as choice and control, dignity and respect, and health and emotional well-being.
Of the 152 councils responsible for adult social care services in England, 95% (145) were assessed as performing well or excellently – the same proportion as the previous year (when there were 148 councils). However, the number performing excellently has increased by five to 37.
Seven authorities were assessed as “adequate”, and CQC said they needed to improve their performance in all outcome areas. For the seventh year running, no councils were rated “poor”.
CQC chief executive Cynthia Bower said: “About 1.75 million people across England rely on the care arranged for them by their council. The large majority of councils provide good standards of care, whether they run the services themselves or commission them from the private or voluntary sectors. But a few need to improve considerably before they can say they are providing good services for local people.
“Our experience is that good performance is the result of strong leadership and commitment by elected councillors and service managers, working together with a skilled and dedicated workforce.
“They encourage people to be actively involved in shaping their own care packages, and they develop and commission the services that meet people’s individual needs.
“The best-performing councils work closely with health agencies to deliver joined-up care, with joint commissioning and monitoring of services becoming more common. This year partnership working was found to be a key strength in half of councils and an area for improvement in a third.”
The system of performance assessment that has operated since 2002 is changing. From the current year, 2010-11, the councils themselves will take more responsibility for driving and monitoring improvement locally, in line with the Government’s vision for the future of social care.
CQC is assisting in the design of a new system with the Department of Health, the Local Government Group and the Association of Directors of Adult Social Services (ADASS).
Ms Bower said: “Councils have achieved improvement year-on-year since 2002. Now the challenge for them, as we move to a new approach, is to continue to perform at this level and to strive to improve even further. The new system will include ways of focusing on the few councils that were assessed as ‘adequate’. We anticipate this will involve an element of peer assessment by other councils.”
Each council sets the level of need that makes a person eligible to receive funding towards their care. There are four levels of eligibility criteria: ‘critical’, ‘substantial’, ‘moderate’ and ‘low’. In 2009-10 one council raised its eligibility criteria and two lowered theirs. Of the 152 councils, three (2%) set their criteria at critical, 107 (70%) at substantial, 37 (24%) at moderate and five (3%) at low.
Key areas of the 2009-10 (April 2009 to March 2010) assessment were:
Choice and control. Councils should help people to take control of their care support by providing clear information and advice on the care options and funding available, helping them to assess their needs, and providing a broad range of support services. Two more councils are performing excellently in this respect, taking the total to 28, and the number judged to be performing well has gone up from 88 to 102. One council was assessed as poor.
Dignity and respect. Councils should have effective “safeguarding” procedures to co-ordinate the response to cases of abuse or people being at risk of abuse, and they should ensure that people’s dignity and privacy are respected in care services. The number of councils judged to be adequate decreased from 45 to 24, while the number performing well or excellently increased from 101 to 125. But the number of councils performing poorly in this area increased from two to three. Concerns reported to councils under the adult safeguarding system increased by nearly a third, to a total of 103,000 referrals. CQC said this rise was largely the result of an increasing awareness of safeguarding through public information campaigns and closer working between councils and health agencies.
Health and emotional well-being. Councils should provide people with personalised advice, information and support to improve their health and well-being and help them to live independently, with the option of individual budgets and local services that meet a range of needs. The number of councils performing well or excellently in this area increased from 136 in 2008-09 to 148 in 2009-10.
CQC’s report, Performance judgements for adult social services, can be found on its website (from Thursday 25 November) at: /guidanceforprofessionals/councils/annualassessments/annualperformanceassessment2009/10.cfm
Thursday 25 November 2010
Tuesday 9 November 2010
Adult social care services have improved but the market must respond to meet future needs, says CQC
The overview report has been compiled using data on council commissioning patterns, national minimum standards and registration data.
CQC’s analysis is restricted to the regulated adult social care market. This includes care homes, home care (domiciliary) care services, nursing agencies and shared lives schemes. These are schemes that pay a family to accomodate an isolated or under-supported older or disabled person. Shared lives schemes are also used as day support and respite care.
Adult social care services have improved significantly since 2008 but further growth in the market is required to meet future needs, according to a Care Quality Commission (CQC) report published today.
The national analysis of the adult social care market examines capacity, quality and commissioning and has been developed using technical data and discussions with leaders within the sector.
An assessment of the market since 2004, the report is based on the CQC’s responsibilities under the now defunct Care Standards Act (2000), giving a final definitive report on evidence gathered under this legislation.
This data shows that this year, 83 percent of care homes, home care services, nursing agencies and shared lives schemes were rated good or excellent compared to 69percent in 2008.
Other findings include:
-There is stability in provision in the adult social care market but further growth will be needed to meet future needs. Overall, the number of services has increased. Residential care home numbers have fallen but nursing home numbers and home care services have increased. The rise in nursing home provision reflects an increase in the number of people who may have been cared for in hospital but are now living in nursing homes.
-It also reflects that people with complex needs are living longer. Demographic forces mean an increase in the number of services will be required if future demand is to be met. For example, according to research, the number of older disabled people is expected to rise by 108 percent by 2041. The challenge is for providers and commissioners to work together to further develop the market to anticipate future long term care needs.
-People are increasingly being supported to live in their homes. Home care services are increasing. In some parts of the country, such as London, significantly more services are geared towards providing care to people in their homes rather than in residential care. Self-directed support, such as direct payments, is enabling people to design their own home care in new ways. To make sure people can continue to be supported to live independently and in their own homes in the future, NHS and council commissioners need to be able to develop local markets.
-Year-on-year councils are commissioning better care homes and home care services. Comparisons with the quality of care arranged by councils from 2008 and 2009 shows a growing improvement in the numbers of services rated good or excellent. However, there remain considerable regional variations within commissioning.
Data contained in the briefing are reported on the cusp of significant economic change and local markets may experience turbulence in the future, the report adds. For example, fewer publicly funded care home places may put pressure on services. However, the national picture of stability in terms of numbers and quality may disguise significant local and regional variations. For example, in London there are fewer care home places available for the over-65s, including places for those with dementia. However, London also has the highest percentage of people living in homes rated good or excellent.
CQC chief executive Cynthia Bower said: ‘We’re greatly encouraged to see the improvement in quality of adult social care and the growth in levels of provision.
‘However, we acknowledge there remain pockets of poor practice. Where we have concerns about quality we will not hesitate to act swiftly, using our tougher enforcement powers.
‘The pressures of the current economic climate mean it is particularly important for providers and councils to work together to develop local care markets and anticipate future long-term care needs.
‘Policy makers should also ensure future social care strategies encourage capacity building for commissioners to develop markets, which will require innovation in the light of economic and budgetary constraints.’
CQC has introduced a new tougher system of regulation based on registration under the Health and Social Care Act 2008. This brings together all the sections of the health and adult social care sector, which are required to meet the essential standards of safety and quality to be registered. Adult social care providers were registered under this system on 1 October.
CQC’s analysis is restricted to the regulated adult social care market. This includes care homes, home care (domiciliary) care services, nursing agencies and shared lives schemes. These are schemes that pay a family to accomodate an isolated or under-supported older or disabled person. Shared lives schemes are also used as day support and respite care.
Adult social care services have improved significantly since 2008 but further growth in the market is required to meet future needs, according to a Care Quality Commission (CQC) report published today.
The national analysis of the adult social care market examines capacity, quality and commissioning and has been developed using technical data and discussions with leaders within the sector.
An assessment of the market since 2004, the report is based on the CQC’s responsibilities under the now defunct Care Standards Act (2000), giving a final definitive report on evidence gathered under this legislation.
This data shows that this year, 83 percent of care homes, home care services, nursing agencies and shared lives schemes were rated good or excellent compared to 69percent in 2008.
Other findings include:
-There is stability in provision in the adult social care market but further growth will be needed to meet future needs. Overall, the number of services has increased. Residential care home numbers have fallen but nursing home numbers and home care services have increased. The rise in nursing home provision reflects an increase in the number of people who may have been cared for in hospital but are now living in nursing homes.
-It also reflects that people with complex needs are living longer. Demographic forces mean an increase in the number of services will be required if future demand is to be met. For example, according to research, the number of older disabled people is expected to rise by 108 percent by 2041. The challenge is for providers and commissioners to work together to further develop the market to anticipate future long term care needs.
-People are increasingly being supported to live in their homes. Home care services are increasing. In some parts of the country, such as London, significantly more services are geared towards providing care to people in their homes rather than in residential care. Self-directed support, such as direct payments, is enabling people to design their own home care in new ways. To make sure people can continue to be supported to live independently and in their own homes in the future, NHS and council commissioners need to be able to develop local markets.
-Year-on-year councils are commissioning better care homes and home care services. Comparisons with the quality of care arranged by councils from 2008 and 2009 shows a growing improvement in the numbers of services rated good or excellent. However, there remain considerable regional variations within commissioning.
Data contained in the briefing are reported on the cusp of significant economic change and local markets may experience turbulence in the future, the report adds. For example, fewer publicly funded care home places may put pressure on services. However, the national picture of stability in terms of numbers and quality may disguise significant local and regional variations. For example, in London there are fewer care home places available for the over-65s, including places for those with dementia. However, London also has the highest percentage of people living in homes rated good or excellent.
CQC chief executive Cynthia Bower said: ‘We’re greatly encouraged to see the improvement in quality of adult social care and the growth in levels of provision.
‘However, we acknowledge there remain pockets of poor practice. Where we have concerns about quality we will not hesitate to act swiftly, using our tougher enforcement powers.
‘The pressures of the current economic climate mean it is particularly important for providers and councils to work together to develop local care markets and anticipate future long-term care needs.
‘Policy makers should also ensure future social care strategies encourage capacity building for commissioners to develop markets, which will require innovation in the light of economic and budgetary constraints.’
CQC has introduced a new tougher system of regulation based on registration under the Health and Social Care Act 2008. This brings together all the sections of the health and adult social care sector, which are required to meet the essential standards of safety and quality to be registered. Adult social care providers were registered under this system on 1 October.
Friday 5 November 2010
CQC says essential standards of care are being met at Wrightington, Wigan and Leigh NHS Foundation Trust
The Care Quality Commission (CQC) said today (Friday) that essential standards of safety and quality at Wrightington, Wigan and Leigh NHS Foundation Trust are being met. Since 1 April 2010, all NHS care providers have been required by law to be registered with CQC and must show that they are meeting the essential standards. Wrightington, Wigan and Leigh NHS Foundation Trust was registered on 1 April.
This latest review of the trust was triggered by concerns about patient care. This resulted in unannounced visits on 22 September 2010 at two locations - the Royal Albert Edward Infirmary, Wigan and Wrightington Hospital.
“Following a meeting in July that was part of our review of the trust, I authorised an unannounced visit which took into account concerns raised by local people,” says Sue McMillan, CQC Regional Director for the North West. “I was keen that we assess the trust against three specific standards: care and welfare of people who use services, assessing and monitoring the quality of service provision, and complaints.
“The assessment team reported that the trust was meeting all three standards.”
Inspectors visited three wards at the Royal Albert Edward Infirmary: Ince Ward (Cardiology), Swinley Ward (Surgery) and the Acute Stroke Unit (Shevington), and Wards 5 and 6 at Wrightington Hospital. This was to directly observe care, treatment and support, talk with patients about their current experience of the hospital and speak with the staff who work on these wards. CQC concluded that patients receive appropriate care as directed within individual care pathways.
In addition, CQC reviewed the trust’s systems for assessing and monitoring the quality of services it provides. The trust demonstrated it had an appropriate framework of governance in place that gathers, records and evaluates information about the quality and safety of care, treatment, support and outcomes of clinical services. CQC also considered relevant information it holds about the trust received from various other sources.
CQC also reviewed the management of complaints and concluded that the trust has procedures, followed in practice, for receiving and managing complaints which are monitored and reviewed as required. Recent changes to these procedures have been implemented. For example, the Medical Director now meets with all complainants, should their complaint not be resolved within three months of instigation. Although staff clearly understood the trust’s complaints procedure and management of complaints, they do not receive ongoing training in complaints handling.
While CQC was content with the cleanliness and tidiness of the wards it did note that the Stroke Unit at the Royal Albert Edward Infirmary was more disorganised, with a generally cluttered environment. It acknowledged that staff were very busy and at times looked stressed. CQC also noted that this ward has recently undergone organisational changes that have resulted in two ward areas being joined and it is still in a period of transition.
A total of 14 patients and 13 staff across both locations were interviewed. Without exception CQC was informed during discussions with patients, of high levels of satisfaction with the care received. Most staff felt happy with the level and frequency of training available and newly qualified staff felt effectively supported by other colleagues or Ward Managers.
“Following this unannounced visit I am satisfied that the trust is meeting essential standards. I am also reassured that the Chief Executive and the senior management team have an up to date assessment of the day to day running of the wards visited,” says Sue McMillan. “And while there are a few actions the trust has to take in respect of record keeping, tidiness on one ward, and regular complaints management training, we did not deem these sufficiently serious that they warranted compliance action. However, we will continue to monitor progress. Finally, I would like to thank the patients, visitors and staff who provided us with vital evidence during our visit.”
Full report: http://www.cqc.org.uk/publications.cfm?fde_id=16473
This latest review of the trust was triggered by concerns about patient care. This resulted in unannounced visits on 22 September 2010 at two locations - the Royal Albert Edward Infirmary, Wigan and Wrightington Hospital.
“Following a meeting in July that was part of our review of the trust, I authorised an unannounced visit which took into account concerns raised by local people,” says Sue McMillan, CQC Regional Director for the North West. “I was keen that we assess the trust against three specific standards: care and welfare of people who use services, assessing and monitoring the quality of service provision, and complaints.
“The assessment team reported that the trust was meeting all three standards.”
Inspectors visited three wards at the Royal Albert Edward Infirmary: Ince Ward (Cardiology), Swinley Ward (Surgery) and the Acute Stroke Unit (Shevington), and Wards 5 and 6 at Wrightington Hospital. This was to directly observe care, treatment and support, talk with patients about their current experience of the hospital and speak with the staff who work on these wards. CQC concluded that patients receive appropriate care as directed within individual care pathways.
In addition, CQC reviewed the trust’s systems for assessing and monitoring the quality of services it provides. The trust demonstrated it had an appropriate framework of governance in place that gathers, records and evaluates information about the quality and safety of care, treatment, support and outcomes of clinical services. CQC also considered relevant information it holds about the trust received from various other sources.
CQC also reviewed the management of complaints and concluded that the trust has procedures, followed in practice, for receiving and managing complaints which are monitored and reviewed as required. Recent changes to these procedures have been implemented. For example, the Medical Director now meets with all complainants, should their complaint not be resolved within three months of instigation. Although staff clearly understood the trust’s complaints procedure and management of complaints, they do not receive ongoing training in complaints handling.
While CQC was content with the cleanliness and tidiness of the wards it did note that the Stroke Unit at the Royal Albert Edward Infirmary was more disorganised, with a generally cluttered environment. It acknowledged that staff were very busy and at times looked stressed. CQC also noted that this ward has recently undergone organisational changes that have resulted in two ward areas being joined and it is still in a period of transition.
A total of 14 patients and 13 staff across both locations were interviewed. Without exception CQC was informed during discussions with patients, of high levels of satisfaction with the care received. Most staff felt happy with the level and frequency of training available and newly qualified staff felt effectively supported by other colleagues or Ward Managers.
“Following this unannounced visit I am satisfied that the trust is meeting essential standards. I am also reassured that the Chief Executive and the senior management team have an up to date assessment of the day to day running of the wards visited,” says Sue McMillan. “And while there are a few actions the trust has to take in respect of record keeping, tidiness on one ward, and regular complaints management training, we did not deem these sufficiently serious that they warranted compliance action. However, we will continue to monitor progress. Finally, I would like to thank the patients, visitors and staff who provided us with vital evidence during our visit.”
Full report: http://www.cqc.org.uk/publications.cfm?fde_id=16473
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