Welcome to the UKQCS newsletter. If you have any difficulty in reading the newsletter please let us know and we can provide you with a stripped down version which can be read by all email clients. This newsletter is free, so please pass it on to your colleagues, who can sign on for their own copy by visiting our website at www.ukqcs.com and completing the brief details requested. In order to keep the newsletter to a reasonable length, we are now using more hyperlinks to external articles and information. Where the links are extremely long we use Tinyurl to shorten them. Using Tinyurl links is safe; many national newspapers use them. Simply click on these to see them, or copy and paste the link into your browser if your email client switches the automated links off. If you are experiencing problems please let us know so that we can improve and/or fix it CSCI has announced a significantly enhanced enforcement policy. Quoting from the CSCI press release: "Seven new specialist enforcement teams will tackle poorly performing care services, under new proposals agreed by the Commission for Social Care Inspection (CSCI). The move reflects CSCI’s commitment to improving services and stamping out bad practice wherever we see it. Based in each of CSCI’s seven regions, the enforcement teams will be led by highly experienced senior inspectors – called Regulation Managers – supported by specialist inspectors and support staff. The teams will work closely with CSCI’s lawyers to improve the speed, quality and consistency of enforcement activity in England. CSCI will also inform local councils, who purchase services for local residents, about poorly performing care services in their area, and the legally binding ‘requirements to improve’ placed upon services by CSCI inspectors." The full text, including a link to the enforcement policy, is at http://tinyurl.com/3xbrqp and in Useful Documents on UKQCS management system client’s personal web sites The UKQCS Care Quality Management System, a Total Quality Management (TQM) system, is the only resource which providers and managers need to enhance their compliance with regulatory requirements, and to foster best practice throughout their organisation. For details contact us on 08707 489899, email us at enquiry@ukqcs.com, and download our PowerPoint presentation at http://www.ukqcs.com Published in the CSCI Professional web site on 6th June, reference: http://tinyurl.com/3czour An extensive new Policy and Procedure covering the MCA 2005 is being uploaded to the UKQCS web site. The UKQCS web site has had a number of information and training resources added under “Useful Documents” and “Useful Links”. UKQCS Care Quality Management System users, including employees, will receive instantaneous notification of the upload in their sign-in page. The Service User Pre-admission Assessment Pack is being modified to include reference to the Act. Underperforming NHS trusts and care homes face fines and closure under powers for a new health and social care watchdog, a leaked government document suggests. The watchdog could impose fines, instigate a statutory warning notice demanding improvements, issue a formal caution or a temporary suspension of registration, impose conditions restricting what can be provided, or start a criminal prosecution. Full story at: http://tinyurl.com/39qzus A new Smoking Policy, one each for institutional and community settings, is being uploaded to the UKQCS web site to meet the new regulations. The UKQCS web site also has had signage and other smokefree resources added under “Useful Documents”. UKQCS Care Quality Management System users, including employees, will receive instantaneous notification of the upload in their sign-in page. Further guidance at: http://tinyurl.com/35z52h The Service User Pre-admission Assessment Pack, and the Recruitment Pack are both being modified to address the new regulations. CSCI have a new information page about the effects of the smoking ban at: http://tinyurl.com/36eavz The contents of the CSCI site top level page follows: (copyright CSCI) Find out what changes are needed to your service from the new law that will ban smoking in public places like care homes. The legislation introduced by the Department of Health from 1 July 2007 will affect Care homes, domiciliary care and nursing agencies, and your staff. Smoking will only be allowed in certain rooms that are clearly marked – such as a bedroom or designated room that can be accessed by all residents. These rooms will be checked by your local council and must meet the requirements of Regulation 2 of the Smoke-free (Premises and Enforcement) Regulations 2006. You can find a range of booklets, guidance and posters from the NHS website at http://www.smokefreeengland.co.uk/ Key regulations: Read the key regulations for care services available from the Office of Public Sector Information website: http://www.opsi.gov.uk/si/si2006/20063368.htm, and http://www.opsi.gov.uk/si/si2007/20070765.htm Note – mental health units: Under Regulation 10 of the Smoke-free (Exemptions and Vehicles) Regulations 2007, mental health units are not included in the new law until 1 July 2008. These units are not care homes - they are medical treatment centres regulated by the Healthcare Commission. Domiciliary care and nurses agencies: People’s homes do not have to be smoke free when a carer or nurse is providing personal or nursing care. Staff who don’t smoke may ask to use a smoke free room that has not been used for smoking within the last hour of their visit - and it should be well–ventilated, for example with opened windows. Read the regulation about smoking in people’s homes on the Office of Public Sector Information website: http://www.opsi.gov.uk/si/si2007/20070765.htm Coping with a compliance visit from any official body, let alone the Home Office, can be a nightmare if not handled correctly. But the process need not be so stressful provided you are on the right side of the law. Care Homes all over the UK are receiving letters, questionnaires and visits from the Borders and Immigration Agency’s (formerly Work Permits UK/Home Office) Compliance Department. In the meantime Work Permits and extensions are becoming increasingly harder to obtain, as rules are ‘reinterpreted’ by Work Permit case officers. Full story at: http://tinyurl.com/2lqjht The Borders and Immigration Agency are reviewing the Senior Carer Work Permit scheme, prompting widespread fears that no further permits will be granted. Full story at: http://tinyurl.com/2otnkg A speech to the Association of Directors of Social Services by Paul Snell, Chief Inspector, Commission for Social Care Inspection The Chief Inspector for Social Care Inspection discusses how the role and regulation of social care is changing while at the same time retaining the same ethos and values that have helped so many in society. More . . . http://www.egovmonitor.com/node/10575 ON 1 January 2007 the Companies Act 1985 rules relating to the information that must be on company documents were amended and explicitly extended to include order forms, electronic documents and websites. Business letters and order forms—whether in hard copy, electronic or other form—and all of the company's websites must include the company's full name, its place of registration, its company number, the address of its registered office, and in the case of company exempt from the requirement to use "limited" as part of its name, the fact that it is a limited company. These details do not need to be on every page of a website, but they do need to be "legible", which means they can't be in tiny print. Many emails that go out of the company are likely to be classed as business letters, so all outgoing emails should include a footer with all the required disclosures. The company's full name, but not the other details, must be on all of its notices (of meetings etc) and other official publications, cheques, orders for money or goods purporting to be signed by or on behalf of the company, bills of exchange, promissory notes, invoices, receipts, bills of parcels and letters of credit—whether in hard copy, electronic or other form. Where a company is being wound up, whether voluntarily or by the court, a statement that it is being wound up must be included on every invoice, order for goods, business letter or order form—whether hard copy, electronic or any other form—and all of its websites. The latest policy is published by CSCI at: http://tinyurl.com/2szggc, and in Useful Documents on UKQCS management system clients' personal web sites The Infection Control Nurses Association can be found at http://www.icns.co.uk The DoH published the Code of Practice for the Prevention and Control of Health Care Associated Infections on 1st October 2006, and this can be found on the DoH web site http://tinyurl.com/3dj7qe and in the Useful Documents section of the UKQCS web site. We have also added the Stockport PCT Guidance to Care Homes on infection control, a very comprehensive document, to Useful Documents on our web site, We have added a very useful document to Useful Documents on our web site. This is the PAINAD pain assessment for use with people with advanced dementia. Also on the site is the terms definition document. The documents are in Useful Documents in UKQCS client’s managed web sites This item is reproduced for two reasons. First, it illustrates some CSCI concerns, but secondly to illustrate a very obvious trend in the media for stories about problems with care providers. This is either stemming from reporters regularly reviewing CSCI reports, or someone feeding them the information. We pick up at least 20 stories per week at the moment, and the number is growing by the week. Reprinted from Sudbury Today A nursing home has been warned it must treat residents with dignity and respect in a report by independent inspectors. The Commission for Social Care Inspection issued the ultimatum to Catchpole Court nursing home, in Walnuttree Lane, Sudbury, after two routine random inspections in October and December. The warning comes at the same time as inspectors are considering a complaint over the treatment of 81-year-old Edna Dallas, who died in October. Their report lists 38 improvements that must be made at the home. They include: >Ensuring residents are "treated with respect at all times and that their wishes are respected" >Repairing fixtures and furniture in bedrooms >Training staff in handling residents >Telling residents' relatives about the complaints procedure and keeping a full record of complaints, including details of investigations and any action taken >Assessing and monitoring carers' proficiency in English. The report also highlights a bath that was running at 48 degrees C which should have been at around 43 deg C. Between the routine inspections, Sue Buckle, of St Mary's Close, Chilton, lodged an official complaint with the commission about Mrs Dallas's care. Mrs Buckle claims the home failed to take swift action when her aunt suffered a fractured elbow, hip and deep bruising to her side in a fall last February 19. She is also unhappy with the way her aunt was cared for following her return from hospital to Catchpole Court. Mrs Dallas died at West Suffolk Hospital, on October 20, following a severe chest infection. Inspectors probed the complaint about her treatment on their December visit and have yet to reveal detailed findings to Mrs Buckle. Craegmoor Healthcare, which owns Catchpole Court, conducted its own investigation. In a letter to Mrs Buckle David Fothergill, its divisional managing director for older people, said there appeared to have been a lack of "dynamic intervention" on the night Mrs Dallas had her fall. There were insufficient records of the events to draw conclusions, he said. A commission spokesman said: "When we do inspections we look at standards of care within the home and give them deadlines to improve, and if they do not improve their services then we can take action against them which could include closing them down." The report says residents and relatives complained of a problem understanding what was said by some of the overseas staff, and that language could be a big barrier within the home. However, there was also praise for the home with two local GPs, of 15 professionals contacted, telling the commission they were happy with the level of care. The other 13 did not respond. It says 97.5% of relatives of patients were happy with the level of respect shown by staff. And 87.5% were happy with the level of care. They are reported by inspectors as finding a "warm, welcoming" atmosphere. Shortly after BUPA Care Homes (CFC Homes) Limited was fined almost £35,000 for failing to ensure that BUPA's bed rail policy was properly implemented, Southern Cross Healthcare has been fined £175,000 following fatality involving bed rails and pressure mattresses. The case brought by the HSE follows its investigation into the death of a 69-year-old resident who suffocated in her bed at Hornegarth nursing home in Staffordshire on 15 April 2005 after becoming trapped by the legs in a gap between one of the bedrails on her bed and the bed’s mattress. She was trapped in a face down position and suffocated because she had had very limited upper body movement and could not free herself. Speaking after the case, HSE investigating inspector Andrew Bowker said: "The death of Margaret O'Mara was the tragic result of a failure by Hornegarth nursing home to follow its own quality procedures relating to the safe use of bedrails. There was a catalogue of errors at the home that resulted in Margaret being exposed to unnecessary risk. "Her room had both incorrectly fitted bedrails and an incorrectly fitted pressure mattress. The care staff who were required to fit this equipment had not been trained on how to do the job properly and had no access to instructions. Risk assessment documentation specifically designed to guide staff through the safe use of this equipment was not being used at the site." Southern Cross Health Care Group PLC, which owns Hornegarth nursing home, pleaded guilty to a breach of section 3(1) of the Health and Safety at Work etc Act 1974; and guilty to a breach of Regulation 3(1) of the Management of Health and Safety at Work Regulations 1999. It was fined a total of £175,000 with costs of £15,919. Regulation 3(1) of the Management of Health and Safety at Work Regulations states: "Every employer shall make a suitable and sufficient assessment of the risks to the health and safety of persons not in his employment arising out of or in connection with the conduct of his undertaking for the purposes of identifying the measures he needs to take to comply with the requirements or prohibitions imposed upon him by or under the relevant statutory provisions." Note that the UKQCS Restraint Policy and Procedure contains a checklist for assessing each use of a restraint such as bed rails. Copyright UK Quality Care Solutions Ltd. 2007, PO Box 2129, Wrexham, LL12 9ZD. 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