Care Quality Commission | June 2019 | Smiling matters: oral health care in care homes
Care Quality Commission (CQC) has published its review of oral health care in care homes across England. The review also includes a number of case studies .Their findings show that too many people living in care homes are not being supported to maintain and improve their oral health.
What CQC did
Dental professionals accompanied our adult social care inspectors on 100 routine inspections. Three years on from the publication of the NICE guideline
(NG48), oral health in care homes is still not a priority and people are not always able to access the dental care they need.
Seventeen per cent of care homes said they never assessed people’s oral health on
What CQC found
Among the homes visited:
most had no policy to promote and protect people’s oral health (52%)
nearly half were not training staff to support daily oral healthcare (47%)
73% of care plans reviewed only partly covered or did not cover oral health
it could be difficult for residents to access dental care
10% of homes had no way to access emergency dental treatment for residents
A cross-sector approach including:
sharing best practice
repeating and reinforcing the guidance
mandatory staff training
oral health check-ups for all residents moving into a care home
Adult inpatient survey 2018 | Care Quality Commission (CQC)
The results of the latest inpatient survey show what over 75,000 adults who stayed in hospital for at least one night in July last year said about the care they received. The survey covered the quality of information and communication with staff, whether they were given enough privacy, the amount of support given to help them eat and drink, and their discharge arrangements. The results are provided for England as a whole and by NHS trust.
Across the majority of questions asked in the survey there has been no improvement since it was last carried out, and this year’s results show an increase in those reporting lengthy delays, greater dissatisfaction with the amount of information provided when leaving hospital, and those who felt a lack of involvement in their care.
Most results for the 2018 Adult Inpatient Survey have slightly declined since last year or remained static.
Relationships with the medical and nursing staff are usually positive although there is a small decline compared to last year. For example, patients reported that overall, doctors and nurses answered their questions in a way they understood.
Trust in doctor and nurse is high, although declining slightly compared to last year.
Fundamental needs of most patients are being met in terms of food, hydration and rest.
The proportion of patients reporting being given enough privacy when being examined or treated continues to be very high.
However, this year’s results indicate that there are many areas in need of improvement:
Patients are reporting poorer experience when it comes to the integration of their care.
Patients are reporting that they are waiting too long at admission and longer than previous years at discharge.
At the time of being discharged, significant numbers of patients were unsure about their situation. This includes not being given appropriate information about their care after leaving the hospital, and not receiving enough notice.
Significant numbers of patients reported not being sufficiently involved in decisions regarding their care and treatment.
Certain groups of patients consistently reported poorer experiences of their time in hospital, including
The Care Quality Commission | June 2019 | Driving improvement: Case studies from eight independent hospitals
CQC visited eight hospitals that had improved their ratings to hear, how they have driven improvement for people who use their services. From this they identified common themes in the hospitals’ improvement journeys:
Care Quality Commission | May 2019 | Interim report: Review of restraint, prolonged seclusion and segregation for people with a mental health problem, a learning disability and or autism
This report from the Care Quality Commission (CQC) gives the interim findings from our review of the use of restrictive interventions in places that provide care for people with mental health problems, a learning disability and/or autism.
The interim report shares findings from the CQC’s visits to 35 wards (assessing the care of 39 people), alongside information gathered from a request sent to 92 registered providers of services for people with a mental health problem, a learning disability and or autism. The report outlines the CQC’s preliminary findings.
What the CQC found on their visits:
Many people the CQC visited had been communicating their distress and needs in a way that people may find challenging since childhood, and services were unable to meet their needs.
A high proportion of people in segregation had autism.
Some of the wards did not have a built environment that was suitable for people with autism.
Many staff lacked the necessary training and skills.
Several people that we have visited were not receiving high quality care and treatment.
In the case of 26 of the 39 people, staff had stopped attempting to reintegrate them back onto the main ward. This was usually because of concerns about violence and aggression.
Some people were experiencing delayed discharge from hospital, and so prolonged time in segregation, due to there being no suitable package of care available in a non-hospital setting.
The interim report focuses exclusively on the experience of those people cared for in segregation on a mental health ward for children and young people or on a ward for people with a learning disability or autism. It makes a number of recommendations for the health and care system, including CQC.
OverviewAt the end of 2018, Matt Hancock, the Secretary of State for Health and Social Care, asked us to look at the use of restrictive interventions.
This interim report focuses on 39 people who are cared for in segregation on a learning disability ward or a mental health ward for children and young people (Source: CQC).
Care Quality Commission | March 2019 | The state of care in independent doctor and clinic services providing primary medical care
The state of care in independent doctor and clinic services providing primary medical care, presents the CQC’s findings from their analysis of sample reports (85 inspection reports for independent doctor and clinic services and themes from a review of inspection reports for 38 independent slimming clinics) from their inspection programme. This analysis showed that many services were responding to the needs of patients, some however were not meeting regulations and not providing safe and effective care.
The caring key question had the most positive feedback and fewest concerns, whereas most concerns fell under the safe key question. CQC’s main areas of concern related to:
safe and effective prescribing
awareness of safeguarding and establishing patients’ identity, particularly for children and their parents or legal guardians
arrangements for clinical oversight, governance frameworks and quality monitoring and improvement
recording details and managing patients’ care records
gaining appropriate consent
sharing information with a patient’s NHS GP or other health professionals in accordance with guidance from the General Medical Council (GMC)
On re-inspection, providers showed improvement in a number of areas where we had found concerns. Where they did not, CQC have taken the necessary enforcement action (Source: CQC).
Care Quality Commission | March 2019 | Learning from deaths- a review of the first year of NHS trusts implementing the national guidance
The Care Quality Commission (CQC) have published Learning from deaths- a
review of the first year of NHS trusts implementing the national guidance. The CQC conducted qualitative interviews and held a focus group with with CQC inspection staff and adivsors; alongise this they also carried out case studies within trusts rated as ‘outstanding’ for being well-led between September 2017- June 2018. CQC identified variation in how the new guidance was implemented in trusts.
In light of their findings, CQC have suggested the following factors have an impact on how the guidance is implemented:
values and behaviours that encourage engagement with families and carers
clear and consistent leadership
a positive, open and learning culture
staff with resources, training and support
positive working relationships with other organisations (Source: CQC)
Care Quality Commission | February 2019 | New research for CQC shows people regret not raising concerns about their care – but those who do raise concerns see improvements
The Care Quality Commission (CQC) is encouraging people who have concerns about their care to raise concerns. According to their research 7 million people in England who have accessed health and social care during the last five years have concerns about their care but have not raised them. More than half (58 per cent) expressed regret about no raising concerns (Source: CQC).
The main explanations given for raising a concern were:
delays to a service or appointment
lack of information
poor patient care
Reasons cited for not raising a concern were:
Not knowing how (20 per cent)
Not knowing who to raise it with (33 per cent)
Not wanting to be seen as a trouble maker
Worried about not being taken seriously
More than a third (37 per cent) felt that nothing would change as a result of raising a concern
Although when concerns were raised two-thirds found their issue was resolved quickly.
The findings have been published to coincide with the CQC campaign ‘Declare Your Care’- which is encouraging people to share their experiences of care with CQC to support its work to improve standards of care in England.