sector update july 2015 registered managers network
TRANSCRIPT
Sector UpdateJuly 2015
Registered Managers Network
10.00 Welcome and Introductions
Aims and Purpose of the Network
(NSA/Skills for Care funding & Offer)
Issues from Other Meetings (Inaugural meeting for Mid/East Surrey)
Recruitment
Care Certificate
Key Issues Facing Managers
Group Discussion
Sector Update - Changes and developments
CQC LatestMCA/DOLS latest developmentsCare Act Update – Safeguarding changes (new briefing from SSAB)CQC Review trends and themesDiscussion and Actions
Action Planning
Identification of activity to be undertaken outside of the meeting for feedback to SCA or SCC etc
Any other business
Discount for SCAMembers
https://www.nsasocialcare.co.uk/registered-managers
Update
Examples of misinterpretation?
The following slides are new/ish resources whichhave been referenced by
Andrea Sutcliffe as being important.
http://www.skillsforcare.org.uk/Finding-and-keeping-workers/Finding-and-keeping-workers.aspx
http://www.skillsforcare.org.uk/Finding-and-keeping-workers/Fostering-talent-and-increasing-skills/Fostering-talent-and-increasing-skills.aspx
https://www.nsasocialcare.co.uk/people-performance-management
Full Report available here
On Line only – no ability to download
MCA/DoLS UpdateSCC Letter
Law Society Guidance
SCIE Resource
DOLS update / Briefing Note to Surrey Care Association – May 2015
Following the Supreme Court Ruling in March 2014 Surrey County Council (SCC) has seen an unprecedented increase in requests for DOLS authorisations from Managing Authorities in Surrey, and around the country for people we have placed in other counties, as have all local authorities.
In 2013/14 SCC received 112 requests for DOL authorisations
In 2014/2015 we received 3,045 requests (an increase of over 2,700%).
This increase has presented significant challenges to SCC as a Supervisory Body and these will continue. The current situation is that for the majority of requests we have not been able to meet the timescales required for completing assessments or making authorisations. Every request is, however, prioritised on receipt and an acknowledgement sent to the Managing Authority with information regarding action to take if there is a significant change in the persons circumstances. We are focused on aiming to meet this challenge and to ensure that Surrey’s residents are safeguarded, by delivering high standards of support and assessment.
SCC has significantly increased the number of Best Interest Assessors (BIA’s) trained from within our Adult Social Care service, from 20 to 34 over the last year, and we intend to continue to train more as courses become available. These staff have been completing DOLS work on a rota basis for the last year, alongside their core work, and from June this year we are trialling a new system whereby each BIA will have a DOLS assessment in progress, as a way of increasing our capacity, and in the expectation this will be a better way for them to incorporate this with their day to day work under the Care Act.
The frontline DOLS team have recruited two additional permanent BIAs to join our current team of three, and we continue to advertise with the intent that we increase our capacity further. We are also exploring other options such as using independent BIAs, and utilising Social Work agencies to provide BIAs, but these options require careful consideration, to ensure both quality and value for money for Surrey residents.
Currently the Law Commission are completing a review and consultation over the coming months regarding DOLS, as they have been tasked with considering “how deprivation of liberty should be authorised and supervised in hospitals, care homes and community settings, where it is possible that Article 5 rights would otherwise be infringed. This includes considering the legislation underpinning DoLS in its entirety”.
They will be reporting back to the government with recommendations for reform and a draft bill in the summer of 2017. We would encourage Managing Authorities to take part in the consultation by visiting their website or attending one of the events they will be arranging over the coming months.
http://lawcommission.justice.gov.uk/consultations/a-z-consultations.htm#d
Our DOLS Team has provided advice and guidance on our Surrey CC website for providers with regards to the Mental Capacity Act and DOLS, and we have recently added a link to the Law Commission’s guidance regarding DOLS, which gives helpful guidance and scenarios for everyone working in adult social care to consider. Within the guidance there are helpful quick reference guides, and more detailed considerations for particular care settings that providers should find interesting and helpful.
http://new.surreycc.gov.uk/social-care-and-health/care-and-support-for-adults/understanding-the-law/mental-capacity-act-2005-deprivation-of-liberty-safeguards/deprivation-of-liberty-safeguards-team-and-submission-of-dols-forms
We have positive working relationships with Managing Authorities in Surrey and are committed to working closely with providers to help provide outstanding care for individuals. We always encourage Managing Authorities to contact our DOLS team, to discuss any specific concerns they have regarding the provision of care to people who lack capacity with regard to their care or treatment or for general advice about working with the Mental Capacity Act.
If Managing Authorities have current DOLS requests waiting for SCC to arrange assessments it is important that the DOLS Team are notified with updates regarding any significant changes, in order that we can continue to prioritise them appropriately.
We are always happy to discuss cases and prioritise accordingly to ensure that those people who require a fast response are seen as quickly as possible to safeguard their rights and to support the Managing Authority. We are mindful that the Care Quality Commission (CQC) address issue of DOLS in any inspection visits they carry out. From the Managing Authority Perspective it is important that they submit DOLS requests where appropriate and that CQC reporting requirements are adhered to.
Court of Appeal ruling means streamlined deprivation of liberty process is fatally flawed.
Clarity on the law in relation to deprivation of liberty cannot come soon enough in the light of another landmark case June 16, 2015.
Court of Appeal handed down a landmark judgment on the ‘Re X’ process for authorising deprivations of liberty in the community.
Two of the individuals in the Re X cases went to the Court of Appeal arguing, among other things, that a process determining their deprivation of liberty without them being a party was not fair and breached their human rights.Others joined the appeal on related issues for a hearing in February 2015.
Each of the individual appellants had in fact been made a party to the proceedings to review their deprivation of liberty, and so had arguably no standing to say that they were adversely affected by the Re X approach.
That said, when the court did hear argument about the issue of party status, there was a lot of doubt that the process could be fair if P was not to be joined as a party.
The judgment published this morning includes a fully reasoned contribution from each of the three judges, led by Lady Justice Black. The headlines are that:-
• Though sympathetic with the challenges facing Sir James Munby, all three judges were critical of the unorthodox approach taken to deal with the issues (for example, in paragraphs 58, 127 and 146 of the judgement).
• However, they concluded that the Court of Appeal had no jurisdiction to overturn the ‘Re X’ process, which should instead be properly challenged by judicial review against the practice direction (paragraph 50).
• Crucially, they all said that if they actually did have the jurisdiction to decide this, they would have said that P should be a party to any deprivation of liberty proceedings.
http://www.lawcom.gov.uk/project/mental-capacity-and-deprivation-of-liberty/#mental-capacity-and-deprivation-of-liberty-consultation
SfC
This guidance identifies a number of challenging safeguarding dilemmas, and aims to make clear how these should be handled within the new legal framework of the Care Act 2014.
CQC Update
As at 8 May 2015, the recruitment team had made 385 offers to new inspectors and 71 to inspection managers.
Update from the Adult Social Care (ASC) Directorate Adult Social Care Inspection and Ratings Since 1 October 2014, the Adult Social Care (ASC) Directorate has carried out over 4,800 comprehensive ratings inspections across community based adult social care services, hospice services and residential social care services and, as of 4 May, we have published 3473 ratings as follows; 20 (1%) as Outstanding, 2020 (58%) as Good, 1139 (33%) as Requires Improvement and 280 (8%) as Inadequate.
What can we learn from Inspections April – June
April6 reports PublishedNo Dom Care
May13 Reports Published2 Dom Care1 Good 1 Requires Imp.
June11 reports PublishedNo Dom Care
Staffing NumbersMCA/DoLS – (Consent)Staff Training/Appraisal/SupervisionNot Sufficient ActivitiesInfection Control/CleanlinessAudit/Action on AuditsPoor Practice in Caring/Dignity
Staff PracticeAudit/Action on AuditsMedication ManagementMCA/DoLSStaffing NumbersPoor Practice in Caring/DignityInconsistent Practice
Staffing LevelsAudit/Action on AuditsMCA/DoLSMedication Administration/RecordingSupervision and Appraisal not taking placePoor Practice in Caring/Dignity
April
May
June
Improvement top tips – Andrea Sutcliffe
here are my top tips - not just for integration, but any improvement.
Top tip one: it's hard workDon't underestimate the time, commitment and effort it takes to achieve successful, sustainable improvement. Quick fix sticking plasters fall off and sometimes do more harm than good. Get everyone involved, especially people using the service, their families and carers and staff, have a plan, pay close attention to culture and behaviours, make the time needed and be determined!
Top tip two: use what worksSomeone somewhere has probably tried to sort out your particular problem before and there are lots of resources available to show how they did which can probably help you. The Social Care Institute for Excellence and Skills for Care are always good starting points and their new joint website Care Improvement Works helpfully brings together their resources linked to each of our five key questions – is the service safe, effective, caring, responsive and well-led?Last week I was introduced to a resource I didn't know before but think is brilliant – the virtual dementia-friendly environments website from Stirling University, definitely worth a look.
Top tip three: be inspired by othersThere are some great services and a quick look at our Good and Outstanding reports will give you lots of inspiration.
Visiting or finding out about other services will also gives you good ideas. I had the privilege last week to visit Meath Epilepsy Trust in Godalming. I was encouraged to go by members of the Surrey Care Association who told me about the transformation Chief Executive Mike Keighley is leading there. I was very glad they’d pointed me in this direction. Meath supports people living with severe epilepsy many of whom also have learning and/or physical disabilities in their residential service, home care and skills and enterprise centre (formerly a more traditional day centre).
The ethos at Meath is to think about what people can do, not what they can’t and to recognise the talent in everyone. I heard tales of white-water canoeing in the Ardeche the week before, a thriving furniture upscaling business and the innovative and successful Art House enterprise. I was inspired and I’m sure you would be too.
Top tip four: listen to peopleEvery report about poor care we read tells us the same thing – listen to the people using your service and the people working in it. They can spot problems and solutions and can really help you to make the improvements you may need. When I was at Meath I also met four of the residents who are being trained to be internal quality assurance assessors. They already had some great insights on further improvements that could be made.When we look at how well led a service is, we will be asking about how inclusive and transparent the culture is and a key part of that is listening and responding to the voice of people using services, their families and carers and staff.
Top tip five: believe you canThis goes back to the first top tip – it is hard work but can be successful if you believe you can do it. Another lesson from Meath – so many people using adult social care services are told about what they can’t do, but you should have seen the pride and joy on the faces of the people who were telling me about their white water canoeing trip.
All Change! (Can we read anything into this?)
It was announced today that David Prior, the Chair of the Care Quality Commission, has been appointed to the position of Parliamentary Under Secretary of State at the Department of Health.He will take up this post with immediate effect and will therefore step aside from his role as Chair of CQC. The search for a permanent replacement will begin immediately; Michael Mire, a current CQC Board member, will Chair next week's Board meeting.
Camilla Cavendish has been appointed Head of the Policy Unit at 10 Downing Street. She will take up this post with immediate effect and will therefore step aside from her role as a member of CQC's Board.
David Behan, Chief Executive of CQC said:"I am delighted that Camilla Cavendish is to take up the post of Head of the Policy Unit at 10 Downing Street. We are sorry to be losing her from the Board. She has brought a sharp intellectual challenge to the work of CQC. She has made a significant contribution to CQC's development and new direction. She will be missed and we wish her well in her new role."