CQC

    There are units/wards two at Blackheath
    Heathside Neurodisability Unit & Thames Brain Injury Unit

    I had the misfortune of being on Thames Brain Injury Unit
    So im soooo confused. The CQC are true monsters, they pass service as ‘ok’ where they are no!

    Thames Brain Injury Unit

    CQC Inspection

    First point (on process) These two CQC reports are in different formats. This makes a quick comparison almost impossible.

    Most patients we spoke with were aware of their care planning, however patient’s involvement in their care plans was not evidenced in the records we reviewed. There was also a lack of evidence of mental capacity assessments in care plans

    and…

    However, there was no information about annual health checks in patients’ care plans.

    How can you have a care plan and not involve the person you’re caring for!

    Hospital had no plan to tackle autistic woman’s weight gain, coroner rules

    While not at Blackheath, it highlights the need for health checks and a care plan(s) that actively encourages the patient.

    and…

    We found that a number of staff did not have current Disclosure and Barring Service (DBS) checks. We also found that incidents were not escalated or documented immediately.

    So the legal checks that establish if a person is fit to work with vulnerable people have being ignored. Is that not gross misconduct
    Not reporting incidents is also gross misconduct

    Heathside Neurodisability Unit

    CQC Inspection

    This inspection of Heathside Neurodisability Unit took place on and was unannounced. The last inspection of the service was on . The service met the regulations inspected at that time.

    This give a picture of a nice, safe environment. Where your needs are met & independence will be promoted. However…

    The service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager has been absent from the service since October 2014.The provider had made arrangements for the service to have an interim manager. The service was not always we-led.

    I assume “we-led” is well led we-led vs. well led

    Point 1.
    The CQC have now corrected the spelling error of “we-led” in this document.
    This document has no revision history so changes are not tracked.
    Making these published reports worthless as the CQC can change them.

    The service had not always sent us the required statutory notices in relation to Deprivation of Liberty (DoLS) applications and authorisations. We could not be certain that the service had consistently met legal requirements in relation to DoLS.

    And..

    The service met the legal requirements of the Mental Capacity Act 2005. When people were assessed as not having the mental capacity to make a decision, a “best interests” decision was made. The service had appropriately made Deprivation of Liberty Safeguards (DoLS) applications to the local authority.

    The two above statements are very confusing! You either provide the DoLS application or you don’t.

    So when appropriate the CQC can ignore legal requirements. This will put vulnerable people in the hands of people who don’t take the responsibility fully.

    We trusted the CQC to rate and monitor the service offered, what happens when we lose faith in CQC.

    UPDATE

    @CareQualityComm: @danielmcmorrow Hi Daniel, I’m we’ll need a bit more information. Could you contact the team on information.access@cqc.org.uk please.

    http://www.cqc.org.uk/sites/default/files/new_reports/AAAC3016.pdf

    “The service had not always sent us the required statutory notices in relation to Deprivation of Liberty (DoLS) applications and authorisations. We could not be certain that the service had consistently met legal requirements in relation to DoLS.”

    And

    The service met the legal requirements of the Mental Capacity Act 2005. When people were assessed as not having the mental capacity to make a decision, a “best interests” decision was made. The service had appropriately made Deprivation of Liberty Safeguards (DoLS) applications to the local authority

    These to statements and very contradictory please clarify Under who’s authority can the CQC “ignore” legal requirements ?

    The service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run

    The registered manager has been absent from the service since October 2014.The provider had made arrangements for the service to have an interim manager. The service was not always well-led.”

    How can a service that is not well led pass CQC inspection? What aspects where not well led

    http://www.cqc.org.uk/sites/default/files/new_reports/AAAD0055.pdf

    We found that a number of staff did not have current Disclosure and Barring Service (DBS) checks. We also found that incidents were not escalated or documented immediately

    How can CQC be sure of the staff when DBS checks are incomplete ? Failure to process these checks could potentially put a vulnerable patient in the care of someone unsuitable. Would CQC accept responsibility for allowing inaccurate DBS checks?

    Would failure to document an incident not amount to goss miss conduct? How can patients records be relied on if there is a possibility of wrong information being present.

    UPDATE

    I emailed information.access@cqc.org.uk on as you would expect no response!

    So we have www.whatdotheyknow.com/request/legal_requirments
    Within SIX minnutes we get the following response…

    Dear Mr McMorrow

    Thank you for emailing CQC regarding information you require. We note that you have asked the questions under FOIA, but as these are requests for explanations (e.g. how, why and what questions) rather than requests for recorded information, we cannot answer them under FOIA. The Freedom of Information Act 2000, places a legal obligation upon a public authority to provide recorded information that it holds, but this would not cover producing new information by way of explaining our decisions.

    As you are asking for clarification of information published in two inspection reports, I have passed your queries to the Inspection Team for the two services your refer to and also to the Corporate Provider Inspection team on the 7 July 2015.

    Unfortunately they have not as yet responded and I will chase them up again today. My apologies for not acknowledging your original email, but I was hoping for a quicker response from my inspection colleagues.

    I note you have also not asked the same questions via the What Do They Know website, however, as explained to answer these questions will mean the creation of new information and as such is not something we will likely be able to respond to under FOIA processes.

    If you have any further questions please let me know and I will try and ensure they are responded to.

    Kind Regards

    Russell Wynn
    Senior Information Access Officer

    Legal Services & Information Rights, Care Quality Commission
    Citygate,Gallowgate,Newcastle Upon Tyne, NE1 4PA

    transparency-must-be-heart-everything-we-do

    However, it is extremely important that we share this information publicly and widely. Right from the beginning of the developments of our new approach the public, providers and our stakeholders rammed home the point that we must be a transparent regulator. We expect this of our providers and we must deliver nothing less ourselves. It is so important that we share all the information we hold and use to inform our work with the public, who are rightly at the very heart of everything we do here at CQC.

    It would appear transparency is ok as long as you don’t question the CQC’s methods.

    UPDATE

    I love putting facts to random statements. HOW MANY WEBSITES ARE THERE IN JANUARY 2014?

    As of Janaury 2014 there are around 861,379,000 registered host names,which is an increase of around 350,000 compared to December 2013.

    Now not all of these websites will be “biogs” or even have comments? Lets use 100,000 for comparison. I’m also taking Patient Websites, to be personal websites not .nhs.uk sites.
    So 6000 is 6% Of 100,000

    This would also have to be automated, meaning a pre-definde list of “negative” words has to exist.

    UPDATE

    For most companys protecting band image and intellectual property is key – in a company who deal with information its key as mis-information can lead to mistakes.

    @CareQualityComm: @KayFSheldon @RoyLilley @CQCpressoffice Hi Roy, Kay’s correct, they’re not our adverts.

    Less 30 seconds on google gave me…
    http://www.ukqcs.co.uk/

    Now UKQCS look to be selling software designed to help with CQC Assessments/Requirements
    Now if this software is not endorsed by CQC then UKQCS have some very big questions to answer!

    UPDATE

    Dear Mr McMorrow

    I write in response to your query of in relation to the inspection report on Heathside Neurodisability Unit and to the inspection report on the Thames Brain Injury Unit. As your questions are not requests for recorded information, but asking for explanations as to CQC’s actions, we are responding to this as business as usual, rather than under FOI.

    Heathside Neurodisability Unit

    You quote two statements from the report in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLs). You were concerned that the report was contradictory.

    Your first quote is, “The service had not always sent us the required statutory notices in relation to Deprivation of Liberty (DoLS) applications and authorisations. We could not be certain that the service had consistently met legal requirements in relation to DoLS.” This means that the service had not sent us the required notifications over a period of time. We could not be certain that they had always met the DoLS requirements in the months preceding the inspection.

    Your second quote is, “The service met the legal requirements of the Mental Capacity Act 2005. When people were assessed as not having the mental capacity to make a decision, a “best interests” decision was made. The service had appropriately made Deprivation of Liberty Safeguards (DoLS) applications to the local authority.” This refers to the situation we found on the day of the inspection. It is therefore not contradictory with the above quote which is in reference to the months preceding the inspection and therefore CQC does not consider that we have ignored legal requirements.

    Firstly neither of the above quote are prefixed with dates or reference a date. Unless you have prior knowledge of the CQC or Blackheath these comments are in contradiction of each other.

    With regard to your quote, “The registered manager has been absent from the service since October 2014.The provider had made arrangements for the service to have an interim manager. The service was not always well-led.” You have asked, “How can a service that is not well led pass CQC inspection? What aspects where not well led?” There is a detailed explanation of how the service is not well-led is given at page 10 0f the report, “The service had not always sent the CQC notifications in relation to the outcome of Deprivation of Liberty (DoLS) applications. We could not therefore be certain that the service had always met legal requirements in relation to DoLS. This was a breach of CQC (Registration) Regulations 2009 Regulation 18 (4a and 4b).
    The provider made checks on the quality of the service. The provider had conducted a detailed audit of medicines management procedures in October 2014. The audit checked practice in the service against current guidance for the management of medicines in an adult social care setting.

    Consequently, the provider had identified a number of improvement actions in relation to the management of medicines. No timescales had been set for their implementation. At the time of the inspection, not all of the actions had been completed. For example, one of the uncompleted audit actions related to ‘PRN Protocols.’ The audit report stated, “There do not seem to be any PRN protocols in place. Could these be completed by the named nurse?” A ‘PRN protocol’ explains how a person should receive medicines prescribed for conditions such as pain or anxiety which are to be taken only when the person needs it. It was important staff had guidelines in place about how to manage these medicines as some people in the service could not ask staff for these medicines when they need them due to their communication needs.

    The interim manager told us the aim was to have all the actions completed within the next few days, as the service was due to be re-audited. Whilst these PRN protocols were not in place we could not be certain that people in the service had always received their PRN medicines safely as prescribed. Identified areas for improvement were not addressed in a timely way. People were at risk of receiving inappropriate care and support. This was a breach of Regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.”

    In relation to CQC actions, page 11 of the report explains the regulations which were not being met and that we have asked the provider to send us a report to say what action they are going to take. We did not take formal enforcement action at this stage. We will check that this action is taken by the provider. Therefore CQC does not consider that we have ignored legal requirements.

    Thames Brain Injury Unit

    In relation to the second part of your request we have answered your questions relating to the staffing requirements laid down in the Health and Social Care Act 2008 and associated regulations.

    “How can CQC be sure of the staff when DBS checks are incomplete ? Would CQC accept responsibility for allowing inaccurate DBS checks?”

    The responsibility for recruiting suitable staff and carrying out required pre-employment checks rests with registered providers. It is for them to provide assurance to themselves, CQC and any other stakeholders that the staff they employ are suitable, appropriately qualified, skilled, and experienced.

    CQC is not responsible when providers carry out incomplete DBS checks, but will take appropriate action if we find any breaches of regulations 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These regulations make specific legal requirements on providers in relation to criminal records checks.

    Is Not having checks not a breach then?

    “Would failure to document an incident not amount to gross misconduct?”

    Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 requires providers to ‘maintain securely an accurate, complete and contemporaneous record in respect of each service user, including a record of the care and treatment provided to the service user and of decisions taken in relation to the care and treatment provided’. Responsibility for monitoring staff conduct in relation to this requirement rests with the registered providers. CQC does not prescribe what acts would amount to gross misconduct, and it is not for CQC to determine the disciplinary measures a provider should take.

    “How can patients records be relied on if there is a possibility of wrong information being present?”

    CQC role is to check the quality and safety of services. Good record keeping is an essential part of providing a good service. Where we find that wrong or inadequate information is being recorded, we require the provider to take the necessary steps to improve.

    UPDATE

    People need to have trust in the NHS and have confidence that their personal medical records will be secure and protected at all times.

    We already have data protection law but its clear the “powers” know these laws don’t work.
    When A Dr broke my right to medical privacy by responding to a letter for my employers, without my knowledge or cencent. The ICO, GMC, CQC & PHSO have all done nothing… 

    Besipite the clear breach. 

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    Daniel McMorrow

    34 Year old disabled geek,

    One thought on “CQC”

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