More than 300 residential care homes for younger disabled adults have not been inspected by the care watchdog for more than two years, according to official figures obtained by Disability News Service (DNS). The figures, released by the Care Quality Commission (CQC) in response to a freedom of information request, also show that 87 care homes in England have not had an inspection since 2014. And 10 homes have not had an inspection for between three and four years. In all, the CQC figures show that, on 1 June 2017, there were 311 care homes for adults under 65 (out of a total of 5,358 homes across England) that had not had an inspection by the regulator in the previous two years. Despite DNS alerting CQC to the figures on Monday, the commission failed to respond to requests for a comment by noon today (Thursday). The commission’s press office claimed today that its “team of analysts” were not clear how the figures were compiled, even though the press office has been told that they were
Within these contracts to Atos and Capita there should be a quality standard in that if an appeal is won by the claimants then these organisations should have to pay back some or all of their fees received. This would go some way the ensure that the assessments were subject to good quality, for if they were then the appeal success rate would not be so high, or is it the benefits themselves are not fit for purpose as well as the organisations conducting the assessments.
Any system is open to abuse, but this is where quality monitoring should be a prime requisite. However, due to austerity cuts, local councils are consistently looking to reduce rates for care providers and by doing so these providers will need to reduce some of the areas which are included in the cacluation of their rates. They may only pay the minimum wage for to pay less is illegal, however, they may try to not provide reimbursments of travel expenses, make charges for uniforms and others. They may also reduce training costs and so may reduce recruiting, however, the latter may mean their staffing numbers may reduce which could mean they can not provde staff for all their contracts. It would be unusal for the profit element to be reduced.
It is therefore essential that there is a robust quality checking facility, This is done to some extent in the UK by the Care Quality Commission, but can they regularly check all establishments. So who else could check quality, this could be the local authorities, but with the Government cuts are they in a position to do so, for although they are constently quoting ‘value for money’ is quality at the forefront of their mind, as they only appear to be looking for the cheaper care providers. Then in doing so will not quality suffer.
These are the risks when privatisation is allowed to occur in vital public services. In these tendering processes each organisation is supposed to submit their tender and a business plan., however in the eagerness to provide the lowest tender some organisation will cut costs to the bone and in doing so quality is the area which suffers.
When you question organisations like the CCGs they are always quoting they have to see value for money, but if a tender is not viable then it is not value for money, but once granted tenders are rarely monitored as a viable commodity. As this in itself would cost and will not have been allowed for within the process.
Rise in care homes going out of business, research by accountancy firm Moore Stephens finds
In my view this is just the start as care homes are the first, as it will not be long before this is occurring in supported living and home care service providers, if not already. While it is good that there is the national living wage, even though it is not sufficient, the bench mark should be the Living Wage.
These providers are having to pay their staff the national living wage when the Government is reducing funding to local authorities, who then are short of funding to allow these providers to increase their fees accordingly. Care is in crisis.
Before closure the care homes, and service providers could try to reduce their overheads by cutting training, however this and any other cut backs will result in a reduction of quality, which no one wishes to see, as in some areas quality is only just being achieved, if that.
Accessibility Statement Jobs Keep in touchPress office
‘……………….By Chris Ham Chief Executive
We were asked to report on the development of a health systems scorecard which would aim to:
- allow commissioners to assess the quality and effectiveness of local services and identify areas for improvement
- provide accountability to patients and the public, allowing them to compare local health services on the basis of objective information
- help NHS England identify areas where clinical commissioning groups (CCGs) may need targeted support to improve care quality and health outcomes.
The review is a contribution to Secretary of State for Health Jeremy Hunt’s ambition to put ‘intelligent transparency’ at the heart of NHS performance improvement in this parliament. We believe intelligent transparency demands a clear line of sight from the Secretary of State through NHS England and CCGs to the populations they serve, based on indicators that reflect what really matters to the public and NHS priorities. This would deliver the single definition of success for local systems of care and CCGs that the Health Secretary has spoken of as being needed for providers.
To deliver this clear line of sight, we recommend radical simplification and better alignment of existing frameworks for assessing performance in the NHS. Our report also argues that there should be rationalisation of the disparate public-facing websites to provide the public with an integrated view of health and care services in an area. The public should be consulted on which aspects of performance should be covered and how information should be presented – at the moment this is an evidence-free zone.
Intelligent transparency demands careful attention to how performance indicators are selected and presented if it is to achieve its desired results. Done well, performance assessment can help to strengthen accountability to patients and the public, as well as support commissioners and providers in improving care. The challenge is to adopt an approach that recognises the complexity of performance assessment and the pitfalls that await the uninitiated.
To avoid these pitfalls, we looked at experiences in a number of other health care systems as well as in the English NHS. We recommend that information about the performance of local health systems should draw on the three national outcomes frameworks that currently exist and the commissioning outcome indicator set. This information should be presented at three levels to inform patients and the public about services in their area and to support commissioners and providers in achieving improvements in care.
The first level would focus on a small number of headline indicators aimed at providing a picture of performance for the population as a whole. The second level would be organised around the domains and indicators in the outcomes frameworks and the commissioning outcome indicator set. The third level would include a larger set of indicators to enable patients and the public to drill down into population groups and medical conditions of particular interest to them, and to support commissioners and providers in quality improvement.
Over time we recommend that the three outcomes frameworks be consolidated into a single framework covering the NHS, adult social care and public health.
One of the clearest conclusions of our review is that an aggregate score of the performance of local health systems should not be produced using performance indicators alone. Aggregate scores can mask good or poor performance on individual indicators and therefore may not give a meaningful overall picture. This was strongly supported by our review of the evidence and experience in other countries, as well as by the group of technical experts that we convened to advise us in our work.
Further work is needed to understand more thoroughly the information that the public and CCGs want, as well as how appropriate data could be presented and accessed to support the causes of transparency and improvement.
- Read the review: Measuring the performance of local health systems
- See the press release: NHS performance frameworks need radical simplification and alignment, The King’s Fund review finds
- More about the review: Measuring the performance of local health systems
The Report …………….’
‘…………..The extent to which the NHS has kept abreast of the latest medical and technological advances and trends in health care needs is testament to the commitment the workforce has for continuing professional development. Few other industries can match this capacity for continual learning. However, with the increasing complexity of modern health care, high quality care is less a product of oneto-one clinician–patient interactions and more the outcome of multiple decisions and interventions across many care settings and teams. In this context, it is no longer enough for clinicians to be equipped with specialist medical knowledge; they also need to have the knowledge and skills necessary to improve the quality of care and to work safely and effectively, as part of a team and across the health care system. ………………..’