Weekly political news round up – 1st August 2014

August 1, 2014 in News by Whitehouse

Around the sector

Children and Young People Now has reported that the Government is set to miss its target for recruiting health visitors unless it recruits 1,900 more in the next 12 months. Shortly after coming into power in May 2010, the Government said that it would increase the number of health visitors from 8,100 to 12,300. In the past four years only 2,300 have been recruited – almost half of what is required for the five year period.

The Government has announced businessman and academy chain trustee David Hoare as the new chair of Ofsted. Hoare, who has over 30 years’ business experience with companies including DX Group and Virgin Express, has been a trustee of the Academies Enterprise Trust (AET) academy chain since January. Education Secretary Nicky Morgan said he has “crucial” experience in leadership and governance. Hoare will take up his new post in September.

Education Secretary Nicky Morgan has appointed Luke Tryl, former head of education at gay rights charity Stonewall and a Conservative activist in south London, as her latest special advisor – joining former lobbyist Chris Wilkins.  The appointment is attracting media attention because Morgan, the new Education Secretary and equalities minister, voted against same sex marriage in May last year. Tryl had worked closely with former Education minister Elizabeth Truss MP in her Norfolk constituency, suggesting he was a recommendation of the Environment Secretary.

The House of Lords started its parliamentary recess this week, and will sit again on the 13th October 2014. The Commons entered recess last week and will return on the 1st September for two weeks before rising again for the party conference season.

Care Quality Commission launches consultation on guidance for the new fundamental standards of quality and safety

The Care Quality Commission (CQC) has launched a consultation on draft guidance outlining how providers of health and social care should meet the CQC’s new fundamental standards of care. These standards were published following a consultation by the Department of Health on the requirements for registration with the CQC, which ran from January 2014 to April 2014.

The guidance is intended to replace the CQC’s current Guidance about compliance: Essential standards of quality and safety and the 28 outcomes that it contains. As with before, all registered providers of health and social care must demonstrate that they are meeting regulatory requirements in order to register with the CQC and continue to deliver regulated services.

Despite the new regulations being introduced due in large part to the outcome of the Francis Inquiry, where the subsequent report repeatedly mentioned failures with regards to continence care, continence is not explicitly mentioned. Moreover, provisions for children are virtually absent from this guidance.

However, four of the fourteen regulations are still of relevance to the PCF as they impact on continence care and general patient experience. These are highlighted below:

Regulation 9: Person-centred care

The intention of this regulation is to ensure that each service user receives care that is personalised specifically for them, that meets their needs and reflects their preferences. Specifically, it states that:

9.—(1) The care and treatment of service users must—

(a) be appropriate,

(b) meet their needs, and

(c) reflect their preferences.

It then outlines a number of actions that a registered person must undertake to comply with paragraph one, including provisions that:

  • Care and treatment is designed to ensure it meets all of the service user’s (relevant person’s) needs and, if a service user’s preferences in any way affect the provider’s ability to meet their needs, the impact is explained to the service user, including exploring any alternatives so that they can make informed decisions about their care and treatment.
  • A clear plan of care and treatment should be developed and should be available to all staff and others involved in the delivery of care.
  • Each service user (or relevant person) is provided with all the necessary information about their care and treatment, in a way they can understand.
  • Service users (or the relevant person) are given opportunities to be involved in making decisions, for example, participating in any discussions, invited to meetings, encouraged to ask questions and provide suggestions.

Breaching this regulation does not constitute a prosecutable offence itself, however breaches may be subject to regulatory action by the CQC.

Regulation 10: Dignity and respect

According to the guidance, this regulation is intended to ensure that service users are treated with respect and dignity while receiving care and treatment. The regulation states that:

10.—(1) Service users must be treated with dignity and respect.

(2) Without limiting paragraph (1), the things which a registered person is required to do to comply with paragraph (1) include in particular—

ensuring the privacy of the service user;

supporting the autonomy, independence and involvement in the community of the service user;

having due regard to any relevant protected characteristics (as defined in section 149(7) of the Equality Act 2010) of the service user.

Of particular relevance is the following guidance provided by the CQC:

10(2)(b) supporting the autonomy, independence and involvement in the community of the service user;

  • Service users are offered support in order to maintain their autonomy and independence in accordance with their needs and stated preferences. Service users are offered support when needed; however, staff respect any expressed wishes to act independently.

Again, breaching this regulation does not constitute a prosecutable offence itself, however breaches may be subject to regulatory action by the CQC.

Regulation 12: Safe care and treatment

The intention of this regulation is to ensure that all service users have given consent in accordance with this regulation before any care or treatment is delivered. The regulation includes the following requirement for providers:

12.—(1) Care and treatment must be provided in a safe way for service users.

Below are relevant regulation components for self-care and treatment:

b) doing all that is reasonably practicable to mitigate any such  risks;

  • Plans and pathways are followed by staff.
  • Medication reviews are part of, and align with, service users’ care and treatment assessments, plans or pathways and are completed and reviewed regularly in relation to changes in medication.

(e) ensuring that the equipment used by the service provider for providing care or treatment to a service user is safe  for such use and is used in a safe way;

(f) where equipment or medicines are supplied by the service provider, ensuring that there are sufficient quantities of  these to ensure the safety of service users and to meet their needs;

  • Service users’ medications should be available at all times in the necessary quantities, in order to prevent risks associated with medication not being administered as prescribed, including when service users manage their own medicines.
  • Equipment, medicines and/or medical devices necessary to meet service users’ needs are available (e.g. at hand when needed/obtainable within a reasonable time without posing a risk) at all times in sufficient quantity, and devices are in full working order.
  • The equipment, medicines and/or medical devices that are needed to meet service users’ needs are available when they are transferred between services or providers.

(h) assessing the risk of, and preventing, detecting and controlling the spread of, infections, including those that are health care associated;

Breaches of these fundamental standards constitutes a prosecutable offence.

Regulation 13: Safeguarding service users from abuse and improper treatment

This regulation is intended to safeguard service users from suffering any form of abuse or improper treatment, such as discrimination or unlawful restraint, while receiving care and treatment. The regulation states that:

13(4)(d) significantly disregards the needs of the service user for care or treatment.

The following piece of guidance is relevant:

  • Care and treatment is planned and delivered in such a way that all of the service user’s needs are able to be met, including ensuring that enough time is allocated to allow staff to deliver care and treatment in accordance with the service user’s assessed needs and preferences.

Breaches of this regulation constitute a prosecutable offence, subject to investigation by the CQC.

The consultation asks the following questions relevant to the PCF:

  1. Is it clear what providers should do to meet the requirements of the fundamental standards (regulations 9 to 19)? If not, how could it be made clearer?
  1. Is there anything missing from the guidance?
  2. Is there anything that should be taken out of the guidance?

SEND Code of Practice passes Parliament after Lords debate

This week, after four years of debate and nearly two years of legislative scrutiny, Parliament has passed the secondary legislation that underpins the Children Families Act, allowing the SEND reforms to come into law in September.

The guidance for implementation of these reforms is the statutory SEND Code of Practice, which the House of Lords debated and passed this week. The peers who steered the progression of the Children and Families Bill to ensure it was fit for purpose also had the final say on the Code. Almost all the peers in attendance welcomed the Code, notably Lord Storey and Baroness Hughes – speaking for the Liberal Democrats and Labour respectively.

The chief concerns raised in the debate included how children and young people without plans would be supported; how education and health authorities would be held accountable; how young children would have their needs identified and met; and how the workforce would be prepared to meet needs.

Schools Minister Lord Nash said:

  • The Government acknowledges that the Code is “not perfect” and therefore it will be kept under review (opening the door for future tweaks through statutory instruments).
  • Short term, to ensure accountability over implementation, local authorities and parent carer forums will be asked to complete implementation surveys on a termly basis.
  • Longer term, the Government will develop “an accountability framework for monitoring the delivery of the reforms”, which they expect to have in place by September 2015.
  • Ofsted is completing its survey of how local areas are working on the reforms and will make recommendations “soon” about the possible role of inspection in monitoring and accountability.