Issue - meetings

Dignity and nutrition - findings of Care Quality Commission

 

 

Meeting: 13/12/2011 - Health & Wellbeing Scrutiny Committee (Item 5)

5 Dignity and Nutrition for Older People - response of Stockport NHS Foundation Trust

Judith Morris, Director of Nursing and Midwifery (Stockport NHS Foundation Trust) will attend the meeting and make a presentation on the Foundation Trust’s Action Plan arising from the Care Quality Commission report published during the summer 2011 on dignity and nutrition for older people in hospitals.

 

Further details on the CQC report can be found at http://www.cqc.org.uk/public/reports-surveys-and-reviews/themes-inspections/dignity-and-nutrition-older-people

 

An update on the Trust’s actions to prevent a recurrence of medical product contamination will also be provided, as requested by the Scrutiny Committee at its last ordinary meeting.

 

Officer contact: Jonathan Vali, 0161 474 3201, jonathan.vali@stockport.gov.uk

 

Minutes:

Judith Morris, Director of Nursing and Midwifery (Stockport NHS Foundation Trust) attended the meeting and made a presentation on the Foundation Trust’s response to the Care Quality Commission’s (CQC) report ‘Dignity and Nutrition for Older People’.

 

Following a visit undertaken by the CQC, a number of areas for improvement at Stepping Hill Hospital had been identified around Outcome 1 ‘respecting and involving people who use services’ and Outcome 5 ‘meeting nutritional needs’of the CQC’s standards. In response the Trust had implemented an Action Plan to address these areas of concern and following a further visit by the CQC in November the feedback had been very positive.

 

The report and its findings had highlighted the need to ensure appropriate information was available to senior managers to ensure that where specific issues may arise these could be identified early and steps taken to prevent problems.

 

The following comments were made/ issues raised:-

 

·         The Trust had been unable to provide evidence of appropriate training on dignity and nutrition, which had now been addressed. Each ward had now had a ‘Champion’.

·         There were challenges to ensure busy staff on wards with challenging patients had sufficient time for supervision. Where senior nurses were absent it was important to ensure that appropriate additional support was available. Managing long term vacancies and absences was a challenge and was vital to ensure problems did not arise.

·         There was already a change taking place in the way food was delivered to wards, with colour coding being utilised to denote the differing levels of assistance required for individual patients to be provided by either nurses or trained volunteers.

 

Judith Morris also provided a brief overview of the interim response of the Trust to the recent contamination of medical products, including increasing the security of storage of saline products, ‘double handling’ within treatment rooms and increased CCTV. It was anticipated that the Strategic Health Authority would begin an inquiry following the conclusion of the Police investigation and the CQC had already indicated a number of areas for action.

 

The following comments were made/ issues raised:-

 

·         Discussions would soon take place between the Trust and the Chair of the Safeguarding Board.

·         Concern about the potential impact on the efficiency of the hospital and the cost implications of the additional security measures.

·         The incident had impacted staff morale, but the sense of ‘indignation’ amongst many staff had led to them pulling together.

·         There had been a very positive response to the challenges from all partners in the health economy.

·         The events had been exceptional, unforeseeable and potentially could have happened in any hospital. The measures implemented at Stepping Hill in response to the incident were likely to become standard practice nationally.

 

RESOLVED – That Judith Morris be thanked for her attendance and presentation.

Meeting: 01/11/2011 - Health & Wellbeing Scrutiny Committee (Item 4)

4 Engagement with the Care Quality Commission pdf icon PDF 301 KB

Representatives of the Care Quality Commission (CQC) will attend the meeting and make a presentation on the role of the Commission and on opportunities for the Scrutiny Committee to engage with them and their work.

 

Attached for information is a document prepared by the CQC for health and social care scrutiny committees.

 

Officer contact: Jonathan Vali, 0161 474 3201, jonathan.vali@stockport.gov.uk

Minutes:

Fiona Bryan (Compliance Manager) and Sue Jennings (Enforcement Officer) from the Care Quality Commission (CQC) attended the meeting and made a presentation on the work of the Commission as the independent regulator of all health and social care services in England.

 

The presentation covered the following areas:-

 

·         the background to the establishment of the CQC, its aims and scope of its activities;

·         the information required for registration of health and social care facilities;

·         key outcomes and standards against which providers were measured and assessed, including changes brought about following problems at the Winterborne Home such as the increased emphasis on feedback from service users;

·         enforcement activity and sanctions against providers who did not meet the required standards;

·         the re-launch of the CQC website and the Care Directory that detailed the findings of all inspections in care facilities in England;

·         the value of developing a dialogue between the CQC and the Health Scrutiny Committee to improve monitoring and improving standards without the need for enforcement action.

 

Councillors and officers discussed the presentation and the following issues were raised:-

 

·         The need to take an overall view of a service rather than focus on any individual user’s experience. It was important to determine the risk to service users of any problems.

·         There was a role for both the CQC and service commissioners to respond to complaints to resolve problems early and officers from the Council and the CQC were developing mechanisms to facilitate this.

·         There were concerns about the registration of providers of cosmetic procedures and the potential risks to the public.

·         There was a role for the CQC in contributing to continuous improvement of services, as well as to monitor compliance, although there were limited resources to do this.

·         It was hoped that there was a thorough process of re-registration when providers or facilities were taken over by other providers.

·         There were many professionals and organisations involved in providing services who had opportunities to identify problems and improve services before the need for the CQC to intervene. There was a need to change the culture of many organisations to ensure these groups took responsibility.

·         Concern was expressed about the use of fines as a sanction and the impact this would have on resources available to provide vital public services.

·         The CQC was considering how better to address the underlying problems associated with providers that were oscillating between failure and compliance to ensure they improved permanently.

·         There was a potential loop-hole in the registration process which allowed providers of care to begin providing specialist forms of care by amending their Statement of Purpose but without having to notify the CQC and without having to demonstrate appropriately trained staff and procedures. There was a vital role for commissioners to ensure that providers were suitable for the care they were offering.

·         The dignity of service users was a key priority for the CQC and something taken very seriously by inspectors.

 

The Chair reported that he had invited representatives of Stockport NHS Foundation Trust to the next meeting to discuss the recent findings of the CQC into dignity and nutrition and the steps being taken by the Trust to address concerns raised by the report.

 

The Executive Councillor (Adults & Health) undertook to address the issue raised in respect of risks associated with changes to Statements of Purpose.

 

RESOLVED – (1) That Fiona Bryan and Sue Jennings from the Care Quality Commission be thanked for their attendance and presentation.

 

(2) That the Care Quality Commission be invited to make a further presentation to the Health Scrutiny Committee in 12 months time to provide an update in respect of their work in Stockport and on progress with developing effective relationships with Council service commissioners.

 

(3) That the Democratic Services Manager be requested to circulate further information from the Care Quality Commission in respect of the extent of the use of fining as part  ...  view the full minutes text for item 4