The state of health care and adult social care in England 2018/19

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Purpose of Briefing

This briefing summaries the main points of Care Quality Commission’s (CQC) assessment of the state of care in England  2018/19 report  published  in October 2019.

It is intended to help everyone within NCG  reflect upon the conclusions made specifically in respect of the services that the organisation provides.

The full document, a summary and an easy read version of the report is available at www.cqc.  

Summary of Report

The report concludes that most of the care that CQC sees across England is good and, overall, the quality is improving slightly.

But the report goes on to say that people do not always have good experiences of care and sometimes have difficulties in trying to get care and support when they need it. Sometimes people do not get the care they need until it is too late, and things have seriously worsened for them.

CQC points out that the lack of access to help is especially worrying when it affects people who are less able to speak up for themselves – such as children and young people with mental health problems or people with a learning disability.

The report states that too often, people must chase around different care services even to access basic support. In the worst cases, people end up in crisis or with the wrong kind of care.

Issues for people with a learning disability or autism.

The report states that in many cases the support given to people with a learning disability or autism is not acceptable.

The report says that, too many people with a learning disability or autism are in hospital, because there are not enough specialist services with the right staff where they live

CQC suggests that a better system of care is needed for people with a learning disability or autism who are, or are at risk of, being hospitalised, segregated and placed in overly restrictive environments.

CQC urges that everyone must work together to make this happen.

NCG is keen to be part of this by the continued provision of a range of services based in the community.

Issues for people with mental health issues

The report also looks at services for people with mental health issues.

It finds that people with the most severe and enduring mental ill-health do not always have access to local, comprehensive rehabilitation services and are often in inappropriate placements far from home. This weakens support networks and the ability of family and commissioners to stay in close contact, sometimes with devastating consequences.

The need for a well skilled Workforce.

The report finds that some of the issues it has identified are underpinned by significant issues around staffing and workforce.

A key issue for CQC is that it is finding too many mental health and learning disability services with people who lack the skills, training, experience or clinical support to care for patients with complex needs.

Other issues identified

The report talks about other issues that are important and need to be looked at.

These include:

  • That other services (not just those for people with a learning disability or mental heath issues) are under pressure.
  • That there needs to be more joint working between organisations to help meet the pressures identified
  • That there needs to be greater innovation and use of technology to help meet people’s needs.

NCG response to the report

NCG is pleased that the report has identified some of the pressure facing individuals with a learning disability and mental health issues and their families as for far too long, these have been overlooked.

NCG has an important part to paly in supporting improvement in services for with complex needs.

As an organisation, we treat the need to train our staff very seriously and have invested in people, systems and external courses to support this.  We are aware that we need to do more to ensure the training opportunities created are taken up by all and is clear about the expectation that everyone has a responsibility to commit to their own personal development.

Where quality within services fails to achieve the high standards expected, NCG will quickly take action to improve standards.  The introduction of an electronic system to support improved audit of standards has been approved and will be implemented in 2020.

NCG is committed to investing in innovation including technology and welcomes feedback from all staff where they think this can be improved.

Finally, NCG looks forward to working with all organisations to improve the quality and range of services available to individuals with a learning disability, mental health issues or acquired brain injury.

Learning Points

  1. Take some time within your next team meeting to think about the role your service plays locally in improving the lives of the individuals you support – can you evidence all the good work?
  2. Have all the learning and training opportunities that are available within NCG been taken up – what does My Learning cloud say about training in my service?
  3. Is my own learning up to date?
  4. What are the opportunities for using more technology where you work – what ideas would you like NCG to consider?
  5. Is everybody aware of the role they must play in ensuring that quality is at the heart of what they do?
  6. What did the last inspection report about the service within I work say? Could anything be improved?