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Found 287 results
  1. News Article
    The Biden administration set a first-ever minimum staffing rule for nursing homes Monday, making good on the president’s promise more than two years ago to seek improvements in care for the nation’s 1.2 million nursing home residents. The final rule, proposed in September, requires a registered nurse to be on-site in every skilled nursing facility for 24 hours a day, seven days a week. It mandates enough staff to provide every resident with at least 3.48 hours of care each day. And it beefs up rules for assessing the care needs of every resident, which will boost staff numbers above the minimum to care for sicker residents. For a facility with 100 residents, it translates to a minimum of two or three registered nurses and at least 10 or 11 nurse aides per shift, as well as two additional staffers who could be nurses or aides per shift, according to the administration’s interpretation of its new formula. Set to phase in over the next few years, the mandate will replace the current vague standard that gives operators wide latitude on how to staff their facilities. While the administration has said the rule will improve care, industry lobbyists have said it’s unworkable, with staffing goals that will be impossible to achieve because of a shortage of workers. The administration received 47,000 public comments on the rule since it was proposed last September. They included observations of people lying in their own filth for hours, not being fed appropriately and being left on the floor too long after falling, Secretary of Health and Human Services Xavier Becerra said in an interview Monday. Read full story Source: Washington Post, 22 April 2024
  2. News Article
    Predatory staff who target vulnerable adults in care homes are free to move jobs unchallenged, The Independent can reveal, as almost 10,000 incidents of sexual abuse have been recorded in the last three years. The fact that abusers can move from home to home emerged in an independent review sparked by complaints made three decades ago by the family of a man with learning disabilities. Clive Treacey was allegedly groomed and sexually abused at the age of 23 in a private care home in Cheshire and then moved to Staffordshire where his abuser was able to access him again, it was claimed. Both Mr Treacey and his alleged abuser have since died. His story was first reported by The Independent in 2021 and the review into his care – carried out by the most senior safeguarding expert in England Professor Michael Preston-Shoot and seen exclusively by this publication – showed huge failures in dealing with concerns raised by his family. It warned that vulnerable adults across the country could still be at risk of harm with no national guidance for officials on how to respond to allegations of abuse of adults by care home staff in positions of trust. Read full story Read the Discretionary Safeguarding Adults Review into Clive's case Source: The Independent, 18 April 2024
  3. Content Article
    Following consultation, the Care Quality Commission have now published final guidance to help providers understand and meet the new fundamental standard on visiting and accompanying in care homes, hospitals, and hospices. The guidance (on Regulation 9A: visiting in care homes, hospitals, and hospices) also sets out what people using health and social care services and their families, friends or advocates can expect.
  4. Content Article
    In my 15 years focusing on developing drink thickening solutions for dysphagia patients, the intersection of dysphagia management and patient safety has become increasingly apparent. Dysphagia, or difficulty swallowing, presents not only as a significant health challenge but also as a critical patient safety issue. The condition's underdiagnosis, particularly in vulnerable populations, heightens the risk of severe complications, including choking, aspiration pneumonia, dehydration and the profound fear of choking that can lead to malnutrition.
  5. Content Article
    As part of the Care Quality Commission's (CQC's) commitment to person-centric care, they have worked with the University of Bedfordshire to produce guidance for care home managers and members of the public on the availability and management of alcohol in care homes.   This guidance focuses on both the benefits of having alcohol available to care home residents who want it, as well as how to mitigate potential risks.   The University of Bedfordshire spoke to residents, their family members, care home managers and CQC inspectors, and captured their expectations and requirements on how alcohol is managed in care settings.  
  6. News Article
    People with Covid-19 were discharged to care homes over fears about the NHS getting “clogged up”, the pandemic inquiry has heard. Professor Dame Jenny Harries, England’s deputy chief medical officer during the pandemic and now head of the UK Health Security Agency, told the inquiry of how an email she sent in mid-March 2020 described the “bleak picture” and “top line awful prospect” of what needed to happen if hospitals overflowed. Discharging people to care homes – where thousands of people died of Covid – has been one of the central controversies when it comes to how the Government handled the pandemic. On Wednesday, the Covid inquiry was read an email exchange between Rosamond Roughton, an official at the Department of Health, and Dame Jenny on March 16 2020. Ms Roughton asked what the approach should be around discharging symptomatic people to care homes, adding: “My working assumption was that we would have to allow discharge to happen, and have very strict infection control? Otherwise the NHS presumably gets clogged up with people who aren’t acutely ill.” Ms Roughton added that this was a “big ethical issue” for care home providers who were “understandably very concerned” and who were “already getting questions from family members”. In response, Dame Jenny emailed: “Whilst the prospect is perhaps what none of us would wish to plan for, I believe the reality will be that we will need to discharge Covid-19 positive patients into residential care settings for the reason you have noted. “This will be entirely clinically appropriate because the NHS will triage those to retain in acute settings who can benefit from that sector’s care. “The numbers of people with disease will rise sharply within a fairly short timeframe and I suspect make this fairly normal practice and more acceptable, but I do recognise that families and care homes will not welcome this in the initial phase.” Read full story Source: The Independent, 29 November 2023
  7. News Article
    A woman who spent nine months in hospital waiting for a suitable care home placement became a "shadow of her former self", her mother has said. Jocelyn Ullmer, 60, from West Sussex, saw her health deteriorate after being admitted to hospital in June last year. Her mother, Sylvia Hubbard, 86, said: "We tried to get her out of hospital, but no-one wanted her." Across England, around 60% of patients classed as fit to leave remain in hospital at the end of an average day. Figures show the biggest obstacle is a lack of beds in other settings, such as care homes and community hospitals. The government said it was investing £1.6bn over the next two years to help improve the situation. Read full story Source: BBC News, 8 November 2023
  8. Content Article
    While at Amberley Hall Care Home for rehabilitation, Geoffrey Whatling’s family had raised concerns that he was unwell. He was scored as a 7 on the National Early Warning Score (NEWS2) system on the 8 April 2023. Such a score requires a 999 call to be made, however instead a 111 call was made. The 111 call taker was not made aware of his NEWS2 score. Further observations were carried out on 9 April 2023 (NEWS2 score 6), and 07.00 (NEWS2 score 5) and again on 10 April 2023 at 12.13 (NEWS2 score 9/10), when emergency services were called and Mr Whatling was admitted to Queen Elizabeth Hospital. Despite treatment his condition continued to deteriorate and he died on 26 April 2023.
  9. Content Article
    The Strengthening Medication Safety in Long-Term Care initiative, funded by the Ontario Ministry of Long-Term Care was established in partnership with the Institute for Safe Medication Practices (ISMP) Canada to address the medication safety-related recommendations in Justice Gillese’s Long-Term Care Homes Public Inquiry Report. The three-year initiative is designed to improve medication management processes, including those intended to deter and detect intentional and unintentional harm in long-term care homes across the province of Ontario. This bulletin provides an overview of the initiative and highlights selected examples of improvement projects completed in the first phase.
  10. News Article
    Some care home residents may have been "neglected and left to starve" during the pandemic, Scotland's Covid Inquiry is expected to hear. Lawyers representing bereaved relatives said they also anticipate the inquiry will hear some people were forced into agreeing to "do not resuscitate" plans. Shelagh McCall KC told the inquiry that evidence to be led would "point to a systemic failure of the model of care". The public inquiry is investigating Scotland's response to the pandemic. Ms McCall is representing Bereaved Relatives Group Skye, a group of bereaved relatives and care workers from Skye and five other health board areas of Scotland. In her opening statement, she told the public inquiry that families wanted to know why Covid was allowed to enter care homes and "spread like wildfire" during the pandemic. She added: "As well as revealing the suffering of individuals and their families, we anticipate the evidence in these hearings will point to a systemic failure of the model for the delivery of care in Scotland, for its regulation and inspection. "We anticipate the inquiry will hear that people were pressured to agree to do not resuscitate notices, that people were not resuscitated even though no such notice was in place, that residents may have been neglected and left to starve and that families are not sure they were told the truth about their relative's death." Read full story Source: BBC News, 25 October 2023
  11. Content Article
    Orchard Care Homes had noticed high numbers of antipsychotic medicines being prescribed to people living with dementia. There appeared to be little consideration of why these people were distressed and communicating this through behaviour. Orchard staff were convinced pain was a key factor in these distress responses—they were not necessarily because the person had a diagnosis of dementia. Orchard adopted PainChek, a digital pain assessment tool, in 2021 to support their dementia promise framework. They worked with the PainChek team and ran a pilot with the app. They were one of the first care providers to use this solution in the UK. It was originally launched it in one of their specialist dementia care communities, but is now in all 23 Orchard homes. Since the rollout of the app, there has been an increase in available pain relief and a decrease in conflict-related safeguarding referrals. There is increased time available for colleagues and a reduction in polypharmacy. There has been a 10% decrease in antipsychotic medicine use across all 23 homes, promoting a greater quality of life. People now have effective pain management plans. Orchard have also been able to ensure distress plans are in place which firstly considers if pain is the cause of distress. This case study was submitted to the Care Quality Commission's (CQC's) Capturing innovation to accelerate improvement project by Orchard Care Homes.
  12. Content Article
    The National Early Warning Score (NEWS2) is calculated using routine vital sign measures of temperature, pulse and so on. It is used by ambulance staff and emergency departments to identify sick adults whose condition is likely to deteriorate.  NEWS2 has been shown to work among the general population. However, it has been unclear if it could monitor the condition of care home residents because of their age, frailty, and multiple long-term conditions. New research from the National Institute for Health and Care Research (NIHR) shows that, among care home residents admitted to hospital as an emergency, NEWS2 can effectively identify people whose condition is likely to get worse.
  13. Content Article
    This alert is for action by all those responsible for the use, purchase, prescription and maintenance of medical beds, trolleys, bed rails, bed grab handles and lateral turning devices including all Acute and Community healthcare organisations, care homes, equipment providers, Occupational Therapists and early intervention teams. From 1 January 2018 to 31 December 2022, the MHRA received 18 reports of deaths related to medical beds, bed rails, trolleys, bariatric beds, lateral turning devices and bed grab handles, and 54 reports of serious injuries. The majority of these were due to entrapment or falls. Investigations into incidents involving falls often found the likely cause to be worn or broken parts, which should have been replaced during regular maintenance and servicing, but which were either not carried out or were carried out improperly.
  14. News Article
    Thirty families are starting legal action against the government, care homes and several hospitals in England over the deaths of their relatives in the early days of the Covid pandemic. The families argue not enough was done to protect their loved ones from the virus. They are claiming damages for loss of life and the distress caused. The government says it specifically sought to safeguard care home residents using the best evidence available. The legal claims focus on the decision in March 2020 to rapidly discharge hospital patients into care homes without testing or a requirement for them to isolate. The cases follow a 2022 High Court judgement that ruled the policy was unlawful - as it failed to take into account the risk to elderly and vulnerable care home residents of asymptomatic transmission of the virus. One of the cases is being brought by Liz Weager, whose 95-year-old mother Margaret tested positive for the virus in her care home in May 2020 and died later in hospital. "What was happening in the management of those care homes? What advice were they having?" Liz asks. "It goes back to the government. There was a lack of preparedness, which then translated down to the care home." Read full story Source: BBC News, 25 August 2023
  15. News Article
    Just one-fifth of staff at a trust engulfed in an abuse scandal expressed confidence in the executive team, according to the Care Quality Commission (CQC), which has downgraded the trust and its leadership team to ‘inadequate’. The CQC inspected Greater Manchester Mental Health Trust following NHS England launching a review into the trust in November 2022 after BBC Panorama exposed abuse and care failings at the medium-secure Edenfield Centre. The two inspections, made between January and March 2023, which assessed inpatient services and whether the organisation was well-led, also saw the trust served with a warning notice due to continued concerns over safety and quality of care, including failure to manage ligature risks on inpatient wards. Inspectors identified more than 1,000 ligature incidents on adult acute and psychiatric intensive care wards in a six-month period. In the year to January, four deaths had occurred by use of ligature on wards which the CQC said “demonstrated that actions to mitigate ligature risks and incidents by clinical and operational management had not been effective”. Read full story (paywalled) Source: HSJ, 21 July 2023
  16. Content Article
    Paul Brand investigates why 6,000 people have been given "notices to quit" by care homes across England, and why so many people are being kicked out of them.
  17. Content Article
    Visits from loved ones are vital to the health and wellbeing of people receiving care in care homes, hospitals and hospices. There have been concerns about visiting restrictions in health and care settings for several years, and the restrictions introduced in response to the COVID-19 pandemic exacerbated these concerns. While those restrictions were in place at the time to control the risk of transmission and keep people safe, it was detrimental for loved ones to have been kept apart or not to have had someone supporting them in hospital. Guidance is now clear that visiting should be encouraged and facilitated in all circumstances. This consultation seeks views on introducing secondary legislation to protect visiting as a fundamental standard across CQC-registered settings so that no one is denied reasonable access to visitors while they are resident in a care home, or a patient in hospital or a hospice. This includes accompanying people to hospital appointments (outpatients or diagnostic visits). Related reading on the hub: Visiting restrictions and the impact on patients and their families: a relative's perspective It’s time to rename the ‘visitor’: reflections from a relative
  18. News Article
    The government has proposed new legislation to make patient visiting a legal right and also give the Care Quality Commission (CQC) fresh powers to enforce it. The Department of Health and Social Care has launched a consultation to seek views from patients, care home residents, families, professionals and providers on the introduction of new legislation which will require health and care settings, including hospitals, to accommodate visitors in most circumstances. It said the new visiting laws will also provide the CQC with a “clearer basis for identifying where hospitals and care homes are not meeting the required standard”, and enable it to enforce the standards by issuing requirement or warning notices, imposing conditions, suspending a registration or cancelling a registration. It said although the CQC currently has powers “to clamp down on unethical visiting restrictions”, the expected standard of visiting rules is not “specifically outlined in regulations”. Read full story (paywalled) Source: HSJ, 21 June 2023
  19. News Article
    The depth of suffering in care homes in England as Covid hit has been laid bare in a court case exposing “degrading” treatment with residents being “catastrophically let down”. Care levels at the Temple Court care home in Kettering collapsed so badly in April 2020, when ministers rushed to free up NHS capacity by discharging thousands of people, that residents were left lying in their own faeces, dehydrated, malnourished and suffering necrotic, infected wounds, the Care Quality Commission found. Fifteen of its residents died with Covid in the first weeks of the pandemic. The case foreshadows the UK Covid-19 public inquiry module on the care sector, which next year will test Matt Hancock’s claim to have thrown “a protective ring around social care”. The prosecution resulted in a £120,000 fine handed down at Northampton magistrates court last week. The operator, Amicura, apologised but said it had been “acting in the national interest and supporting the NHS by accepting patients discharged from hospitals into care homes under government policy”. Read full story Source: The Guardian, 29 May 2023
  20. News Article
    Experts are calling for "do not resuscitate" orders to be scrapped, saying they are being misused and putting people's lives at risk. One woman told BBC News that her elderly father might still be alive if the DNR in his medical file had been properly checked. When Robert Murray began choking on a piece of fruit at breakfast, staff at his care home called 999. He'd stopped breathing and the ambulance service operator immediately sent paramedics to attend. But seconds later, the care home told the dispatcher that the 80-year-old had a do not resuscitate form (DNR) in his medical records. The paramedics were stood down. Mr Murray died minutes later. However, it was all a terrible mistake. It hadn't been made clear to the ambulance service that Mr Murray was choking - the DNR was only meant to apply should he have a cardiac arrest. Mr Murray's death, at a nursing home in Eastbourne in June 2021, is an example of what experts call "mission creep" in the use of DNR - also known as DNACPR (Do Not Attempt Cardiac Pulmonary Resuscitation) - decisions. Researchers from Essex University say some care home residents are "being inappropriately denied transfer to hospital or access to certain medicines" due to the recommendations. Read full story Source: BBC News, 16 May 2023
  21. Content Article
    At Patient Safety Learning we believe that sharing insights and learning is vital to improving outcomes and reducing harm. That's why we created the hub; providing a space for people to come together and share their experiences, resources and good practice examples.  Dementia is an umbrella term for a number of diseases that affect the brain, with Alzheimer’s disease its most common cause. We have picked nine resources and reflections about keeping people with dementia safe in health and care settings, and when considering medication choices.
  22. Content Article
    Care home residents are particularly vulnerable to patient safety incidents, due to higher likelihood of frailty, multimorbidity and cognitive decline. However, despite residents and their carers wanting to be involved in safety initiatives, there are few mechanisms for them to contribute and make meaningful safety improvements to practice. This study aimed to develop a measure of contributory factors to safety incidents in care homes to be completed by residents and/or their unpaid carers.
  23. Content Article
    Social care in England entered the pandemic in a fragile state. With much already written about the government’s response to the Covid-19 pandemic in the social care sector, this new report from the Nuffield Trust in collaboration with the Care Policy and Evaluation Centre analyses the structural and systemic factors that influenced that initial national response. Covid had far-reaching impacts on social care and exacerbated many longstanding issues. This work seeks to highlight progress and identify where action is needed to create a more resilient system.
  24. Content Article
    The Relatives and Residents Association (R&RA) is conducting a survey which aims to gather evidence on the impact of the Covid-19 pandemic on access to healthcare services for those living in care homes. R&RA is seeking responses from people who were living in care homes at any point during the pandemic, or from their relatives and friends. Our analysis of the responses will be shared with the UK Covid-19 Inquiry, including anonymised examples. The survey should take around 10-15 mins to complete.
  25. Content Article
    In this article, published on Richard Smith's non-medical blogs, Richard describes the events surrounding his elderly mothers trip to A&E from her care home. Richard highlights a number of safety issues in his account and improvements that could be made to the system and processes. "The nurses have much more confidence in the benefits of the hospital than I do. Hospitals, I know, are dangerous and miserable places for everybody but particularly for the demented; and the danger is increased in the pandemic. There has to be considerable benefit to outweigh the inbuilt risk."
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