Date posted: 7th November 2016

The Care Quality Commission have recently published their State of Care Report 2016. The report highlights the state of care given by providers and while some show exceptional levels of development, others are struggling to increase their proficiency beyond ‘requires improvement’. Here, CPIMS review the findings of the report.

Providing quality adult care

According to the CQC findings, despite increasingly challenging circumstances throughout the care setting, many providers are managing to deliver good quality care and are even showing encouraging levels of improvement. According to the CQC, three-quarters of care homes and agencies that were inspected during the research project were originally rated inadequate. However, upon re-inspection, the level of service had increased dramatically, meaning their rating could improve. This still leaves a quarter of services who didn’t manage to advance their level of care and, on re-inspection, their overall rating stayed the same.

The demand on primary care services

At present, the pressure on primary care services is having a huge impact on both the performance of secondary care and the people who are relying on these services. This lack of balance is mainly due to the fragility of the adult social care market, which is set to become even more demanding due to a combination of a growing and ageing population and the number of people with long term conditions. In the current challenging economic climate, this can only mean a greater demand on care services and therefore an increasing issue for people accessing care.

There is a strong likelihood that the greater demand will impact primary care services and may be reflected in the form of increased A&E attendances, emergency admissions and delays when people are leaving hospital. The demand will directly impact those accessing the services, as well as care givers who may fail to meet performance or financial targets.

State of care in home care agencies

The CQC has stated the falling level of care by home care agencies may be due to financial challenges, including falling profit margins. Arguably, the pressure on fees and the national living wage contribute to the financial struggle of care providers and consequently, the same level of care can no longer be provided.

The diminishing availability of nursing home beds and undeliverable care contracts are just two consequences of the financial struggle that care providers are facing. While the financial challenges have been extensively documented, little is being done to help improve profit margins and help care standards to get back to the level they were at previously.

The CQC noted that too many acute care facilities were rated inadequate, particularly in emergency and medical services. However, they accepted how difficult it is for trusts to make changes to the level of care provided without the adequate funding and suggested care providers with financial difficultly should work closely with facilities who are operating to a good standard.

The State of Care report 2016 also highlighted the great work done by general practices, with the majority being rated good. While some were even awarded outstanding certification.

You can read the full Sate of Care Report 2016, published by the Care Quality Commission here.

CPIMS offer expert witness and case management services to those who have suffered catastrophic injuries. Specialising in neurological and spinal cord injury, we are committed to providing innovative, reliable and

Date posted: 4th November 2016

Recently, the CQC undertook research into the integrated care for older people in homes. Gathering evidence from a range of sources, including site visits and speaking to older people and their carers about their experiences, the Care Quality Commission aimed to look at the effective co-ordination of care and understand the current flaws of integrated care services. Here, CPIMS look at the research findings.

The delivery of integrated care for older people

While the research phase illustrated many initiatives that focused on the delivery of integrated care, further investigation demonstrated a lack of action when it came to putting the plans into practice. In many cases, providers and commissioners were focused on improving the way the services work together. However, there was considerable variation between the care provided and experiences of older people.

Integrated care service finding

Following the research, the CQC published a report where they outlined their research findings. Below is the list of discoveries, based on how integrated care services are working together and their impact on the experiences of older people:

The CQC found:

  • Widespread commitment to delivering integrated care
  • Organisational barriers made it difficult for care services to identify older people who were at risk of deterioration or an unplanned emergency admission to hospital
  • Examples of joint working in delivering health and social care, but these were often inconsistent, short-term and reliant on partial or temporary funding and goodwill between different providers. They were not a mainstream part of the way in which services were planned or delivered around older people
  • Monitoring and evaluation was often not carried out locally or was insufficient
  • The lack of connection between services often resulted in older people and their families or carers needing to take responsibility for navigating complex local services. This could result in people ‘falling through the gaps’ and only being identified in response to a crisis.
  • Older people often had multiple care plans because professionals did not routinely link together and share information.
  • Older people were not routinely involved in decision making about their needs and preferences.
  • Older people and their families or carers did not routinely receive clear information about how their health and social care would be coordinated, in particular if there were changes in their circumstances or if there was an unplanned or emergency admission to hospital.
  • Local leaders achieved integrated person-centred care by working closely across health and social care services to share information, reduce duplicated efforts and use resources more effectively.

Recommendations to improve the integrated care for older people

The CQC has provided some recommendations which would help care providers plan and implement initiatives to improve integrated care for older people. Some of the recommendations include:

  • Health and social care leaders should develop and agree a shared understanding and definition of what integrated care means for the population in their local area, and then work towards delivering this shared aim.
  • NHS England and Association of Directors of Adult Social Services (ADASS) should lead on developing an agreed methodology and data set for identifying people at risk of admission to secondary care or deterioration.
  • Older people should be meaningfully involved in making informed decisions about their care needs and care planning – in particular about the outcomes that are important to them – based on the existing national and local guidance.
  • Commissioners and providers in an area should ensure that information and support for older people and their families or carers is available, and this sets out connections between services, and how the people’s accessibility needs will be met.
  • The National Quality Board, in partnership with the National Information Board, develop and share a set of validated data metrics and outcomes measures for integrated care with person-centred outcomes at the heart of decision making about service provision and based on a consistent, shared view and definition of integration.

You can read the full CQC report regarding the integrated care for older people here.

CPIMS are leading care providers for individuals with neurological injury. Specialising in spinal cord and brain injury, we pride ourselves on providing individual care for individual people. Contact us today on 0844 371 0616 or alternatively email

Date posted: 11th October 2016

Spirometry is an important medical examination for patients with respiratory problems. However, at present, the test is thought to fail the essential quality standards. In our latest blog, CPIMS uncover the effects this may have on patients, as well as identifying the key elements of diagnostic spirometry.

Continue reading Diagnostic Spirometry

Date posted: 3rd September 2016

Case Managers are an integral element of rehabilitation delivery, advocating, enabling and implementing the rehabilitative process to ensure clients receive the best quality of care. A recent study set out to conceptualise the expectations that personal injury solicitors have of Case Managers (CMs) and establish the extent to which those expectations were met.

One of its key findings was that: ‘against a background of steeply-rising costs for care and already criticised for high costs in the provision of case management services, it is essential the CM works professionally, collaboratively as part of a team and acts at all times in the best interests of their client.’

Reassuringly, CPIMS practices exactly what this study preaches on a daily basis, as part of our ‘individual care for individual people’ approach.

You can read the full article here – What do Personal Injury solicitors expect of Case Managers?.

Date posted: 2nd September 2016

The Care Quality Commission, also known as the CQC, has published its annual monitoring report regarding the deprivation of liberty safeguards, which is a part of the Mental Capacity Act. The report questions how we can provide care to those who are unable to consent, due to a lack of mental capacity following a medical condition, such as a brain injury or dementia.
You can read the full article here – Report on the deprivation of liberty safeguards published by Care Quality Commission.

Date posted: 31st August 2016

The NFA, or neurofunctional approach, was introduced in the 1980s to assist individuals with their rehabilitation process, following traumatic brain injury. The NFA focuses on the needs and goals of individual clients who require a Case Manager to assist with the rehabilitation process, incorporating skill learning principles and routine development.

By encouraging the progress of activities required for everyday living, the NFA aims to assist individual clients in a more effective way than the cognitive-retention approach. The following paper looks at the features, theoretical basis and implications of the NFA for those who have suffered traumatic brain injury.

You can read the full article here – Revisiting the neurofunctional approach.

Date posted: 30th August 2016

The five year forward view, published by the NHS in 2014 set out a vision for the future, breaking the boundaries between primary care, community services and hospitals. The ‘statement of intent’ illustrates how the Care Quality Commission, or CQC is supporting providers as they develop new care models.

David Behan, Chief Executive of the CQC said:

CQC has an important role in supporting organisations to make these changes so vital to the future of health and care services and to the people who use them. We recognise the need to become increasingly nimble and to develop our approach to support, not obstruct, change. In doing so, we will not compromise our focus on high quality care.

You can read the full article here – How CQC is supporting the development of new care models.

Date posted: 5th July 2016

The Ministry of Justice, responsible for publishing death reports, have recently issued their annual statistical bulletin. The document includes the death statistics for 2015, across England and Wales, postmortems findings and inquest conclusions. This year, the document comprised a section entitled Deprivation of Liberty Safeguards, illustrating the deaths of vulnerable people in care facilities. As part of the key findings, they stated the number of total deaths in 2015 has risen by 6% (12,565) in the past year, along with a rise of deaths that occur under DoLS. The death of vulnerable people has risen considerable since 2013, as the figures below illustrate.

Continue reading The risk to Vulnerable People – The Ministry of Justice 2015