Tag Archives: Safeguarding Adults

NMC to review ‘serious cases’ before the employer does so

There’s an old saying, with many variations on the same theme:  ‘everything comes to him who waits’, and my favourite variation is  ‘all things come to him who waits – provided he knows what he’s waiting for’.  I’m not absolutely sure that this next revelation is something I knew I was waiting for – but after years of waiting for the NMC to get its act together, there’s a small chink of light appearing.

The NMC (Nursing and Midwifery Council) is to review serious cases before internal investigations are conducted by the employer of the nurse(s) in question.  According to Nursing Times

Nurses and midwives involved in “very serious cases” that pose a risk to patients should be referred to the Nursing and Midwifery Council prior to an internal investigation, the regulator has stated.

In updated guidance on referrals, the NMC has called on employers to make referrals as quickly as possible in order for it to consider issuing an interim suspension until the case has been fully investigated.

The regulator said it had “clarified its advice as a result of cases in which employers have misunderstood their responsibility to refer quickly if patient safety is at risk”.

It states: “The revised advice specifically encourages employers to refer a nurse or midwife at an early stage in very serious cases, even before they conduct their own internal investigation.”

NMC director of fitness to practise Jackie Smith said: “We would like to remind employers that if they believe the public’s health and wellbeing is at immediate and serious risk, they should contact us straight away.

“This will give us the opportunity to issue an interim suspension or restrict the person’s practice while the case is investigated,” she added.

The revised advice and information also notes that in less serious instances cases may be referred back from the NMC to the employer to be dealt with locally.

The guidance also includes more detailed information about the existing responsibilities of employers to check references, identity and competence.”

This news is of such importance, that I’ve just given you the full content of the Nursing Times article, and I trust that will be acceptable.   It’s not so easy to find the updated guidance on the NMC website, but this is the nearest I’ve found – Urgent referrals and interim orders.

As an employer you have the power to suspend or dismiss a member of staff, but this will not prevent them from working elsewhere. Even suspensions by a local supervising authority midwifery officer (LSAMO), which would prevent a midwife from practising in that region, will not prevent a midwife from practising in other regions, or practising as a nurse if registered accordingly.

We are the only organisation with the powers to prevent nurses and midwives from practising if they present a risk to patient safety. In very serious cases it will therefore be appropriate to refer a nurse or midwife to us at an early stage, even before you conduct your own internal investigation. This allows for the possibility of issuing an interim suspension or restricting the practice of the nurse or midwife concerned until the case has been thoroughly investigated.

I am shocked to discover that this has only just been ‘clarified’ by the NMC, but it goes a long way to explain to me why I’ve had such a fight on my hands for the last 4 years now. 

Perhaps I was naive and took it for granted that the onus was already there on the employer, in my case one of the big care home providers, and that the NMC would be contacted by any employer who has serious concerns about the standards of care being provided by a registered nurse or midwife.  I didn’t know then how easy it was for the employer to allow several registered nurses to resign from their employment. 

Perhaps I was equally naive to expect that the Local Authority would have a duty to follow through with all the sensible procedures, in order to protect other people who could be at risk if those same registered nurses who were allowed to resign were then ’employed’ elsewhere.  But when a care provider has several 25-year contracts with the same local authority, you begin to learn how to whistle in the wind! 

Perhaps I was even more naive to expect that the local authority’s Safeguarding/Protection of Vulnerable Adults unit would be equally responsible for ….. safeguarding others.

The NMC is a Regulator.  The GMC is a Regulator.  The CQC is a Regulator.

What is being a regulator all about if it fails to regulate in the way that most of us, mere mortals that we be,  would want and expect a regulator to regulate?


Filed under care, care homes, justice, personal responsibility, professional responsibility

Care home secrecy slammed

It is with some considerable personal pleasure that I have just read  in the East Anglian Daily Times that POLITICIANS have hit out over secrecy surrounding an Essex care home which was shut down amid abuse allegations.

If any politicians would like to ‘hit out’ over the secrecy surrounding Lennox House care home in Islington, they only have to ask me, and I will provide as much detail as has so far been available in the public domain – and I can provide far far more than has ever been made available in the public domain, if that’s what would help you, Politicians, to achieve honest, decent, caring systems of care for our honest, decent, caring vulnerable elderly citizens.  The rest is still shrouded in secrecy.

They have slammed a decision to bar the public from a meeting next week where lessons learned from the saga at Greenways Care Home, Colchester, will be discussed.

Well, in Islington family were barred from meetings too – let alone the public.

Why does this all interest me enormously?  Because my own relative was the person who suffered neglect, which is a form of abuse, in that Islington care home, Lennox House.  Nobody from our family was allowed to attend any one of the ‘meetings’ held.  We have never been allowed to see the full report either.

But the care home management, the care home provider, the healthcare professionals, the social care professionals were all invited to attend those meetings.  The care home management, the care home provider, the healthcare professionals and the social care professionals were all provided with a copy of the full report of the investigation carried out into the neglect of my relative.  So that they could all comment on  it and have any ‘amendments/alterations’ made before it was finalised.  That is one aspect of the whole mess that I will never understand.

The family of the person who was the vicitim of abuse in care, neglect in care,  was not allowed that same privilege.  No ability to attend meetings; no ability to contribute significantly to the final report; no ability to inisist on changes to that final report – other than simple factual inaccuracies, that is.

Our family member was no longer in a position to ask to attend meetings, to see the report before it was finalised – she died within 3 weeks of suffering that abuse/neglect in care.

The Safeguarding Adults team ‘chose not to inform the police’; they chose not to inform the Coroner either; they chose not to inform family that they had the right to ask the Coroner to conduct an inquest.

And yet, the whole situation was considered sufficiently serious for the then CSCI  to impose ‘enforcement action’ and to refuse new admissions for a year to Lennox House.  The CSCI inspection reports are all still available on the CQC website.

The perpetrators  are the ones to have been protected.  The care home provider that couldn’t provide care has been protected.

What was that policy called?  I remember –


No secrets: guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse

Our relative wasn’t protected.  She was dead before anybody thought about massive ‘action plans’ and ‘enforcement action’, all of which the Care Provider willingly complied with of course, and all of which will have been of benefit to the other residents and future residents.  Too late for our relative.

My thanks to Vern Pitt at  Community Care for bringing to my attention the fact that politicians seem to have opened their eyes.  Long may they stay open.

Open up please also the hearings/meetings/serious  case reviews/adult protection procedures to public scrutiny.  Otherwise we will never believe that you really care.  And then we too can see whether lessons have been learned.


Filed under abuse, care, Care UK, dementia care, liability, Local Authority, neglect

From foster care of children to care of vulnerable elderly people – we care!

A news item from Communitycare.co.uk caught my eye the other day.  ‘Name the bureaucrats who hamper fostering, says minister’ – the minister being Tim Loughton, Children’s Minister at the Dept of Education, who has called on foster carers to tell him which councils are “excessively bureaucratic” when it comes to allowing them to make day-to-day decisions for the children they foster.

Loughton says he plans to demolish some of the ‘myths’, as he sees them, surrounding fostering.  A laudable approach, even though those myths are more fact than fiction according to foster carers.  Even more laudable if he really does manage the ‘cultural change’ that Jackie Sanders, communication manager for the Fostering Network, called for.

I’ve just watched the Tonight programme, and learned a lot about the hurdles that potential foster carers are required to go through, via the fostering panel.  The ‘vetting process’ includes an intensive investigation and examination of a potential foster carer’s early life experience, their family history, their suitable training, CRB checks of themselves and any other family members who may come into close contact with a fostered child, assessments of the suitability and safety of their home, their financial situation; references are all thoroughly checked, medical and mental health checks carried out, schools contacted for information, plus social worker interviews and visits.  To name but a few.  I would not for one moment criticise the need for each and every one of those safeguards.  Where vulnerable children are concerned, they certainly deserve the quality care that may only be ensured by such a volume of ‘risk assessments’.

Gradually, I found myself seeing not the young, vulnerable children featured in the programme, but elderly vulnerable adults living in residential care homes.  I began to wonder  whether  a similar cultural change is perhaps something we should be demanding of Tim Loughton’s counterpart.  Not in the Department of Education, but in the Department of …. ….

Where’s your equivalent, Tim Loughton?  Where is the Older Person’s Minister?  Who is he or she?  And has s/he made him/herself known to us all?  Paul Burstow’s the Minister for Care, but that encompasses old, young and in-betweeners.  So perhaps you’re our man, Mr Burstow.

I challenge you now to provide the same safeguards for all elderly people in care: a vigorous and rigorous vetting process for all care providers and all paid caregivers, encompassing their past history and regardless of the 30 year contracts they may have been handed.  A full and detailed assessment of the suitability and training of all those taking charge of our older persons.

Make that full and detailed assessment available in the public domain for anyone to access – that really would show the loopholes in the current system!   The CQC– and its predecessor the CSCI – failed to provide the safeguards that should surround each and every residential care home for vulnerable elderly people.  The standards of supervision, training, and care for and of vulnerable elderly people are all too often abysmal.

But who cares?

We care.

We really do care.

The person in need of care cares.

The family and friends of those in need of care care.

The family and friends of those in residential care homes care.

But who cares enough to listen to us?

Who cares enough to care about the shabby standards of care that are being allowed to continue?

Who cares about the elderly vulnerable people of this rich country of ours?

One of the young people in the programme, Anita Johnston, said she realised that ‘something needed to change’ in her life in order to make it a life worth living – “so I did”, she said.  She changed.  She managed that change in herself, with the help of her wonderful and caring foster parents.  “Without them, I wouldn’t have a hope”, she said.

Without a similar change in those involved in the care of our vulnerable elderly people, we don’t have a hope either.

Anita Johnston, I wish you a happy and successful future.  With your caring attitude, with the respect you manage to show, with your wisdom you must have a great future ahead of you.  Would you like to become Minister for Older People?  You’d do a grand job!!

You could then demolish some of the ‘real myths’ that surround care for older people.  All is not what it should be there – so your refreshing caring presence would be more than welcome.


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PS. to Tim Loughton – your website biography needs a rapid update!  Or do you still see yourself as a Shadow?

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Filed under care, care homes, dementia care, domiciliary homecare

Second Coventry OAP killed by bed sores

Another story of neglect in care.  No comment needed from me – the words speak for themselves.

Second Coventry OAP killed by bed sores.

The full story is here in the Coventry Telegraph.

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Filed under abuse, care

Criminal gangs now target care homes and restaurants

When I read the headline Powers needed to stop Scottish gangs running care homes on Vern Pitt’s Adult Care Blog, I was startled.

When I read the full article in The Herald, I was even more startled.

Illegal gangmasters are expanding into new industries such as care homes, construction and the restaurant trade to take advantage of a loophole in the law.

“There is opportunity within this for people to be involved in serious organised crime because so much ready money is passing through their hands. This is my personal opinion, but it is extremely frustrating that illegal gangmasters can stop working in agriculture and move into another area for which we don’t have legislation. I would be looking to regulate the care sector and service industry.”

But I still couldn’t work out why I was so startled.

Then I remembered.

I remembered asking the Managing Director of the care home provider to prove to me that the staff working in a certain care home were all above-board, genuine, quality assured, legally employed, references checked, and so on …  nurses and care workers.  He couldn’t do that, because ‘apparently’ the laptop containing all that vital information had been ‘stolen’.

Then I was startled too.

Now, I remember another of those staggering stories, from 2008.  Care home workers don’t have full criminal record checks.  “….  migrant workers who may have committed a crime in their home country are not being vetted to same standard as British colleagues.

From next year, a new body called the Independent Safeguarding Authority will check applicants for jobs working with vulnerable people against barring lists and criminal records.

However, a report on the new system by Cheshire Chief Constable Peter Fahy and North Yorkshire Chief Constable Grahame Maxwell warned it would not address the problem of the lack of checks on migrants, with some foreign countries not even holding a record of convictions.”

I remain startled.

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Filed under care, care homes, Care UK, dementia care

Child abuse reports are to be published

Full reports of official investigations into recent notorious cases of crimes against children are to be published, ministers have confirmed.

Children’s Minister Tim Loughton said the serious case reviews into the deaths of Baby Peter and Khyra Ishaq would be released in full.

In an interview with Children and Young People Now, Mr Loughton said: “When you read some of these reviews it becomes clear that a lot of fault can be laid at the door of other agencies.

“Yet it is always social workers who take the brunt of the criticism.

“Actually, this is a way of helping to restore some of the lost confidence in social workers.”

I have only just picked this story up, via BBC News.   But I am personally delighted to read that child abuse reports are to be published.  I have no problem with the removing of the names of those abused. Just get it all out in the open, so as to open the eyes of those who refuse to see.  Maybe I would question the need to use the word ‘notorious’, if only because abuse is abuse.

There are many more reports that should be published in full, also.  Investigations carried out under the banner of ‘Adult Protection Procedures’, or ‘Safeguarding Adults’, for example. This is often abuse of elderly vulnerable people.  It is also often criminal.

As long as it’s all kept ‘behind closed doors’, nothing will change.  Social Workers may well continue to bear the brunt of criticism  – even though there are many other agencies involved.  But, if it’s all kept ‘secret’, in spite of the NO SECRETS policy that was hailed loud and clear a while ago, nothing will change.  And vulnerable elderly people will continue to be abused.

Until the Baby Peter case, I knew nothing of ‘serious case reviews’.  I  have since learned that there are far fewer serious case reviews conducted where elderly people are the subject of neglect or abuse.  The one is voluntary; the other is obligatory.  Why should elderly people be treated differently by the law-makers and by the protectors?

Yes, I am speaking largely now about those elderly vulnerable adults in residential care.  Abuse takes many forms – which is something that not a lot of people realise, to paraphrase a well hackneyed phrase, albeit a true one.

As a so-called society, we show far too often that we care less about the abuse and neglect of Older People than we care about children.  That has got to change.

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Filed under abuse, care, Care UK, growing older, neglect