Judgement framework - Care Quality Commission

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Stage 4: Outcome 13 Case study 2 Case study 3 Case study 4 On the day of visiting a care home for 10 people, we find that there are two fewer staff on duty than on the rota. The manager says that there has been a stomach bug going around and three staff have called in sick. They have found cover for one member, but not the others yet. Otherwise, they have clear procedures for accessing agency staff and their staff record shows they are very rarely down in staff numbers. On the day in question, some of the activities had been rearranged so that all residents had adequate staff support. ● ● ● This has a low impact on people using the service, because activities have been changed to ensure people have the support needed. The likelihood of it recurring is unlikely, because there are clear procedures in place that show this is an infrequent occurrence. This means it is a minor concern. At night time, the five acute medical wards in a hospital often have a high proportion of newly qualified junior nursing staff on duty. There are some senior nursing staff on duty, but they are not available on all wards and have to be called if needed, so there can be a delay in people receiving the right care. ● ● ● This has a low impact on people using the service, because there can be a delay in care. The likelihood of it recurring is possible, because of the skill mix of staff during the night. This means it is a minor concern. A residential home for four people with learning disabilities has recently employed a registered learning disabilities nurse. The owner of the home felt this would be a positive move for the care of the residents. While the owner followed the appropriate recruitment procedures, he allowed the nurse to visit and spend a couple of hours at the home prior to all appropriate employment checks being confirmed. During the visit, the nurse was asked by a member of staff to help them with a resident who had fallen in the bath. No other staff were available as they had taken a resident to the shop while the ‘new manager’ was there. The nurse reported this incident to the owner and explained that she felt that she should not have been put in that position. The owner admitted that he had told staff that the new manager was coming in to help. A few days later, all employment checks were completed satisfactorily. On commencement of her employment, the new manager reviewed the home’s safeguarding policies and implemented training sessions for staff. ● ● ● This has a medium impact on people using the service, because of the potential safeguarding issue due to checks not being confirmed. The likelihood of it recurring is unlikely, because the new manager amended the policy and provided training to prevent it happening again. This means it is a minor concern. 114 Care Quality Commission: Guidance about compliance Judgement framework March 2010
Stage 4: Outcome 13 Outcome 13 Moderate concern Where moderate concerns are identified, people who use the service are generally safe, but there are risks to their outcome, health and wellbeing. Provision of care is inconsistent and may not always meet this safety and quality regulation. There is some assessment of the needs of people who use services and the skills, qualifications and experience that are needed in order for staff to provide care that is safe and effective, and which meets those needs. But the need to protect rights and promote independence are not considered. At different times, such as at weekends or outside regular working hours, there are insufficient numbers of staff or an inappropriate mix of competence, skills and qualifications. Changes to staff numbers and mix can be difficult and slow to make. Care Quality Commission: Guidance about compliance Judgement framework March 2010 115
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Guidance about compliance Judgement
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Contents A new system of registrati
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The judgement framework The judgeme
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Section Outcome Regulation* Title I
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Taking account of other influencing
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Putting the judgement framework int
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Stage 2: Checking whether the evide
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Stage 3: Determining the impact on
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Stage 4: Validating the judgement S
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Stage 4: Validating the judgement O
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Stage 4: Outcome 1 Case study 4 Peo
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Stage 4: Outcome 1 Case study 5 Cas
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Stage 4: Outcome 2 Outcome 2 Minor
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Stage 4: Outcome 2 Outcome 2 Modera
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Stage 4: Outcome 2 Outcome 2 Major
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Stage 4: Outcome 4 Outcome 4 (Regul
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Stage 4: Outcome 5 Outcome 5 Minor
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Stage 4: Outcome 5 Outcome 5 Modera
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Stage 4: Outcome 5 Outcome 5 Major
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Page 73 and 74: Stage 4: Outcome 7 Outcome 7 Minor
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Page 87 and 88: Stage 4: Outcome 9 Outcome 9 Minor
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Judgement framework - Care Quality Commission

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