Caring for the carer .
Recommendation 5. We recommend that the Trust should carry out a review of current practice for aftercare planning , to take account of patients, and patients as carers, with a view to giving more weight to their needs in those contexts . ...
planning for the implementaion of the [ CARERS RECOGNITION AND SERVICES ] Act 1995. .... difficult to understand how there could be such limited attention to the life of the patient outside hospital ...... and his role as a carer ( for his forgetful father ) . Conclusion 10. - the major responsibility rests with the Trust but the Health Authority has not met its responsibility to ensure that central policy was implemented. Management did not press for implementation of a Care Programme Approach procedure . The CPA is not an alternative to best practice and common sense . It should be seen as an enhancement of best practice and common sense and may act as a check and a framework within which the adoption of best practice and common sense can be ensured .
" Senior management assumed because seminars and expressions of policy had been made... that implementation would proceed ... "
" Action at management level does not necessarily translate into action by staff dealing with patients .
There is a duty on management to actually see what is happening and to discover whether it is sufficient ... "
"... audit tools consisting of forms and records can never be sufficient in themselves... management can only be sure by actual examination of what is happening in practice at the level of patient care, and by actual physical inspection at the workplace ....there is a duty on management to discover what is actually happening and to discover whether it is sufficient . "
p1.3.3..Tees Health Authority is absolutely specific in requiring that the CPA " will be fully implemented within 1994/95 "
p1.3.1. The main responsibility for the implementation of the CPA ( Care Programme Approach ) lay with the Health Authority to whom it was addressed rather than to Social Services who were only asked to collaborate with Health authorities .
p1.10 .. the responsibility for introducing CPA lay with the Health Authority and it delegated this to the Trust by including it in the specifications . There was a joint duty on the Trust and the Social Services to ensure this by directive in 1990 . LA SSL 90 (11)
p1.11. Individuals within social services found themselves unable to influence the multi-disciplinary teams in the hospital , of which the social workers were only a small part .The issue of confidentiality bears its ugly head here also . Incredibly the Inquiry reports ...
that there were doubts about what impact the requirements of confidentiality would have on liaison between teams assisting two different patients ... ... said that conflicts about confidentiality could affect multi-disciplinary working ,and mentioned that psychologists in particular seemed to have somedoubts about what information they can share . The doubts were not apparently a concern for the staff who actually dealt with patients and seem to be confined to the management .Conclusion 3.
Conclusion 16. passive practice
..... Consultant slow to change - ought to have been leading change ...and should have taken more of a leadership position ...
Conclusion 15
....a fomal CPA for either Keith or William Taylor would have involved a review of the care of both , in practice , and would have resulted in an after-care coordinator being identified ... (the) role would have involved reviewing KT' progress .
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