Welcoming new services, CQC inspections and judging at The National Learning Disability Awards

2nd April 2015  Add comments

My blog is going to be shorter this week because I had two days annual leave last week. As a result, I was only able to get round and visit seven of our services. I popped into our Chandon service in Ashtead and was very pleased with the efforts that the staff team had gone to, to help one of the people living there have a fabulous birthday party. It was well attended, including by her advocate.

Last week was busy preparing for taking over services in different parts of the country following CMG’s successful winning of various tenders. We took over providing supported living services in three sets of accommodation for people in the Basingstoke area on Monday, took over the provision of supported living services for two groups of people living in Croydon on Tuesday and took over the provision of specialist support for people with a diagnosis of autism in a supported living service in Newport in South Wales.  We would very much like to welcome both the people we support and their staff in joining the CMG family. As well as introducing ourselves to people we support and their families, we have arranged inductions for staff transferring to us so that we can explain about who CMG is and our ethos and values.

A big congratulations to the staff team of our Albion Road service in Sutton which received a good overall rating in their recent CQC inspection. They were rated good on each of the five areas that CQC now look at, well led, safe, effective, caring and responsive. CQC has been inspecting using their new approach since October, so some of our services were inspected in their pilot phase during last summer. So far, ten of our services have been inspected, with nine rated good and one, The Ridgeway as outstanding. Our Kings Road service in Hampshire came very close to getting an outstanding rating; you have to get outstanding on two areas and good on five to get an overall outstanding rating. Kings Road had one outstanding and four good. At our recent family conference, Andrea Sutcliffe, Chief Inspector with CQC, told us that only about 1% of services inspected so far have received an outstanding rating. We hope to get significantly more than one in CMG.


I was delighted to be invited to act as a judge for the National Learning Disability Awards and went to the spectacular Edgbaston Stadium last Thursday to be a category judge for the trainer award. There were eight nominees and both I and my fellow judge were very impressed with the calibre of the entrants. CMG was shortlisted for two awards (Newcomer Award and Sporting Chance Award) and my colleagues were also there being interviewed.



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Visiting services, disappointing CQC outcome and judging awards for the people we support

25th March 2015  Add comments

I had a busy week last week and only managed to visit 6 services. This included two of the 15 services in Abergavenny that have recently joined CMG. I would very much like to welcome the people we support, their staff and families to the CMG family. I would also like to welcome the people we support, staff and families of the Glyn group in the New Forest who also joined us recently.

On my visits to services last week, I was particularly impressed when visiting our Willesden Lane support living service in Brent to see information about the sensory stories which staff have been using with the people we support. These can be really effective in providing interesting and stimulating activities for people with the most profound level of disability. I met some relatively new staff in the service and was very impressed by their enthusiasm and commitment.

We received one of the new style CQC reports last week. The service concerned was rated overall as good but was found to require improvement on one area, effectively, mainly because there was evidence that the people being supported didn’t always have a healthy and balanced diet. This is a concern which we are addressing straight away and we will also be sharing lessons to be learnt with other services across CMG. It was a frustrating finding given how much emphasis we place on supporting people to eat healthily. We cover healthy eating in our training and also developed an accessible “healthy lifestyles pack” which we distributed to all CMG services. So far, we have received 10 of the new style inspection reports, 9 services are rated as good and one is outstanding. I am keen to increase the number of outstanding rated services which CMG has, but I don’t underestimate the challenge. At our family conference on the 14th March, Andrea Sutcliffe, chief inspector with CQC, told us that out of around 1,500 services inspected so far across England, only 18 have been rated outstanding.

I continued to receive some very positive emails from family members last week saying how much they enjoyed our family conference. We will definitely make it a regular occurrence.

Carl Johnson - 1st Place (joint) Most Inspirational Service User 2014We had the judging for our Service User Awards take place this week. We had over 100 entries in 12 categories and some incredibly inspiring stories, so there were some really hard choices to make.   Thanks to our Service User MP’s who helped the panel with their decision making. All winners will be notified shortly and invited, with family members, to our Awards Ceremony which will be taking place on 15th May 2015.

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Success at our Family Conference, impressive audit by Regional Director, and finding creative ways for Local Authorities to engage with providers

18th March 2015  Add comments

We had our first ever CMG Family Conference on Saturday and I was delighted that it was so well attended and went so well. We had around 80 family members attending and the feedback was overwhelmingly positive. People said that they found it very informative and appreciated the opportunity to meet other relatives of people we support. The idea of the conference came from our Driving Up Quality Code self assessment day last year when we identified that there was scope to improve the way we communicate with families. We worked with a number of family members who kindly gave up their time to help us plan the format for the conference. We had two excellent keynote speakers; Andrea Sutcliffe, Chief Inspector for Adult Social Care for CQC and Viv Cooper, Chief Executive of the Challenging Behaviour Foundation.

Andrea SutcliffeViv Cooper










We also held the four following workshops:

Positive Behaviour Support – promoting positive coping skills and reducing challenging behaviour

Best practice in supporting people on the autistic spectrum

Transparency and quality in CMG – How do you really know what is going on?

The Mental Capacity Act and DoLS (Deprevation of Liberty Safeguards) – challenges and changes

I visited 10 services this week and was particularly impressed with two things; the excellent implementation of person centred support at 5 Fengates in Reigate, Surrey where I observed the people living there being actively involved in a wide range of domestic activities including cooking and cleaning. I was also very impressed when I visited a service in Sutton to meet the Regional Director who has been there since 7 o’clock in the morning and was carrying out an incredibly thorough quality audit. It is this sort of attention to detail that really makes a difference in ensuring our services are of high quality.

I also went to a ‘market warning’ event with a Local Authority. The purpose of the event was to warm up local provider markets that this Local Authority is about to carry out a re-tendering exercise and what objectives they are trying to meet. I go to events like this reasonably regularly and they usually involve Local Authorities giving a presentation followed by some questions and answers. The one I went to this week followed that format and it made me think that perhaps Local Authorities are missing a trick in not finding more creative ways to really engage and have conversations with their providers. In my opinion the split between commissioners and providers has created an element of suspicion and mistrust from both parties when really what we need to be doing is working together to help vulnerable people have the best possible quality of life.

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Standards slipping, new government green paper and shortlisted finalists in National LD Awards

10th March 2015  Add comments

I managed to visit 18 services last week including 11 in Wales. I visited a couple of services where I noticed that standards had started to slip. To me that shows the importance of constant vigilance; it doesn’t take long for standards to drop even in services that you think are well managed. Whilst quality assurance systems are important, I don’t think you can beat walking around services and seeing for yourself what the atmosphere and quality is like. We are taking action to address the concerns that I had. They were relatively minor but indicated to me that the service was moving backwards rather than heading in the right direction.

On a more positive note, I was very pleased to see the great deal of person centred active support in evidence in our Welsh services. This includes service users being supported to do their own ironing and one person very rigorously and enthusiastically cleaning their own bathroom without any visible prompting from staff at all.

The new government green paper was issued for consultation last Friday on strengthening rights and choices for people to live in the community. I would encourage everyone to read and comment on it. I agree with the aspirations that it contains; my only concern is whether it will make a difference to people and their families on the ground. https://www.gov.uk/government/consultations/strengthening-rights-for-people-with-learning-disabilities

I was very pleased to hear that two of our staff in CMG have been shortlisted for the National Learning Disability Awards. Congratulations to Karen Macmarters, who has been shortlisted in ’The Newcomer Award’. Karen is a Support Worker at one of our services in Dorking and has hit the ground running since starting at CMG, despite having no previous experience. She soon learnt to understand the complex needs of the people she helps support and has demonstrated excellent person centred communication. Michael Fullerton, our Clinical Director has been shortlisted for ‘Karina Bryant with Cossima Paradine (centre) and Stephanie Nash (right)The Sporting Chance Award’. Aside from the excellent work that Michael does on a daily basis in his clinical and quality role, he is also a fantastic advocate of healthy lifestyles and ensuring as wide a range of sporting options are available to the people we support. Michael is the inspiration behind CMG’s highly successful Annual Athletics Championships and has also set up a number of sporting enterprises including a CMG Options Academy which sees instructors from Tottenham Hotspur Foundation coaching individuals from CMG.

Last year, Sarah Evans, CMG’s Head of Learning and Development, won ‘The Trainer Award’ so we wish the best of luck to both Karen and Michael this year.

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Excellent work in our services, winning a tender and CMG’s annual programme of events

4th March 2015  Add comments

I visited 14 services last week and was particularly impressed when I went to our Tuscany service in Dorking. I got there early in the morning, just after a potentially difficult incident had been de-escalated by the staff on duty. I was impressed with their knowledgeable and calm attitude and the fact that they had successfully followed an individual’s positive behaviour support plan to the letter. I was also very impressed to see a pictorial menu board in the kitchen showing lots of tasty looking and healthy meals which the people living at Tuscany had been supported to choose. On a separate note, I was also very pleased to hear about the excellent work of our Chetwynd Road staff team in Portsmouth who supported one of their tenants to get back in touch with her son who she hadn’t seen for many years.

We heard this week that we were successful in winning a tender for two supported living services. This is the third tender that we have won in the last few months and we are having a busy time at the moment making the necessary preparations and planning the transfer of existing staff to become CMG employees. We have detailed communication plans in place to make sure the people we support, their families and staff find out about CMG and are encouraged to feel part of our organisation.

Family conference invite_Page_1

We have a busy programme of events throughout the year and this year could be the busiest so far, starting with our Family Conference on 14th March at Imber Court Sports and Social Club in East Molesey, Surrey. This conference is open to all families of people with learning disabilities and will include keynote presentations from Andrea Sutcliffe, Chief Executive of Adult Social Care at CQC and Viv Cooper, Founder of the Challenging Behaviour Foundation.


Our 2015 events programme is as follows:

Family Conference – 14th March 2015

Service User Awards – 15th May 2015

Driving Up Quality Day – 30th June 2015

Service User Conference – 16th July 2015

Supportive Therapies Day – 23rd July 2015

Athletics Championship – 25th August 2015

Registered Managers’ Conference – 28th September 2015

Celebrating Culture Day -15th October 2015

Staff Awards – 19th November 2015

If you would like any information about these events, please contact our Marketing and Events Manager, Sue Pym.

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Appointment of Rachael Dodgson, social inclusion and the expense of tenders in an age of austerity

26th February 2015  Add comments

Rachel DodgsonRachael Dodgson joined us last week as Operations Director for England and has made a good start. I have already received positive feedback about her and I am sure she will fit into CMG very well. She has already made a useful contribution by helping us word a factual accuracy response to a draft CQC report which we received recently for one of our best services. The service received a good rating but we are hoping to get that changed to an outstanding one.

I visited ten services this week and was impressed with a number of the things that I saw. At our Rogerstone service in South Wales, I was really impressed by the huge commitment of the staff team to the people they support. The individuals living there have profound and complex autism and the staff team are incredibly tuned in to their needs and wishes and use a range of communication methods to help the individuals express their wishes. One of the people at Rogerstone has been poorly for quite a long time and the team has shown huge commitment in supporting him to get the right medical intervention. He is now back home and looking much better. I was also impressed when I visited 283 Dyke Road in Brighton to see a young man being supported to iron his own shirt. In CMG, we talk a lot about active support which is an approach where staff do things with the people they support, not for them. He was going out on a date and it was important that his shirt looked the part. I was also impressed that the tenants, with staff support, where planning to discuss the important topic of human rights at their forthcoming meeting. On a different note, I was also impressed by the manager of Brook Lane who actively invites different external speakers to attend her staff meetings to talk about a range of topics. This included, for example, their CQC Inspector. It is excellent that she is being so proactive in broadening the understanding and perspective of her staff team.

Our social inclusion campaign continues and services across CMG are regularly posting updates showing good practice and we have produced out first ‘Social Inclusion at CMG’ newsletter. I was very impressed with a proposal put forward by a person we support at Burlington Street in the Vale of Glamorgan, that she wanted to set up a social inclusion committee in the area involving other people supported by CMG to plan a range of activities and events.

We also spent time this week finalising another tender application. This one is actually a framework application but is called a tender which is very confusing. It was long and a particular challenge as some of the questions weren’t written very well. As you know, I have a bit of a bee in my bonnet about tendering as it is a lengthy and tedious process which incurs a great deal of cost on the part of both Local Authorities and providers in what is supposed to be an ‘age of austerity’. I heard anecdotally this week that there have been problems in a particular Local Authority area where a major tendering exercise was carried out and a provider which isn’t known for high quality won a significant chunk of work. Apparently because of quality concerns, a number of families are choosing to move their sons and daughters to alternative providers. I think that says it all. Instead of being a test of an organisation’s essay writing skills, I really do think tendering should test a provider’s actual ability to provide a service. For example, we are never asked, things liked ‘what is your CQC compliance level’ (98%) or how many people have you successfully supported into paid employment (60).

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Social inclusion examples to inspire staff and the lack of clear standards in the provision of positive behaviour support nationally

17th February 2015  Add comments

I visited eleven services last week and was particularly impressed, when I visited The Paddocks in Essex, with the positive attitude of the staff team who are actively looking for voluntary employment opportunities for a complex young man with autism. It is really important that we see peoples’ potential, rather than letting their disability or their behaviour get in the way. Our Social Inclusion campaign is continuing and I am very impressed with the number of responses I am receiving from different services sharing good practice. Those e-mails are shared throughout CMG so all staff can read them. I hope they inspire our teams to try something new for the lives of the people we support. We are preparing a newsletter for front line staff which will include a number of these case studies to help motivate an inspire them.

I am the provider representative on the Learning Disability Programme Board, which is chaired by the Minister, Norman Lamb. I am impressed by the range of policy work that is underway looking to improve the lives of people with Learning Disabilities. This includes work on employment, reducing early mortality and on the support people with Learning Disabilities receive in the criminal justice system. I raised this specific issue of why the positive behaviour support academy was not included in the NHS England response to the Bubb report. I was told that this is because there is going to be a work force programme to look at how we employ and train our staff with the expertise to support people with complex challenging behaviour in the community. Whilst I would agree with that aim it misses two very important additional actions which are required nationally. Firstly, there needs to be clear standards set as, currently, anyone can claim to be a positive behaviour support (PBS) provider and there are no set standards or accreditation schemes in place. Secondly, not all commissioners will have the expertise to commission person centred services designed around the needs of individuals, as the late professor Jim Mansell recommended for many years, and there is a danger that they will commission new institutions to replace the older ones.

We have a very real example of the challenges that are faced in providing community based services for people with the most complex and challenging needs. We have been asked to provide a single person service for a young man who can present the most extreme challenges and who requires three to one support. He will be joining us in the next two months and we are planning his service extremely carefully and with huge attention to detail. We also want to work very closely with all the health professionals who know him so that we can get his service right and help him achieve the outcomes that he and his family wants. This is someone who could very easily end up languishing in a hospital setting for many years.

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Recognising and valuing staff and frustrations with the tendering process

11th February 2015 1 Comments

I visited ten services this week and have now moved on to my February theme of the month, which is, Valuing Staff. This is something that we have been discussing at our recent staff representative meetings. You may have heard of the ten to one ratio which is the ratio of positive comments you should make to a member of staff compared to the number of negative and critical comments. I think it is really important that we recognise the excellent work and commitment of most staff in CMG and there is a danger sometimes that may get overlooked and we only focus on feedback where there are only areas for improvement. I try to make sure that I always recognise and congratulate good work and I want to encourage a culture throughout the organisation of doing the same. One of our excellent managers, told me that he always thanks his staff when there has been a good shift at work and a lot has been achieved. He is a very modest individual but he is extremely highly regarded by his staff and throughout CMG.

I am continuing to promote our social inclusion campaign and am delighted with the number of responses I have been receiving from staff across the organisation, sharing excellent practice. We are planning to collate all this into a newsletter targeted at our front line support staff to encourage them to explore more social inclusion opportunities for the people they support. I was particularly pleased to hear about an initiative which the Paddocks staff team in Essex are actively exploring which involves finding voluntary work in a cafe for a young man with Autism who can present with complex and challenging behaviour. It is really good that they are seeing beyond his disability to his potential and that is something I would like to encourage with all our staff.

Following our Driving Up Quality self assessment day last year, we have revamped our staff representatives system and now have staff representatives from each of our services who meet with our Head of Learning and Development and Human Resources, Sarah Evans and I on a regional basis. We have now had four meetings and I am extremely impressed by the positive attitude of the staff representatives and their good ideas for improving the way that CMG runs.

We received feedback on a tender this week. Although we weren’t successful, we did receive top marks for our implementation plan question which asked how we would go about getting the service set up if we were successful. Recently we received poor feedback and low marks on our answer to an identical question in a different tender. I was interested to see how different our answers were given the big difference in scores. I was interested to find that our answers were actually identical which I think is good evidence of what a lottery the whole tendering process is.


Social inclusion, CQC inspections and the Bubb report

4th February 2015  Add comments

I visited fifteen services this week and continued my conversations with staff about the importance of ‘attention to detail’. I find that giving specific examples makes it easier to get the concept across. I also looked for more examples of good practice in relation to our social inclusion campaign.

  • Heathcote Road tenants did a brilliant job raising nearly £200 for Children in Need. I think it’s really important that we support people to make a positive contribution, rather than just being passive recipients of care and state benefits.
  • At the Ridgeway, 3 tenants are in paid employment, one does voluntary work at a local centre for elderly people and tenants regularly attend the “Church of Rock” which plays heavy metal music on a Sunday. They have also raised money for Macmillan Cancer Relief.

We had a tender presentation and interview last week and another one this week, so fingers crossed! It is notoriously difficult to read tender interview panels; I can remember two where we were adamant that we hadn’t done very well and we ended up being the provider selected. More recently, we had a tender interview that went very well and we were very hopeful, only to find we were unsuccessful.

I received the inspection report for Goldstone Crescent and Brook Lane this week, which were both rated as ‘good’ by CQC. Congratulations to the managers and staff team for their hard work. So far we have received seven on the new style CQC inspection reports, one of which was ‘outstanding’ and the remainder ‘good’. It can take several months for inspection reports to come through and I do hope CQC are able to speed up this process.

Our agency usage in January was £29,000, significantly down on December. This represents less than one percent of our expenditure on staffing. We are very hot on agency usage in CMG and monitor it every week. My target is to try and get down to £10,000 a month.

NHS England issued their response to the Bubb Report this week. I was rather disappointed by it as I didn’t think it included enough practical action to really address the issue of people really needing to be discharged from assessment and treatment units. I have had feedback from colleagues in the sector whose views are similar. There was no reference in the response to the proposed Positive Behaviour Support Academy which was in the Bubb Report. CMG has played an active role in developing proposals for the Academy and will continue to lobby for one. I think it is really important that there is one agency in England with the knowledge and expertise to set standards and champion best practice in relation to positive behaviour support, a concept which is still poorly understood by many provider organisations, including, I suspect quite a few hospitals where people with learning disabilities are being treated.

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Attention to detail, social inclusion and the tender process

28th January 2015  Add comments

I visited fourteen services this week, mainly in the Brighton and Hove area. I took the opportunity to talk to a number of staff about my theme of the week, which is, ‘attention to detail’. I explained that this is about being thorough, careful and getting the little, but important, things right in the lives of the people we support. I gave the example of a young man we support who went home wearing the shirt of another person he shares his home with, to make it real to people the kind of thing I was talking about. I was also in a service where the pictorial rota was out of date and I pointed out the fact that having the photos of the wrong staff members on duty that day was a very clear example of lack of attention to detail.

When we carried out our Driving Up Quality self assessment day last year, one of the areas for improvement identified was promoting social inclusion, which is a challenge that many provider organisations face. We do it well in some parts of CMG but not consistently. I had a meeting last week with a number of our Social Inclusion Co-ordinators whose role in services is to seek out opportunities for individuals to participate meaningfully in the community and to encourage them within the staff team. I was very impressed with the enthusiasm and creativity of the Social Inclusion Co-ordinators who I met. They gave me a long list of really good ideas which I am going to cascade across the organisation through our Regional Director team. Please let me know if you would like a copy of their list of ideas. One of the things that we agreed is that, when I visit services, I will make a point of noting any good ideas of social inclusion and will then send out a weekly email across CMG highlighting those and encouraging those to follow that example. I will also include those in my weekly blog. I was particularly impressed by two services in the Brighton and Hove area;

  • At 53 Rutland Gardens, we  support a young man with Asperger’s Syndrome. He has been supported to join a group for people with Aspergers and as a result has made several new friends. He also has a voluntary job at the Salvation Army centre and has got to meet people there. He is arranging to invite some people from the Salvation Army to come to his home and visit him.
  • At 283 Dyke Road, they support people to participate in a range of activities in the community. One person they support works at a local allotment, another person does voluntary work at a local radio station and two other people are in a rock band.

We heard this week that we were successful in winning a tender which is great news. I can’t tell you where yet, because we are in the ‘standstill’ period. For two weeks after a tender is awarded, other providers have an opportunity to challenge the decision and it can’t be announced until after then. We also encountered a challenge with another tender we won recently because when the tender documents were issued, it made clear that the staff who would transfer to us had opted out of a pension scheme. It has now become clear that the information we received was inaccurate and a number of people are in a pension scheme. Pension schemes can be extremely complicated and I won’t try and explain all the issues here. However the important point, is that, when people are in final salary pensions, typically the Local Government and NHS ones, there can be both extra cost and significant financial liabilities on providers. Providers have been known to be bankrupt by not managing pension liabilities properly. We are trying to find a resolution to this with the Local Authority concerned. We are also finalising our submission for the Cardiff tender was submitted on Monday. Tendering takes up quite a lot of our time and if I’m honest, is not the most exciting thing that we do in CMG. I met Michelle Murray who is leading on the procurement strategy for Adult Social Care and is part of the Winterbourne View joint improvement programme. She told me about plans which are being developed to make tenders shorter and more person centred. That will be a very welcome development, because to be honest, they are more of a test of your essay writing skills that your ability to actually run services. They can also be extremely long and time consuming to complete.


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