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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Attention to detail and new quality audit tool

21st January 2015  Add comments

I visited nine services last week and my theme for this month is ‘attention to detail’. This is something we talk about a lot in CMG including at staff induction, but I want to reinforce the point as I go around services. In my opinion, the care industry is very poor at ‘attention to detail’. I was speaking to a colleague a little while ago who used to work in care and now owns his own restaurant. He said how struck he was moving from one industry to another about the difference in attitude of staff and managers; he said you simply can’t afford to make a mistake with the quality of what you produce in a restaurant, otherwise your customers will stop coming and you will go out of business. Whenever we receive complaints in CMG, they are never down to anything difficult or complicated; they invariably relate to something simple where a member of staff didn’t think or didn’t bother to check. An example from last month, which horrified me, was a complaint from a mother whose son went home to stay with her at Christmas wearing a t-shirt belonging to someone else who he shares his home with; this is completely unacceptable.

Continuing on the subject of quality, we have decided to replace our quality ratings system in England. We developed the system three years ago in response to feedback from our managers that they were frustrated with the CQC compliance/non compliant system. Once a service becomes fully compliant, there is no higher level of quality to which the manager and staff team can aspire. We developed our quality ratings system to address that and it involves an annual rating process for every CMG service looking at over 100 indicators of quality. Given how rigorous the new CQC inspection system is, we have decided to replace this system in England with a very thorough audit tool which will assess the readiness of each service for its CQC inspection, looking at the five areas of safe, caring, effective, responsive and well- led. Our senior team has developed the audit tool which includes elements of the previous quality ratings system and I will be sending it out to our managers this week for their comments. Please let me know if you would like to see a copy of the document.

We will continue to use the current quality ratings system in Wales where they have a different regulatory system.

Peter Kinsey

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Concerns from a family member, CMG’s Relative Liaison Officer and CMG’s Family Conference

14th January 2015  Add comments

Last week I visited eight services. My week started with meeting the parents of a young man who we support who had some concerns about the care he is receiving. I am going to meet them every month until the issues are resolved. We also had another situation last week where a couple of unfortnate silly mistakes were made by staff which led to a complaint from a parent. These kind of situations frustrate me enormously as attention to detail and always doing what you say you are going to do are extremely important values for me. We are trying hard to inculcate them in CMG. It seems that there is a laissez-faire attitude in care where sloppiness is seen as acceptable. You wouldn’t expect poor service in a restaurant and I’m determined that the same should apply in CMG. Having said that most of our services are very good and most families are very happy with the support their loved ones receive.

Because we really want to listen to families and work in partnership with them, we created the post of Relative Liaison Officer about a year ago. Helen Woods occupies that role and regularly talks to families if they have any issues or concerns, so please do contact her ( Many CMG families know me personally as well and I’m always happy for them to contact me as well (

We are about to start delivering two care packages to young people with complex needs. One lives with his mother in Cardiff and the other lives in his own accommodation in Croydon. In both cases, we see it as extremely important that we develop a good relationship with those people’s families right from the start.

As working with families has been a theme in this blog, I would like this opportunity to remind CMG families and any other families of people with learning disabilities, that we will be holding our first ever family conference on Saturday March 14th, 10.30am-4pm, at Imber Court Sports and Social Club in East Molesey, Surrey. Keynote speakers include Andrea Sutcliffe, Chief Inspector of Adult Social Care, CQC and Vivian Cooper, Founder of the Challenging Behaviour Foundation. We will also be holding workshops on:

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 know what really goes on in services

The Mental Capacity Act

Family conference invite_Page_1








I do hope you can attend.

Peter Kinsey

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27 Christmas visits, safeguarding case and Happy New Year!

7th January 2015  Add comments

The week between Christmas and New Year is always quiet and I like to work then because the roads are clear and it is easier to get around and visit services. I managed to visit 27 last week, including the 5 services in the Vale of Glamorgan, which I don’t get to see as often as I would like. I was particularly impressed, when I visited our Beddington service on the border of Croydon and Sutton, to see one of the service users being actively encouraged to exercise on the treadmill. A number of our services are purchasing exercise equipment of different sorts, which I think is an excellent way of encouraging healthy lifestyles.

I also attended a safeguarding meeting last week as the Regional Director, who covers that area, was on annual leave. The case related to an anonymous whistle blowing allegation and appears to have been malicious, coming from a disgruntled member of staff. Unfortunately, some people choose to use the whistle blowing process as a way of getting back at their colleagues or manager, which is completely unacceptable. On this occasion, both the local authority and police were very pragmatic and we managed to get the investigation carried out very quickly.

A challenge for CMG and lots of other care providers is that the fact that the police often get involved, even in fairly low level safeguarding allegations and typically take between 6 weeks and 3 months to investigate. Invariably, they decide after that time, not to take any further action and then hand the investigation over to the provider. Apart from the fact that this costs millions of pounds a year in staff suspensions, the impact on individual staff members who are fearing for their job and career, can be enormous. It is not uncommon for a member of staff to go off sick with depression after a significant period of suspension. I have previously tried to tackle this issue with the Police Federation but will see if I can get a coalition together across the sector, as I know this is an issue that concerns my fellow Chief Executives in other organisations.

I would like to wish you a very happy and prosperous New Year.

Peter Kinsey

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