Another remarkable letter today from the Sloven Board Chair (who I’m now beginning to think might be deluded). We’re still thrashing through various issues around Sloven’s behaviour since LB died. Real scum bucket behaviour. Perhaps not surprising really given the Kirkup report this week that details shockingly awful actions in another NHS “Trust”. We’re clearly a way away from candour, honesty and transparency. Despite all the blather.

So. One part of the letter was about social media surveillance. Mr Waugh states

Like many organisations, the Trust monitors media and social media mention of its name, hence the content of the briefing to which you refer. This does not constitute surveillance of an individual.

Mmm. A quick Oxford dictionary search…..

Surveillance: ‘close observation, especially of a suspected spy or criminal’.
Monitoring: ‘maintain regular surveillance over’

Ok. Not sure the monitor/surveillance distinction is holding up here. I blogged about this issue a while back but a screen grab is helpful for a quick glance. Yep. Clearly monitoring. The blog written by the mother. An individual. A specific and targeted close observation (particularly given we rarely mention the Trust by name (unless it is now actually called Sloven)).

This briefing was written and circulated one day after LB died. [He died?] How the Board Chair of a public body can continue to be so deceitful and underhand to the family of a child they let drown in the bath is unfathomable. You were monitoring/surveilling my social media activity and it was more important to your organisation to think about reputation protection, less than a day after our son died, than seriously look at the service being provided in the STATT unit.

How can this level of dishonesty and immoral action possibly be allowed to continue?

The CQC Sloven inspection findings published today are something that demand careful reading. Remaining mindful of the amount of behind the scenes preparation and coaching that goes on for these inspections.

Brief headline: overall finding requires improvement.

We heard of many new initiatives and the trust was continually looking for ways to improve. However it was clear that time was needed to fully realise the scale and complexity of the changes and embed these across the trust.

Mmm. The bar clearly set so blinking low from the off. Businesses can have teething problems expanding, take-overs and the like. Mistakes can happen. For trusts those mistakes have high stakes. Like LB’s life. [He died?]

Growing so big, so fast and spreading yourself so thin across a wide geographical area inevitably ain’t going to work well. As the report today illustrates.

And a startling number of issues identified in previous CQC inspections in Oxfordshire that still occur. The stench ridden “Always about to…” model very much alive and kicking still in Sloven Towers. ‘Point a CQC inspector at us to show us the right route and we’re on it‘ jibberjabber spewing like vomit from a carsick toddler.

Only they ain’t.

Todays batch of failings:

Not enough staff, delays in the supply of equipment, mismanagement of medicines, buildings unfit for purpose, ligature risks, inappropriate seclusion and restraint practices, lack of crisis services and an unanswered crisis line, lack of available local beds, lack of examination of patients by doctors on admission, long assessment waits, uncertainty and low morale among staff, inaccessible records.

There’s some positive stuff I’m not going to record here. The positive stuff is people doing their jobs properly. Good. But not remarkable. The above list, combined with previous CQC inspection findings should lead to action. Not nonsense ‘learning fluff’ spouted by Sloven execs but real action. This bunch of muppets clearly should not be running an empire of crappy healthcare provision across four or five counties.

I worked at home today. Unexpectedly. And the phone didn’t stop ringing. Various people asking for thoughts about the report. There have been some cracking responses (in addition to the now legendary local news coverage). Andy McNicoll at Community Care and Chris Hatton’s contributions are stand out moments.

But hey, what about the Slovens? How have they responded to a grandly piss poor review of their services? Particularly  given their obsession with awards and all things shiny?

In a typical Sloven way.

Heard on the grapevine the big old CQC inspection of Sloven will be published tomorrow. Probably good timing to have a little whizzle through some CQC inspections of Oxfordshire based Sloven provision conducted since LB’s death. Particularly given we’re a year on from publication of the Verita investigation into LB’s death.

STATT/JOHN SHARICH HOUSE [November 2013]: No therapeutic interaction, illegal deprivation of liberty, privacy, modesty and dignity of patients not respected, impoverished environment, family and friends not involved, inappropriate risk assessment, lack of training, no understanding of neglect or institutional abuse, mismanagement of medication, out of date oxygen, no battery in the defibrillator, out of date oxygen, unsafe buildings, ligature risks, faeces on chair, inadequate quality monitoring, inaccurate record keeping, poor engagement between management and staff.
Sloven response [Katrina Percy] The team are reviewing internal processes and providing “the leadership and knowledge required to ensure best practice is shared.” 

PIGGY LANE [March 2014]: Lack of staff (a “problem with the Sloven recruitment practice”), lack of appropriate assessment, care, treatment and support, poor engagement between management and staff, delay in getting necessary equipment, lack of records about safeguarding incidents, inaccurate medical records, out of date medication, poor management. “It is so unsafe here at times, you have no idea“.
Sloven response [Phil Aubrey-Harris]:  We have reviewed the levels of quality and immediately put in place an action plan to address all of the issues raised. After subsequent re-failure in June 2014 Sloven unattributed response: a “robust action plan” has been put in place to ensure it was compliant in all areas.

EVENLODE [April 2014]: near miss incident in seclusion, ligature risks, poor engagement between management and staff, a culture of “listen but do nothing constructive”.
Sloven response [Lesley Munro] welcomed the report and took the findings “very seriously”. Necessary building works to ensure the unit is fully compliant were “due to be completed imminently”. 

HOUSE 2, SLADE HOUSE [Jan 2015]: No registered manager, not enough staff, lack of leadership and poor engagement between management and staff.
Sloven response [spokesperson]: The CQC report acknowledges that appropriate actions have been taken in response to their concerns, in most cases, on the day of the visit, that was over 4 months ago. 

Wow. A seedy, foul little whizzle. I almost apologise for dragging you back through it. Still. Big statements from Sloven big guns about stuff about to happen or be put in place.

Must admit, I’m baffled beyond bafflement the more I learn about the workings of the NHS. Particularly this whole patient safety stuff that is big at the mo. Details circulating on twitter this morning about the latest HSJ money spinning awards [for a full analysis of previous HSJ delights, click here] now combined with the annual Patient Safety Congress.

What confuses me is the content of this congress (concordat/concrap). ‘Making the business case for safety‘ and ‘Preparing for a CQC inspection‘. Eh? Patient safety? Isn’t that about keeping patients, er, safe? Not number crunching and coaching to pass inspections. Serious brain melt stuff.

At the same time, at a more personal level, the Sloven board chair last week reiterated Sloven’s acceptance of the Verita findings and recommendations into LB’s death. One of the reasons the Sloven bigwigs wanted to meet with us apparently was to confirm their “absolute acceptance of every aspect of the Verita report”.

Oh. That’s a bit odd. Why the hell are they wasting public money having a legal team, including barristers, who have tried to narrow down the scope of the inquest then? Why have legal representation at all? 

I just don’t get it.

It’s like the music is playing loud and clear, but Sloven, and the NHS, insist on dancing to a different tune.

Received a response from Simon Waugh (SW), Board Chair, Sloven Health this afternoon. That it came by email is about the best thing I can say about it. Selectively copied in to the cc list (bypassing Katie Razzall, Newsnight and JusticeforLB headquarters).

Brief context: We had questions, Katrina Percy refused to answer them, SW answered them Sept 17 2014. In a really crap way. In such a crap way I arranged to talk with him on the phone (23.9) convinced he wasn’t really up to speed with what was happening under his watch.

The big conversation back in September? A mistake really other than the occasional droplet of insight. We’ve continually shot ourselves in the foot and made ourselves look as incompetent and uncaring as possible. Er, yep. The truth is simple. His care was not what it should have been. Yep. SW also said he’d learned to reflect about being on the receiving end of letters from him in his capacity as Board Chair and think about what it must be like to receive such a letter (does it help or does it widen the gap?). Good stuff. (Though this was in connection with sending my sis a letter meant for another patient, rather than real reflective stuff about the content and meaning of what you write).

Unfortunately, these drops were obliterated by a drill hammer communication style, clearly aided by a set of key points) that looped across the two hour conversation (LB was fab, fit and able, staff forgot he was a patient, Sloven appear crap (but ain’t really) and there are valid excuses (or cliches) for everything). Once the repetition became apparent, it was a really uncomfortable conversation.

A couple of examples of the excuses:

Sloven didn’t dive into the unit to see that the hell was going on when a “fab, fit and able” young man died unexpectedly in the bath [he died?] because the police told them not to. Mmm. Not sure about that SW. How come the CQC could just pitch up and inspect weeks later?

“Well you’re damned if you and damned if you don’t”, was the slightly tetchy non answer. Followed up by a seedy little attempt to lay the beyond appalling CQC failings as having occurred in the six weeks or so after LB died. That pesky cleaner walked out 10 days before the inspection… [at several points during this conversation I wondered if I would experience long term effects from the sickening rage it generated.]

The second example involves the other patients in STATT. SW wrote that “unfortunately” STATT patients were unable to attend LB’s funeral because of “the family’s understandable restrictions on staff attending”. Not true, I said. I explained how we wanted staff not directly related to LB’s care to bring them. Bluster bluster.. SW meant the other patients’ families thought their relatives weren’t in the right mental state to attend. Oh. Why didn’t you write that then? I asked. Puff, huff and puffenstuffen, Dr Ryan. He couldn’t possibly include every line he wanted to include in the letter. It would be impossible.

Another damned if you do and damned if you don’t situ. Clearly.

So, back to today. The emailed reply. First of all he attached the letter sent on Sept 17th for the partial cc list to read. The fudged and fake responses letter. That is pretty crap. He reiterated the fact we’ve refused to meet across two paragraphs. Yep. With regard to staff disciplinary actions apparently the final one is part-heard and will be completed shortly. Mmm. (17 Sept letter “The final hearings for the remaining investigations are scheduled to be completed in the coming weeks”. 23 Sept phone call, staff disciplines will be completed “in the next 2/3 weeks”.)  There have been no delays with the second Verita investigation and the incredibly insensitively timed email, sent on 23rd December, wasn’t sent by the Trust’s solicitor. Even though it, er, was.

Wow. Mr Waugh. That stuff about reflecting on letters sent, foot shooting and incompetence (or worse)… ? You got a bit of a waugh to go, I’m afraid.