By Kuljeet Kaur 12 Oct, 2017

Thought you’d nailed or just managed to get your head around the CQC inspection using the 5 KLOEs and then bang CQC announced they were changing the focus of their inspections. Frustrating I know but the process has been designed to simplify the process especially for those who provide more than one type of service.  

The changes to KLOEs and prompts are the result of feedback following CQC’s Next Phase consultation. CQC has amalgamated previous versions, added new prompts / key lines to strengthen specific areas and in addition there has been substantive changes to wording to improve and simplify language.

So instead of 11 frameworks it’s down to 2 - a standardised approach to the whole of healthcare – sounds better surely!

So you are probably asking ‘why has CQC done this’, well they done this to achieve:

  • A consistent approach to defining and measuring quality and to collecting information
  • Be clear and consistent about how they assess the quality of care across different types of services

So where CQC refer to ‘people’ they will include adults, young people and children, where applicable.

CQC have published their document reflecting the changes to enable providers to prepare for the changes. Check out the different times of when the revised framework will be introduced:

By Kuljeet Kaur 09 Oct, 2017

Last week was national Work Life Week, which was an opportunity for employers and employees to focus on well-being at work and the importance of achieving a work-life balanced life.

A few days away I read about a 31-year-old Japanese woman who had died from clocking up 159 hours’ overtime in one, yes one month. Miwa Sado had only taken two days off the previous month before she died of heart failure in July 2013.   

Did you know in Japanese there is actually a specific word for ‘death from overwork’, which is karoshi .   

Since Miwa Sado death some Japanese companies have made some changes, an ad agency, Dentsu, requires their staff to take at least five days off every six months. It also shuts the lights off every night at 22:00hrs as an incentive for people to head home.

Figures released by TUC last year indicated that UK workers apparently gave their bosses £31.5 billion worth of overtime in 2015. More than five million people put in an average of 7.7 hours extra work a week in unpaid overtime in 2015 had those five million been paid then if they were paid an average wage that would be an addition £6,114 in the workers’ pay packet.

With the development of IT and technology the days of working 9 – 5 are long gone especially in some sectors. A few years ago when I was working for a private company there was an expectation I would be at work for 7am and work till 6 / 7pm plus answer emails and phone calls in the evening and weekends. The point I realised this was completely ridiculous was when I was told to call one of my clients about 10pm – I asked myself would I appreciate a ‘work’ call that late, the answer was a firm no! – when do you actually switch off from work – never!

I know I wasn’t the only person experiencing this ‘expectation’ because I, like many wanted to keep my job (I was aware that the company would find someone to replace me), be seen to be going above and beyond in the hope of a promotion, extra bonuses, recognition and appreciation so when and if redundancies are made my name isn’t on the list.  I know many can relate to this feeling. It got to the point that my husband’s was diagnosed with stage 5 renal failure when I sat back and realised that I had not gone to many to his hospital appointments, didn’t really know what had happened (I was relying on my husband to tell me but he downplayed everything because he didn’t want me to worry as he was aware that I worked long hours). Only when I attended a consultant’s appointment and I heard the words ‘dialysis’ ‘4% kidney function’ that I knew I had to make some changes because I had a choice either I continued to work nearly 12 hours a day and miss out time with my husband (at the time we didn’t know if he would make it – he was described as a ticking time bomb and could have heart failure at any time) or I get the work-life balance right before it was too late. I made the later choice of course and bought some changes in my work life so I could give time to my family.

A colleague once told my about her ex-colleague who was the ‘yes’ person in the office, never said no to taking on additional work, staying late and helping others. He travelled to work on the train and one day he was going home to his family (late because he had stayed over to get some work done) and whilst on the train he had a nervous breakdown – he had worked not only his ‘working hours’ but it transpired that he was also taking work home because there wasn’t enough time in the day to get everything done.   Tragic that it took this incident for the company to look into the well-being of the staff.

France has a law that gives employees the legal right to avoid work emails outside of working hours – I’m sure a lot of us of would welcome this in the UK.

Mind completed a survey, which came from 15,000 employees across 30 organisations and it found that men are more likely to experience work-related health problems due to their job, compared to problems outside of work.

The data showed that men are less prepared to ask for help and take time off than women. While two in five women (38%) feel the culture in their organisation makes it possible to speak openly about their mental health only one in three men (31%) say the same. Two in five women had taken time off for poor mental health at some point in their career compared to only one in three men (29%). - .WdsrRtOGMdU

A lot of employers have taken on board mental well-being and support their staff with tackling stress and also helping those people with mental health problems but there is still a lot more to do and employers need to recognise what they can do to address mental health in the workplace.

A friend of mine applied for a job some years ago and she declared that she had bipolar on her application form, the employer discussed this in her interview and she told than she knew her trigger points and when she will have an ‘episode’ – rather than the employer saying ‘OMG this could be a problem employee – sickness, disrupting other workers’ they employed my friend because they saw her as an asset to the company because of her experience, skills and honesty and worked with her rather than against her.

I know and I’m sure you do as well people in your work environment that have nothing or very little in their lives except work, they don’t have time to develop and make friendships and the only ‘friends’ they have are work friends, great until you are working in the same company but once people leave those relationships also dwindle because what the only thing that kept them together was work.

I share this because not because of Miwa Sado, my personal story or my friend but because we have to remind ourselves that all work and no play can have a negative and damaging effect not only on our own physical and mental health but also the impact on family and friends.  

I don’t want to sound like a cliché but we do only have one shot at life so make sure that you make the most of it. Look after your mental and physical health as you are the important person, without you being fit and healthy you are no good to anyone including yourself.

Below are some links for further reading:

Mind have a great resource ‘How to support staff who are experiencing a mental health problem’

Mental health problems at work – Fit for Work

Why men are struggling with work-related mental health problems

Mental Health – Acas

Stress and mental health at work and home

Work –life balance – Mental Health Foundation
By Kuljeet Kaur 28 Sep, 2017

Great work by Headway as part of their Justice Project they have succeeded in getting the Brian Injury Card supported by all major police organisations in the UK, including the National Police Chief’s Council, which covers England and Wales, Police Scotland, and the Police Service of Northern Ireland, NHS England’s Liaison and Diversion Service, National Appropriate Adult Network and the Police Federation of England and Wales.

The Justice Project’s aim is to raise awareness of brain injury; improve brain injury identification; get the right support for brain injury survivors who come in contact with the criminal justice system and are treated appropriately; given access to specialist legal advice and representation; divert people with brain injuries away from the criminal justice system where appropriate.

Prince Harry who launched the card as part of Headway’s Justice Project said ‘This is surely a life-changing moment for people with a traumatic brain injury, whether or not they every get arrested’. The card would be a ‘saving grace’ for police as well as for brain injury survivors.

We all know that brain injury can be described as a ‘hidden disability’ and can lead to misunderstandings and difficulties for survivors. “The Headway Brain Injury Identity Card is designed to help the police to identify survivors at the earliest opportunity, ensuring they receive suitable support and are diverted away from the criminal justice system where appropriate.

“The card also has the additional benefit of breaking down social exclusion, with card holders having renewed confidence in the knowledge that they can easily explain their support needs should they require assistance in everyday situations.

More importantly the card will also benefit breaking down barriers and social exclusion many brain injury survivors face and explain their support needs as and when they require support in everyday situations.

When you visit Headway’s website you see a number of case studies the first thing that is apparent that people are judged on how they look and behave and it is so easy to ‘pigeon hole’ people without actually getting to know the ‘real’ facts.  The card is also a way to educate, challenge preconceptions and stereotypes people have in that just because someone is unsteady on their feet and / or staggering and / or has slurred speech doesn't mean that they are under the influence of drink or drugs.

The card is a positive move not just with the police, criminal justice system but also in everyday life situations; it will hopefully get the right support for brain injury survivors and promote more independent living for people. 

Case Studies from Headway’s website

Tom Birch 

Like many people with brain injuries, Tom Birch walks with a slight stagger and has impaired speech. Often it gives the impression he is drunk, and this has led to unfair treatment.

Samuel Bishop

Samuel can often get confused and people struggle to understand him, which is why he’s supporting the new Brain Injury Identity Card project.

Phil Broxton

Phil often feels under pressure to prove he has disabilities to others and explain the effects or symptoms of his brain injury – which include balance problems, chronic fatigue and cognitive issues.

Nell Gregory

Nell's brain injury has left her with a number of problems that affect her memory, sight and balance problems. She also suffers from bouts of severe fatigue. She said the card has provided her with a boost in confidence, especially tackling those everyday tasks that people often take for granted.

Jamie Gailer 

On 10 April, 2016, Jamie was driving home from the shops in heavy rain and lost control of his car. He sustained a cut to his head and was found at the scene confused and disorientated. Police mistakenly believed Jamie Gailer was driving under the influence of alcohol and arrested him.

Callum Mclean 

A brain tumour left Callum with a number of problems such as impaired balance, affected temperament and limited mobility. These symptoms have brought many challenges, including dealing with the often inappropriate ways people react to his disabilities.

The Brain Injury Card is available to anyone aged over 18 + it is free of charge so if you or anyone you know wants to apply for the card then all you need to do is complete an application  and provide clinical verification of brain injury, a photo and some information about how your brain injury affects you.

For more information or to apply for the Brain Injury Card visit


By Kuljeet Kaur 05 Sep, 2017
To get to the heart of service users' experiences of care, the CQC inspections focus on the quality and safety of services.  

The five key questions which are below are further broken down into more questions, which are called key lines of enquiry.   When CQC carry out inspections, they use these to help them decide what they need to focus on. For example, the inspection team might look at how risks are identified and managed to help them understand whether a service is safe.  Different key lines of enquiry are used in different sectors.

Are they safe? 
 Are people protected from abuse and avoidable harm?

Are they effective? 
 Does people's care, treatment and support achieve good outcomes, promote a good quality of life and is it based on the bets available evidence? 

Are they caring?  
 Do staff involve and treat people with compassion, kindness, dignity and respect?

Are they responsive to people's needs?
 Is the service organised so that it meets people's needs?

Are they well-led?
 Does the leadership, management & governance of the organisation assure the delivery of high-quality person-centred care, supporting learning and innovation, and promoting an open and fair culture?
By Kuljeet Kaur 24 Aug, 2017

According to the Office of National Statistics an estimated 137.3 million days were lost due to sickness or injury in the UK in 2016. This was equivalent to 4.3 days per worker.

Minor illnesses (such as coughs and colds) were the most common reason for sickness absence in 2016, accounting for approximately 34.0 million days lost (24.8% of the total days lost). This was followed by musculoskeletal problems (including back pain, neck and upper limb problems) at 30.8 million days (22.4%). After ‘other’ conditions, mental health issues (including stress, depression, anxiety and serious conditions) were the next most common reason for sickness absence, resulting in 15.8 million days lost (11.5%).

Also, did you know that workplace absence costs the UK economy £18bn in lost productivity; there has been a year-on-year increase since 2011. Apparently the prediction is that the cost of absence will increase to £21bn in 2020 and £26bn in 2030.  It’s not just about the cost of workplace absence, which also includes paying sick pay and someone else having to pick up the work of the employee who is off sick but high levels of sickness can also have a negative effect on those employees who are in work, affecting productivity and moral.

With these eye-watering facts are you managing and monitoring sickness levels?

Below are some reasons why holding a return to work interview may be beneficial:

  • You can delve into the reasons and the nature of the absences
  • It can help you find solutions to short-term absence and improve attendance
  • Keeping a record of these meetings allows you to monitor absences and spot any trends – is the member of staff taking every Monday after pay day or is it because they have a particular ailment e.g. back pain
  • It can help you identify if reasonable adjustments are necessary – if a long-term health issue is identified then as an employer you have an obligation to consider making reasonable adjustments if they are disabled as defined under the Equality Act. Carry out a risk assessment of the working environment; make changes to tasks and structure of a job so an employee with a disability can fully do their job
  • It can deter employees who are not sick from ‘pulling sickies’ as they know that absence is being managed and monitored

Revisit your sickness absence policy and check if you have set trigger points for unacceptable levels of short and frequent sickness absence.

Review the last 12 months’ attendance record and make sure that the employee is actually fit to return to work, if you do have any doubts then ask them to provide a fit for work certificate from their GP before they return to work.

When you sit down to conduct a return back to work interview best practice like most companies is to do these after every absence and one the day the employee returns to work.

To make sure that you are following the same process as well as being fair, consistent and treating employees equally use a standardised form for all return to work interviews.

Some of the things you may want to include in the schedule may include:

  • Welcome the employee back to work and confirm that they are fit to be in work
  • Discuss and ask about the employee’s health and reason(s) for absence and if anything work-related or other issues may have been a contributory factor in their absence.
  • Highlight any problematic trends in attendance. In line with your organisation’s absence policy explain any consequences
  • Discuss and explain what measures can be taken to prevent further absences, if relevant, and offer support to the employee

Whatever you do, and I have seen this happen, don’t hold the return back to work interview in a public open place; hold it in a private room. Any personal information you document / collate must be kept confidential and in line with the Data Protection Act.

Keep a record of the notes from the interview and ensure that as an employer you undertake any action points you need to.  Ensure that both the person carrying out the return back to work interview and the employee sign and date the form, so there are disputed things later.


By Kuljeet Kaur 17 Aug, 2017

As an employer you have a legal obligation and requirement to check the right of new employees to work in the UK; if you don’t obtain this evidence then you could be liable to pay a penalty of up to £20k – ask yourself….is it worth ignoring and I hope the answer is no!

As well as doing the right to work check it is also worth looking at other pre-employment checks to ensure that you are not only protecting but not risking your company’s finances and reputation. Plus, more importantly you stay on the right side of the law but also confirming the new employee does have the required qualifications and experience they have stated.

You will have seen in the papers or on the internet where applicants have lied about their qualifications, experience and capabilities and if you have seen ‘Trust Me’ on BBC. The drama is about a nurse who fraudulently works as a senior doctor in A&E, which is a scary thought in itself because when you go to A&E who out our trust in the doctor knowing that s/he is appropriately qualified and competent in doing their job but had the pre-employment checks been carried out this could have been avoided.

Some checks can include:

  • Identity Checks
  • References Check  
  • Criminal Records Check (DBS)
  • Credit Check
  • Verification of Qualifications
  • Public Safety Records (a rise amid concerns over terrorism security and workplace violence)
  • DVLA Check
  • Employment History Check
  • Medical or Health Checks
  • Social Media Checks
  • Professional Membership Checks

However, this doesn’t mean you complete every single check mentioned or anything else you can think of; you need to get the right balance. A background check should only be carried out if it is relevant – e.g. for a care worker you would carry out checks to include references, DBS, verification of qualifications but you wouldn’t to an adverse credit check as this wouldn’t be relevant for the worker to undertake their duties unless you can justify why it is necessary.

So let’s look at some do’s when carrying out checks:

  • Verify an applicant’s identity – are they who they say they are
  • Get applicant’s consent in order to meet data protection obligations – do this from the initial stage
  • Get the facts on their figures – financial red flags can highlight bankruptcies or other evidence of financial stress
  • Check qualifications – The Corporate Manslaughter Act means that companies now have to provide evidence that they have carried out proper health and safety checks on the staff. E.g. a lorry driver who is convicted of causing accidental death without a valid business driving licence, the company who employed the lorry driver is liable and will face prosecution.
  • DBS Checks
  • Check applicant’s legal right to work in the UK
  • Develop on-going employee screening policy – can help identify changes in an employee’s circumstances
  • Provide effective training for those responsible for recruitment – companies can face high fines if they fail to carry out appropriate checks so invest in your recruiter to ensure that they know what they need to do

  And some Don’ts  

  • Check all positions not just senior ones
  • Underestimate reputational risk – do the right and relevant checks to avoid damage to your company’s reputation, the last thing you want is a damaged reputation or remembered and known as someone who will take on anyone
  • Accept a CV at face value – apparently more than 50% of people lie on their CV
  • Use Data Protection as a reason not to pre-screen – you need to make sure that at the application stage you make the applicant aware of your background checking policy and also the specific checks that will be carried out once a conditional offer has been made and accepted.

Background checking should be applied at all levels not just senior positions; we all work in positions of trust so make sure that your employee(s) don’t risk or damage you financially or reputation-wise. Experian found that that it’s not uncommon for as many as 15% of applicants to drop out when made aware that a thorough background check is used in the recruitment process – removes time wasters and potential fraudsters.

In 2004 an unqualified gynaecologist Dr Henry Akpata and the forced resignation of NHS Trust chief executive Neil Taylor for awarding himself a non-existent degree were part of a string of revelations concerning employees claiming to be something they are not.

Ian Huntley, double child murderer, is a chilling case where he was given a job as school caretaker despite police awareness of prior convictions.

In 2010 a woman faked her qualifications to secure a £23k a year job was jailed for 6 months – she wrongly claimed to have two A-levels and also made up references. Suspicions were raised about her performance and she admitted lying on her CV. Her reference was forged and signed using her partner’s name. She was apparently the first woman in the UK to be imprisoned for lying on her CV.

Also in 2010 a man was jailed for 3 months after he lied about his qualifications to land a top job NHS job in Stoke-on-Trent. He claimed he had a doctorate and Masters degree when it transpired he only had a second-class science degree.

Earlier this year a former builder and probation officer was jailed for two years after it emerged that he had lied on his CV in order to gain a very senior management role in the NHS that netted him more than £1m over ten years.

YouGov found that 1 in 10 Brits have lied on their CV, and that lies about education and qualifications are the most common.

When you search the internet you will find a whole host of cases like the ones above so in order to avoid being prosecuted as an employer make sure that you are carrying out the necessary checks that I stress are relevant for the job the applicant is applying for. For applicants make sure that do actually have the qualifications, experience, right immigration status etc. because if caught you could find yourself sacked and or prosecuted.



By Kuljeet Kaur 18 Jul, 2017

The higher the contract value the more demanding the whole tender process can be. To tender for a contract, you may have to go through a qualification process or pre-qualification questionnaire (PQQ) however this is not always the case.

The PQQ is written for the purpose to persuade the reader that you have the prerequisite experience, knowledge and capability to take on the work you are bidding for.

Once your PQQ has been successful you will be shortlisted and move to the next stage of the process which is, the invitation to tender (ITT).

We have worked a number of clients, working closely with them to complete full and partial writes for tenders and something that has been highlighted to us is that we need to offer some sort of checklist to help our clients know what they need to have in place or able to get in place. So we have complied a generic checklist, which hopefully will give you an idea of what information and documents that you need to have in place when considering or applying for a tender.

In addition to the checklist you also need to ask yourself some questions; such as:

Is this the right tender for me?  The tender process is in place to help buyers to choose the right supplier(s) who offers the best value for money, deliver the contract with minimal risk, has the relevant experience, skills etc. 

Is my company too big or too small? This is about making sure that you are able to deliver the contract – no buyer will award a £400k contract to a start-up who is delivering a small number of hours.

Can I meet the contract’s needs? Always read the tender documents, can you deliver what the specifications of the contracts are (always check the mandatory elements) if you can’t then your chances of being successful can be low.  A tender that one of our clients wanted to apply for had a mandatory requirement that they must have achieved a ‘good’ or above CQC inspection but the client had not to date yet had an inspection, so you then have to ask yourself the question, is it worth applying for and the answer has to be...not at this stage.

What is my experience? When applying for a tender you need to show that you have the relevant experience e.g. references; if you are unable to provide this then you need to demonstrate that you have the necessary transferrable skills.

Are my accounts and trading history long enough? When you look at the checklist below you will see we have put 2 years’ accounts; this is because most buyers will request this. If you are a start-up, then you will need to provide a detailed cashflow forecast. However, saying this read the tender documents first as the buyer may be looking for an established company with a long enough trading history and may want 10 years trading history.

I know we all want to grow and secure contracts but don’t see a tender and rush to apply for it, be realistic and just because someone you know in your business circle is applying for that tender doesn’t mean you have to as well. Wait for the right opportunity for your company – sometimes it is best to grow steadily, be secure and stable. Until then grow your business and build your history and creditability. Another option is to work in collaboration with other businesses, a consortium, this way each business can complement each other and reduce any gaps.

By Kuljeet Kaur 29 Jun, 2017

You’ve received notification (if you are lucky) that you are due a CQC inspection – rather than panic and increase your stress levels keep calm and see this as an opportunity to showcase what you are achieving on a day-to-day basis.

You may have one inspector or a team and as you will already know each service is evaluated on 5 key lines of enquiry (KLOEs) that look at whether the service is:

Safe  – service users, staff and visitors are protected from abuse and avoidable harm
Effective – People’s care, treatment and support achieves good outcomes, promotes good quality of life and is evidence-based
Caring – staff involve and treat people with compassion, kindness, dignity and respect
Responsive – services are organised so that they meet people’s individual needs
Well-led – leadership, management and governance of the organisation assures the delivery of high-quality person-centred care, encourages and supports learning and innovation, and promotes an open and fair culture

This is not an exhaustive list but things to consider when preparing for your inspection / visit:

  • Inform key staff about the inspection but be aware as the last thing you want is a member of staff calling in sick on the day of the inspection so try and keep it low key
  • Meet and greet – ensure that someone is available to meet and greet the inspector(s), check their badge(s) and sign in as per your company procedure
  • Name badges – make sure all staff are wearing their badges
  • First Impression – as you know you don’t get a second chance to make a first impression. Make sure that your premises are clean and tidy and hand-gel is available (infection control)
  • Notice boards / public notice boards – is it up-to-date? Presentable – no rips etc. Do you have a Health and Safety poster, current employers’ liability insurance, info on fire extinguishers what different types are for and how to use them, health and safety policy, who is the first aider, infection control and safeguarding officer etc.
  • Training - make sure appraisal and mandatory training is up to date, all staff have completed the relevant training required to enable the member of staff to carry out their job and duties
  • Medicines Management – if you manage medicines is your MAR chart is up-to-date?
  • Policies – check and go through your policy folder to ensure that your policies have been updated and you don’t have a number of different variations (this has happened to someone), have they been signed and dated? Do staff know where to find the policies, are they accessible?
  • Files – check that all files, staff and service user, have relevant forms signed and dated. In addition, check that you have two written work references for staff, copy of application form, interview notes, training certificates, supervision notes, staff training record etc. Do you carry out regular staff meetings, have you got a record of this? Copy of staff rotas.  Service user files have a completed care plan, call logs, MAR chart, reviews, assessments etc. – most importantly are they up to date and not months / weeks out of date.  Have a file for each KLOE and add evidence showing how you achieve this
  • On the day – during the inspection / visit the CQC inspector will want to speak to staff and service users ensure that individuals are available but also the Registered Manager / Nominated Individual to answer any questions and or provide additional information as required.   The inspector(s) prior to the visit will gather information about your service and this information can include: comments they have received via phone calls, letters, emails or CQC’s share your experience page; from local Healthwatch and other organisations, feedback from activities, information from staff / service users who have raised concerns and from other care providers so they will have a good idea of your company and service.


Hope this helps with helping you prepare for your inspection / visit – good luck!

By Kuljeet Kaur 15 Jun, 2017

With the increased demand for skills and legislative training in the UK, and the requirement to reduce training costs, more and more UK companies are moving to e-learning for staff development as part of a blended approach with on the job training. Employers who are already benefiting from the use of e-learning have stated that it:
  • Delivers learning at the point of need - no waiting so a lot quicker delivery;
  • Improves the relationship between study time and workplace competency;
  • Meets CQC standards of compliance for continuing professional development;
  • Improves training delivery time;
  • Reduces training costs by up to 70%;
  • Lower costs - travel, trainer, classroom, refreshments etc.;
  • Flexibility;
  • 247 access - anywhere at anytime;
  • Reduction of the carbon footprint;
  • Self-Paced;
  • Less intimating than instructor-led; and
  • Consistent.
The UK government’s Skills Minister, who has himself experienced the benefit of online learning, is right behind the increased use of technology to improve education, he said “there’s clear evidence technology can improve teach and learning, and help colleges and providers deliver better learning in tight financial times”.

Did you know that M&S saved £500k in a year making the switch to E-learning for one of their needs, now isn't that an impressive saving!

There are so many courses and providers available so the world really is your oyster; why not dip your fingers in and explore the world of e-learning.  

Check out our courses at  you never know it may even change the way you learn.
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