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‘ IPED users rarely view their behaviour as being similar to users of other substances . This mindset results in many users being reluctant to access any formal treatment services ...’
IPED users rarely view their behaviour as being similar to users of other substances . This mindset results in many users being reluctant to access any formal treatment services outside of generic needle exchange programmes . Consequently , IPED users are less likely to recognise and acknowledge , let alone address , the potential risks and behavioural issues associated with this group of substances . Jody Leach is SWEAT project manager and quality coordinator at Open Road
Open Road ’ s conference ,
‘ A Shot in the dark Steroids , iPeds – the hidden harm ’
is on 26 April in Colchester , Essex . Details and booking at www . openroad . org . uk / conference
with the low moments and he stuck with the programme . A new healthy diet and workout regime meant , to Justin ’ s surprise , that his testosterone levels began to return to normal after a few months – he even kept most of his ‘ pumped-up ’ physique .
He also conquered all the self-doubt and re-built his self confidence . His relationship with his wife is now more honest and fulfilled , his children are even prouder of their father , and he spends more time with them now because he is no longer obsessed with weight training . And he ’ s no longer feeding dodgy suppliers with cash that should be spent on his family .
‘ SWEAT is the first service that actually listened to my needs and understood the difficulties behind my steroid misuse ,’ he said . ‘ Most other services just give you your needles and don ’ t ask how you are .
‘ The team gave me hope and helped me help myself into a sensible diet and fitness routine , and I would probably still be using now with no way out , if I hadn ’ t found them .’
Nicole Ridgwell answers your legal questions
HOW DO WE PROVE OUR SERVICE USER INVOLVEMENT ?
We are disappointed with the results of our recent CQC review – one of the things we were marked down for was not involving our clients in planning their care . We dispute this as patient involvement has always be central to how our service operates . How can we compile evidence to back up our challenge ?
To launch an effective challenge , providers must understand the parameters of the process itself . With CQC draft inspection reports , challenges should be made through the factual accuracy process , through which the provider has ten working days to submit a response from the date of receipt .
It is important to note that CQC factual accuracy guidance implies that providers can only challenge facts . That is wrong as a matter of law – CQC must take into account all written representations about the inspection process and the content of the report . It may be , for example , that a provider agrees that specific documentation error occurred but does not agree with the inspectors using that isolated example to conclude that the service has systemic failures in record keeping .
Factual accuracy representations must be as detailed as possible . When we draft responses , we scrutinise the draft line by line ; identifying not just factual inaccuracies but negative or imprecise wording and vague criticisms . This level of detail is necessary to ensure that providers lodge all valid objections . Should matters progress to enforcement action , it is much more difficult to retrospectively challenge something about which providers were initially silent . For a successful challenge , providers must provide evidence to rebut the criticisms , where possible using CQC ’ s own language . It is much harder for CQC to ignore a challenge where a provider demonstrates compliance with CQC ’ s own guidance .
In our question , the touchstone would be CQC ’ s Better care in my hands : a review of how people are involved in their care , which ‘ can be used by providers … to understand what CQC expects to see when we regulate how well services involve people …’.
Where possible , therefore , the evidence gathered will explicitly align to
CQC ’ s own examples . In this case :
• personalised care plans – written with people , for people , and with their wishes and preferences clearly identified and monitored
• the sustained and supported involvement of families and carers in the care of their loved ones
• the coordination of people ’ s involvement in their care as they move between services
A strong challenge will cross-reference provider polices and policy implementation . Care plans , patient notes , minutes of family meetings and patient reviews ( to name potential sources ) will demonstrate how patients are involved at every stage of care planning and show the outcomes of that involvement .
In preparing for any challenge , success is in the detail . Sweeping criticisms are rebutted only by specific , consistent evidence of best practice compliance . Compiling the evidence may therefore be painstaking and protracted in the short term , but a successful challenge which restores your service ’ s reputation will always be worth it in the long run .
Nicole Ridgwell is solicitor at Ridouts Solicitors , www . ridout-law . com
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