Agenda item

Quality Assurance and Compliance Update

[Sarah Smith,Head of Strategic Commissioning, to present report]

 

 

 

 

 

 

Minutes:

David Watts, Service Director Adults, introduced the report and invited panel members to comment on the content. The Service Director explained that the report covers both adults and children’s but the focus of discussion will be services provided to adults. The panel queried a concern raised by a resident that their needs had not been assessed six months after moving into a residential home. The Service Director advised that a care assessment would be done before a person was moved and agreed to investigate and contact the Councillor directly.

 

The panel queried the frequency of visits made by members of the quality assurance and compliance team and how visits are co-ordinated with those made by Care Quality Commission (CQC). Jas Kakkar, Lead Commissioner, explained that the team works closely with the Quality Nurse Advisors from the CCG to plan visits to homes during the year.  The team will discuss with providers any actions plans produced following an inspection and help them to improve the quality of services – for example, sharing good practice from other establishments.

 

The Service Director explained that the Council can suspend further admissions where there are serious concerns and prevent new admissions until the required improvements have been completed. A decision to suspend or re-instate admissions to a home is taken by the Service Director.

 

The panel queried what checks are done to ensure the necessary care is provided as part of domiciliary visit to a service user and whether it was sufficient for their needs. The Lead Commissioner advised the panel that she was confident that the current monitoring arrangements provide information about the time spent during a visit. The system records the time the carer arrives and leaves and we will review the situation if they are spending more time or less time on tasks based on the previous assessment of needs. The situation will be reviewed and changes made as appropriate to the care package in discussion with the service user and their family members. The system would also record missed visits. In addition, a social worker will visit the service user to check if their care needs have changed and their views on the quality of care provided.

 

The Service Director added the Council want to encourage people to raise concerns about the quality of care and not to feel concerned that it will be held against them. The Lead Commissioner added that the service is working with representatives of Wolverhampton Healthwatch to collect information about the user experience. The Lead Commissioner added they Healthwatch are being more independent and this will hopefully encourage service users to share any concerns about the care they are receiving.

 

The panel commented suggested that the structure of the report was difficult to follow as it included details of both children and adults. The panel suggested that in future they would like a progress report to focus on the provision of services to adults. The panel commented that section 3 of the report should be redrafted to make clear the role of the regulator.

The panel commented that the paragraph 3.4 of the report contains errors in the calculation about the rating of nursing homes and needs to be checked and redrafted. The Service Director accepted the comment and agreed to make the necessary changes to the content of the report.

 

The Service Director added that the rating given by CQC of a nursing home can be affected by issues such as change in management and a high turnover staffing changes – which result in homes being graded down on management score that affects the overall rating given to the home. The Lead Commissioner, added that where there are concerns about a nursing home that staff from the service will make more regular visits, some of which are unannounced, to check that progress is being made to make the changes detailed in the improvement action plan.

 

The panel discussed the training and support given to lay volunteers who to be able to ask the appropriate questions to provide reassurance that examples of poor care are identified and the necessary action taken. The Lead Commissioner explained the good practice is shared with volunteers to help them to understand what ‘good care’ looks like.

 

The panel commented on the value of desktop intelligence exercises but also it was important to get information directly from users when making judgements about the quality of care provided to vulnerable people by a provider.

 

The panel suggested para 4.3 of the report should include details of the number of suspensions of placements, contract defaults and contract termination. The panel suggested that the information should cover a three-year period so that trends could be identified. The Service Director Adult Services agreed to provide the information and make changes to future reports. The Service Director suggested that the report for each establishment could also include more detail about the reasons for the decision and if for example, placements have been suspended previously for the same home.

 

The panel discussed the willingness of care staff to report concerns about the quality care provided. The Service Director explained that there is a general requirement for all care establishments to have a whistleblowing policy and that staff should feel confident to report any concerns. The Service Director added that the service will also collect information from other sources to help to identify examples of inferior quality care.

 

In addition, the Council also undertakes a bi-monthly case file audit to look in detail at case notes and make recommendations about what can be improved and specific issues are taken forward by senior management team.

 

The Chair commented on the valuable information and training provided by the Head of Safeguarding and encouraged panel members to make enquiries, as it would help members to better understand the work being done to support vulnerable people.

 

The panel asked the Lead Commissioner to set out future challenges for the service and key priorities for 2018. The Lead Commissioner commented that the key aim of the service will be to sustain the improvements made so far and to continue working with providers. The Lead Commissioner commented that there are seven people in the Quality Assurance and Compliance Team - the service is being restructured and there is a plan to appoint a Quality Assurance Manager to the team.

 

Resolved:

1.    The Service Director agreed to make the suggested changes to the layout and content of future reports to the panel summarising findings from the annual programme of all registered social care providers.

2.    The Service Director to provide the panel with an analysis of number of suspended placements, contract defaults and contract termination during the previous three years.

 

Supporting documents: