Agenda item

This item will cover:

A summary of current and future commissioning arrangements for care homes in Southwark for older people.

Proforma used by monitoring officers when visiting Care Homes and the last 6 months care home monitoring reports from officers.  The reports on care homes are contained in the closed agenda as they identify individuals.

Two discussions were held on Care Homes, firstly on progress towards commissioning two new nursing care homes, and secondly on quality assurance in present homes used by Southwark.

Commissioning new Care Homes

The Director of Commissioning provided a presentation that outlined the Council Plan commitment to open two new nursing homes and current commissioning progress on delivering this. Cabinet has given permission to award contracts for local provision.  The intention is to tender with three bidders to award contracts for high quality care. The Engagement Group is the core group coordinating the programme. This consists of council and CCG staff, Healthwatch and Age UK. Wider engagement has taken place with the community sector, residents, older people in care homes and families. A Co-design group has been established of volunteers and this has conducted interviews with providers. Theses are now being evaluated.

The chair invited questions and the following points were made:

·  The decision on the providers will be decided utilising the process the Director of Commissioning outlined. Presently the specification and price is being decided, with a decision pending May.

·  Two providers are definitely offering to build new homes. Other provision might come from utilising existing buildings.

·  The majority of residents who are presently housed out of the borough want to move back to Southwark; however a minority may want to stay where they are. A survey showed that 80% would want to move closer to home.

Contract monitoring of existing Care Homes and Lay Inspector visits

Two proformas were enclosed in the agenda. One used by monitoring officers when visiting care homes and one used by Lay Inspectors when visiting care homes (provided under item 6). In addition members were provided with the last 6 months care home monitoring reports from officers and two example reports produced by volunteer Lay Inspectors when visiting care homes.  The reports on care homes were contained in the closed agenda as they identify individuals; however the discussion is summarised here.

The following points were made regarding visits and inspections:

·  Officers explained that Anchor homes are consistently rated Good by the CQC, which means the CQC will only return every two years. It was noted that the quality of care in a home can deteriorate quite quickly if a good manager leaves.  If Lay Inspectors visit and make a poor report that would not trigger a CQC visit as there is no direct link, however it would influence the  contract management relationship. Individuals can raise concerns with the CQC, as can the council. Officers do share intelligence with the CQC; however this doesn’t always trigger a visit, though on occasions it does. The council would always visit if there were concerns raised.

·  Members commented that Ofsted do not always seem to acknowledge local feedback. Offices said that the CQC ought to acknowledge responsive feedback and they also have a financial list of providers at risk.

·  Officers advised that the Older People’s Hub could give more information to prospective older people and friends and family on how to choose a care home. For example encouraging people to visit prospective care homes, and looking out for how welcoming it is.

·  Members asked how councillors can manage risks in care homes and monitor quality. There is not a current reporting framework in place that sets out how the council has responded to Lay Inspectors reports. There is, however, a contract management board that the Director of Commissioning chairs.  Currently there is an annual report on home care which goes to Cabinet. An annual report on Care Homes to cabinet could be useful, summarising visits and inspections. 

·  The scrutiny Project Manager, Julie Timbrell, advised that following The Francis Report on the failings at Mid-Staffordshire NHS Foundation Trust a report was provided to scrutiny with recommendations on learning for scrutiny and the local health accountability system, this included recommendations to share quality alerts with members and partners, such as Healthwatch and the CQC.

RESOLVED

Circulate the Mid Staffordshire scrutiny report.