Agenda item

5.1  The chair drew members attention to the questionnaire feedback received mainly from relatives. The chair noted that people are broadly pleased with the improvements since HC One and Four Seasons have taken over from Southern Cross. He went on to note that there were some comments about the need for improved communication from providers about the change in ownership.

5.2  The chair explained that the LINk had agreed work to work in partnership with the committee on this review. He invited Barry Silverman, LINk member, to give evidence about LINk's recent visits to homes and report back on discussions they had had with residents. Barry commented that he was very pleased to have this request to assist with  this review and went on to explain that the LINk have special powers to do Enter and Views which are complementary to the scrutiny powers . He explained that LINk had visited all three homes; Camberwell Green, Burgess Park and Tower Bridge. He explained that prior to the visit preparation work had been done with LINK staff and council officers.

5.3  Barry explained that the homes were cooperative and they were able to interact with residents. However many of the residents lost interest quickly, particularly as there were many vulnerable people with dementia. Barry went on to comment that his impression was that people tend to say what they think you want to hear and it became apparent that sometimes residents were confused. A resident Barry spoke to about Southern Cross’s demise said they would have liked to have been told before it came on TV.

5.4  Barry commented that one home had programme of entertainment on during the visit and that was very attractive. A member asked about his general impression and Barry commented that the refurbishment in all three homes was making a difference and that before the homes must have been quite shabby. They were clearly looking much brighter.

5.5  He went on to report that he had received comments that suggested that staff moral had improved, from the limited information the visits were able to gather he had formed the impression that the homes were not very happy places when they were being run by Southern Cross.

5.6  Barry commented that they had looked at food and it was mainly English, and while there were routes available to order takeaways these were not very clear or very accessible. He commented that one home had a cat; Rosie, who was much loved by all the residents. He commented that residents had said that the cat could be relied to arrive if there was any dissension! 

5.7   He reported that in each home he had asked about a space to pray and spiritual access. He explained that on each occasion they were pointed to a room, however anybody could access this. He reported that no homes had the means to deal adequately with spiritual welfare; although he reported that there was a catholic priest who saw residents in their room in one home.

5.8  A member asked the food and if this is an area that could be followed up by the Care Quality Commission. Barry explained that LINk went into these homes to look at the transition of ownership after the demise of Southern Cross. Barry explained that when LINk to an Enter and View they have to make clear what LINk want to look at .Barry went on to explain that if scrutiny had wanted the LINk to look at food in detail they would need to say this in advance. However, Barry commented, we may not have specific expertise in nutrition. He suggested that the views of residents and family may be the best way to consider this.

5.9  A member asked Barry if he thought the any of the homes are too large. Barry responded that many of the homes were not being used to capacity, so they often had lots of vacancies, however they were rearranged on floors with separated lounges. 

5.10  A Member commented that there is good research that stimulation is good for preventing the further onset of dementia. Barry commented that there were activity programmes and some homes engaged outside entertainment. He reported that many of the residents were singing along to an activity in one of the homes. He reported some residents were actively participating, others were slumped in chairs. A member commented that this could be of concern that people were slumped in chairs and not engaged. Barry responded that some residents were half asleep, but he got the impression that staff was caring. 

5.11  A member commented on the divergence of views in questionnaire filled out mainly by relatives. The member noted that some were very satisfied but some were talking about neglect. Overall the statistical average was good. He asked Barry if he received complaints and he responded no, on the contrary, they received positive comments, for example residents were pleased that they could access alcoholic drinks freely. Barry said he had one concern that in bathrooms that had not been refurbished the taps might have a risk of scalding. 

5.12  A member commented that some of the feedback in the questionnaire talked about worries about basic care going wrong; for example teeth and clothes going missing. She asked if there any evidence of regular meetings with staff. Barry explained that they didn’t ask that question. The members went on to enquire if he saw staff interacting with the residents.  Barry reported that the staff were present for the entertainment but he didn't see any staff engaging with residents in particular. He went on to comment that questions about interaction are important but the LINk would need to visit longer to assess this. He explained that the LINk would be willing to go back and look at any issues you would like us to investigate.

5.13  Tom White explained that the Lay Visitors do regular visits and are able to have an open remit. He reported that Tower Bridge now have five activity officers, where they before had one. He went on to comment that all the staff members have training now in encouraging interaction.  He said that residents are all able to use their room to pray. A member commented that a prayer room is very important and that there is a duty of care as many people want to keep their room private.

5.14  Tom said that the Lay Inspectors are hopeful from the comments made by the new care home owners.  

5.15  Tom  reported that the new criteria for entering care homes is so high that it means that you need to have a high support need such as dementia to become a resident now,  and this means all the  care homes now have a high percentage of residents with dementia. A member commented that we need to look at the evidence of good practice; highly trained staff and stimulation prevents the onset of more severe dementia.

5.1  The chair thanked Barry and the LINk for their visits and work to support the review. Barry said he was very pleased to be developing a closer working relationship with the scrutiny committee.

5.2  The chair commented that the report will  focus on communication with residents, the financial  stability and viability of care homes and the quality of care