Agenda item

5.1  The chair reported that he had a discussion with the vice chair about amendments to the recommendations.  A member commented that she would like to see regular timetables set in the recommendations. The chair indicated his agreement and invited the committee to consider each recommendation in turn.

5.2  The committee discussed the first recommendation and decided that on occasion it might necessary to consider the financial viability of a care home owner more often than annually. It was agree that a final clause would be added to the last sentence, indicating that monitoring should be done more frequently, if required.

5.3  A member referred to the second recommendation and commented that the work of the Care Quality Commission (CQC) and Monitor is not within the committee’s scope. The chair responded that this recommendation is to lobby the government to improve financial oversight. A member reported that the CQC is facing cuts to its budget,  so this will not be easily given.

5.4  Members discussed recommendation three and agreed that a financial assessment of a provider before, rather than after, a change of ownership takes place would be advisable, as a safety net.

5.5  The chair commented that recommendation four came from feedback by residents and their relatives that they would like more information in the event of a change of ownership.

5.6  The chair and vice chair reported that they would like recommendations five and six to become recommendations nine and ten. The chair explained he had devised recommendation five in response to comments that sometimes frail elderly residents may have been treated a little roughly on occasions and complaints that sometimes staff do not speak English adequately. A member responded that all staff should meet these standards under current requirements anyway, and a more important issue is the level of staffing. The chair pointed out the strong evidence in the questionnaires to support recommendations five and six.

5.7  The chair commented that recommendations eight and nine are to ensure that reports done by LINk and the Lay Inspectors and are seen by the appropriate  health and adult care scrutiny committee and that they are responded too by senior management.

5.8  Members agreed to strengthen recommendation ten, so that the proposed leadership network would meet at least quarterly.

5.9  Members noted that one of the best times for Lay Inspectors to visit care homes is at 10pm. Friends and families also often want to be able to visit in the evenings. The committee agreed to add an additional recommendation eleven,  advocating flexible visiting times.

RESOLVED

A summary of the recommendations is below, with changes inbold italics:

Recommendation 1

That the council works with other local authorities to monitor the financial viability of the company(ies) that own and operate care homes in the borough on an annual basis, or more frequently as required.

Recommendation 2

That the council work with other local authorities to lobby central government to widen the scope of the Care Quality Commission or Monitor’s remit to include oversight of the financial viability of care home providers.

Recommendation 3

That the council conduct an assessment of a provider before or immediately after a change of operator/ownership occurs (e.g. now that Terra Firma have taken over from Four Seasons).

Recommendation 4

That the council works with the operators of the care homes to ensure residents and their families receive timely and accurate information of any future changes in ownership, clearly setting out what has changed, what remains the same and where residents/family members can go for further information.

Recommendation 5

To drive continued improvements in care standards it is recommended that the council works closely with Southwark LINk, SPAG and the lay inspectors to continually monitor the standard of care and receive an alternative point of view.

Recommendation 6

That the HASC is sent copies of all future inspection reports from the lay inspectors, and the formal responses from the strategic director/contract management team and where appropriate from the registered care home manager.

Recommendation 7

That reports generated by Southwark LINk be submitted to the Director of Adult Social Care, the Cabinet Member and the management of the home concerned and that a formal response is provided with a timetable for rectifying any deficiencies found, and that the HASC is sent copies of any such correspondence.

Recommendation 8

That a ‘leadership network’ is established. This would be a forum where care home and residential home managers and relevant staff from the council can meet  at least a quarterly  basis to share best practice.

Recommendation 9 (moved)

That the care home managers ensure staff are sufficiently trained to handle residents with the appropriate level of care and that staff members’ English skills reach the required standard.

Recommendation 10 (moved)

That the care home providers (monitored by the council) produce timely bills to residents and their family members and to ascertain whether there are any issues to be addressed arising from the move to personal budgets.

Recommendation 11 

Visiting times for family, friends and lay inspectors should be flexible