Agenda item

Review: Care Homes quality assurance - officer overview

A report is to follow.

Minutes:

Genette Laws, Director of Commissioning, provided an overview of care homes and extra care domiciliary care, with reference to the report circulated in advance. The Director of Commissioning highlighted the following points: 

·  There is a commitment to open two new nursing homes by 2022, so that those needing care will live closer to their loved ones and are in services that are subject to a tendered contract. One of Partnership Southwark priorities is improving nursing homes.

 

·  There is also a commitment to establish a residential care charter which officers intend to take to Cabinet in the spring of 2020. This charter will focus on supporting homes to focus on the drivers related to delivering high quality care.

 

·  There is more work to be done to involve the service user voice and wider community in quality assurance. Currently the council are working with Age UK to deliver the Lay Inspectors scheme, however the Lay Inspectors only work with older people. The council would like to ensure similar work with wider groups.

 

The chair invited questions:

 

·  Members asked if 6 monthly visits are enough. The Director explained that commissioners take a risk based approach, which means that visits can take place more frequently – some are done some quarterly, some even weekly if there is higher risk.

 

·  The Director was asked about the consequences of poor performance and she explained that one outcome is the provision of a default notice on the contract, and ultimately to remove people from the care provision.

 

·  Members asked about the number of safeguarding concerns and complaints received and how these are dealt with. The Director commented that Southwark does seem to receive less than other councils she has worked with. This could be because these Local Authorities were in areas of more affluence and therefore have more self funders and so there could be more confidence and sense of more entitlement. However, she emphasised, that  everybody is entitled to complain and this could be an area that warrants more focus.  Members asked how the council might ensure that there is an improved ability to raise a complaint and the Director suggested that this could be looked at through the nursing contract and the monitoring process.  The Director also offered to provide some comparison with another borough to attempt to benchmark performance, but she cautioned that would be difficult as no two boroughs are alike in terms of types of provision or deprivation.

 

·  Joan Thomas, former coordinator of the Lay Inspection service, spoke from the public audience, and said that often people do not understand safeguarding or what good quality looks like, for example the ability to de-escalate conflict and calm things down, or change a pad regularly. Lay Inspectors are trained in dementia. She added that she is concerned that the Lay Inspector coordinator post has not been filled since her retirement .She said the absence of a coordinator means the volunteers in place are not able to sustain the number of visits, which previously would sometimes be as many as 10 over a period of 4 or 5 months. These visits address both qualitative and quantifiable good practice.

 

·  Another audience member agreed that the Lay Inspection scheme is currently not functional; there is one inspection in the pipeline and they are finishing off another, but no coordinator means that the work cannot be sustained.

 

·  A different audience member explained  that he was also a former Lay Inspector volunteer and that the services was able to make comparisons between homes with similar management , and as a consequence  have learned that a good manager is crucial . He added that the Lay Inspectors also ask if there are times set aside for relatives and carers to visit and speak meet and speak with care home staff.

 

·  The Lay Inspectors asked about funding and the Director explained this is year on year.

 

·  The Lay Inspector volunteers cautioned that while they are able to establish trust with other older people they would not have the ability to visit younger people, however they did think young people , for example with disabilities, would also benefit from a Lay Inspector programme by peers.

 

·  The Director responded that the council do want to make the Lay Inspection work all age functional, however that does not mean it would necessarily be delivered by Age UK.

 

·  A member of the audience commented that when she complained to a provider about a service the complaint was investigated by the home, rather than someone impartial. One of her complaints was the inadequacy of the GP service. The Director said the council do monitor homes they fund. She said commissioners are on a journey with monitoring, and they are now improving this through quicker writes ups and more focus on quality. She added that the CCG are responsible for the quality of GPs services, as this is part of nursing provision.

 

·  The Director was asked if monitoring officers go to the relative meetings. She said that sometimes they do. Healthwatch suggested this could be useful.  Lay Inspectors present cautioned this could involve quite a lot of meetings. A focus on bigger Southwark providers and going quarterly could make best use of resources.

 

RESOLVED

 

Officers will provide a comparison with a comparable borough on number of complaints

Supporting documents: