Agenda item

The Care Quality Commission (CQC) Inspection and Regulation of Adult Social Care

Minutes:

DONCASTER CARING

 

This report provided an update of the Compares Doncaster’s Care Quality Commission (CQC) ratings published on the 12th September 2018, for regulated services against the national and regional picture of performance. It also outlined current contract monitoring activity to support providers with less than an adequate CQC rating.

 

There was a brief discussion around the national home care provider, Allied Healthcare who had appeared in the media. Concerns had been raised around whether Allied Healthcare was financially viable and what was the impact of recent events on the delivery of its services. 

 

It was reported that Doncaster Council and the Doncaster NHS CCG worked closely together during this period of uncertainty.  It was explained that the organisation was now in a stable position, although there were no guarantees around what may happen later.  Members were also informed that contingency plans were currently in place

 

It was outlined that Allied Healthcare would not be continuing its services and that the Council had been able to look at a transition plan.  Assurances were provided that packages were still being continued and that staff will TUPE to the strategic lead provider which was being facilitated by the Council. 

 

It was explained that the report did not include day services that were not regulated by CQC. 

 

The number, percentage and outcome of all active Adult Social Care Services by South Yorkshire Authorities - The following areas were highlighted to Members;

 

·         Positive that there has been an increase in providers that had been rated as outstanding and good. 

·         Doncaster continued to have the lowest percentage of providers rated as “requires improvement”.

·         Doncaster had the highest percentage of Providers rated as “Good” by CQC.

·         Three Providers in Doncaster had been rated as inadequate, all of which were care homes.  It was explained that of these 3, 1 was inactive as they had not had any residents for over a year, however, the CQC would not re-inspect that home for that reason.

 

The number, percentage and outcome of Community Adult Social Care Services by South Yorkshire Authorities: The information provided for Community Services included domiciliary care, supported living and extra care services. There had been some positive increases and decreases across South Yorkshire Community Services. It was recognised that although information around community services was largely positive.  Members were informed that of Doncaster contracted providers that 25 (86.2%) were considered as good. Members were assured that the Council would maintain oversight of those services by continuing to offer support, advice and guidance.

 

The number, percentage and outcome of Residential & Nursing Care Homes in Adult Social Care Services by South Yorkshire Authorities – It was reported that one nursing home was classed as being inadequate and that Doncaster had the highest percentage of nursing homes achieving good, an increase from the previous CQC report. Members were informed that there had been an increase in homes classed as inadequate and the Council provided support to those providers.

 

CQC - It was commented that the CQC was under pressure nationally to maintain their role.  Although this had not impacted on Doncaster, there was concern for those providers that had not yet been rated. It was explained that a new service once set up could take up to 12 months before that service was inspected and where re-inspections took place (that could also take a while).  It was reported that providers could find themselves in a vulnerable situation and this was where the Council provided support and advice. 

 

In regards with how the CQC communicated with residents, it was noted that open afternoons took place as well as an ongoing dialogue with residents and their families.

 

With investigations of deaths in homes, it was reported that in Doncaster there were reportable incidents around safeguarding and as a contract provider the Council received notification of it.  It was added that monitoring would be undertaken and that there was a shared agreement in place with the coroner.  Members were informed that work took place with health partners such as the NHS CCG and the nursing element side. Following such incidents, it was commented that there was an expectation that appropriate care plans and actions should be in place.

 

It was explained that where there were no published rates in the charts, this was generally because that home not been inspected or it may be because the home had been inspected recently but it would then take some considerable time to reach the end of the process.

 

Reference was made to the negative impact that larger employers e.g. Amazon had in the Borough on the recruitment of social care staff when comparing levels of pay. It was recognised that the Council was not able to fund services at the same level during such times of austerity.

 

In terms of domiciliary services supported care, a Member raised concern that companies competing for tenders were looking to reduce costs in order to be more competitive and that those cuts might then be passed onto staff.  Concern was raised that the cuts may demoralise staff and place them under increased pressure. 

 

In terms of what influence the Council has, Members were informed that they could be mindful of pay rate and set a rate in the tender. It was explained that services could set an hourly rate or a floor and ceiling rate (with the view that organisations may then bid in-between).  It was acknowledged that even though there were good quality staff in place there were even more added pressures at work.  It was shared that there were fewer numbers of staff undertaking more calls.  It was explained that more was being done around monitoring to see what the delivery of services should look like.  This was supported through the introduction of electrical monitoring which would provide real time records.

 

Members were assured that steps were being taken to monitor current staffing levels, as staff were the main component of the business.  It was recognised that there were challenges around how to build up a career pathway, ensure staff feel valued and all up against financial pressures and a lack of investment.

 

A Member asked about employment and recruitment as a driver which may be affected by social economic conditions affecting performance and delivery.  Reference was also made to the uncertainty of Brexit on the freedom of movement of individuals to fill vacancies. Officers noted that they would be maintaining a close eye on the impact of Brexit on services.  Concern was raised around the impact of terms and conditions and that without staff; organisations were at risk of not being able to deliver its service, whether in a private or public market.

 

RESOLVED that the Panel note the report.

 

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