Agenda item

The Strategic Director for Social Care and Education submits a report regarding the quality of care provision for Adult Social Care.

The Strategic Director of Social Care Education submitted a report to provide an update on work that was being progressed to address the challenge of quality in the Care Quality Commissions (CQC) settings for Adult Social Care.

The Strategic Director of Social Care and Education introduced the report, noting that while the CQC was responsible for registration and inspection of providers, the Council had an obligation to ensure a high-quality market. The large majority of home care providers were not contracted and therefore the Council had no contractual powers over them. Providers could be varied in size from national organisations to small groups of people.

The Deputy Head of Contracts and Assurance for Adult Social Care and Commissioning presented the item, it was noted that:

·         This report was an analysis of the 39 CQC inspections of local providers.

·         The Council worked closely with providers and would visit if there were any concerns.

·         In the home care market there were 190 registered providers, just 32 of those were in-contract with the Council, of which there were now just 2 providers who required improvement.

·         The CQC was now moving to a new framework, to enable this transition routine inspections would not be taking place over the next 6-9 months.

·         A programme of activity was ongoing which included a review of the core contract agreement. Work was ongoing with bordering Authorities to come up with an LLR wide to come up with a joint specification for specialist services.

·         Analysis of reports from 29 providers of concern resulted in 215 individual issues being identified and broken down into 19 overarching areas.

·         The report showed that 5 providers had been found to be inadequate, however this had recently come down to 4 and it was hoped that it would be down to 3 soon.

·         The Council was working closely with the remaining 3 inadequate providers. This would include addressing all CQC areas of concern. Local training and support available was being identified and made available to those providers.

·         It was hoped that stronger providers could become part of a peer support network.

·         An approach of not announcing visits in the older persons service was being trailed.

In response to Members questions it was noted that:

·         The Council did not charge providers for the admin support provided by the Council in order to build a positive relationship. Costs were incurred to providers to invest in training and other system changes.

·         The Council was able to offer intensive support including daily visits if found to be necessary.

·         A ladder of intervention document determined the timescales for when a provider could be found to be in breach of contract.

·         The County had considered a quality mark for high-quality providers; therefore, the City Council would also consider this.

·         The Valuing People team had helped to rewrite elements of the Quality Assurance Framework. This involved having conversations with those using the service to get direct lived experience.

The Chair expressed her concerns in the decline in the rate of CQC inspections and stated that they should not just be reactive to issues as they appear. The Chair also expressed her frustrations with the state of the market, where the Council paid for a service but still was required to provide interventions for those providers.

AGREED:

1.    That the Commission notes the report.

2.    That the Commission notes their concerns regarding the decline in the rates of CQC inspections.