To consider a presentation about quality assurance
Minutes:
Sarah Smith, Corporate Commissioning Manager, and Kate Phillips, Commissioning Manager for Quality Assurance, provided a presentation about the Council’s new Quality Assurance Team (QA Team). During the presentation the following points were made:
· The QA Team was responsible for monitoring of the independent sector market for care and support with a view to raising standards, minimising risks to service users.
· Cheshire East Council hosted the QA Team but it was a partnership initiative with the two Clinical Commissioning Groups (CCGs) in the Borough.
· The CQC was represented at fortnightly governance meetings, which involved senior managers from the Council and CCGs, to share intelligence.
· Healthwatch Cheshire East were also represented at meetings to ensure there was no duplication with the QA Team’s work and Healthwatch’s “Enter and View” programme.
· A QA Team toolkit was being developed to ensure providers were complying with national standards and contractual requirements. This was expected to be completed by April 2015 and was being led by South Cheshire CCG.
· The QA Team supported the closure of care homes when they occurred and attempted to learn lessons from closures to make improvements in the future.
· Since September 2014 the number of care homes at high risk of having their contract with the Council cancelled (in Default stage) had reduced from eight to one. This was considered to be due to good engagement with the QA Team in raising standards of care.
· Generally there were positive relationships between the QA Team and providers.
When the presentation was completed the Committee asked questions and the following points arose:
· There had been a joint stakeholder event about quality assurance was held in November 2014 and was well attended by GPs, CCG officers, the CQC and Councillors. Feedback from attendees was positive.
· Concerns regarding a care home were communicated to service users and their families via a letter informing them of the issues that needed to be addressed and the timescales involved.
· QA Team’s visits were unannounced. Homes were prioritised for visits if there was a suggestion there were major issues at a home. If follow up visits were required to assess delivery of required improvements these would be announced.
· Any Safeguarding issues identified during a site visit were dealt with by frontline services immediately.
· The Council’s contracts with providers were regulated by national minimum standards. If a provider was not meeting any one of the standards they would be in default. If the provider failed to deal with an issue causing a default then the Council could cancel the contract.
· Providers had to be registered with the CQC before being able to gain a contract with the Council. All providers were considered for contracts using the same methods during the tender process.
· The QA Team always referred findings from visits to the CQC and the activity of the QA Team was coordinated with the CQC. The Council only had power to cancel its contract with a home and did not have powers to close homes which was the responsibility of the CQC.
· The Council paid the provider a rate per bed in the care home and did not have any control over the rate of pay for carers within independent sector homes. The amount providers paid carers did not necessarily correlate with the quality of care received. It was suggested that culture and managerial style with a provider had the most impact on quality of care.
· The Council had contracts with approximately 70 providers to provide more choice to service users. Members suggested that many care homes were already full which limited the actual level of choice service users had.
· The QA Team review all care homes in the Borough whether they were a supplier to the Council or not. The Council had some service users placed out of Borough but the host local authority was responsible for monitoring and councils shared information with each other.
· There was scope to involve overview and scrutiny members in the work of the QA Team and the development of policies and practices.
RESOLVED – That the presentation be noted.