Local democracy

Agenda item

UPDATE FROM THE CARE QUALITY COMMISSION (CQC)

The report of the Quality Care Commission Inspection Manager,

 (Document “X”) provides a current update from the Adult Social Care Directorate. This is based upon published reports. 

 

Recommended –

 

That the report be noted.

 

(Lorna Knowles – 03000 616161 / 07789875791)

Minutes:

The report of the Quality Care Commission Inspection Manager, Document “X” provided a current update from the Adult Social Care Directorate based upon published reports.

 

Members were assured that throughout the pandemic the CQC’s regulatory role did not change and the core purpose of keeping people safe remained.  The routine inspection programme paused, however, an Emergency Support Framework (ESF) was launched and used as a monitoring tool. 

Infection Prevention and Control (IPC) thematic reviews and risk inspections were in place together with Designated setting inspections and Infection Prevention Control (IPC) outbreak inspections.

 

Thematic work reviewing the use of do not resuscitate decisions during COVID-19 was also presented.

 

Appended to Document “X” was an update from the CQC Adult Social Care Directorate in the Bradford district.  This included a summary of the current situation; COVID-19 response priorities; developments in the monitoring approach; responding to risk; rating providers and reporting on findings including statistics for Bradford services; piloting new ways of working; lessons learnt and the future of adult social care.

 

 

A definition of ‘culture’ contained in the presentation was requested and it was explained that this was how services were run, how things were done and learnt behaviours.  A closed culture indicated a service where people had worked for a number of years, they all knew each another, not many visitors were allowed and rules where not always followed as staff believed they knew what they were doing.  Closed culture produced bad, learnt, behaviour.  Rather than do what was correct staff would do as older staff exhibited.  There would be inspections if a closed culture was suspected as closed cultures were not good for service users.

 

Members raised a number of questions to which the following responses were provided: -

 

·         Key Lines of Enquiry would be conducted by telephone and in response to comments that this could not be independent if conducted whilst managers were present assurances were provided that calls were made to staff outside of their working hours.

·         There had, at the start of the pandemic, been huge difficulties in getting Personal Protective Equipment (PPE) to staff.  If problems were identified in IPC decisions were made and enforcement or a S164 letter issued highlighting concerns with 24 hours to respond were issued. Other agencies such as the IPC team in Bradford were contacted and made aware.

·         Visits to Care Homes were not allowed.  There should not be blanket restrictions and reports of that would be a concern.  Care must be taken with the management of gifts but care homes would be expected to facilitate contact.

·         The Government were considering compulsory vaccinations of care home staff, however, refusal would impact on staffing levels. All Inspectors were vaccinated and tested weekly.  Lateral flow tests were also conducted on the day of inspection visits.

 

In response to concerns that there were approximately one quarter of services in the District rated as inadequate or requiring improvement it was reported that these were monitored closely and enforcement action taken.

 

 A Member was anxious that the normal inspection routine was paused and believed that visits to facilities were required to get a feel for a facility and notice the behaviour of service users which zoom facilities would not reveal.  It was also questioned if targeted inspections would ignore any concerns not regarding the targeted topic.  Assurances were provided that issues identified during targeted inspections would be addressed.  A pilot of inspections had taken place on Domiciliary Care Agencies and it was agreed to check if any pilot inspections had taken place in care homes and report back to the Overview and Scrutiny Lead.

 

A Member suggested that the Healthwatch, Bradford and District, could be utilised to increase inspection capacity and it was confirmed that work was undertaken with the Local Authority and other partners but those suggestions would be taken on board.

 

In response to reliance on other professionals, such as GPs, it was confirmed that work was undertaken with other professionals including GPs, ambulance services, district nurses and hospitals who have an eye on services.

 

The Quality Care Commission Inspection Manager was thanked for the provision of an informative report and it was confirmed that the CQC were invited to the meeting annually.

 

Resolved –

 

That the report be noted and the Inspection Manager be thanked for her informative presentation.

 

Action: Overview and Scrutiny Lead

Supporting documents: