Report of the Director of Adult Services, Children and Families Directorate

Our Manchester ambition is for all care homes to achieve good or outstanding Care Quality Commission (CQC) ratings within the next 2 years. Delivery will be supported by the MHCC performance and quality improvement team framework, providing effective tools and guidance for providers to achieve our aspirations.

This paper highlights the current CQC and MHCC quality compliance status of the nursing and residential care homes across Manchester and explains the efforts being made to support and improve the standard of care and quality for the residents in receipt of those services.

The Committee considered the report of the Director of Adult Services that highlighted the current Care Quality Commission (CQC) and Manchester Health and Care Commissioning (MHCC) quality compliance status of the nursing and residential care homes across Manchester and explained the efforts being made to support and improve the standard of care and quality for the residents in receipt of those services, noting that the Our Manchester ambition was for all care homes to achieve good or outstanding CQC ratings within the next 2 years.

The Director of Adult Services referred to the main points of the report which were: -

·                Providing information on the current CQC rating of the nursing and residential care homes across Manchester and explaining the efforts being made to support and improve the standard of care and quality for the residents in receipt of those services;

·                Describing the work undertaken by the performance and quality improvement (PQI) team with the inadequate care homes of Manchester since April 2017, had seen the reduction of the 7 providers we started with, to the current 1 that is in the City and was inspected in December 2018;

·                Providing information on the PQI framework for adult social care (ASC). Describing that the framework brought health and social care colleagues closer together, and focused efforts in areas that needed it the most, such as care homes that were rated as “inadequate” or “requires improvement” with the CQC;

·                All homes that had a “require improvement” rating from the CQC had been visited during 2018/19 in a prioritised order and were subject to a high level of scrutiny by the care home improvement group;

·                The ASC PQI team were currently working with the two main tools within the framework to assess and monitor quality across the sector with care homes being the first cohort of providers;

·                Information on the current CQC ratings for care homes in Manchester as of February 2019, noting that self-assessment used by the care homes rated as good and outstanding had also proven effective as services maintained their outcome following recent inspection;

·                Describing the work undertaken at a Greater Manchester level to develop good practice;

·                Describing the new models of care with future commissioning of care homes offering a more holistic approach to care placement and monitoring, in line with Our Manchester values; and

·                Future improvement initiative.

Members welcomed the improvements reported to date and supported the stated ambition for all care homes to achieve good or outstanding CQC ratings within the next 2 years, noting that this demonstrated an Our Manchester approach to delivering improvements. A Member commented that consideration also needed to be given as to where Care Homes / Residential Homes were located as this was very important to people in receipt of care and their families.

A Member commented that it was very important to recognise that Care Home systems could be very difficult for families of those receiving care to navigate and it was important to remember at all times that it was people, who were potentially vulnerable who were in receipt of care in such places. The Director of Adult Services acknowledged and agreed with this comment.

The Director of Adult Services further referenced that the MLCO, MHCC and Manchester Metropolitan University had co-produced teaching care home packages which had prioritised the top 5-10 nursing and residential care settings that admitted the most number of patients into the Manchester Royal Infirmary, North Manchester General Hospital and Wythenshawe.  The educational packages would be delivered by experts in subject areas such as catheter care, wound care, mobilisation, nutrition and hydration, dementia care and so forth.  

The Performance and Quality Improvement Manager, Adult Social Care responded to questions from the Committee regarding sharing good practice and experience across care homes to help improve and maintain standards. He said that a ‘buddy scheme’ had been established to support homes identified as requiring improvement following inspection. A Member commented that those homes that had moved from a requires improvement rating to a good or outstanding CQC rating should be used as a ‘Buddy’ as these homes had successfully undertaken an improvement journey.

In response to a question from a Member, the Performance and Quality Improvement Manager, Adult Social Care informed the Committee that they actively worked with the CQC post inspection to address any issues identified and on occasion had successfully challenged ratings. He stated that the predominate issue identified for improvement by the CQC related to the category of ‘Well Led’ and work was ongoing across providers to address this. 

The Executive Member for Adult Health and Wellbeing stated that a report on the ongoing Bed Based Review, that focused on the entire continuum of provision that was not either delivered within a person’s home (e.g. homecare / domiciliary care) or within an acute setting and for which the person required a bed would be submitted to the Committee for consideration at an appropriate time.

Decision

The Committee notes the report.