Agenda item

To consider the report.

Cllr Sarah Wakefield, Lead Member for Adult Services, introduced the report, and Jon Padfield gave a presentation on key performance measures within Adult Social Care.

During the discussion, the following points were raised and responded to:

·       82.7% care providers have a CQC rating of Good or Outstanding. What about the 18%? There are a number that our QA team are actively working with to support them. When they become inadequate or requires improvement we stop placing people in those homes until they improve. We put an improvement plan in with them and have regular reviews. Where there are small areas we are unsure about we place with caution and are clear about who we place and why.

·       None of the providers were closed? The stats only refer to active CQC registration.

·       Calls that are being diverted – is there a follow up on what happens to those people if they are referred to voluntary or non-statutory service, how do we find out if those are resolved? The contact centre doesn’t follow up with everyone but does a dip sample to see if it was resolved. We also look at repeat callers where things were marked as resolved at the first call – it’s clearly not resolved.

·       Could we have feedback on this in the next performance report? Yes.

·       Is there a correlation between overdue assessments and reviews and the low level of unmet need – if we catch up is that going to make that worse? Yes, there probably is a correlation between the two. Care Act Assessments when completed will result in a paid service so will increase demand on our sourcing care team. We are working to understand that and monitor the two together, but we do have a good supply in the homecare market at the moment.

·       Quality audits – what actions are put in place to tackle those areas that are marked below? We now have a practice quality board in place, chaired by Principal Social Worker and Principal Occupational Therapist. We have some specialist OTs and Learning and Development Advanced Practitioners. The Board’s role is to bring things out from the audits, the learning from audits, Safeguarding Adults Reviews (SARs), and Learning from Lives and Deaths of People with Learning Disabilities and Autistic People (LeDeR).

·       Overdue assessments – assuming they are done on risk assessment basis, e.g. low risk ones waiting more than a year, is that correct? Yes – we do risk assess every single individual waiting for assessment. There is a priority matrix which is reviewed.

·       5% of people came out of hospital and into a bedded pathway. How many of those are appropriate because the right care wasn’t provided? There are some individuals that probably could have gone through to reablement. We scrutinise the decision in multidisciplinary transfer hubs to make sure the right decisions are made. Of those who go into intermediate care, around 40% of those individuals go on to home, not a long-term placement. Constantly reviewing that and there is a program in place with Somerset Foundation Trust as it is joint work. Not everyone goes into funded by ASC, some self-fund or may choose to go to family members outside of Somerset.

·       Is there a difference in inspection outcomes now that CQC have changed their inspection process? Yes, we have attributed those. The change in framework in how these choose to assess, inspecting those more likely to cause concern, saw a significant drop of 8%. They have now returned to Business As Usual.

·       Of the feedback forms, how many do you send out, and what is the proportion of those sent out that you get back? The link is included in every document and interaction, so it is not as simple as seeing a percentage sent out and coming back.

·       For the audit table, it would be useful to see trends, whether they have increased or decreased, and it would be useful to know what the targets are.

·       It would be helpful to know what percentage of care packages change after reviews, particularly when they’re overdue.

·       What percentage of those in hospital discharged home are readmitted within 28 days, and is that because we haven’t provided the right care? Who holds that data? Where people are discharged from acute into a pathway, we look at outcomes at the end of the pathway. A minimal percentage become unwell and are readmitted. There is a statutory measure of those who are discharged to reablement and whether they were home 91 days after discharge. This is considered successful reablement. The way we measure this is changing.

·       Will the new measure be brought here? Yes, previously only brought yearly but now will be brought quarterly.

·       Of the front door who are signposted away – do we have data on how many of them come back? It is not something we currently have but it is an area we are working on.

·       Overdue assessments have increased 100% on this time last year – why is it so much higher? What is the plan? Across the board there are various different challenges, particularly workforce challenges. Some teams only have 50% staffing. We are prioritising based on risk. We are also looking at demand management, working closely with Somerset Direct and linking with Village and Community Agents, so nobody is left without any support. It wouldn’t be appropriate to have a blanket target across teams as there are staffing challenges and different demand. There is a lot of work going on. There is also a national piece of work around waiting lists, as we are not the only ones struggling, and we are working nationally and regionally and looking at what we can learn from other people.

·       Social workers deserve a huge amount of thanks for the work they do.

·       Want to congratulate you for the good interaction between the NHS and the Council, seen from the perspective of the voluntary sector. Readmissions are concerning, but only see a small proportion. We need to think about the age of the population – we tend to work with 85 and above. If they’re 100 years old and they’re going home that’s fantastic. At 85 and above, they may well fall or have another health problem. Readmission isn’t always bad, it’s about how we can support people. Often people are readmitted with something different because they are older and that’s what happens.

The chair thanked the officers for their presentation.