Agenda item

The panel received a further presentation from the Assistant Director for Commissioning and Performance that sought to provide an overview of the North Northamptonshire Care Quality Market.

It was heard that the update provided a focus on independent care providers using Care Quality Commission (CQC) ratings as a proxy for quality that had resulted in an observation of positive changes to ratings. A reflection on the national position with the CQC, its inspection priorities and approach to transformation was also provided.

It was reported that in March 2020, CQC had paused its inspections as a result of the Covid pandemic, a regime that featured set frequencies for provider inspections based on rating levels. A new strategy had subsequently been adopted, moving towards a more data and intelligence led regime, moving away from frequency rules for inspections, with inspections prioritised based on risk. This had resulted a downturn in the rating profile within the sector as there was no longer a priority for CQC to go back and reflect improvements made. A recently published national review commenting on CQC’s implementation of its new strategy was critical of that approach and CQC was currently reflecting upon that approach to inspections.

The Panel noted the current position of the local provider market, the Council’s approach to quality assurance and supporting improvement in both the in-house and external care market. It was reported that there were 278 CQC registered locations providing regulated care activities (residential, nursing or community) in North Northamptonshire. It was further noted that day care services were not registered with the CQC.

The meeting heard that the Provider Quality Assurance Team visited contracted providers to complete quality assurance visits, with people receiving care providing their observations and experiences of service provision as well as looking at processes, procedures and ways of working. The team worked in partnership with local care providers who were mostly smaller or independent providers, with confidence that such working was the reason for the improved ratings profile. It was heard that a new quality framework had been implemented towards the end 2022, that had subsequently been reviewed with providers and positive feedback received.

The Council currently had a number of internal services that were supported in an intensive manner by the Quality Team, with each service allocated a Quality Officer that visited the service on a monthly basis as detailed below:

·       Thackley Green (Building-based Reablement) – GOOD (inherited rating)

·       Reablement North (Community-based Reablement) – GOOD

·       Specialist Support Services for Younger Adults / Da Vinci Court(Community Support) – GOOD

·       Pine Lodge (WAA Respite & Transitions) – Requires Improvement

It was reported that the Council held one large block PPP contract with Shaw, an independent provider that offered 250 residential care beds across six services with all of these rated as “Good” by the CQC. The Council worked closely with this provider to support the quality of service.

The Independent Care Market locally had 352 providers the Council contracted with, each Quality Officer holding a portfolio of providers enabling relationship building and service support as a result of this partnership approach. It was heard that between May and July 2024, 123 visits had been undertaken to contracted providers with a mix of welcome visits, intensive monitoring visits, action plan reviews and those where high risk or welfare checks had been identified to ensure service user safety.

The meeting was advised that ratings for providers were improving positively, with the Council’s rating profile increasing at the most rapid rate across the East Midlands and seeing a rise to a ranking of 35^th among unitary authorities in the country up from a position of 56^th 12-months previously.

It was reported that across community care quality services that provided regulated personal care activity, 42% of services were rated as “Good” or “Outstanding”, although 49% of service providers were yet to receive a rating due to being newly registered and not having yet received an inspection. The Council was confident that the rating profile would increase yet further once those inspections were undertaken.

It was noted that a provider feedback questionnaire had been sent to contracted providers at the end of 2023, with 107 respondents providing positive feedback, with most providers strongly agreeing that the Council provided a supportive and informative service, rooted in partnership working. Feedback also highlighted that providers had regular engagement with their allocated Quality Officer and that the Council was good at sharing resources that helped them to provide better quality care and support. The Council also worked closely with the Integrated Care Board (ICB) to ensure consistent partnership working.

The Chair queried whether there was a capacity issue at CQC in terms of inspections given the number of authorities it was required to inspect. In response it was noted that new inspection methodology, significant changes to the technology employed by CQC and staffing issues had resulted in it being unable to maintain inspection rates or clear the backlog accrued as a result of the Covid pandemic, however the commission was aware of the challenges and was actively seeking ways to mitigate these.

Cllr John McGhee queried how mow many unitary authorities the Council was benchmarked against and raised the issue of having the right people involved with the ICB meetings to ensure correct feedback. In response it was noted that there were 62 unitary authorities that the Council was benchmarked against for performance in this sector.

A brief discussion was held regarding the Shared Lives service, akin to fostering for adults as an alternative to longer term forms of care and the need to grow this offer. It was heard there were currently around 30 people supported through this service and details were provided regarding the types of assistance and support received to both service users and those families who welcomed the users into their homes.