Agenda item

The Chair reported on the main findings and recommendations arising from the Scrutiny workshop undertaken by the Select Commission in April, 2018 to consider residential and nursing care home for adults aged over 65.

The Council contracted with 35 independent sector care homes for adults aged 65+ with 1,709 beds available for residential care and nursing care, including residential and nursing places for people with dementia.  As at April, 2018, 19 were rated as Good, 14 Required Improvement, 1 was Inadequate with one still to be inspected by the CQC.

Rotherham had 700 more beds than comparator local authorities, but most were residential beds.  There was a shortage of nursing beds due to a number of homes deregistering from providing nursing care and becoming solely residential care homes.  Greater availability of nursing beds could assist in reducing demand for acute services by potentially reducing hospital admissions and facilitating discharge back to the care home after an inpatient stay once the patient was well enough.

The findings were set out in the report but the key themes were:-

-         Governance.

-         Management.

-         Operational issues.

-         Finances.

-         Workforces.

A discussion and a question and answer question ensued with the following issues being raised:-

·             Contract compliance  and information sharing with individual ward councillors on care homes experiencing problems to aid queries at surgeries.

Ward Members would be given some insight into concerns in their own areas, but the detail of concerns would remain commercially confidential and sensitive.

·             Process for someone becoming a Care Home Manager and the qualifications required.

The process was controlled by CQC and registration of Care Home Managers was their responsibility, but the Quality Board would be proactive regarding any concerns.   Details of qualifications required would be subject to confirmation.

·             Availability of training for staff in care homes, monitoring take up and application of the training.

Training and workforce development for 2019/20 was currently under review.  This training would be open to care homes and any adult care provider whether they were private or voluntary.  There was regular liaison with managers about specific training needs and how best the training could be taken up by operational staff.

·             How was take up of the Care Home Support Service and the Clinical Quality Adviser monitored?

The service was commissioned by the CCG and overseen by key members of the Quality Board.  Compliance Officers were in regular dialogue with front line staff to focus on any identified areas.  Care homes need to be receptive to this service and engage.  Statistics on take up would be fed back. 

·             How could residents and families be made aware of an expected level of care before someone went into a care home and so they recognised signs or concerns so these could be addressed and resolved quickly?

Families were welcome to look at CQC ratings for care home who worked closely with the Council.  It was important that family members visited regularly and liaised with staff.  Anything of concern should be fed back to the Local Authority and CQC so that it could be screened from a safeguarding perspective.  Should any Elected Member be alerted to concerns these should be fed back to the Council.

In care settings it was expected that a social worker would be providing information.  Self-funding and self-selection of homes by individuals presented more of a challenge.  Valuable information was available on the website along with a good mixture of signposting to other organisations and information, advice and guidance would be developed further.

The Chair asked the Health Select Commission if there were any additional recommendations the Commission wished to make and there were two with regard to training and to support from the Care Home Support Service and Clinical Quality Adviser.

Resolved:-  (1) That briefings should be provided for Ward Members on issues relating to any care home in their ward at an early stage.

(2)  That Rotherham MBC Officers liaise with the Care Quality Commission regularly around Registered Managers in care homes to identify any potential concerns.

(3)  That all care homes be encouraged to work with the Care Home Support Service and Clinical Quality Adviser.

(4)  That all care home staff be encouraged to attend organised training sessions and that the take up and impact of the training be monitored.

(5)  That the final report be submitted to the Overview and Scrutiny Management Board for consideration.