Agenda item

To consider a presentation on the actions being taken in preparation for regulatory inspection of adult social care services.

Consideration was given to a presentation by the Cabinet Member for Adult Social Care and Health and the Head of Localities which outlined the plans and progress made in respect of the Adult Social Care Service in preparedness for regulation. The Cabinet member outlined the introduction of a new regulatory framework including a new inspection regime for adults which had come into effect amid nation-wide challenges in respect of staff retention and recruitment within an underfunded sector that is experiencing increasing demand on services. As the pilot phases of the inspection regime were being implemented, the Service garnered additional learning and intelligence that informed the preparations. The current picture was outlined, including zero people on the care home waiting list and a significant reduction in the number of people awaiting assessment. The Service had also recently been awarded a mental health concordat as an exemplar of excellence. The Service had developed a plan for self-assessment and peer review which would be implemented in the run up to regulation, which involved taking account of areas which were good and where improvements could be made.

In discussion, members sought additional details around how the service is linked up with other services. The Cabinet Member considered that this was part of listening well to people’s voices and preferences, and there was now strong co-production work, but there was more work to do in this area.

Members were intrigued by the adoption of a similar test to the NHS ‘friends and family test’ and sought additional information about how this would be implemented. The response from the Head of Localities explained that a pilot was active which utilised an automated text option, but other options were used where there are accessibility preferences. Further details regarding good practice were sought and provided for reference by the Deputy CEO of TRFT. The response from the Deputy CEO noted that there were numerous ways of doing this, for example, volunteers could sit down with patients to go through the questions, or the CQC can write out to patients who write back with their response. This was felt to be very powerful information. As a further example, a Google search for ‘TRFT friends and family’ would return the questions that were asked by the Trust.

Members requested to know more how the rating system would work. The Cabinet Member noted the range of possible ratings. During the first tranche, there were no ratings given. The Cabinet Member aimed for the Service to be rated ‘good’, noting the significant improvement journey of the Service over the last eight years. The Cabinet Member noted that more knowledge around how the process will work gives the Service more insight into how to prepare well to achieve the desired outcome.

Members sought additional information on how the Service had performed in the self-assessment, and how the inspection process could involve participation by Councillors. The first pilot was a reduced version, however, in phase two there would be questions asked of Councillors. There would also be conversations with partner organisations.

Members sought additional assurances around the role of ASC within the discharge process from hospital. The Cabinet Member affirmed the virtual wards as a strong approach that had been effective. The Cabinet member noted that this would be part of the regulation framework. The Cabinet member summarised the Better Care Fund funding and monitoring of the initiative through the Rotherham Place Board and noted that there was a desire to expand this approach. The Deputy CEO of TRFT noted the current numbers of patients receiving care through virtual wards, which worked closely with the Integrated Discharge Team to focus on patients in acute care who were able to go to a care home or home package. It was felt that this was working well.

Members sought additional details regarding how the service would respond if there was found to be a need for extra support and help. The response from the Cabinet Member noted that an action plan would be created based on the specific areas or weakness and the urgency and scale of the required improvements. The improvements would then be delivered according to the action plan, but significant improvement had been done, and self-assessments undertaken to recognise areas in need of improvement, with preparation in place to strengthen the position.

Members sought additional assurances that the focus on passing the test would also result in improvements to the Service. The response from the Cabinet Member affirmed that a good result from the inspection would be a sign of having an improved Service. The preparation had prompted the Service to get stronger at co-production and to improve in areas where it had been identified that there was room for improvement. The Head of Localities noted that the inspection is an opportunity to do the right thing by looking at all the areas to identify gaps and implementing plans to address these. The Director of Public Health noted also that the inspection would not be about simply meeting a standard, but required the Service to demonstrate self-awareness around what was good and what needed to be improved. The self-assessment was a very important part in this process which showed there would be progressively better outcomes achieved. The Cabinet Member noted that the summary report regarding the self-assessment review had been so substantial and thorough, that readers had requested an abridged version.

The co-opted member representing Speak Up Self Advocacy noted the need for ‘you said, we did’ evidence of co-production that uses plain language rather than jargon. It was also hoped that co-production initiatives would not conflate learning disability and Autism. It was felt that Autism should not be forgotten within what could sometimes sound like a generic discourse around disability. The response from the Cabinet Member confirmed that a focus group solely around Autism was currently being set up.

Members also sought further assurances that there were sufficient staff capacity to deliver the improvements in line with the ambition following on from the assessment. The Cabinet Member noted there were no current vacancies in the Riverside-located side of the Service, and there were discussions of bringing on someone specifically to ensure the Service is on track for the assessments. The Cabinet Member further noted regarding the interface regarding the residents and the Service, the shortage of workers across the sector, and the several factors contributing to the shortage. This was why the Council had increased the funding to Care Homes for staff.

The Chair expressed a desire to know more about how equalities was a part of the preparations for regulation. The response from the Chair offered to supply data to illustrate any particular area of the plans which members would like more information on. 

Resolved:-

1.    That the presentation be noted.

2.    That a plain language ‘you said we did’ approach be adopted to demonstrate the responsiveness of the Service and the impact of user feedback.

3.    That the Service continue to ensure the assessment process prioritises the duty to equalities as it drives forward improvements.

4.    That the response of the Service to the peer review be included as part of the next update in January 2024.