Stockton-on-Tees Borough Council

Big plans, bright future

Adult Services and Health Select Committee Minutes

Tuesday, 29th April, 2014
4.00 p.m.
Jim Cooke Conference Room, Stockton Library, The Square, Stockton on Tees
Please note: all Minutes are subject to approval at the next Meeting

Attendance Details

Cllr Mohammed Javed(Chairman), Cllr Kevin Faulks(Vice-Chairman), Cllr Paul Baker, Cllr Elliot Kennedy, Cllr Ray McCall, Cllr Mrs Sylvia Walmsley, Cllr Norma Wilburn, Cllr Mrs Mary Womphrey
Jenna McDonald, Peter Mennear(LDS)Liz Hanley (CESC), Peter Kelly (PH)
In Attendance:
Christine Wharton, Jackie Herring(CQC)Cllr Beall
Apologies for absence:
Cllr Evaline Cunningham, Deborah Miller
Item Description Decision
AGREED that the minutes were signed by the Chairman as a correct record.
AGREED - 1. that the information be noted;
2. further updates be received at future meetings;
3. and guidance for health scrutiny committees be circulated when available.


AGREED - that the information be received.

AGREED - that subject to making the final amendments outlined above, the final report be agreed and submitted to Cabinet and the relevant NHS organisations.
AGREED - that the work programme be noted.


The evacuation procedure was noted.
Cllr Mohammed Javed declared a disclosable pecuniary interest as he was employed by Tees, Esk and Wear Valleys NHS Foundation Trust.

Cllr Ray McCall declared a personal interest as he was an Associate Hospital Manager and Governor for Tees, Esk and Wear Valleys NHS Foundation Trust.

Cllr Kevin Faulks declared a personal interest as he was a patient at the Woodbridge Practice.
The minutes for the meetings held on 11th February 2014 and 4th March 2014 were signed by the Chairman as a correct record.
An Inspector from Care Quality Commission (CQC) and the Inspection Manager from CQC were in attendance of the meeting to provide Members with a presentation on CQC. The presentation included:

- CQC's new strategy;
- How CQC would have changed their approach to monitoring and inspecting services;
- How CQC wanted to work with Overviews and Scrutiny Committees;
- and the results of recent local inspections.

The Committee heard that the CQC had a new three year strategy in place from 2013 - 2016. It was highlighted that the strategy stated that CQC would focus on developing relationships with local authorities including overview and scrutiny committees. The strategy also stated that when CQC were involving overview and scrutiny committees CQC would have made sure that information was shared locally about people's experiences of care.

Members heard that the purpose of CQC was to make sure health and social care services provided people with safe, effective, compassionate high quality care and to encourage care services to improve. In order to meet their purposes and aims, CQC monitored, inspected and regulated services to make sure that they met fundamental standards of quality and safety. It was highlighted that all findings from CQC including performance ratings to help people choose care were published.

The new strategy was in place in order to ensure that it focused on tougher inspections and highlighting good and bad practice, with a similar inspection regime to Ofsted. The

The Committee was informed that from April 2014 changes included:

- Specialised Inspection teams responsible for different areas of care such as:
Acute, Community and mental health services, Primary and Integrated care and Adult Social Care, rather than the previous generic approach.
- A new organisational structure would have been set in place
- A new approach to acute hospital inspections would have been introduced following pilot inspections.
- The first pilot for Adult Social Care inspections would have taken place.
- The first wave of Primary care inspections would have taken place.
- CQC would continue to inspect other services as usual.

Members heard that CQC had five areas of quality and safety in their new approach to inspections. The five questions for inspections included:

1. Are services safe?
2. Are they effective?
3. Are they caring?
4. Are they well-led?
5. Are they responsive to what people tell them?

It was highlighted that CQC officers did not only visit an area of care as part of scheduled inspections but also following an expressed concern which related to that particular area.

The representatives in attendance of the meeting informed Members that they would have liked Overview and Scrutiny Committees to have continued an ongoing relationship with local CQC staff in order to have been kept up to date with all CQC inspection activities.

The CQC inspector in attendance of the meeting informed Members that all local social services which were registered had been inspected unannounced during 2013-14 and an out of hours project inspection had been conducted.

There were eighty five registered social care services in Stockton. Members asked how many unannounced inspections had been carried out by CQC and heard that all care home inspections were unannounced. It was heard that a 48 hour notice period was required if a home care agency inspection was to be carried out. It was highlighted that 20% of Dentists and 12% of GPs had been inspected.

Key themes for improvement assessed during inspections included: Care and Welfare, consent (relating to the Mental Capacity Act and Deprivation of Liberty Safeguards), Medicine Management, Staffing, and record keeping. It was highlighted that CQC were happy with the progress of inspections and follow ups on compliance actions. One service had had ongoing issues - Acorn House - but this had since closed.

Members asked how CQC would have inspected private sector organisations. Members heard from the CQC officer in attendance that if a private organisation was not registered, enforcement action would have been taken. All organisations providing health and adult social care were required to be registered with the CQC and were subject to its inspection regime.

Members were informed that CQC had positive relationships with other organisations including Stockton Council’s commissioning team and attended meetings including Health Watch. The Committee asked the representatives from CQC what outcomes they would have liked to have achieved from partnerships with other organisations. In response, Members heard that CQC would have liked to have received information that had linked into the process as well as feedback - negative and positive.

The Committee asked whether or not there was a formal procedure in place for sharing information with the public and different organisations. It was heard that there was an enquiries link available to the public and there was also an option provided to the public to subscribe to receive online alerts from the profile of any service in England. It was highlighted that CQC officers were happy to set up a direct contact for the public.

The Committee discussed its interaction with the CQC and the need for a regular flow of information back and forth. It was confirmed that copies of meeting papers were circulated to the CQC and completed pieces of work, for example final reports, were sent to CQC. Inspection reports were circulated to all Members of Council on a weekly basis. New guidance for scrutiny committees was being developed.

The Committee agreed that inspections carried out by CQC would have a positive impact on organisations due to identifying the negative and positive codes of conduct in a work place and therefore helping to identify where there was room for improvements and where good practice had been recognised.

Officers from CQC informed the Committee that they would have been happy to have returned to the Committee at a later date to provide feedback and results from inspections.
The Committee considered the final report of the Peer Review carried out in February 2014 and noted that the results of the Peer Review had been positive.

Members heard that as part of the review and on request, twice the usual number of case file audits had been carried out, which were evaluated positively. It was highlighted that broader recommendations had been received than just safeguarding. Members heard that the majority of the more general issue will be addressed through the Adult Board.

The Committee was informed that the Adult Services was in the process of putting recommendations into an action plan.

It was highlighted that Members of the Committee who had been involved in interviews for the Adult Safeguarding Peer Review agreed that the questions asked were robust.
Members considered the draft final report for the review.

It was highlighted that there had been some occasions where an ambulance had taken a long period of time to attend to a call. It was highlighted that in the past, similar concerns had been expressed elsewhere with regards to the length of time it took an ambulance to attend to a call. Members heard that ambulance services had been briefed on the concerns of local authorities and the public.

It was agreed to amend the recommendations to ensure that there was greater monitoring of ambulance performance by local and regional health scrutiny committees.

The Director of Public Health congratulated Members on the excellent standard of work which went into the report. It was highlighted that recommendations were very good and would be shared with Health Watch and other relevant teams. Members agreed that implementing and explaining the recommendations to partners was important.
Members heard that the next review topic for Adult Services and Health Select Committee would be Homecare. Members highlighted that Minimum Wage and Zero hour contracts should be looked at during the homecare topic.

The Chair provided no update.

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