Agenda item

Consideration was given to the latest quarterly summary regarding Care Quality Commission (CQC) inspections for services operating within the Borough (Appendix 1).  Four inspection reports were published during this period (January to March 2024 (inclusive)), with attention drawn to the following Stockton-on-Tees Borough Council (SBC) contracted providers:

Providers rated ‘Requires Improvement’ overall (1)

·       Willow View Care Home had been upgraded from a previous overall rating of ‘Inadequate’.  Improvements were, however, still required to address breaches in relation to medication management, infection prevention and control, assessing risk, and good governance.

Discussion ensued on the current situation around Willow View Care Home, with Members expressing disappointment that the ‘safe’ domain had remained ‘inadequate’ despite a six-month gap between the previously published CQC report (12 July 2023) and the last inspection (30 January and 8 February 2024), especially given it was a residential dementia service.  The Committee once again noted that this was another case where issues relating to medication had surfaced, and also queried the existing occupancy levels within the setting (an overarching summary of capacity and occupancy was subsequently requested).  Responding to Member comments, the SBC Director of Adults, Health and Wellbeing confirmed that the Council were engaged on a daily basis with Willow View prior to its latest inspection, had met with owners to make clear its expectations of the service, and had spoken with residents and their families.  A further CQC inspection was anticipated around July / August 2024.

The remaining three reports were in relation to non-contracted providers.  Focused inspections of the home care / supported living services, Moon Rise 24hr Recruitment Ltd and Avalon Teesside Services, saw them both maintain their overall ratings of ‘Good’.  Finally, a short notice announced focused inspection of maternity services at The James Cook University Hospital (South Tees Hospitals NHS Foundation Trust) saw the Trust maintain its overall rating of ‘Good’ despite maternity provision being rated ‘Requires Improvement’ due to issues involving staffing levels, environment shortfalls, a lack of action following risk assessments, and inconsistencies around governance arrangements.

Focus turned to the section on Provider Assessment and Market Management Solutions (PAMMS) inspections (Appendix 2), of which there were 15 reports published during this period (January to March 2024 (inclusive)):

·       One service, Longlast, had retained its overall rating of ‘Excellent’.

·       Eight inspections had led to services being given an overall rating of ‘Good’ – Prioritising People’s Lives Ltd maintaining their previous overall rating, with Ingleby Care Home, Victoria House Nursing Home, Highfield (Stockton), Churchview Nursing and Residential Home, Real Life Options – 96 Bishopton Road, Allison House, and Real Life Options – 2 Frederick Street all being upgraded from their previous ‘Requires Improvement’ outcomes.

·       Of the remaining six reports, Five Lamps Home Care (Eldon Street) was downgraded to ‘Requires Improvement’ from a previous overall rating of ‘Good’, and Partners4Care Limited, Mandale Care Home, Woodside Grange Care Home (Older People’s service only), and Cherry Tree Care Centre were still deemed ‘Requires Improvement’ following a similar overall rating from their previous inspection.  Springwood received its first PAMMS inspection in January 2024 and were subsequently rated as ‘Requires Improvement’ overall.

Whilst welcoming the improved ratings of several services, the Committee drew its attention to less encouraging features of this latest quarterly update.  Shortfalls in maintaining a clean environment at Mandale Care Home were considered inexcusable, and Members supported the decision to give the setting a ‘major concerns’ quality assurance level based on the latest inspection findings.  It was subsequently confirmed that the service currently had a 30% vacancy rate, something which can have an impact in terms of income, staffing levels, and estate investment.

Concerns were expressed around issues involving DBS checks at Springwood and a further example of medication-related shortcomings at Woodside Grange Care Home (Older People’s service only).  It was reiterated that the SBC Quality Assurance and Compliance (QuAC) Team worked closely with the North of England Care System Support (NECS) Medication Optimisation Team to continually monitor this high-risk element of provision.

The downgrading of Five Lamps Home Care (Eldon Street) was discussed, with Members seeking information on the immediate steps taken following their latest inspection.  Assurance was provided by SBC officers around the formulation and monitoring of the post-inspection Action Plan and the monthly in-person visits from the QuAC Team to check on progress.  The Committee expressed concern in relation to the length of time since the last CQC report was published about the service (14 July 2021), and also noted that it had previously been used in emergencies for those coming out of the University Hospital of North Tees as part of the ‘Discharge to Assess’ process – SBC officers stated that Five Lamps’ involvement around the latter was currently under review (their current contract due to expire in October 2024) as part of ongoing work regarding Reablement provision.

Members commented that a number of the inspections within this latest quarterly report to the Committee involved services within the Thornaby area which had been subsequently rated ‘requires improvement’ overall, and asked if the public had access to the PAMMS inspection findings.  SBC officers confirmed that information on local providers was available via the ‘Capacity Tracker’ website (the link could be shared) and that people considering social care support were directed to the CQC as well as advised to visit services at different times of the day (and unannounced) to gain a fair reflection of how a setting operated.  SBC could not recommend a provider / service (instead encouraging people to look at a range of offers) and would continue to work with the regulator to address any identified care which fell short of the required standard.

Referencing the Allison House inspection, Members queried whether it was appropriate for the ‘Quality of Management’ domain to be deemed ‘Good’ when shortfalls in staffing had been identified.  The QuAC Manager stated that staffing was a matter for the provider rather than the manager of an individual service, and noted the continuing recruitment and retention challenges for both manager and staff roles (that said, the North East was in a better place than other parts of the country).  The SBC Director of Adults, Health and Wellbeing highlighted the ongoing lobbying for fairer social care funding and the first-ever production of a Skills for Care workforce strategy (due to be released in July 2024), and confirmed, in response to a Member question, that local providers did not have to rely on international recruitment.  The Committee reinforced the need for authorities to start properly valuing people who worked within the care sector, particularly in relation to pay. 

Special mention was given to Longlast for its outstanding inspection results and the amazing group of young people it cared for.  It was noted that the more a service appeared to engage with Local Authority initiatives (as Longlast clearly did), the better it seemed to perform.

AGREED that:

1)    the Care Quality Commission (CQC) Inspection Results – Quarterly Summary (Q4 2023-2024) report be noted.

2)    a summary of overall capacity and current occupancy of the Borough’s care homes be provided.