Agenda item

Consideration was given to the latest quarterly summary regarding Care Quality Commission (CQC) inspections for services operating within the Borough (Appendix 1).  Six inspection reports were published during this period (January to March 2025 (inclusive)), with attention drawn to the following Stockton-on-Tees Borough Council (SBC) contracted providers:

Providers rated ‘Good’ overall (2)

·       Mandale Care Home had been upgraded to ‘Good’ overall (though rated ‘Requires Improvement’ for the ‘Well-Led’ domain) from its previous ‘Requires Improvement’ judgement in February 2023 – this followed a similar focused inspection which saw ratings for only the ‘Safe’ and ‘Well-Led’ domains.  The latest assessment was undertaken to follow-up on past breaches of regulation, and it was found the service was driving improvement and all breaches of regulation were now met.  However, shortfalls were identified with records relating to the management of time-specific medicines; topical medicines, and medicines administered on a ‘when required’ basis.

Woodside Grange Care Home, meanwhile, maintained its overall ‘Good’ rating (deemed ‘Good’ across all five domains, with ‘Well-Led’ being upgraded from ‘Requires Improvement’) which it achieved following its previous inspection that was published in January 2021.

The remaining four reports were in relation to non-contracted providers.  For primary medical care services, Myton Park Dental Centre was deemed to be meeting all regulations across the five CQC domains, whilst Norton Medical Centre received an overall rating of ‘Requires Improvement’ (with the ‘Responsive’ domain being judged ‘Inadequate’), a downgrade on its overall rating of ‘Good’ following its previous inspection in 2022 which was published in January 2023 (prompting the Committee to invite the practice to the last meeting in May 2025 to respond to the CQCs findings and provide assurance on how it was addressing the concerns raised by the regulator).  The final two reports were in relation to hospital and community health services, with Butterwick Hospice Stockton being upgraded to ‘Good’ overall following its previous ‘Inadequate’ judgement in 2021, and Tees, Esk and Wear Valleys NHS Foundation Trust – Mental Health Crisis Services & Health-Based Places of Safety retaining its overall ‘Good’ rating (though the ‘Well-Led’ domain was downgraded to ‘Requires Improvement’).

Focus turned to the section on Provider Assessment and Market Management Solutions (PAMMS) inspections (Appendix 2), of which there were 17 reports published during this period (January to March 2025 (inclusive)):

·       Victoria House Nursing Home, Hadrian Park, Stockton Lodge Care Home, Churchview Nursing and Residential Home, Highfield (Stockton), The Poplars Care Home, Wellburn House, Allison House, and Elton Hall Care Home all maintained an overall rating of ‘Good’ – the same grading all nine services achieved following their previous inspections.

·       The Beeches Care Home, Cherry Tree Care Centre, Mandale Care Home, Willow View Care Home, and Woodside Grange Care Home were all upgraded to ‘Good’ overall from their previous ‘Requires Improvement’ rating.

Given past issues highlighted to the Committee involving Willow View Care Home, the SBC Quality Assurance and Compliance (QuAC) Officer linked to that particular service was in attendance at this meeting to provide further details on the improvements it had made.  Key reasons for its positive inspection outcome were the appointment of a new experienced manager and the inter-departmental work undertaken across the Council to support better practices within the setting.  Before this, there were several changes in management (highlighting that handovers / procedures may not have been robust enough), deadlines for achieving required standards drifted, and there was a high number of safeguarding alerts (these had started to reduce to expected levels).  The CQC subsequently inspected the service in light of these latest PAMMS outcomes.

The Committee asked when Willow View’s admissions embargo was lifted and heard that this was conducted in a phased manner following the service’s exit from the Responding to and Addressing Serious Concerns (RASC) framework in August 2024.  Admissions to the setting remained controlled so it was not overwhelmed, with 25 beds currently empty.  Members commended the home and the hard work of staff for addressing concerns which had been prevalent since the emergence of the COVID pandemic, noting that this was particularly important given the Borough’s limited dementia care provision.

·       Three services received an overall rating of ‘Requires Improvement’.  Allington House was downgraded from the previous ‘Good’ judgement it received in 2022, with shortfalls identified in relation to personalised care / support and safeguarding / safety.  Similarly, Roseville Care Centre was downgraded from its previous ‘Good’ rating in 2022, with the need for improvements found across all five PAMMS domains.  Finally, Ingleby Care Home was no longer ‘Good’ overall (as it was deemed in 2024), with concerns raised in all but the safeguarding / safety domain.

As this was the final quarterly update of the 2024-2025 period, the Committee was informed that a total of 19 reports had been published by the CQC during the year following inspections of Stockton-on-Tees providers (10 adult services; seven primary medical care services; two hospital / other health care services) – this compared to 46 in 2019-2020.  Members expressed concerns about this reduced output, as well as the fact that many CQC inspections in recent years only focused on two (‘Safe’ and ‘Well-Led’) of the well-established five domains.  Allied to the reluctance of CQC representatives to attend the Committee to give an annual update on the national and local state of care, this was yet further evidence of a disappointing downward trend in the reliability of the regulator to supply intelligence on the performance of health and care providers.  The Committee requested that a letter be sent by the Chair to relevant CQC representatives reflecting ongoing frustrations.

AGREED that:

1)    the CQC / PAMMS Inspection Results – Quarterly Summary (Q4 2024-2025) report be noted.

2)    a letter be sent by the Committee Chair to relevant Care Quality Commission (CQC) personnel reflecting the Committee’s concerns around the visibility and output of the regulator.