Agenda item

The Committee was presented with the PAMMS Annual Report 2025-2026.  Summarised by the Stockton-on-Tees Borough Council (SBC) Quality Assurance and Compliance (QuAC) Manager, key content was relayed as follows:

·       The Provider Assessment and Market Management Solutions (PAMMS) was an online assessment tool developed in collaboration with Association of Directors of Adult Social Services (ADASS) East and regional Local Authorities.  It was designed to assist users in assessing the quality of care delivered by providers.  The assessment was a requirement of the Framework Agreement (the ‘Contract’) with providers, and they were contractually obliged to engage with the process.

·       Due to SBCs contractual commitment to the Framework Agreement, priorities for 2025-2026 were focused on homes that had a place on the ‘Older Persons Residential Framework Agreement 2024-2029’.  Assessments were planned around priority of support / level of risk, taking into account factors including date and rating of the last Care Quality Commission (CQC) / PAMMS assessment, outcomes from the most recent CQC / PAMMS assessment report, other intelligence and data that increased the risk of service quality deterioration, and the number of PAMMS assessments that could be completed within current team resources.  Assessments were also conducted on newly contracted providers delivering Care at Home and Housing with Care services within the Borough (that had not previously been assessed).

·       A summary table of assessments for contracted care homes (covering nursing, residential, learning disabilities, and mental health) undertaken by the SBC QuAC Team throughout 2025-2026 showed that, of the 29 inspections carried out, two services (Park House Rest Home and The White House Care Home) were rated ‘Excellent’ overall, 26 services had received a ‘Good’ overall PAMMS rating, and one service (Churchview Nursing and Residential Home) had been graded ‘Requires Improvement’ overall.  As was the case in 2024-2025, none of the 16 learning disability-focused (14) or mental health-focused (2) services were assessed during 2025-2026.

Overall ratings following assessments published during both 2023-2024 and 2024-2025 were also included for comparison.  2025-2026 had seen a further improvement in ratings when set against the outcomes of inspections from the previous two years (2024-2025 results showed one service graded ‘Excellent’, 22 services rated ‘Good’, and six receiving a ‘Requires Improvement’ judgement).  Accompanying graphs illustrated ratings levels for 2023-2026 across services with a nursing, residential, learning disability, and mental health focus.

·       Summary tables of assessments for contracted Care at Home (2) and Housing with Care (2) services undertaken by the SBC QuAC Team throughout 2025-2026 showed that, of the four inspections carried out, all provision was rated ‘Good’ overall.

·       Key themes from assessments that scored an ‘Excellent’ or ‘Good’ rating were listed, much of which echoed the content of previous Annual Reports – these included highly detailed and well-structured care plans (supporting a person-centred approach and clearly reflecting the wishes of the service-user), the operation of a strong key worker system, the safe and effective management of medication, evidence of thorough and consistent monthly audits across all service areas, robust recruitment procedures, the promotion of choice and independence, the quality and choice of resident meals, positive feedback from service-users and their families, and a diverse and engaging programme of activities (tailored to meet individual and group needs, and promoting social interaction and overall wellbeing).

·       Key themes arising from those assessments that scored ‘Requires Improvement’ were outlined, including incomplete / insufficient life history sections within care planning, improvements to care planning not being sustained over time, inconsistent and conflicting assessment information, care plan reviews not being meaningful (e.g. content being copied and pasted rather than properly reviewed), key worker systems not being used effectively, minor gaps in medication records, and the need for stronger managerial oversight of audit systems.  As noted in last year’s (2024-2025) report, two areas that had consistently shown a direct correlation with a ‘Requires Improvement’ rating were ‘quality of management’ and ‘management of medicines’.  These domains had seen real improvements in quality and service delivery throughout 2025-2026, though remained the primary areas of concern and risk for homes – as such, SBC constantly monitored and reviewed intelligence to ensure risks were mitigated through targeted support for providers.

·       Despite internal re-organisations of NHS England, the NHS North East and North Cumbria Integrated Care Board (NENC ICB) and North England Commissioning Support (NECS), co-ordinated working to assist providers with the medication elements of the PAMMS assessments had continued for 2025-2026.  However, for 2026-2027, operational service delivery had to evolve.  NECS continued to undertake medicines audits within the Borough’s care homes, but combined team visits were not possible due to their own internal priorities and operational commitments (SBC still received audit outcomes and utilised this intelligence for risk management and response planning).  Further details on the future plans of the NECS Medicines Optimisation Team was anticipated in the new year, and SBC would review its own strategy once this was confirmed.

·       The final element of the report (‘Summary and Next Steps’) emphasised the clear improvements in PAMMS ratings during 2025-2026, and documented what happened following a PAMMS inspection.  As well as the formulation of an action plan to address any identified concerns (monitored regularly by the responsible SBC QuAC Officer), inspection outcomes were shared with the CQC and ICB to help inform their own intelligence-gathering.  Key themes were also communicated to the SBC Transformation Managers so they could use the evidence to design projects and further interventions to support all care homes improve quality of care (a section summarising the work of the SBC Transformation Team during 2025-2026 was also included).  Additionally, PAMMS ratings were provided to social workers who could share with families searching for a care home so they could access up-to-date information about the Council’s view of quality, and PAMMS summary briefing reports were also available on the Stockton Information Directory (SID) (linked from the Older Persons Care Home Ranked List) for families / potential residents to access.

The Committee praised this latest annual report and the very positive nature of its content.  Regarding the one care home which had been rated below a ‘Good’ standard (Churchview Nursing and Residential Home), Members noted the reduced frequency of CQC inspections and asked if SBC had any indication when the regulator may re-visit the service.  Although this was not known, assurance was given that SBC did discuss intelligence with the CQC and that all areas which required improvement at Churchview had now been signed off as complete – the service would also undergo another PAMMS inspection in 2026-2027.  Whilst welcoming the response (particularly given the good reputation the care home historically had), the Committee stressed that the CQC still needed to maintain appropriate oversight of this service.

AGREED that the PAMMS Annual Report 2025-2026 be noted.