21 ST JANUARY 2009 SOCIAL CARE AND ADULT SERVICES SCRUTINY PANEL RESIDENTIAL CARE QUALITY ASSESSMENT TONY PARKINSON

FACTS AND FIGURES Middlesbrough Council Purchases –Long Stay Elderly Residential Placements 311 –Long Stay Older People (OPMH) Residential Placements 123 –Long Stay Elderly Nursing Placements 72 –Long Stay OPMH Nursing Placements 33 –Elderly/OPMH Continuing Health Care Placements 53 –Short Stay/Respite Placements equating to Long Term Placements 33 TOTAL 625 Total number of clients supported is 831

ACCOMMODATION HOW THE PROVISION IS REGULATED AND MONITORED Complaints CSCI Registration CSCI Inspection Care Home Adult Protection Local Informal Intelligence Social Care Contractual Obligations Social Care Inspections Social Care Residential Care Quality Assessment Own Residents Surveys

QUALITY ASSESSMENT COMPONENTS Quality of Accommodation45% Service User Perspective22.5% Family Member/Advocate Perspective22.5% Staff10% TOTAL100%

GRADING Quality Linked to Price Grade 595%+£440 Grade 486.3% %£430 * FPC Grade 377.2% %£420 Grade 268.6% %£410 Grade 1 0% %£400

ACCOMMODATION Survey which identifies –En-Suite facilities available –Shared bedrooms –Room size –Internal communal living space –External communal space –Accessibility

SERVICE USERS & REPRESENTATIVES Surveys gaining perception of care delivered, focused upon: –Admission process –Meeting individual needs –Dignity and Respect –Medical issues –Activities –Food –Complaints –Cleanliness and Hygiene –Staffing –Quality of service/care –Top Ups

STAFF Survey which provides information regarding: –Recruitment and Retention –Training and Qualifications –Induction and Supervision –Involvement in Care Planning process –Specific training initiatives –Provision of Equipment

OUTPUTS Grading for each Home (1 – 5) Assessment report for each Home Strategic issues report Service User Brochure

GRADING OUTCOMES GRADE 50% GRADE 428%30% GRADE 352%50% GRADE 210%13% GRADE 110%7% AVERAGE GRADE33

GRADE 1 & 2 HOMES Quality Issues –Staff Quality/Training –Involvement –Overall Care Quality –Dealing with Complaints Each Provider is given a report highlighting areas of good practice and areas for improvement Providers determine response Not to be confused with Contractual Service Quality Issues

DIGNITY AND RESPECT Very Poor0.5%0.6% Poor2.9%1.5% OK21.3%12.7% Good31.4%43.7% Excellent44.0%41.5% Service User perception of their Homes approach to maintaining their Dignity and Respect

CONTRACTUAL SERVICE QUALITY Full inspection every 3 years using specifically designed audit tool Unannounced thematic inspections Inspections are based upon risk management framework Detailed reports provided with recommendations for improvements within timescales Follow up inspections determine whether or not recommendations fully implemented

CONTRACTUAL SERVICE QUALITY Non compliance or serious quality issues can result in: –Action plan and programme of business meetings –Suspension of placements for as long as deemed necessary –Suspension of payments –More frequent inspection and monitoring regime –Service users moved to better quality provision –Closure of service/termination of contract –Invoking Adult Protection procedures In all cases liaison is undertaken with the regulatory body CSCI – soon to be the Healthcare Commission