Market failure Information sharing protocol ADASS Yorkshire & Humber Bev Maybury – DASS, Bradford Dave Roddis - Programme Director, ADASS Yorkshire & Humber

HISTORY Key Regional Risk Area 2017 & Commissioning Network Work Programme Priority Worse performing region – CQC Ratings – 27% Requires improvement/inadequate Regional Stocktake (Leeds Market Failure Tool) & Regional Workshop – April 2017 Focused on Nursing Care initially Responses from 9 out 15 local authorities Those who had not responded said that they found the tool confusing and needed further guidance. People felt it was a useful tool as a regional approach but it needs modification. It was agreed that tool needed to reflect what could be collected HOWEVER WHAT DO WE REALLY NEED TO KNOW?? Agreed actions (June 2017): A large-scale provider survey with a view to developing a heat map of the region. An information sharing and support protocol when issues occur. A quick look tool for identifying risk areas which could be shared across the region when an issue occurs.

The Bradford STORY & THE HEAT MAP Bradford – worst performing area in the region for ‘inadequate ratings’ – 39% Inadequate/requires improvement Bradford developed a Power BI ‘HEAT MAP’ tool pulling in CQC data to show ratings and to provide focus on targeted action Piloted in Bradford and rolled out across all 15 local authorities Bradford have also worked with ‘Brightening Minds’ to support inadequate providers

Market failure Information sharing protocol TRIGGERSitration/For Sale Financial Difficulty CQC – Notice of Proposal CQC - Warning Notice Embargo of new placements Contract Default Less than 70% occupied And that the following implications are known: Location - Hard to replace (as set out in ‘Cordis Bright’ toolkit) Specialism - Hard to replace (as set out in ‘Cordis Bright’ toolkit) Size - Hard to replace (as set out in ‘Cordis Bright’ toolkit) Provider operates in other areas in the region/Closure may affect neighbouring authorities Task and Finish Group established – Rotherham, Calderdale, Leeds and Bradford Development of MOU which would be signed off by all 15 local authorities Development of methodology and flow chart for escalation Development of mechanism to share intelligence – EMAIL!!! Engagement with Providers and CQC?? Twelve months in the making!!!

implementation Endorsed by Branch – March 2018 Signed up to by all 15 local authorities including all Chief Executives – launched May 2018 Commissioning Network to oversee its implementation – a constant review!! On the agenda of every meeting. Triggered 7 times to date Home Closure affecting 3 areas CQC inadequate rating – major provider Removal of residents – poor standards of care Extensively used for Allied issue – quick assembly of intelligence. Everyone knew each others position and could support ie Hull and East Riding. Latest – used to flagged issue with Interserve to put on national radar BREXIT!!!

Learning and teething troubles Started as a regular data collection exercise – so what?? Didn’t happen overnight – lots of ‘what ifs’………still is. Getting it embedded into local systems and protocols Named lead for each local authority, soon became two plus the commissioning mail box “When should I press the button?” Confidence in the system – consistently need to review Too much information …… sensitive language Use it to start the conversation – pick up the phone and follow up!! Use the PROTOCOL group email to explore other areas – captive audience No central administration – it’s your protocol!!

CQC Ratings – January 2019 4% reduction in 12 months but still some way to go………..

Quality Assurance Regional focus over the last 12 months Stocktake of all Quality Assurance arrangements in the region – report produced September 2018 Regional Quality Assurance Principles developed based on good practice – launched February 2019 “The Four Pillars” of Quality Assurance Intelligence Whole System Process/System Resources Next Steps Local Authorities are using this a self-assessment tool Quality Assurance Event – 15th July 2019, showcasing Leeds, East Riding, Wakefield, Bradford and Salford Working with NICE Improving the relationship with CQC

And as for Bradford……….. 13% less indaquate/requires improvement services in 12 months (Jan 19) As at 1st March – reduced by a further 3%

Thank you & any questions?