To receive an update on the Quality Assurance Annual report on care homes and nursing homes in Torbay.

The Divisional Director of Adult Social Care, gave a presentation, as circulated prior to the meeting, which provided an update on the Quality Assurance Annual Report on care homes and nursing homes. 

Members were advised that Torbay Council has a duty to work with the individual care and nursing homes who require improvement to create an action plan and ensure support was provided as required. 

Members raised the following questions: 

·         how the Council worked with care and nursing homes who required improvement;

·         how many residents were discharged too quickly;

·         what opportunities were there for training and career progression for staff working in care and nursing homes to progress to work for NHS;

·         whether the Care Quality Commission (CQC) ratings were publicly available on the Council website; 

·         what impact the increase in National Insurance contributions had had on care and nursing homes;

·         whose responsibility was it to ensure residents were safeguarded when services such as hairdressers/chiropodists visited care and nursing homes;

·         have discussions been held with the various care and nursing homes to ensure that they were provided with bins to allow for recycling;

·         could any subsidies be provided by the Council to care and nursing homes to help young people who wish to join the care sector but were unable to drive, to assist them to learn to drive or travel to clients;

·         details of any themes that had appeared relating to hospital discharge and readmissions rates;

·         if any agencies were used to provide workforce to the various care and nursing homes;

·         details of the inspection ratings process for care and nursing and the frequency of inspections; and

·         details of how the Council monitors the number of residents from neighbouring authorities that use the various care and nursing homes in Torbay.

In response to the questions raised by Members, the Divisional Director of Adult Social Care responded as follows:

·         The Council has a duty to work with individual care and nursing homes who require improvement to create an action plan and ensure support was provided as required. 

·         The Adult Social Care Team within Torbay and South Devon NHS Foundation Trust (Trust) had undertaken intensive work to ensure that the process for pathways for patients to return home were of a good standard.  The Council was committed to ensuring that patients return home where possible and with the correct support instead of a short-term placement in a care or nursing home.

·         There was not a training and career pathway for employees to work in care to progress working for the NHS.  The CQC were responsible for ensuring that the care and nursing home providers make sure that their employees were sufficiently trained to enable adequate standards of care within the care and nursing home.  There were training offers available that were unique to Torbay and providers could contact the Trust to take advantage of training available to ensure that the workforce across Torbay were trained with similar levels of competency. 

·         The CQC ratings for all care and nursing homes were available on the individual providers website. 

·         The Council and Trust work with the various care and nursing homes on an individual basis and any issues reported would be followed up and resolved. 

·         The National Insurance contribution increase was having an impact nationally on various types of businesses.  The CQC, the Council and Trust had built relationships with the various providers and would provide the best possible support within the available resource. 

·         The Adult Social Care Team were working with colleagues from various departments in the Council to review potential sites for supported housing sites within Torbay. 

·         It was the responsibility of the individual care and nursing homes to check that the individual service providers visiting their homes were adequately compliant for safeguarding reasons. 

·         It was the responsibility of the care and nursing home providers to organise for recycling collection through their commercial waste provider. 

·         There had been no concerns raised with the Council regarding issues of employing staff who wish to work in the care sector but could not drive.  There were individual providers who assisted employees by providing a work car.

·         The inspections were completed by the CQC every 2 years.  However, there were some delayed inspections being completed due to a backlog within the CQC.

·         The Council does not monitor how many care and nursing home providers work with neighbouring authorities as it was an open market.  Members noted that Devon County Council would potentially commission services within Torbay and there had been occasions when Torbay Council commissioned services within Devon County Council’s area. 

Resolved (unanimously):

1.    that the Adult Social Care and Health Overview and Scrutiny Sub-Board notes the Quality Assurance Annual report on care homes and nursing homes;

1.    that the Director of Adult Social Care be requested to work with the Chairwoman, to write to Torbay and South Devon NHS Foundation Trust to request a written update on readmission rates and hospital discharge arrangements; and

2.    that the Quality Assurance Annual report update be added to the Work Programme as an annual review.