County Provider Forum Fortescue Room, County Hall 31st March 2010

County Provider Forum
Fortescue Room, County Hall
31st March 2010
Attendees :
Chair : Jennie Stephens (JS)
Jan Ingram (JI)
Geoffrey Cox (GC)
Tui Shirley (TS)
Richard Newcombe (RN)
Graham Varley (GV)
Denise Brabin (DB)
Phil Hartley (PH)
Michael Lloyd (ML)
Rosemary Witherby (RW)
Piers Tetley (PT)
Mandy Sharp (MS)
Debbie Ivanova (DI)
Colin Lloyd (CL)
Apologies for Absence
Apologies were received from Keri Storey, Carolyn Elliott and Parveen Brown.
Minutes of Previous Meeting
Minutes of Meeting of 25 September 2009 were agreed.
Outstanding Action
List of Providers not addressed. Phil Hartley will prompt Right Care Index to
contact Denise Brabin.
Election of County Chairman and Locality Chairs
New Chairs elected in Localities :
South :
Richard Newcombe (Chair)
Tui Shirley (Deputy)
North :
Phil Hartley
Deputy yet to be elected – no volunteers
Exeter/East :
Geoffrey Cox (Chair)
Rosemary Witherby (Deputy)
General discussion about the structure and efficiency of the locality meetings. General
consensus that these were poorly attended across the County.
Principle is applauded but needs revisiting. Feeling that there were not enough tangible
issues to encourage providers to attend.
Proposals for consideration that attendance should form part of contractual obligations.
Quarterly meetings too frequent.
Engagement needs to be more focused – possibly in either service or client areas.
At least three diverse areas battling in a cynical environment. Providers need to see and
hear from direct policy and decision makers.
Proposals for consideration
Single large annual / bi-annual care conference, cabinet member to attend.
Conference to be arranged by Care Market and invite the L.A to attend.
It needs to be an unmissable meeting.
Consideration of adopting Cornish model of forming Trade Associations inviting
Members / Directors / CQC.
Geoffrey Cox raised the proposal re the Surrey Model there is a similar arrangement in
Surrey Care Providers funded £100K by Surrey County Council. Surrey Care provides all
training for the Care Sector.In essence Surrey have externalised their workforce
Proposed that Surrey Chairman be invited to meet in Devon and explain their model.
Piers Tetley confirmed that the budget of £2m for workforce development 73% of which is
spent within the Independent Sector.
Proposal that the Training Conference could form the basis of the annual care conference.
Annual Conference
Specialist locality meetings :
Care Homes
Dom Care
Day Opps
Supporting People
These meetings to be led by Provider Sector.
ACS to review Surrey Model.
April meeting to go ahead but to be informed it will not continue in current form.
Action :
1) Piers Tetley / Tui Shirley to discuss using Training Conference (Sept 10) as launch for
annual conference. Feedback to be circulated before the next meeting.
2) Geoffrey Cox to arrange Chair of Surrey to visit Devon to discuss their model.
3) DB to draft letter jointly signed to inform providers of new arrangements.
New County Chairman to be advised to DB by the end of the month.
Work Plan
Work plan had been circulated prior to the meeting. It was felt there was a need to
Action :
Members to submit priorities by e-mail to GV by end of May 2010.
Formal agreement at next County Meeting. Verbal update and short written
Work plan to be shared with locality meetings.
Putting People First (PPF)
Giles Colton was unable to attend. Graham Varley provided overview.
There is an overview of the PPF programme on the DCC website.
Programme Board and four theme boards, information will be provided at locality forums in
Key issues :
ACS has a target to achieve a Person of Budgets 30% of all service users by 2011
Market Shaping Project
Concern as to how all parties can be engaged in this work. It was agreed that PPF to be a
subgroup of the work programme. As it is key for both ACS and Providers to shape and
drive the business it is important that all parties understand the impact of PPF.
The relevance to Care Homes was raised as there was the impression that the vision and
focus was on community based services.
Day Care / Personal Care Updates – (Jan Ingram)
A small subgroup for personal care had been set up. Consisting of RN, PH, RW, Paul
Collinge, JI and DB. The aim was to facilitate better engagement with this sector of the
market and to work in partnership to address the real challenges.
Issues the group has discussed :
Commissioning of service post September 10
FACs eligibility criteria and application
Finance, cost and efficiencies
Reablement – pilot testing
In-house updates on development
A number of Senior Managers had attended the DICPA meeting in January to discuss the
points above. Individual meetings had been held with all the providers providing 80% of
personal care.
PH, RW and RN confirmed this model had worked well, both parties had been able to have
open and frank conversation in a confidential environment.
RN and RW had been able to keep DICPA members informed of the key issues
between the meetings.
It allowed Providers access at a level which had potential to affect change.
Providers received clear and timely information about ACS intentions.
JI confirmed a similar strategy had been applied to the Third Sector Day Care Providers.
Action :
Geoffrey Cox / Tui Shirley to consider similar model for Care Home Providers. To
feedback by e-mail after North Devon Forum.
Geoffrey Cox feels that within the engagement meetings Safeguarding is not given a high
Safeguarding team and providers not working well together. He queried the relationship
between CQC and Safeguarding, there is a lack of clarity in who is regulating care homes.
Acknowledgement that there is a need to learn from good practice. It was felt there may
be a lot of work being undertaken to address the symptoms and not the cause.
JS confirmed that a new manager of Safeguarding was being appointed next week.
She confirmed that the Safeguarding Team do not undertake all the safeguarding activities
- this is undertaken by Operational staff.
The central team had a clear and tight remit :
Alerts process (referrals)
Chair case conferences
Whole Homes issues and investigations
Debbie Ivanova confirmed that the CQC role was not new, however CQC were revisiting
their safeguarding protocols.
CQC will attend strategy meetings if it is a whole homes issue i.e. numerous concerns.
Their role is about breach of regulations and CQC will follow their own pathway. CQC do
not have a complaint or investigative role.
JS confirmed that shared learning is to be an agenda item in all whole home investigations
and she will ensure that this is monitored.
The meeting felt that a quarterly desemination of learning to a wider audience would be
useful. Safeguarding is a KPI issue for ACS on a quarterly basis.
Agenda items for June meeting.
PH proposed an Independent Sector representative on the Safeguarding Board – this
would enable timely communication of issues.
Action :
County Provider reps to nominate who links with Safeguarding Board.
Externalisation Update
JS informed meeting that due to both the general election and an outstanding Judicial
Review with regard to the Exeter bid for unitary status the tender launched had been
delayed until late May.
She confirmed the tender consists of two separate entities :
Care Homes
Block contracts for beds. 600 in total
(nb this figure includes Exeter – may change as a result of
the Judicial Review)
JS confirmed she will remain in her position as Interim Executive Director until
31.9.10. During the summer the position will go to national advertisement.
Resuscitation in Care Homes
Examples of an individual in a care home who had collapsed, staff did not know
the wishes of the individual.
Implications for ACS during assessment need to discuss End of Life (EoL) issues.
Care Homes had not routinely discussed EoL issues with residents and there was
also a lack of clarity in the CQC Minimum Standards.
There was an acknowledgement this was a federal issue and it was necessary to –
promote and educate everyone about their responsibilities in this area. The issue
has been reported to the national Safeguarding Committee and a response is
Action :
GC agreed to form a working group to include Police, NHS EoL leads namely
David Pennington and Amanda Williams.
CQC Registration Process
DI reminded the meeting of the new registration process. It was important that
Providers adhered to the strict timescales if they were not to find themselves in an
illegal position.
Training of Inspectors is lagging behind the applications.
Medication Prompting
DB sought clarity from DI re the definition of when the prompting of medication
required the organisation to register with CQC.
Action :
DB to e-mail DI with details of clarity required.
Date of Meetings 2010
Chair pre-meeting with JS
County Meeting
27 May 10.00 am
10 June 10 am – 1 pm County Hall
26 August 10.00 am
9 September 10 am – 1 pm County Hall
25 November 10.00 am
9 December 10 am – 1 pm County Hall
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