County Provider Forum Fortescue Room, County Hall 31st March 2010 Minutes 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) 1 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. 2 Minutes of Previous Meeting Minutes of Meeting of 25 September 2009 were agreed. 2.1 Outstanding Action List of Providers not addressed. Phil Hartley will prompt Right Care Index to contact Denise Brabin. 3 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. 1 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 Somerset. 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 development. 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. Proposal - 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. 4 New County Chairman to be advised to DB by the end of the month. 5 Work Plan Work plan had been circulated prior to the meeting. It was felt there was a need to prioritise. 2 Action : 6. 1) Members to submit priorities by e-mail to GV by end of May 2010. 2) Formal agreement at next County Meeting. Verbal update and short written summary. 3) 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 April. 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. 7. 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 : i) ii) iii) iv) v) 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. 3 Action : Geoffrey Cox / Tui Shirley to consider similar model for Care Home Providers. To feedback by e-mail after North Devon Forum. 8. Safeguarding Geoffrey Cox feels that within the engagement meetings Safeguarding is not given a high priority. 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. Action: 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. 9. 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 : 4 10. - Care Homes - Block contracts for beds. 600 in total (nb this figure includes Exeter – may change as a result of the Judicial Review) A.O.B. 10.1 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. 10.2 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 awaited. Action : GC agreed to form a working group to include Police, NHS EoL leads namely David Pennington and Amanda Williams. 10.3 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. 10.4 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. 11. 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 5