Agenda item

Report ACS10004

The Lead Inspector of the CQC Inspection, Tim Willis outlined the outcome of the Care Quality Commission (CQC) inspection of Adult Social Care carried out in August 2009, which focused on Adult Safeguarding and Choice and Control for older people.

Mr Willis thanked all those who had been involved in the inspection process, and outlined the aims of the inspection team, which was to undertake an in-depth and intensive inspection that would add value to the existing provision of the Council and examine the processes that supported service delivery.

In terms of Adult Safeguarding, the inspection had identified how Bromley Council was working to deliver more individual, personalised and universal care to care users.  Evidence had been gathered from a range of sources, including officers, front line staff, partner agencies, carers and service users. 

The Inspection Team recognised developments that the Council and its partners had made in safeguarding and the increasingly effective delivery of multi disciplinary support for vulnerable people.  Incidences of good practice were also highlighted and a range of areas where further work could be undertaken were identified.  A need for greater focus on providing a more holistic approach to care planning and in identifying the aspirations of service users was underlined within the inspection report.  It was noted that a sound strategic vision and strong processes were in place to increase Choice and Control for older people, and that this was supported by robust performance information. 

In response, the Director of Adult and Community Services acknowledged the work that had gone into supporting the Inspection process and highlighted the Council’s commitment to ensuring its service provision was part of an ongoing process of continual improvement and development.  Whilst the inspection had provided only a ‘snapshot’ of current provision, it was important to utilise the recommendations as a tool to support the continuous improvement agenda.  The improvement plan had been developed to deliver on these recommendations.  The Director of Adult and Community Services highlighted the work of the Adult and Community Services PDS Committee in working to improve delivery of Adult Safeguarding in recent years.  The improvement plan included a range of measures to support Adult Safeguarding, and a number of action points had already been achieved.

With regard to the choice and control for older people, the Supporting Independence Programme had specifically been designed to deliver the “Putting People First” protocol with significant progress being made around listening and engaging with people.  A number of actions had been taken since August 2009 to implement measures ensuring that choice and control was delivered to service users across the Borough.

Disappointment was expressed that the service provision across both Adult Safeguarding and Choice and Control for older people had been rated as 'adequate', particularly against a backdrop of such wide-ranging service provision, but was pleased to note the report had acknowledged the ability of the Service to build on current service provision.  Steady progress had already been made in a number of areas, which would support development into the future across the care service.

The Committee considered the findings of the inspection.  A Member queried the context of the report, as Bromley had experienced significant demographic change in recent years.  Mr Willis explained the context of the report was simply used to ‘set the scene’, and that the range of challenges that impacted service delivery across Bromley had been acknowledged within the report and was reflected in the recommendations. 

A Member welcomed the report recommendations as a useful tool to support ongoing performance improvement.  Several incidences of best practice that might have been highlighted in the report were identified, and the Inspector explained that the report particularly focused on two aspects of social care delivery with a range of best practice being identified by the inspection. 

The challenges posed by the older demographic of Bromley residents were highlighted.  It was important to ensure that personalised budgets were introduced at a pace that would enable older people and their carers to both understand and fully utilise this opportunity.  The Inspector appreciated the care taken to drive forward this culture change effectively, but underlined the importance of encouraging service users to have personalised plans where appropriate.

The Chairman highlighted it was important to note the good work of the Policy Development and Scrutiny Committee in providing scrutiny of the development of the direct payment agenda.  The Committee had placed emphasis on ensuring safeguarding measures and the marketplace were developed sufficiently to provide older people with the required choice whilst ensuring that risks were minimised as far as possible. 

A Member queried the number of care packages examined as part of the consultation.  Mr Willis explained that the service inspection process set down the number of cases to be examined and that this was standard across all English councils.  Another Member was concerned that recommendations be based on quantifiable evidence to ensure that the areas of concern identified reflected genuine areas of need and led to improved service delivery for all service users.  Mr Willis highlighted that there was an emphasis on ensuring that the evidence was gathered from a wide range of sources, and that this evidence was corroborated to ensure that any findings made were based on the experiences of more than one source. 

Another Member raised the issue of the role of the care management team in supporting adult safeguarding.  Mr Willis noted that the report had identified a number of areas of good practice, but highlighted that it was important to ensure risk identification and planning was delivered consistently into the future, and that quality assurance was in place across all case management processes.

The issue of ensuring equality of opportunity in care service provision was discussed.  A leading officer within Adult and Community Services led on the training of equality impact assessments across the Council, and it was important to ensure services delivered by Adult and Community Services provided effective equality of opportunity. 

A Member highlighted the importance of recognising that some of the issues identified within the report were of national concern, such as the proportion of carers who felt undervalued.  Mr Willis agreed the need to develop a partnership-approach with carers and to place their role within a range of support measures was acknowledged.

The Portfolio Holder raised a number of concerns around the quality of the evidence that supported the evaluation process, and questioned the extent to which the report reflected the significant strengths of delivery of existing care services by the Council.  He also underlined the commitment of Members and officers to ongoing service and organisational improvement across the social care agenda, as demonstrated by the support of the improvement plan.

The Director of Adult and Community Services provided an update on actions within the improvement plan, highlighting a range of actions that had already been achieved.  A further range of actions were also planned to ensure continuous improvement of outcomes across care services, and these would be carefully monitored and developed over time. 

Following a brief adjournment the lead Inspector confirmed that the Commission were content that the Council had accepted the findings of the Inspection and were satisfied that the Action plan represented an appropriate response to those findings.  Mr Willis highlighted the monitoring processes that would be undertaken over the next six months.  He and the Area Manager of the London Region would provide ongoing support to the development of the action plan and implementations of actions.  An interim meeting would be convened after 3 months to report progress, and a final meeting would be held in September 2009 to ensure actions had embedded sufficiently to support improvement into the future.

The Chairman noted the outcome of the inspection and thanked the representatives of the CQC for attending the meeting.  She highlighted that the key aim of Members and officers was to ensure Bromley delivered the highest quality care services to service users and their carers across the borough. 

RESOLVED that the outcomes of the Inspection of Adult Social Care and the progress made since the inspection be noted.