Serious Concerns and what we do about them

On Wednesday I attended Suffolk’s Health Scrutiny Committee meeting when we looked at the recent damming report by the Care Quality Commission (CQC) into the newly opened Mildenhall Lodge Care Home by Care UK. Of course if you’ve read my blog you know that the replacement for Suffolk’s very old and not fit for purpose care homes is something I led on in my time as Cabinet Member of Adult Care Services. So the report which followed an inspection 6 weeks after opening the first of 10 new Care Homes across Suffolk, in Mildenhall, was doubly disappointing given the work Suffolk put into finding them as a partner. Equally it’s bizarre given that they are investing £60 million into the new homes that they would fail to keep their eye on the ball sufficiently to deliver a quality of care in this the first, which of course should be, was promised to be and was commissioned to be commensurate with the quality of buildings they are delivering.

At the start of the agenda item, Care UK apologised unequivocally for their failing and it was welcomed, but the point was made to them in no uncertain terms that an apology without an action plan and proper implementation was…well just words.

A colleague on the committee demanded to know why the failing had taken place, I rather thought and then said the reading of the CQC report clearly indicated a common thread of low staff numbers and to be fair Care UK did seem to recognise this and were putting in place the sort of actions that were demanded of them and promised by them during the commissioning process we originally undertook. This was built on the back of the work I and my officers found during the initial thinking about the issue we had before us, namely the longitudinal study by Birmingham University as Birmingham City Council closed all of their 26 care homes and rather than re-provide into new facilities, they dispersed their residents to the existing private sector care homes in the city. The study looked at the most effective ways to help people move homes and how best to support those transitions.

The point about provider and commissioner is an important one I’ll comeback to in this blog. Across Suffolk far wider, that the small percentage of the private total market that Care UK represents and in the number of beds Suffolk provides for those who need a residential Care Home but are unable to provide for themselves. Suffolk County Council purchases (commissions) on the basis of good care and inspects to make sure good care is provided. No distinction is made and no excuses accepted.

During the course of the scrutiny a couple of things emerged. At the start of it we had a presentation from CQC about the robust nature of its new inspection regimes and I reflected on the difference between the organisation and the initial thoughts when the coalition government came in, I recall a meeting between myself and my officers with the then local CQC team announced they were moving from a full time care inspection organisation to more of a light touch registration organisation and beyond our shock as such a move, for our part we began thinking about how we needed to react to this with our own inspection regime and how we went about our working relationships with the Care Homes in Suffolk. From the presentation we saw the conclusion of a quiet transformation of that organisation into a sort of OFSTED for Care. Those of us who watch this sector closely of course know this has been happening over the past couple of years firstly with the surprise recruitment of David Behan the former Permanent Secretary to the Care Minister to tis CE role and the well-respected Andrea Sutcliffe to head up its care sector. All, I have to say, brought about by a Government that properly recognised the significance of the likes of the Panorama TV Programme’s shocking investigation into care and a concerted efforts of Local Government and other care organisations as reported in the national press, to seek to rise the issues of care standards up the national agenda.

What also emerged from the scrutiny was that this Tuesday, the second of Care UK new homes has a ‘stop to new admissions order’ instigated not by CQC but by Suffolk County Council’s own team, equally the original suspension of Mildenhall Lodge by the same team was before the CQC inspection. These are important points because despite officers informing the committee that the department was reviewing if it needs to have more people inspecting Suffolk Care Homes in addition to the CQC work, actually they did pick up the failings before CQC and the robust quality of the Suffolk County Council team working with care providers, despite the close relationship they have with Care UK as it replace the Council’s former homes, the relationship of commissioner and provider is in place and Suffolk County Council are already properly holding them to account.

Equally I was really proud to sit on the Health Scrutiny on Wednesday as it robustly did its job. Last week I was in Scunthorpe and one of the things I was tasked with doing was to meet with the Chairman of their Health Scrutiny Committee, as we considered as a part of the LGA Adult Safeguarding Peer review if we thought it was fit for purpose (which it is). Such important consideration follows on from the Francis Report into Mid-Staffordshire Hospital where one of the system failing highlighted was the lack of robustness of that County Council’s Health Scrutiny to ‘shine a light into dark corners’ and hold a provider to account, in that case, the NHS trust which failed to keep people safe in that hospital.

Of course we all want Care UK to just keep to their end of the bargain and deliver the quality care they promised. From the Health Scrutiny Committee point of view we have charged them and the department’s officers to keep us up to date on the action plan and its implementation that they have learnt their lessons and the opening of each new care home will go as we want it to and I know we all hope these actions can be of comfort to worried residents, loved ones and families as they transfer into their new home.

Political Determination

Mildenhall Lodge opening

Mildenhall Lodge opening

Last Friday I attended the official opening of the New Mildenhall Care Home built by Care UK to replace the former County Council home at Wamil Court and what a splendid new facility it is.

Care UK will open, over the coming months, 10 similar new care homes across Suffolk investing some £60M in the process. As per my promise when I visited every single one of our 16 ageing care homes to meet with residents families and staff, in my former role as Cabinet Member for Community and Adult Social Services, all of those residents in Suffolk County Council’s former homes who wish to, will transfer across to a wonderful new home supported by the county council, that is now happening.

At the recent political training sessions I was involved in for both Director of Public Health and Directors of Social Services we talked a lot about what motivates a Councillor to get involved and of the ‘quality’ of Leadership.

I put forward my personal view that whilst there are many reasons people enter politics, I entered to firstly represent my community which I work hard to do and secondly to make an actual difference. It is all too easy to appear to be busy, fronting this and that decision or policy when in reality those would have been Council policy and decisions irrespective of if you or another person from your own or another party was fronting them, the council would make those decisions if you were there or not and there are many of those.

In respect of Supporting Lives, Connecting Communities, a number of great new mutuals delivering outstanding services to some of the most vulnerable in our Suffolk community, at costs lower than before (thus protecting front line services) and in respect of the replacement of all of Suffolk County Council’s care homes with something to be proud of, I was the key political decision maker. Of course I was ably supported by a great officer team who made it happen and colleagues who backed me but it was my political vision and determination often in the face of quite challenging opposition that made these things happen.

That, to my mind is the great challenge of being a Councillor, to have made an actual difference, rather than simply serve your time, to be a journey man if you will. In doing so you’re not always going to get right but at least you will have made a difference.

Visits to Care Homes to discuss New Homes

Over the past couple of weeks I have been visiting Care Homes in Mildenhall, Lowestoft and Haverhill.

The tour was to meet with the Customers, Families, Carers and Staff at each home that will be relocated to three brand new homes if our bid for £30M of PFI Credits is successful which will allow the County Council to build 3 new Care Homes in the county over the next 4 years.

At each home I and a small team of Officers went through what and why we are building new homes and was a great opportunity to hear and learn what residents and their families wanted from our outline proposals. If you were one of those who came along thank you for taking the time to come and listen to what I hope was helpful information about our proposals to build a fantastic new care home facilities as part of a round of investment of £30million pounds for older people in Suffolk.

These meetings were residents opportunity not only to find out more, but to ask questions and have your say on the proposals.

We took along a scale model that intentionally was not meant to be any sort of finished model but to demonstrate the concept about what we are thinking to achieve and it proved quite a talking point at each presentation.

The first question we tried to answer was why we were thinking of bulding new homes. All 16 of the County Council care homes in Suffolk are rated core either ‘good’ or ‘excellent’ according to the Care Quality Commission and the homes we visited were no exception.

I personally think this is both reassuring and points to the high standard of care for older people in Suffolk we currently and want to in the future provide.

However, we know that the demand for care will increase in future with a growing older population and more people who will have special care needs, particularly associated with dementia or memory difficulties and other issues.

We need to plan for this demand increase this means meeting the standards of excellence expected of care homes in the 21st Century, supported by research which shows that careful building design can be a tremendous aid to people’s health and wellbeing. We want to reflect this in our homes and meet the high expectations of the people we serve.

Of course, our main focus is to support people to live independent lives at home wherever possible, but when that is no longer achievable, we have a duty to ensure that we can provide the best care and support wherever people live.

So if the proposals go ahead, all the residents in the four homes we visited will be able to move into a new home in 2015 in their town, and we will help them prepare for the move well in advance and all along the way.

What we prosing will be cutting edge and what we actually mean by modern cutting edge is a home that in the background is efficient with modern kitchens and the best equipped bathrooms etc., but at the same time is designed as, you or I, would want it to be.

I think the danger when you here about a larger home is that you might think that it will be some large impersonal institution and that is absolutely not what it will be.

It will be design around small clusters of rooms to deliver a home within a home, warn, friendly, a place where residents will get to keep the friendships they have built up with their neighbours in their home and those who care for them.

We got lots of very useful and interesting feedback that will become an integral part of my thinking as we finalise our plans to bid for Government Money to build the new homes.

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