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Annual Quality Report
Care Homes
April 2013 to March 2014
Authors:
Pat Whitaker – Quality Manager
Laura Green– Quality Officer
On behalf of
Kevin Clifford Chief Nurse
May 2014
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1.
Introduction
NHS Sheffield has a role in ensuring that good quality care is delivered in Care
Homes and that underperforming homes are identified and managed.
Working in conjunction with Sheffield City Council (SCC), Sheffield Clinical
Commissioning Group (CCG) ensures that effective processes are in place to
monitor that Care Homes are delivering good quality and safe services.
This report provides information on performance, activity and improvements in
relation to quality and safety during 2013-2014
2.
Background
Sheffield CCG was monitoring 124 registered care homes in 2013-2014. This
included Nursing, Residential, Mental Health and Learning Disability care homes.
3.0
Process
3.1 Routine Inspections
All care homes have one routine inspection by Sheffield CCG every 3 years.
41 care homes (33% of all registered care homes) were inspected in 2013-2014.
Routine inspections are carried out by the CCG Quality in Care Homes Team using
a quality framework agreed jointly with SCC which reflects the essential CQC
standards. Verbal feedback is provided to the home at the time of the visit, and
actions with time scales to improve areas of concern are also agreed. Following the
visit, care homes are sent written confirmation of the agreed actions and
timescales, and are asked to provide evidence, or are re-inspected, to ensure that
they have completed these actions within the agreed timescales. Actions and
timescales are recorded on a database which is used to monitor progress. If
evidence has not been received, or a re-inspection of the home reveals that actions
have not been completed by the due date, then the home is followed up until all
actions have been completed.
For the 41 care homes inspected in 2013-14, 620 actions were agreed in total and
monitored for completion.
3.2 Reactive Inspections
In addition to routine inspections, 105 reactive inspections were also carried out
where intelligence was received that there were concerns with a home. This
intelligence would be from a variety of sources, e.g. other professionals, CQC,
residents, relatives etc.
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4.0
5.0
Additional Assurances

A yearly check is carried out to ensure that all care homes are registered with
the CQC. For 2013/14 this check was carried out in April 2013; all care homes
were registered.

The CQC undertakes yearly unannounced visits of all care homes.

Sheffield City Council undertakes yearly announced visits of all care homes

The CCG routinely informs the relevant GPs of any serious concerns regarding
care homes.
Performance
5.1
Routine Inspections
41 care homes were visited in 2013-2014. At the visits, detailed elements of the
CQC essential standards were inspected. 15 standards were inspected which had
been broken down into 120 elements. Care Homes had to provide evidence that
they were meeting each of these elements. Compliance for each standard has
been worked out on the number of elements within the standard that were
achieved. To score “Met” (Green) 80% or more of the elements within that standard
had to be met. To score “Working Towards (Amber) 51 to 79% of the elements
within that standard had to be met and to score not Met (Red), 50% or less were
met.
Appendix 1 shows the results of performance for the 41 care homes visited. The
standards with the highest level of compliance were “Meeting Nutritional Needs”
and “Supporting Workers”, with 98% of homes being compliant with both these
standards.
The standard with the lowest level of compliance was “Care Plans and Policies”,
with only 22% of homes being compliant with this standard. The Care Home
Support Team continues to provide support and training in this area to assist care
homes in meeting this standard. They will also be producing a care planning
information pack for distribution early 2014-2015.
29% of care homes were compliant with 90% or more of the elements inspected.
54% were compliant with 80% or more of the elements and 46% homes were
compliant with less than 80% of the elements.
5.2
Commissioning for Quality and Innovation Scheme (CQUINS)
This is a local quality incentive scheme for Care homes with a National Standard
Contract for Continuing Healthcare (CHC). The scheme comprised 3 improvement
quality goals – (a) Infection Control, (b) End of Life Care and (c) The Safety
Thermometer (a national data collection system). The number of care homes with a
CHC contract was 47.
57% of eligible care homes met the Infection Control
Standard, 66% met the End of Life Care Standard and 72% met The Safety
Thermometer Standard.
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6.0
Governance
6.1
Key Performance Indicator Group
The Key Performance Indicator Group met 2 weekly throughout 2013/14 and had
representation from the CCG Quality in Care Homes Team, Sheffield Teaching
Hospitals Intermediate Care, Sheffield City Council Contracts, Safeguarding, Care
Home Assessment, The Care Quality Commission and The Care Home Support
Team. Care home performance and concerns are discussed at this meeting and
actions agreed between the partners.
6.2
Commissioning Safeguarding Adults Group
All care homes where there are safeguarding concerns relating to patients receiving
NHS funding were discussed at this group and actions agreed jointly.
6.4
Quality Assurance Committee
The Assurance Committee is responsible for gaining assurance that there is an
effective and consistent process to commission for quality and safety and ensures
that concerns and underperformance are identified and high standards of care and
treatment are delivered. Quarterly performance reports were submitted to the
Quality Assurance Committee. This Committee reports to the CCG Governing
Body.
6.5
Executive Board for Quality in Care Homes
This Board met bi-monthly throughout 2013-14 with a joint responsibility for the ongoing development of quality in care homes and to ensure that appropriate joint
action is taken to increase the quality of services received by the residents of care
homes within Sheffield.
7.0
Support
7.1
Care Homes Support Team
The Care Homes Support Team provided training and support for care homes to
provide identified educational needs. The service specification for the Care Home
Support Team was revised in 2012-13 with the aim of ensuring that this team works
more in partnership with Sheffield CCG and Sheffield City Council and as a result
the team’s support is targeted more effectively to work with those care homes that
are underperforming.
7.2
Infection Prevention & Control
NHS Sheffield’s Infection Prevention & Control Practitioner reviewed practice in 2
care homes where concerns were identified and issued action plans. Sheffield
CCG holds The Infection Prevention & Control Care Home Link Worker Group
which is an educational forum. This continued to be well attended and met 5 times
in 2013-14.
.
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8.0
Key Activity for 2014-2015




9.0
Continue with the programme of planned full monitoring visits
Continue to respond promptly to concerns
Complete and publish the Quality in Care Homes Strategy
Forge closer links with Healthwatch
Conclusion
The report provides assurance that NHS Sheffield has put in place robust systems
to monitor safety and quality in care homes and that concerns are identified and
managed effectively.
10.
Recommendation
The Quality Assurance Committee is asked to note and endorse the 2013-2014
performance and quality assurance of care homes.
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