Page 9 - 20190403 - Minutes - TSAB - PUBLIC

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VW acknowledged that it was a big piece of work and that the scrutiny from the panel was fair, positively
challenging and constructive. The panel highlighted areas of development which will be taken on board.

VW advised that in future the QAF will be divided across service leads to complete and that the process
should become easier each year.

Agenda Item 9 CQC Discussion Presenter: Jean Pegg
Non-Commissioned Care Services
 Gaps in Quality Assurance
JH advised that this discussion came from the SAR Sub-Group and members reflected that the quality of
care for non-commissioned services cannot be monitored by the LA and issues may only come to light if
a Safeguarding Concern is raised. VW highlighted that this would also be the case for private care homes
and self-funded providers.

There were also issues identified when individuals are placed out of area and how LAs can assure
themselves that the care being provided is adequate. It was noted that there is a statutory responsibility
for LAs to visit children placed out of area, but this is not the case for adults. Jean Pegg (JP) felt that the
placing authority should carry out reviews and that this should be a visit to the home and a face to face
meeting with the individual, in her opinion a review should not be carried out over the telephone. It was
noted that previously there was a duty of care on the LA to carry out an annual review, however in the
new Care and Support Guidance there is no mention of a timescale and nothing that states that there
should be face to face visits. Local Authorities may have interpreted the guidance differently - the placing
authority may send a member of staff to visit the home or ask that the resident authority carry out a review
on their behalf. AB suggested that each LA asks their Commissioning Teams what measures they have
in place. VW will raise via the DASS Network and JP agreed to discuss amongst CQC’s networks.

Members felt that this must be a national issue. BP advised that the CCGs have already raised these
concerns via the Accountable Care Partnership and the Learning Disability Partnership. AB agreed to
raise this through the national chairs network and bring to the attention of the Department of Health. There
was acknowledgement that for Local Authorities, people with the most complex needs may be placed out
of area, simply because they do not have an appropriate placement within the local area. There are added
complications of people accessing placements through different systems (people who are placed by the
CCGs, Continuing Health Care or self-funders).

JH made reference to a case where someone was placed in a non-commissioned service in Hartlepool
and the placing authority had not contacted HBC to ask for more information about the home. HBC only
became aware of this individual due to a DoLS request. BP agreed to raise this with NHS England,

JP explained that in Durham, CQC were finding that some providers were contacting the police to manage
behaviour of residents on multiple occasions but not notifying CQC. There is now a trial in place in Durham
where each registered location is tagged and a number of callouts to police will automatically trigger a
CQC inspection. Providers can face a fixed penalty notice if they have not complied with CQC regulations.
This work is now due to be replicated in Redcar – AB asked if conversations could take place with all
Tees LAs.

 Joint Quality Assurance Visits and CQC Inspections (Case 11/16)
This item was not discussed.

Unwitnessed Falls
CQC ask providers to report unwitnessed falls to them as a statutory notification, this often prompts
providers to also report the incident to the Local Authority as a safeguarding concern, which is not always
appropriate. JP advised that there is a link for providers on CQC’s website which describes what should
be reported to CQC https://www.cqc.org.uk/guidance-providers/adult-social-care#notifications. JP
suggested that CQC could attend provider forums to talk through what providers should report.
Action Points Action Owner Deadline
1. Non-commissioned services issues to be raised via: 20/06/19
Minutes approved 20.06.2019 9