Surrey County Council has a quality assurance team of 4.5 quality assurance managers who undertake monitoring visits to care homes, home care providers and supported living schemes. This forms part of our adult social care markets and commissioning resource.
The story so far
The team works closely with clinical commissioning group (CCG) colleagues, undertaking joint visits alongside joint quality assurance team meetings. It has developed a joint report format based on the nine ‘Making it real ‘I’ statements’ developed by Think Local, Act Personal (TLAP) which form part of its service specifications and monitoring visits and which keeps the experience of people who use services at the centre of its work.
Surrey County Council’s working relationship with the Care Quality Commission (CQC) is positive with regular, ongoing information sharing meetings plus bi-monthly meetings with CQC and the council’s operational safeguarding lead. At these meetings, services of concern and who is taking what action are discussed. This information feeds into the quality surveillance group covering Surrey and Sussex where concerns about providers who cross boundaries or where there may be impacts on neighbouring system partners can be considered. Surrey County Council has a horizon scanning process for CQC reports and ask for action plans from services that are rated as ‘requiring improvement’ and ‘inadequate’. The relevant quality assurance manager reviews agreed action plans and offers support as appropriate.
Developments
Throughout 2016, Surrey had seven workstreams looking at how council and clinical commissioning group (CCG) colleagues could develop and improve quality assurance and operate an increasingly multi-disciplinary quality assurance approach. The seven workstreams were:
- Public point of contact: working with local Healthwatch so commissioners, the quality assurance team and partners can get more feedback about services.
- Communications: raising the profile of Healthwatch among the public so they are aware of this option for offering feedback on services.
- Quality assurance information sharing: developing a dashboard to provide an overview of service quality including quality assurance reports and CQC ratings that will be accessible to health and social care.
- Support offer for providers: exploring what system partners can offer providers to support them in improving the quality of their services; identifying services which are Surrey-wide and CCG specific.
- Early warning system and response: developing a Surrey-wide key set of indicators that the council and CCGs agree to collect to help identify services with the potential for deterioration in quality and agree responses to different risk indicators.
- Resources: looking at even greater health and care integration and how we resource a team that can be proactive as well as reactive in responding to quality issues.
- Training and support for health and social care professionals: workshops on what good quality may look like, what poor quality may look like and what social care professionals can do about it.
Next steps in 2017
- Workstreams 1,2,4 and 7 are largely complete and will move to business as usual with reviews at bi-monthly meetings.
- Workstreams 3 and 5 have been merged and are ongoing, being seen as key to implementing preventative approaches through proactive use of shared intelligence.
- Workstream 7 is continuing. Six pilot two hour quality assurance awareness workshops have been delivered to social care staff in Surrey. They have been very well received, feedback citing greatly increased awareness of quality assurance issues in care settings and increased confidence in addressing them. Quality assurance awareness material has also been incorporated into the council’s safeguarding e-learning module, ready in April 2017. Work is ongoing to roll out the training to include solutions for health staff who enter care settings and will also be delivered to Surrey Fire and Rescue colleagues.
Challenges and where next?
The challenge for quality assurance in care in Surrey going forward remains that of working in a more preventative way. Key work planned to meet this challenge includes:
- continued investment in quality assurance officer posts • continuing to promote and deliver joint working across the council and six CCGs
- continuing to make quality assurance in care ‘everybody’s business’ by running ongoing quality assurance awareness sessions
- and alongside all of the above, better use of intelligence on low level concerns through a bespoke countywide IT system.
Contact details for quality assuring care
Julian Temblett-Wood Quality Assurance Manager, Adults Surrey County Council, [email protected]