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Working together on Monitoring Care Homes

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					Working together on Monitoring
         Care Homes
   Brian Demby – LB of Redbridge
   Ian Roberts - LB of Barking and
             Dagenham
Map of London Boroughs
The North East London Group
           A Conversation
•   Budget – Costs of Monitoring
•   Staff – Availability
•   Number of Homes to be Monitored
•   Quality of Care
•   How do you do it and Cope
•   Can we work together.
   We looked at what we did in
    Barking & Dagenham and
  compared it to what we did in
           Redbridge
• They were very similar processes, the main
  differences where around, when, how
  often, and how far the teams travelled.
• We tabled an idea to the NE London group and they
  were very happy with us doing the first stage of
  work.
We agreed:
• To develop a standard monitoring template to be
  utilised by Local authorities.
• the process would not provide sufficient information
  for all authorities and some authorities may still wish
  to pursue their own more detailed process.
  We agreed:

• To develop a standard monitoring template
  to be utilised by Local authorities.
• the process would not provide sufficient
  information for all authorities and some
  authorities may still wish to pursue their
  own more detailed process.
 We agreed:
• To ensure bureaucracy to providers is
  minimised, NELP group will agree common
  objectives which authorities will work to.
• Local Authorities will seek to aspire to
  annual monitoring of care homes more
  frequent monitoring to be determined by
  individual Authorities depending on their
  local policy and resources.
 Step by Step
• We collected every ones older peoples
  monitoring forms and completed a
  comparison.
• From this we devised a form that took into
  account every ones major areas of concern.
• A discussion was then held as to the likes
  and dislikes.
Step by Step
After a Number of Meetings and attempts
      with a half day workshop

           We Found

We Had a Form That Everyone Thought
      Was Good for Them and
         They Could Use.
Step by Step

We agreed a North East London Charter
which set out the principles that we would
work to
 North East London Charter
North East London Charter for Care Home Monitoring
The North East London Procurement Group has been working on cross
borough (joint) monitoring process for care homes to be implemented
during 2010.
NELP group is aware that this process will not provide sufficient
information for all authorities and some authorities may still wish to
pursue their own more detailed process.
To ensure bureaucracy to providers is minimised, NELP group will agree
common objectives which authorities will work to.
To develop a standard monitoring template to be utilised by Local
authorities.
Local Authorities will seek to aspire to annual monitoring of care homes
more frequent monitoring to be determined by individual Authorities
depending on their local policy and resources.
    North East London Charter
•   The aims of this process are:
•   To have a uniform approach for monitoring care homes
•   To share monitoring information via the London Care Placements web site
•   To enable boroughs to work more closely together
•   To share common interests that will enable quality monitoring framework
•   To give the host borough greater responsibilities for monitoring local care
    homes
•   To reduce travelling cost/time involved in monitoring out of borough care
    homes
•   To enhance quality of monitoring
•   To encourage proactive monitoring of care homes
•   To improve information for Brokerage teams
•   To improve quality of care homes
•   Establish common ground for further developments in monitoring, contractual
    arrangements and improvements in care homes for the benefit of service users.
We also agreed that owing to the
way we have to make changes to
   what we are monitoring,
We would need to meet every six
 months to review the contents.
    We achieved one form
        for us all to use
  What to do with the report?

Ian will now talk about how we store
monitoring reports and how anyone in the
group can access them
 An IT solution

• We approached London Councils and had a
  number of meeting to discuss use of the
  London Placement web site.
• This already holds information on children's
  services accessible to London authorities
 An IT solution
• A shared area has been developed that hold
  details of each authority and the registered
  Care home within each authority.
• Authorities have password access
• Each authority is able to upload monitoring
  documents to the specific Care Homes in
  their authority
  An IT solution

• Information can be recorded and shared on
  embargo and safeguarding issues
  Major Benefits Include:
• No visits required to homes outside our own borough.
• Reduced costs and staff time involvement.
• Joint working and an improved understanding between the
  authorities.
• To have a uniform approach for monitoring care homes
• To share monitoring information via the London Care
  Placements web site
• To enable boroughs to work more closely together
• To share common interests that will enable quality
  monitoring framework
 Major Benefits Include:
• To give the host borough greater responsibilities for
  monitoring local care homes
• To reduce travelling cost/time involved in monitoring out
  of borough care homes
• To enhance quality of monitoring
• To encourage proactive monitoring of care homes
• To improve information for Brokerage teams
• To improve quality of care homes
• Establish common ground for further developments in
  monitoring, contractual arrangements and improvements in
  care homes for the benefit of service users.
     Time for Questions

On what you have heard so far.

The future development will
follow shortly
        Future Development
• Extend to rest of London Authorities
• Essex and Eastern Region Counties
• Develop common monitoring form for
  Learning Disabilities
• Discussions with London JIP recent survey
  across London identified:
JIP Survey Headlines
The survey had 51 responses representing a total of 22 of the 33 London
Boroughs. The responses in summary included:

1 Frequency of quality monitoring visits
  It is clear from an initial analysis that there is a wide variety of practice
  in terms of quality monitoring. While almost all Boroughs monitor
  Care Homes in their local area at least once a year (93%), the majority
  (58%) do not monitor Care Homes in which they make placements
  outside the Borough.
2 Visits made in conjunction with other Boroughs or with PCTs
  One third of Boroughs confirmed they undertake joint visits to Care
  Homes but this is usually where there have been safeguarding issues.
3 Sharing information with other Boroughs
  Over 90% of Boroughs confirmed they share information with other
  Boroughs but comments suggest this is usually related to safeguarding
  issues. Only the North East London Boroughs appear to regularly
  share information.
JIP Survey Headlines

4 Active Contract Management
  Most boroughs (83%) report that they actively manage their care home
  contracts although for some this is limited to block contracts. In some cases
  the contract management activity seems to be limited to care plan reviews; this
  may mean the focus is limited to a specific service user's experience rather
  than a more rounded view of the performance of the Home. In the other cases
  there is a clear emphasis on contract compliance and performance which
  includes addressing quality standards as well as a number of other factors.
5 Forms of contract
  While spot contracts are most commonly used for placements in care homes,
  Block and Cost and Volume contracts are also commonly used.
6 New placements in care homes with poor/0 star rating
  83% of Boroughs confirmed they would stop making new placements in 0
  starred care homes but a number commented that they would not inform other
  Boroughs of their action.
7 Links between inflation uplifts and quality
  The majority (80%) make no link between quality and tariff increases but
  many respondents commented that they had not increased tariffs in recent
  years.
JIP Survey Headlines

8 Engaging providers
  The majority of Boroughs engage providers through regular forums in a
  number of places this is in conjunction with the local PCT. Newletters and
  training events are also commonly used.

9   Forming a good Practice Network
    There was a strong appetite (94%) for establishing a good practice network and
    a number of suggestions about the form of collaboration which could be
    undertaken, with an emphasis on joint provider engagement.
Next Steps
• A full report will now be drafted and presented to the Joint
  Improvement Partnership. The Report will also be circulated to all
  those who have expressed an interest in joining a good practice
  network.
• There is currently joint working in quality monitoring in at least two
  areas of London (The West London Consortium and the NE London
  group) which could form the basis of an initiative to promote further
  collaboration.
• With a view to promoting good practice, and sharing information and
  resources, we propose to ask the Joint Improvement Partnership to
  consider what support they could offer to Boroughs to develop:
   – more consistent practice in quality monitoring and contract
       management across London.
   – more robust and systematic arrangements for sharing information
       between Boroughs about the quality and performance of care
      homes
   – a collaborative approach to engaging providers (including, possibly
      establishing a link between quality and performance, and inflation
      uplifts).
Contacts:

Brian Demby – LB of Redbridge
     brian.demby@redbridge.gov.uk

Ian Roberts - LB of Barking and Dagenham
     ian.roberts@lbbd.gov.uk

				
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