Agenda item

To consider a report from the Head of Scrutiny and Member Development summarising Care Quality Commission inspection reports published since the Board meeting in July 2015.

The Head of Scrutiny and Member Development submitted a report that provided details of recently reported Care Quality Commission inspection outcomes for health and social care providers across Leeds.

The following representatives were in attendance:

-  Dr Wendy Barker (Deputy Director of Nursing) – NHS England (North) – Yorkshire and Humber sub-region

-  Ged McCann (Senior Supplier Manager) – Specialised Commissioning Group, NHS England (North)

-  Shona McFarlane (Chief Officer (Access and Care Delivery)) – Adult Social Services, Leeds Council

-  Albert Chelliah (Group Operations Director) – Inmind Healthcare Group

-  David Ramage (Hospital Director (Waterloo Manor Independent Hospital)) – Inmind Healthcare Group.

It was noted that Mr Jonathan Hepworth (Inspection Manager) from the Care Quality Commission had been invited to attend the meeting for this discussion, but was unable to attend due to a prior engagement and had formally sent his apologies. 

In introducing the report, the Principal Scrutiny Adviser drew the Board’s attention to the updated Appendix 1, which was circulated at the meeting.  This had been updated to include some additional inspection outcomes published since the publication of the agenda. The Chair confirmed the intention was to provide the Board with an overview and ‘snapshot’ of recent inspection outcomes for consideration. 

The Chief Officer (Access and Care Delivery) highlighted that the Care Quality Commission (CQC) had recently changed its inspection methodology, which was considered to be much more robust.  It was also highlighted that regular monthly meetings between Adult Social Services and the CQC, provided opportunities to share intelligence and any particular areas of concern.  This helped inform the CQC’s risk-based approach for inspection plans and scheduling. It was anticipated that over time, future overview reports will provide a more balanced service quality landscape in Leeds.

The Board’s attention was also drawn to two specific inspection reports included with the agenda, in relation to Yorkshire Ambulance Service NHS Trust and Waterloo Manor Independent Hospital.

Yorkshire Ambulance Service NHS Trust

The Principal Scrutiny Adviser advised the Board that, given the large geographical covered by the Trust, it had been agreed that Wakefield Council’s Health Overview and Scrutiny Committee would oversee improvement planning against the recommendations and monitor progress.  Health Scrutiny Chairs from other relevant authorities would be invited to participate at appropriate meetings.  Members of the Scrutiny Board were invited to highlight any particular matters to be raised in such discussions.

Waterloo Manor Independent Hospital

The Chair invited those present to comment on the CQC inspection report that had judged service provision at the hospital to be ‘inadequate’ overall and across each of the five domains within the inspection process. A number of comments were made, including:

·  NHS England (NHSE) had been working with the provider at Waterloo Manor since February/ March 2014 when concerns had originally emerged.

·  NHSE had been surprised by the recent CQC inspection outcome, which took place in February 2015 and was reported in August 2015.

·   Following the inspection in February 2015, NHSE confirmed admissions had been suspended and a review of all patients’ had been undertaken.

·  NHSE confirmed that the following had improvement actions had occurred since the inspection:

Ø  A case management review.

Ø  There had been significant changes to the provider’s leadership and governance arrangements.

Ø  Change to care planning for patients.

·  Representatives from Leeds City Council’s Adult Social Care Directorate had been involved in undertaking safeguarding reviews (as the host safeguarding authority) and had been working with the provider since February/ March 2014.

·  Inmind Healthcare Group acknowledged there had been a clear disconnect between the senior leadership and ward staff at the hospital, but was satisfied that the hospital is now safe.

·  It was confirmed that the CQC had recently re-inspected provision at Waterloo Manor, provisionally rating services as ‘good’. 

Members of the Scrutiny Board discussed the information presented and highlighted at the meeting, raising a number of issues, including:

·  Significant concern regarding the 6-month delay from the CQC undertaking the inspection to publishing its report.

·  Concern that despite NHS England and Adult Social Care working closely with the provider since February / March 2014, the CQC had rated service provision as ‘Inadequate’.

·  Concern that the Scrutiny Board had not been made aware of the significant concerns regarding service provision at Waterloo Manor in a more timely and appropriate manor.

·  Concern regarding an inspection methodology where service provision can be rated as ‘inadequate’ in February and then seemingly rated as ‘good’ 6-months later.

·  Assurance that the inadequacies highlighted within the CQC inspection report were not repeated across other hospitals/ service points that formed part of the Inmind Healthcare Group and that similar levels of care were not being undetected in other NHSE held contracts.

·  Requests for a more detailed report of lessons learned across each of the organisations involved. 

In summarising the discussion and future actions, the Chair made the following remarks:

·  The table of published CQC inspection outcomes provided a useful ‘snapshot’ for the Scrutiny Board to consider on an ongoing basis.

·  Changes to the CQC’s inspection methodology had been noted, however the 6/7 month delay in publishing post-inspection reports was unsatisfactory.

·  The distinct and legitimate role of scrutiny in maintaining an overview of quality across health and social care services is well documented.  However, events surrounding Waterloo Manor have highlighted that improvements to local arrangements are needed to ensure the Scrutiny Board is kept informed in an appropriate and timely manner.

·  There was a need to maintain a ‘patient’ focus at all times when considering issues of quality.

·  In respect of Waterloo Manor and the events over the preceding 18-months, the Scrutiny Board would request a more detailed report of lessons learned across each of the organisations involved, particularly focusing on the journey from ‘inadequate’ to ‘good’.

At the conclusion of the item, the Chair thanked those present for their attendance and contributions to the discussion. 

RESOLVED –

(a)  That the details presented and discussed at the meeting be noted.

(b)   That, in respect of Waterloo Manor and the events over the preceding 18-months, a more detailed report be prepared and presented to a future meeting of the Scrutiny Board, highlighting the lessons learned across each of the organisations involved – particularly focusing on the journey from ‘inadequate’ to ‘good’.

(c)  That the more detailed report referred to in (b) (above) be reflected in the Scrutiny Board’s future work programme.