Issue - meetings

32.1     The Committee considered a report outlining the findings of the Care Quality Commission (CQC) Area Review and the local Action Plan developed in response. It was noted that the Social Care Institute for Excellence had supported the development of the plan and that its implementation would be overseen by the Health and Wellbeing Board (HWB) via quarterly progress reports.

32.2     The following points were made in response to questions:

·         The review of the HWB will be led by the Chief Executive and will need to take account of wider relationships, including with the Sustainability and Transformation Partnership, Health Overview and Scrutiny Committee and East Sussex Better Together governance arrangements. The review will include opportunities for existing HWB Members to give views and consideration of issues such as the representation of providers and the balance between inclusiveness and focus. An initial report is expected by July.

·         The rate of A&E attendances from care homes is comparatively good in East Sussex. It was recognised by CQC that work with primary care on this issue was at an early stage. CQC’s proposed improvement relates to the nature of the market and ensuring a system wide approach to development which includes primary care.

·         Particular areas of focus in relation to the care home market are capacity and quality, which are interlinked as the department does not make placements into poor quality homes. A change in the focus of CQC inspections has led to a change in the Quality Monitoring Team’s focus away from monitoring towards supporting improvement. CQC noted an improvement in quality but also identified more to do and there will be a workshop to look at how the continued progression of this work. An increase in fees has stabilised market capacity but further development will be led through the agreement of a bedded care strategy for the health and social care system. The key Adult Social Care (ASC) challenge is nursing rather than residential care.

·         Performance on delayed transfers of care (DTOCs) has improved further since the CQC review and most recent data shows all Better Care Fund targets being met. Given pressures in the NHS, the focus now is on using transitional beds purchased from the independent sector to ensure people who are delayed are not waiting in hospital beds. However it is still essential to ensure onward flow from transitional beds otherwise any gains are lost. The department has had to deploy additional staff at all levels to maintain performance in light of very heavy pressures in recent weeks. This has also involved going beyond those people who would normally fall within the ASC remit to expedite discharge.

·         People placed in transitional beds are still able to exercise choice in choosing their onward placement. A more challenging issue is where the patient or their family want a person to stay in acute hospital bed when they are medically fit. A ‘Let’s get you home policy’ is in place to help manage expectations and there will be further communications  ...  view the full minutes text for item 32