Safety and Quality in Home Care Services The Local Situation Karen Ahmed Divisional Director Adult Commissioning
Close to Home – EHRC Report • Equality and Human Rights Commission • Published 23 November 2011 • Four key themes: – Lack of choice and control – Lack of choice and control – Health and Safety concerns – Reduced wellbeing – A reluctance to complain • Inquiries findings put in local context
What is Home Care? Home Care Care
Home Care in Barking and Dagenham • 750 people are receiving personal care or home care •9 external providers of home care -10,000 visits a week • In-house dementia service with 12 carers
Age of home care users 45 40 No. of Home C 35 30 25 Care Users 20 15 10 5 0 19 36 45 50 56 61 66 71 76 81 86 91 96 101 Age
How do we check people are safe? Staff (e.g. Social Family, friends workers, GPs, Day Centre staff) Reviews Contract Monitoring Telephone spot checks/face to face Complaints Ezitracker Safeguarding
How do we check that people are safe? Assessment Commissioning Choose Provider approved Provider Start receiving home care Contract Monitoring Six week review Ezitracker Annual review Telephone spot checks Face to face visits
1. Reviews • From 1 September 2011 to 2 February 2012 – 400 reviews of people receiving community based services • Six week review • Annual review • All reviews in service user’s home
1. What we have seen from reviews? • Service users are happy with home care • Service users like their carers • Care delivery can be changed (e.g. care times rearranged) • Other issues dealt with (e.g. hoist installed)
2. Monitoring complaints • Address individual concerns • Provider performance – any patterns of repeated complaints • 2011/12 - one provider has had an embargo • Number of complaints in home care: • Number of complaints in home care: No. of Complaints: 2009/10 2010/11 2011/12 40 18 10
2. How we deal with complaints? • 13 December 2011 a complaint arrived at the Council Complaints team from Mrs M’s daughter: – ‘Mrs M’s lunchtime calls are being delivered early and the carer is not cleaning up after the call’ • Response prepared by Provider and Council • Response sent to Mrs M and her daughter on 23 December 2011 • Six week follow up call - Mrs M was happy with revised service with earlier calls
3. Safeguarding alerts • Investigate actual or suspected abuse and neglect • Work together to prevent and protect adults at risk • iCare campaign -150% increase in referrals over last two years • Number of safeguarding alerts in home care: • Number of safeguarding alerts in home care: No. of Safeguarding alerts: 2009/10 2010/11 2011/12 38 19 5
3. How we deal with safeguarding alerts? • Alert received via Complaints team • Immediate investigation showed 10 other service users had missed calls • Strategy meeting held – investigation started • All 11 service users reviewed • All 11 service users reviewed • Findings verified • Action Plan for Provider agreed
4. Telephone spot checks • Home care users telephoned • Asked about home care service they receive • January/February 2012 spot checks: checks: – 120 completed – 95 (79%) very satisfied with home care – 18 (15%) satisfied – 7 (5%) not satisfied
4. Detailed telephone spot check • In January, we asked 25 home care users more detailed questions about their home care. • Positive comments: - ‘Carers arrive reasonably on time, are committed and of pleasant nature’ - ‘Flexible, reliable, honest. Built up a good rapport with carer’ - ‘The carers are good, polite, friendly and carry out their duties with care’ • Negative comments: - ‘ My carers change quite frequently. Times are unpredictable’ - ‘Don’t receive adequate information not told with regard to change of carer or hours when applicable’
5. Contract monitoring • Purpose to quality assure and improve services • Frequency depends on volume and performance • Agenda items: – Commissioning compliance – Complaints/Safeguarding – Service user feedback – Training/Recruitment – Finance – Sharing good practice – Forthcoming issues (e.g. Olympics)
6. Ezitracker • Electronic verification of service delivery • Verifies: – Call time – Call length – Consistency of carer
EHRC theme: Lack of choice and control • Of service users contacted: – 90% happy with length of time carers spend with them – 90% are happy with information provided – 85% feel home care helps their independence • Council developing more support including • Council developing more support including brokerage and advocacy to help service users make their own choices • Monthly audit of Ezitracker taking place to check when care is delivered
EHRC theme: Safety and quality concerns • 95% of service users contacted by telephone are happy with their home care • Starting quarterly home visits to • Starting quarterly home visits to most isolated service users to ask about home care service they receive with Carers of Barking and Dagenham
EHRC theme: Reduced wellbeing • To reduce isolation of older people • Increase participation in community life • Older People’s Strategy 2010-13 – 60+ Leisure Offer – Accessible transport and buildings – Activities (e.g Silversurfers, reminiscence) – Older People’s Day
EHRC theme : Reluctance to Complain • 85% of service users contacted know how to complain • Face to face quality assurance will look at barriers to complaining look at barriers to complaining • Will develop ‘citizen assessors’ to quality assure home care
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