To receive a verbal update on Majlish Home Care services.

The Corporate Director, Education, Social Care and Well-being and the Education, Social Care and Well-being Representative gave a verbal update on issues relating to Majlish Home Care Services.  The Corporate Director noted that the Authority had been monitoring the situation at the Home Care Services provider for some time and advised the Panel that there had been no effective response to the three warnings issued by the Care Quality Commission (CQC).

The following maters were noted by the Panel:

The Education, Social Care and Well-being Representative noted that there were no issues related to care provision or safeguarding but with organisational matters such as management structures, staff training and management level issues.  However safeguarding remained the Council’s priority and therefore CQC were kept fully informed.   

The Panel was advised that:

• Some trustees of the care provider acknowledged the complaints made but they had been unable to implement the changes required.
• The Corporate Director had met with the new Chair of the trustees” and “the previous Chair and another trustee had resigned.
• CQC had inspected the service and were minded to withdraw its registration as a Dom Care provider.  They did serve notice withdrawing the registered manager status.  However the provider had a good history in terms of its service provision and therefore the Corporate Director had consulted with the Chief Inspector to ensure support was engaged. The Education, Social Care and Well-being Representative had been appointed as an external consultant and an interim manager was sourced to replace the de-registered manager.
• A support plan was agreed with the new Chair of trustees.  It was noted however, that generally, the trustees were not supportive of the Council's efforts and while relations with direct staff management was good, the Council had received less welcome from senior staff.
• Presently LBTH were dealing with the issues but due to the sensitive nature of the matter could not comment further at this time.

In response to Members’ questions the following information was provided:

Concerning assurance of safeguarding standards, the Panel was informed that, in its investigation, CQC applied their own investigative methodology.  All recipients of services from this provider had been surveyed and the vast majority had responded positively.  To investigate the quality of the provision and the Council had also approached the families of users and there had been some reports of wrong methodology training e.g. training in client lifting. 

Staff training such as coaching on day-to-day practices such as hoist usage was an area of concern.  It was noted that it was not alleged that staff were not trained however it had been found that a number of staff did not have the training that CQC expected.  It was noted that there was a formal, standard curriculum package for this category of staff training and the Council expected that this should be met since other providers of such service used training packages of this nature.  Additionally the Council had offered its own staff development facilities to the organisation but these had not been taken up.

The areas of concern identified by staff related to management culture, contracts and salaries rather than care provision.  Additionally staff bullying was alleged.  The Panel was advised that the Council had itself become concerned as 50 staff had whistleblown and all subsequently withdrew their representations.  However there was concerted action to ensure that the whistleblowers were protected and could have confidence of the necessary changes in the organisational culture.

Members noted that there had been concerns around this provider for over one year and were concerned about the impacts of failing to act.  The Corporate Director noted the comment and advised that there was work in progress to address the issues that had been identified.  He advised that officers were working towards a resolution in the very near future.  He acknowledged the importance of the provision of quality home care to residents of the borough and therefore the Council had taken steps to install support in order to turn around the concerns reported.

A Panel Member was concerned that there was only one Bangladeshi provider of this kind of home care and therefore there was little choice for residents.  The Corporate Director advised that there are a number of providers in existence and the Directorate was working to enable service choice to be retained in the least disruptive way possible.  Members were advised that these contracts related to users who must possess a personal budget but the core provision was arranged by the Council.  Most of the business comprised spot purchases

The Council was presently monitoring how the service was responding to the implementation plan; however should the Council reach a view that a formal decision or action was necessary then it would act wholly through CQC.  It was noted that CQC would undertake a further inspection (by 31st of March 2014) three months after the implementation of the intervention plan.  This would assess operations and provide evidence to determine whether issues had been resolved.

The Chair thanked officers for their verbal report and requested that the Panel be kept informed of ongoing developments both formally and informally

RESOLVED

That the update be noted

Action by:

Robert McCulloch-Graham (Corporate Director ESCW))