The purpose of the report is to provide the Adult Social Services Review Panel with an overview of the Special Sheltered housing offer within Croydon.
The Head of Adult Day Operations introduced the item by informing the Panel that a review would be undertaken of all special sheltered housing sites, of which there were seven, with all having been inspected by the Care Quality Commission (CQC). The Panel heard that six of these sites were run by Care UK, who had subcontracted to London Care.
Members heard that the council was looking to bring care delivery of these sites back in house, and that a report would be going to Cabinet in July 2019; an insourced team would fall under the Social Care division, meaning the council would have direct oversight of staff, and that the team would have broad access to the resources of the council.
The Panel learned that many issues had been raised across the sites, but that each had been or were being addressed, but more were being raised as progress was made. A Resident Involvement Officer had been hired to liaise with tenants and ensure that residents were involved and engaged around all updates and renovations to the sites. Members raised the importance of having the Resident Involvement Officer as a main point of contact as there had been reports of residents raising issues and nothing having been done; the need to have someone the site who could identify issues was also raised, as many residents were unwell and unable to do so.
Members were told that the service aimed to provide a home for life for residents that needed or wanted it, with the ability to move to other services if required, pooling the combined resources of the council and aiming to move all sites from ‘Good’ CQC ratings to ‘Outstanding’. The aim to move all sites to an ‘Outstanding’ rating was stressed and supported by the Chair.
Members explained that there had been a number of different issues with the sites which fell into distinct strands, and sighted the care element, the maintenance of the properties, disabled access to gardens, maintenance of the kitchens and heating, and the overarching audit of related contracts and responsibilities. Members queried why the report had not separated the issues in this way, and how issues would be monitored going forward. It was also asked what would be done before Summer 2019 to make residents of the sites safer and more secure.
The Head of Adult Day Operations responded that the council would be taking a coordinated approach to these issues and that the care needs of each resident would be reviewed. There were a list of jobs on the improvement plan which were being worked through; some of these were quick (improving the gardens, fixing or replacing furnishings, urgent works), but some were planned works and would take longer (such as fixing issues with the heating). Members heard that the Resident Involvement Officer had been visiting the sites and that the kitchens were being looked into. The Executive Director for Health, Wellbeing and Adults and Director of Commissioning and Procurement had chaired meetings to go through the lists of works and track progress made.
The Director of District Centres and Regeneration offered to provide Members with a detailed list of the completed and planned works. The Panel were told that all faulty washers and dryers at the sites had been replaced, and some functional but outdated models were being looked at; kitchens had been deep cleaned, and commercial cooking appliances had been replaced with consumer equipment to facilitate resident usage. Décor and furniture was being replaced, and this would be tied in to ongoing fire safety works to minimise the disruption to residents as part of the planned works programme, along with external pathways. A full audit of heating systems was being undertaken, and interim options were being considered for the meantime. A handyman role was being developed, and the successful candidate would need to have the relevant skills to engage with residents to catch smaller maintenance issues before they developed; the role would also involve works such as putting up shelves and fitting draft excluders.
Members queried as to when there would be disabled access to the gardens at Freemans Court, and the Director of District Centres and Regeneration agreed to look into it and provide a specific date. The Chair reminded the Panel that the works being considered were broadly for the communal areas of the sites, and that the flats themselves were in a good condition, with the exception of some issues with vacant units.
The Director of Commissioning and Procurement informed the Panel that historically the responsibility for the sites had been split across four directors and there had not been sufficient coordination or delineation of responsibilities. A Task and Finish Group had been assembled to collate all the contracts relating to these sites and oversee the improvement plan and track its progress, with the group meeting fortnightly. There would be an earlier intervention when repairs were required, and greater engagement with residents over their concerns. The goal for the future of these sites would be to be both more ambitious and more inclusive.
Members raised concerns about reports of some residents having had water meters fitted at their flats, which may have been unnecessary or provided to residents with diminished capacity to understand what was being done. The Head of Adult Day Operations stated that this was being looked into as residents who predominately used communal facilities should not have had these fitted.
In response to queries over whether sites received notice of inspections by the CQC, the Panel learned that often notice was given, but that the inspection also involved speaking with the residents and their families, as well as the site leadership, to get a full picture.
Members questioned why Frylands Court had received a ‘Good’ rating by the CQC despite key findings of provisions having been identified as lacking. The Service Manager responded that as the CQC only inspected on the basis of care provision, and that the inspections were not as thorough as those done by the council; as such, these can be limited to findings on the day of the inspection and the failure to observe broader issues. Concerns held by the council had been raised with the CQC inspector, and had been found before the inspection occurred.
The Chair highlighted that there was a robust safeguarding presence on these sites, and that almost all issues were noticed before CQC inspections. The Service Manager added that the council looked at medication MAR charts, which aided and assisted investigations leading on from inspections. Members queried whether stoma bags were checked, and learned that these were only noted on the daily records and could only be picked up upon on the day of an inspection.
Members questioned why problems with the communal cleaning had been attributed to London Care when this had been the responsibility of the council. Questions were raised as to how cleaning would be monitored and carried out when the service was brought in-house. The Director of Commissioning and Procurement informed the Panel that a cleaning schedule was in place for all sites, and that this included kitchens, but inspections needed to be carried out to insure these were now fit for use.
In response to questions about whether nursing care could be provided within the sites, the Panel learned that residents were entitled to the same provisions as other residents, and that on site care could be provided through district nurses and St. Christopher’s.
Queries were raised about the opportunities for residents to access communal meals and were told that London Care had previously stopped providing this in some homes. Work was being done to ensure London Care informed the council of small issues which would prevent these provisions (such as broken dishwashers) so that they could be fixed. Members stressed the importance of communal spaces and activities in preventing isolation.