Surrey County Council Quality Assurance Team

1. Surrey County Council Quality Assurance Team What is “Quality” and “How” do we assess it? November 2012

2. Quality Assurance Monitoring in ASC Part of the role of QA team involves evaluating the quality of adult social care services in Surrey and promoting and sharing good practice. We aim to use a person-centred outcomes based approach to assessment. We try to keep up to date with research, and best practice guidance. • As part of our assessment, we will speak to individuals receiving services, their carers/ family members, care staff, and if appropriate health colleagues/SCC practitioners. • We will complete a report and share this with the provider, that may include recommendations.

3. Features of our approach • Reports are outcome focussed and evidence based (developed from the ASCOT model) • Providers have opportunity to discuss any errors and to provide a response or action plan if they wish. • Reports are stored internally, but may be shared within the safeguarding process, with health colleagues where appropriate (for example, in East, with Community Matrons), and with CQC (Memorandum of Understanding) • Approach is compatible with CQC outcomes

4. What is ASCOT? • Adult Social Care Outcome Toolkit (University of Kent, Personal Social Care Research Unit) • Original domains include; Control over daily life • Dignity • Food and nutrition • Occupation • Personal cleanliness and comfort • Safety (inc.safeguarding) • Social participation and involvement

5. continued • We have added; • Health- treatment, support and equipment to maintain or promote good health • Management and quality assurance systems (includes staffing) • We can use these domains to evidence any outcome regulated by CQC.

6. How are reports used? • Reports are stored within commissioning • Reports can be shared with SCC Team Managers where concerns have been raised • Reports are used as part of safeguarding • Reports may be used to identify trends and themes (shared) • Reports could be used as part of a providers QA • Reports are shared with CQC, and sometimes relevant health professionals

7. How Do We Target Our Resources? • We have developed links with SCC practitioners, District Nurses, Empowerment Boards, Community Matrons • We respond to concerns raised (relative or professional), and look for trends/ themes • Examples of good practice • We receive referrals from safeguarding • Top 10 spend

8. What happens next: Proportionality • We are a small team with limited resources • Ideally we would like to visit providers with SCC funded individuals on an annual basis, but this may not be realistic. We have a higher level of commitment to contact with commissioned services. • We may agree to a higher level of support where a provider is going through a period of change, or where risks have been identified. This can be agreed on an individual basis.

9. How to collect evidence • We will try and use different sources to evidence how an outcome is met (triangulation) • For example; nutrition • We might look at menu planning, how dietary requirements are met, how people with poor nutrition are supported, use of specialist advice, how people are offered a choice, whether people’s complaints are heard, individual feedback, environment, supported feeding, training, aids, care plans

10. Evidence • So you can see one area can be looked at from many different perspectives, and some information may also contribute to meeting another outcome, for example personalisation

11. Outcomes for Quality Assurance • The experience of the person and their carer is at the heart of what we do and we use this to enhance and improve outcomes for the people in Surrey. We do this by: • Building relationships with providers which include monitoring visits • Manage conversations with the SCC teams in relation to how we work with providers. • Feed into the commissioning cycle.

12. Table Exercise: • CQC Inspection • SCC Quality Assurance Monitoring • LINks Enter & View Does it feel like overload? What are your views? Are there benefits, a time to reflect, promote good practice? Or does it feel threatening ?