Schedule 2
East of England
Service Specification
(Care Homes & Accommodation based Services - June 2013)
East of England
Service Specification Care Homes & Accommodation Services
1.Introduction
1.1The Services shall be those services to be provided by the Provider, as set out below, and performed in accordance with the Contract (the ‘Services’).
2.General Requirements (of regulated providers)
2.1In providing the Services the Provider is required to be registered with the Care Quality Commission (CQC) and to maintain that registration throughout the Contract Period. All Providers must meet the ‘Essential Standards of Quality and Safety’ as set out in the Health & Social Care Act 2008 (Regulated Activities) Regulations 2009 and the Care Quality Commission (Registration) Regulations 2009. Each Service Provider must be registered with the Care Quality Commission (CQC) and will be inspected as required by the CQC.
2.3In addition to meeting the requirements of the Essential Standards of Quality and Safety as set out above, the Provider is required to meet the specific Contract Standards, as set out inthe East of England Service Outcomes and Standards of Care, section 12 belowbelow.
2.3Each Provider must ensure that it has the ability to provide the necessary service with sufficient numbers of trained and competent staff necessary to provide care for each Individual. The Service Provider must ensure that each person responsible for the delivery of care is fully aware of the requirements of the Contract Standards as well as the Essential Standards of Quality and Safety and be able to demonstrate a commitment to maintaining and delivering high quality Services for adults with a variety of needs and/or conditions and provide a service where all aspects of a person's care are met.
2.4The Provider will provide services that meet the needs of the Individual and are provided by competent staff in a way that supports the safety and security of the Individual. The services shall be responsive, reliable and maintain a persons dignity and respect at all times. The Services shall be accessible and delivered with understanding and without discrimination.
2.5Where possible services mustalways be provided in a way that enables the Individual to maximise their independence, health and wellbeing and supports their social, spiritual, emotional and healthcare needs.
2.6TheServices should also achieve the outcomes for Individuals in accordance with the White Paper, ‘Our Health, Our Care, Our Say’, namely:
- Exercising Choice and Control
- Improved Health and Emotional Well-being
- Personal Dignity and Respect
- Quality of Life
- Freedom from Discrimination and Harassment
- Making a Positive Contribution
- Economic Well-being
2.7The Provider ensures that its Staff have regard for the Individuals equality and diversity and upholdspeoples human rights (in line with the guidance outlined in the Equality and Human Rights Commission inquiry) and does not discriminateagainst people for any reason. Its policies will incorporate respect for both Staff and Individuals.
2.8The Provider ensures that all staff support in an enabling way that allows Individuals to increase or maintain their level of independence, develops self caring and moves to a reduction in support, where appropriate.
2.9 The Providers practice, culture and values mirror the objectives set out in the Dignity Campaign 2006 updated in Jan 2012 – Appendices 6.
3. The Service: Residential Care
3.1 The Services provided in the Care Home should include a single room
(unless Individuals wish to share), toilet and bathing facilities, full
board, personal care, staffing on a 24 hour basis, and day time and
evening social activities. Exceptions can be made where recorded on
the Individual’s Care Plan as prepared or agreed by the service
user’s Care Manager and the Individual or their representative.
3.2 As well as personal care tasks, Providers should make it a clear and
expected aspect of the work of their Staff that part of their role is for
Staff to spend time talking to, relating with, and understanding the lives
of Individuals and supporting them with appropriate activities.
3.3 The Care Home shall arrange and pay for (unless paid for by the local
Clinical Commissioning Group) any health equipment and materials, for
example, to relieve pressure, aid continence, ensure safe handling or to
provide bariatric care) required by Individuals and work in ccordance
with the Eastern Region Guidance for the Provision of Community
Equipment in Care Homes -Appendices 10.
3.4 To involve Individuals in all decisions which affect the delivery of services including support planning,addressing their specific communication needs and bein responsive to their informed choices and wishes.
3.5 To work in an integrated way with Health and the Third Sector organisations to meet Individuals needs in the most effective and efficient way possible.
3A Specific Service Provision
3A.1 Dementia
The provider will ensure that all care staff receive dementia training in line
with the Alzheimers Home for Home Report.
3A.2 End of Life
3A.2.1.EachProvider must ensure that it has current policy and proceedures in place for End of Life Care and be able to demonstate staff compliance.
3A 2.2 The Council expects that all Providers adhere to NICE standards (National Institute of Clinical Excellence) for end of life care for adults and be able to evidence Individual outcomes against the End of Life Care Quality Markers and Measures (Dept of Health 2009) using the End of Life Quality Assessment tool (ELCQuA).
3A2.3In line with best practice the Council expects the provider to adhere to
the principles of the Gold Standards Framework.
4.Volume of Service
4.1The Provider will provide places for Individualreferrals as agreed from time to time and as set out in the Individualservice contract.
5.Accessing the Service & Assessments
5.1The Council has a statutory responsibility, within its eligibility criteria, to ensure the provision of certain statutory services in order to meet Individual assessed needs.
5.2The needs of each Individual will be identified through an assessment completed by a Care Manager from the Council . If the Individual is eligible for the Services, the Care Manager will produce a personalised and outcome focused Care Plan and a Risk Assessment, with input from the Individual and / or their representative, to identify how their needs will be met and the outcomes to be achieved.
5.3The Brokerage team shall have authority to refer Individuals to the Services on behalf of the Council.
5.4The Provider shall nominate those persons with authority to accept referrals and shall inform the Authorised Officer of their names, addresses and telephone numbers from time to time.
5.5Referrals may be made by telephone or in writing. The Referral and the agreed start date shall be confirmed in writing within 5 Businessdays of the Referral being made by email, by post or facsimile transmission. A copy of the Care & Support Plan and Risk Assessment will also be sent to the Provider.
5.6 The Provider is expected to completed their own pre assessment within 48 hours of the Individual moving into the home.
5.7 The Provider is expected to develop a support plan with the Service User with personalised outcomes/aims and clear objectives.
5.8 The Council expects that moving forward more Individuals will purchase services using a Personal Budget or Individual Service Fund and the Provider will be responsive to the changes.
5.9 The Contract will allow for the provision of an Individual Service Fund (ISF) wherby a Personal budget will be allocated to an Individual and held by the Provider on the basis that it will be spent according to the Individuals approved Care and Support Plan or Care Programme Approach (CPA) that are relevant for this service.
5.1.1The Provider shall provide the Services for the named Individual from the start date, until the Services are cancelled, suspended or varied in accordance with the Contract.
5.1.2The Individuals assessed needs and risk assessment will determine if a trial period is appropriate. This will be agreed at the time of referral and will not exceed 28 days unless the parties agree otherwise in writing.
5.1.3 In circumstances where an Individual requires emergency medical attention the Council expects the home to ensure the individuals safety is paramount. Where an individual requires transferring to hospital the Provider must assess if a staff escort is required and at the point they reach hospital if it is safe to leave the individual. It is expected that any judgement would be based on an individual risk assessment.
5.1.4 In cases of emergency treatment and/or medical intervention the Home is expected to contact the next of kin and any Individual holding power of attorney; in accordance with prior arrangements made with the family, to provide a summary of treatment and needs.
5.1.5 In circumstances where the Individual is discharged from hospital the Council expects the home to be able to facilitate the return of the resident up to 7pm daily seven days a week.In the case of new admissions this should be no later than 4pm seven days a week,unless agreed otherwise by the home and hospital.
6.Care & Support Reviews / Changes in Service
6.1The Provider must inform the Council of the need to review the Care and Support Plan if there is a material change in the Individual's needs, or in the way that a Individual would prefer to have their Services provided.
6.2A care management review will be held as often as the Care Manager considers necessary, or as requested by the Individual and / or their representative, or by the Service Provider but at least annually.
6.3The care management review will involve the Individual and/or their representative, the Care Manager or their representative, and where appropriate, the Provider or designated representative. Consideration will be given to ensure convenience and adequate notice for all participants wherever possible.
6.4The care management review will consider the extent to which the outcomes set out in the Care and Support Plan are being met and will identify future objectives.
6.5The Individual’s service contract will be amended as appropriate following the review.
7.Temporary suspension of Individual places in the Services
7.1In the event of the Individual’s admission to hospital the Provider shall maintain appropriate contact with the Individual, their representative, Contract Finance and relevant Care Management and Assessment officer(s) unless explicitly requested otherwise and in accordance with the timescales set out in 10.1below.
7.2The payment arrangements that apply for temporary suspension of places in the Services are set out in Schedule 4 (Contract Price).
8.Termination of Individual places in the Services
8.1Payment for the Individual Service shall be terminated 3 days after the death of the Individual.
8.2The Council may terminate an Individual place in the Services on giving up to 28 day’s notice to the Provider unless mutually agreed on a case by case basis
8.3The Provider may terminate an Individual place in the Services on giving not less than 28 day’s notice to the appropriate Care Manager and to the Authorised Officer unless mutually agreed on a case by case basis.
8.4At any time during the trial period of occupation of the Home by the Individual (or at any time for a Short Term Individual) the Individual, The Provider, or The Council, shall have the right to terminate the occupation by the Individual by giving 7 day’s notice in writing. Notice by the Individual should be given to both The Provider and The Council. Notice by The Provider shall be given to both The Council and the Individual. Notice by The Council shall be given to both The Provider and the Individual. In the event of an emergency a Individual may terminate his/her occupation without notice.
9How and what we will monitor
9.1The Council is responsible for monitoring the quality of the Service provided and for reviewing the Individual needs of Individuals.
9.2As part of this Contract the Council will periodically monitor the Service delivery to ensure compliance with the Contract Standards, The East of England Service Outcomes and Standards of Care, its Terms and Conditions as well as the Contract Schedules, and to assess the quality and performance of the service being delivered to Individuals in relation to meeting their outcomes.
9.3To do this the Council will use a variety of methods. Assessment will include (but not be limited to) the following:
- By feedback from Individuals and/or their carers on the standards of Services being provided;
- By feedback from Council officers reviewing whether or not the Service is meeting the Individual's assessed needs and meeting their outcomes in the best possible way;
- By systematic monitoring of the Service Provider by the Council, in order to evaluate and record the Service delivered against the Specification;
- By consulting with Individuals and/or their representatives;
- By the investigation of complaints and / or safeguarding instances – Appendices 5 & 9respectively;
- By Provider Performance Monitoring Forms;
- By reviewing written procedures and records for both Individuals and Staff;
- By the Service Provider, submitting to the Council an annual report detailing the outcome of quality assurance processes, including its service improvement plans;
- Through external compliance reports from CQC;
- Through the ADASS monitoring toolkit.
9.4The Provider is required to notify the Council of any CQC inspection and share the draft report at the earliest opportunity.Non compliance will automatically trigger the Councils formal Escalation Policy – Appendices7.
9.5The Council is mindful of the need to apply a proportionate approach in respect to the monitoring of Services
9.6The Council has risk based approach to monitoring Services and this determines the frequency and scope of the visit however the minimum standard is that a full service review will be completed annually.TheProvider will be notified 1 week in advance by email to the Registered Manager.Following the visit the Purchasing & Quality Assurance team will forward a full report of its findings within 10 working days.Any Provider scoring POOR overall will automatically escalate to Provider Performance under the Councils Esclatation Policy.
9.7At the request of the Council, the Provider will return the following additional information on an annual basis;
a)Business Continuity Plan & Emergency Response Plan
b)Accounts for the most recent completed financial year (audited if required by law).
c)Insurance Schedules and Certificates.
d)A Copy of the Provider Compliaince Assessment tool (PCA) or equivelent The Council will examine the PCA or equivellent to identify good practice and areas for improvement.
e)Results of the Provider’s Annual Satisfaction Survey. The Council will use the results to ascertain views on the quality and performance of the service.
f)A copy of the Provider’s annual report including their service improvement plan.
g)A copy of their training matrix for all staff.
h)A copy of the Care Quality Commissions Quality Risk Profile (QRP) for the Provider.
9.8The Service Provider acknowledges and agrees that Officers of the Council may takemay take evidence of risks and concerns identified during contract monitoring visits, including photographs and photocopies,and for this to be used to formulate a plan of action to ensure the Service Provider complies with the Contract.
9.9 The Provider is expected to have its own quality assurance framework and be able to demonstrate how it uses empirical evidence to improve the service and experience of the Individual.
9.9.1 The Provider will at the request of the Council provide a clear and transparent breakdown of the Individualplacement cost and engage constructively with the Council as part of a value for money process.
9.9.2The Provider is required to register with the Skills for Care National Minimum Dataset for Social Care (NMDS-SC) and will:
- Complete an NMDS-SC organisational record and must update all of its organisational data at least once per annum;
- Fully complete Individual NMDS-SC worker records for a minimum of 90% of its total workforce (this includes any staff who are not care-providing). Individual records for workers which are included in the 90% calculation must be both fully completed and updated at least once per annum.
10.Notification to the Council
10.1Without prejudice to its responsibilities under the Health & Social Care Act the Provider will be responsible for notifying Care Management & Assessment team within the Council as soon as it is practical to do so and no later than 3working day’s, if any or the following occur:
(1) Any circumstances where the Individual has consistently refused provision of the service, medication, or medical attention.
(2) Serious accident, serious illness or serious injury to the Individual.
(3) Death of the Individual.
(4) Outbreak of notifiable infectious disease in the Home.
(5) Any emergency situation e.g. fire, flood.
(6) Legacy or bequests to Provider and/or staff.
(7) Unplanned absence of the Individual.
(8) Hospital admission.
(9) An investigation related to Safeguarding of Vulnerable Adults
11.Behavioural Standards and Codes of Practice
The Provider and its staff shall adhere to the relevant codes of conduct for their profession:
The General Social Care Council Codes of conduct available at:
The Nursing Midwifery Council (NMC) codes of conduct available at:
12.The East of England Service Outcomes and Standards of Care:
12.1In addition to meeting all of the above requirementseach Provider is required to meet the specific Contract Standards, as set out in the East of England Service Outcomes and Standards of Care as set out in Schedule 3.