KICA
Domiciliary Care Sub-Group
17th January 2017
Ashford Business Point 2 pm- 4pm
Top of Form
Chair: Janice Drain
Chair: Janice Drain
Attendees: See attached list
No apologies
ITEM / ACTIONS1.
Introductions /
Everyone introduced themselves
Janice welcomed everyone and explained the purpose of the group meeting which was to give more involvement to the membership in order to help the board direct its resources.
2.
Aims and objectives / Recruitment – Britt explained she has a Workforce Development meeting
next week which she will feed back
-Heath & Social Care Guild have 3 monthly meetings and they are talking about 16 – 18 year olds but agree they may be too difficult to recruit e.g. insurance, drivers, double-handers, safety, lone working, challenging behaviour, commitment, understanding, culture
-Some think there seems to be young people and older people to recruit but much more difficult for those in between
-All agreed there is no status for home care workers e.g. ‘I am just a carer!’, there is an outdated system
-Suggestions to lift status were work placements at hospitals, especially as Nurses are not ‘hands on’, they could then be called ‘nursing assistants’, ‘assistant practitioners’, ‘nurse associate’
-Senior staff could be trained integration with OT/health worker
-What would this mean for insurance, CQC
-There is a different risk profile for nurses and social workers
-Although we have been trying to raise the profile for year KICA must continue to do this
-The Media students at North Kent College are putting together a video on Social Care to encourage people to work their way up to top jobs
-Janice has information from schools & colleges who want a volunteer/ambassador to go along and speak to them about Social care
-Social care is not comparable to other low skilled/paid jobs e.g. Call Centre Worker V Care Worker. Social Care asks so much e.g. full Induction, Care Certificate, Mandatory training, regularly adding to skills, flexible hours, travel
-We need to work on Career pathways / If interested place ask Janice for information
3.
Registration of Care Workers
- Ann Taylor / This work is not new, Kent have been supporting this for many years
AT explained that KiCA are involved with the United Kingdom Home-Care Association (UKHCA) on developing a register and Kent may become the ‘Pilot’ site
Scotland and Ireland already have registration
The Register will be voluntary but will be a ‘Kite Mark’ and would have an entry system.
Staff would have to have the Care Certificate; they would have access to a help line. This will not be a ‘Union’; it will be all about development.
At present there are lots of issues but they are working towards the Ireland model.
AT confirms they will also be looking at what they will call care workers
KiCA will be a lobbying group, which they hope will give them a greater voice / Ann Taylor would like to know member’s views on the proposed Register – please contact her on
4.
Kent Home Care Contract / There has been an email passed on to all domiciliary care providers from KCC who are trying to find someone to sit on the contracting group of the Design Phase – they have decided they need someone from the home-care sector! There were discussions held at the last contract and how it was awarded, how it was run, the mistakes made and how it affected the CQC Inspections
It was felt that KCCA did not challenge at an earlier stage – KiCA need to learn from this
Integration of Health & Social Care – KCC will probably be looking at placing the contract with a large provider e.g. Virgin Healthcare who will then sub-contract
AT gave an example of the advantages of the integration between KCCA & KHCA / If any member would like to comment on this please contact the KiCA Board
5.
Integration of Health & Social Care / Everyone needs to have an understanding of what this actually means.
We may need an upskilling of our staff – what would CQC make of this?
A suggestion was made that KiCA could produce a generic paper on this e.g. you can only do so much under the remit of ‘personal care’ – insulin?
The big question is who is going to pay?
Needs a Business Model built with CQC -
-Who takes responsibility
-Training
-Clinical oversight
-Issues with registration
-Insurance – medical malpractice, will the insurers actually pay out, what about the evidence?
6.
NMW & Travel Time / A member had a random visit from HMRC – the group agreed that this could be a separate Forum/sub-group meeting just to get/share information with members
They specifically asked about ‘live-in’ packages – this will inflate the cost of these packages
Janice gave an example of an audit they made and the information on Timesheets
HMRC – any payments providers make will be for travel costs, number of hours worked and pay at the lowest rate the provider pays (examples were given)
All agreed providers need to be aware, the biggest problem is to make care ‘affordable’
Deborah gave an example from the newspaper where ex-pats were being flown in to work in social care, stayed for a couple of weeks, paid then flown back – because this was seen as a ‘Recruitment Agency’, the staff were seen as ‘self-employed’, there was no training and no CQC! / Agenda Items for AGM
7.
Rates for membership / This is usually done by the Board – however it would be good to have feedback from providers / Feedback required
8.
CQC / KiCA have a joint meeting with CQC and KCC on 31st January 2017, this will be a 3 hour meeting, KiCA have 1 hour with CQC then 2 hours with KCC & CQC.
Questions from the group-
-Have they met their Inspection targets?
-Is there a pressure of not having enough Inspectors
-One provider felt they were only inspecting to ‘Good’ and weren’t interested in anything higher
-Feedback from Inspectors is rushed, not enough time e.g. they were there from 9.30am to 5.30pm but the provider felt they needed more time, and another provider said the Inspector was only there from 9am to 2pm!
-Inspections are inconsistent – providers had examples
-Medication is still a big issue
-Some felt the Inspectors came just to inspect negatives
-CQC have targeted contracted providers
-Some Inspectors have preconceived ideas
-One provider had checked the statistic for Kent and any ‘outstanding’ were all private providers that only offered 1 or 2 hour calls
-When the inspector says they have received negative reports from service users the provider is not given the details so they can be addressed, and they can’t challenge
-The name of the Inspector is not on the Reports – can they say why
-Some providers have found that factual inaccuracies cannot be challenged
-What about the extra jobs care workers do e.g. run dog around the garden – why aren’t they recognized
-There was an example of an Inspector who actually told the provider they wouldn’t get an ‘Outstanding’ because of the type of work they do e.g. Lone working
-The meeting with CQC will not be giving names
-The length of the actual inspection e.g. some are one day, some are two and some are three
-What training do the Inspectors have and how
-Some providers were extremely upset at the timing of the inspections e.g. just before Christmas when providers are so busy and do not have extra staff
-Medication is a big issue
Ann Taylor will be presenting to NHS England on Monday afternoon, they will be visiting Kent to help KiCA make the ‘Medication Challenge’. The group was told that AT urgently needed medication examples/case studies. They will then have 365 days to find a solution to the problems. This is only for Community Care.
One member pointed out that care workers are only normally there for 30 minutes. Medication is not in the KCC contract.
Care Workers are expected by CQC to know all the side effects for each person but there is no medication guidance from CQC.
There are also problems with pharmacies.
The embers were asked to send any feedback to KiCA by email. The Medication Challenge Power Pont will be sent to the members.
A discussion was held about PRN medication and MCA clients.
All agreed there should be National Guidance regarding Medication for Community Care
An example of what was required on the Care Plan/Risk Assessment by CQC for a toileting call was 4 pages!!
Most of the group agreed that inspection information required can be unreasonable; you cannot deliver outcome based care with such prescriptive Care Plans. / Medication issues/examples/feedback from home-care providers needed by email as soon as possible
9.
Safeguarding / Janice – The Kent Safeguarding Board say that 2/3 of referrals are not needed. Unfortunately providers feel lots of pressure from CQC to make referrals.
It seems that many KCC Care Managers want an AP1 even if there has been no harm done – lots of these are not ‘real’ safeguarding matters.
Debra Angus is the KCC Head of Safeguarding and would like to come and talk to the KiCA Board to explain. It was agreed that this would be a suitable item for the KiCA Conference in May.
There could also be a Workshop where providers could take examples for discussion and ask KCC how they would deal with them, they do need to target their own Care Managers. / Further discussion and agreement
Care Homes need to be included
10.
Innovation Fund / Skills for Care have an Innovation Fund of £30,000.00 based around recruitment and the integration of Health & Social Care
KiCA will have the opportunity for some members to agree to take this forward
Karen Stevens gave the name of a training provider who will work on this with KiCA, and there can be more than one care provider
The idea is that KiCA work with KCC on this – maybe on integrated care – then pilot the idea. It has to be outcome based
It would have to be in conjunction with CQC & legislation / More details to be sent to providers
11.
Any Other Business / The Kent Care Awards have 4 finalists in the National Great British Care Awards – everyone felt this was an amazing achievement especially for the first year
This year there must be a concerted effort to raise the profile of these Awards, the group were asked to be involved
The information will be given out at the KiCA Conference in May. The Awards will probably be held in Ashford or Maidstone.
These Awards are for all KiCA Members and other Kent providers, it is hoped that they will all be involved / The Kent Care Awards
Next meeting
February TBA
5 pages
KICA
Domiciliary Care Sub-Group
17th January 2017
Ashford Business Point 2 pm- 4pm
ATTENDEES
NAME / COMPANY / EMAIL / TELEPHONEChair
Janice Drain / Nurse Plus /
Nina Allen / Austen Allen Homecare / / 01322 424558
Ann Taylor / Beech Tree Total Care
Paul Knight
Kellie Knight / Home Service Complete Care / / 01227 362312
Britt Grutzmacher / TLC / / 01227 772515
Noreen Ing / ACL / noreen@aclcarehomes.
Deborah McDowell / CAHSE
Angela Johnson / Avante / / 01795 597400
Mary Harvey
Dawn James / Nurse Plus
Nurse Plus /
/ 01233 633350
Wendy Ryan / Birchwood Care Services / / 01892 863710
Ann Davidson / KiCA admin support /
/ 07834239344