Agenda item

This report presents the Central London Community Healthcare CQC rating and associated action plans.

The Committee received a report on the Care Quality Commission (CQC) comprehensive assessment of Central London Community Healthcare NHS Trust (CLCH) and subsequent action plan. Overall the Trust had been rated as ‘good’. End of Life Care had been rated as ‘Requires Improvement’.

Mr Naylor queried whether the tasks to address the criticism in respect of End of Life Care were achievable and when they would be achieved. Ms Ashforth responded that the tasks were outlined in the action plan, with the months in which they would be achieved. There were some longer terms tasks, such as  education and training throughout the Trust, which would be completed by the end of March 2016. The action plan was on track.

Mr Naylor considered that people wanting to die in their own homes was a questionable assumption. There was some indication that people wanted to be looked after and welcomed the opportunity for hospice care. Professor Sheldon stated that the Trust was commissioned to provide inpatient care only at the Pembridge Palliative Care Centre. The Trust collected data on patient’s preferred place of death. An End of Life Care strategy was being developed.

Dr Anya noted that a Joint Strategic Needs Assessment for End of Life Care was in progress. National evidence indicated that people preferred to die at home. This needed to be explored locally. A joint strategy with commissioners would be developed in the following year. Organisations would be asked to input, and the steering group would include representatives from the voluntary sector, including Age UK.  

Mr Naylor stated that the work done eight years ago had disappeared because of lack of progress.

Councillor Lukey noted that the CCG commissioned beds at St. Vincent’s Care Home, and that there were different options in the provision of End of Life Care.

Councillor Vaughan asked the Trust to expand on where it had failed in End of Life Care and specifically the criticism in respect of nutrition, and how it planned to address these issues.

Professor Sheldon responded that the Pembridge Centre also provided outreach services, out-patient facilities and day care. The process of End of Life Care varied for different patients. The focus was on symptom control and patient comfort. Some of the criticism in respect of nutrition related to the Trust not using the recognised nutrition score. Staff had explained why they did things in a different way, but this had not been accepted by a panel of experts.  A number of points raised by the CQC had been quickly addressed.

Professor Sheldon responded to a query that the Pembridge Centre had 13 beds and provided offender health and district nursing services.

The CQC had raised key issues in respect of: risk assessment; community health services for children, younger people and families; and the patient record system. At the time of the visit, there was a high vacancy rate and use of agency staff. The vacancy rate had subsequently been reduced and work was ongoing to reduce further.

The patient record system used within the Pembridge Palliative Care Centre,  ‘Crosscare’, was being reviewed and quality and data would be bench marked with two other palliative care units.

RESOLVED THAT:

1.    The report be noted.

2.    The PAC congratulated the Trust on its ‘good’ rating and staff on their hard work.

3.    It was noted that there were concerns around End of Life Care and that much of the action plan had been quickly implemented.

4.    CLCH would be invited to a future meeting to update on the action plan.

5.    End of Life Care, in a broader sense would be added to the work programme.

6.    It was recommended that Age UK and other voluntary groups be consulted on the End of Life JSNA.

Councillor Vaughan thanked CLCH for attending the meeting.