Overview and Scrutiny Committee
14 May 2015
The Dulwich Care Centre (DCC)
Wards: Service based in Knights Hill
Report Authorised by: Helen Charlesworth May, Strategic Director of Commissioning
Contact for enquiries:
[email protected]
Jennifer Burgess, Integrated Commissioning Manager, 020 3049 4336/07771 344372
Report summary
Representatives of the Dulwich Care Centre have been invited to the Overview and Scrutiny
Committee (OSC) on 14 May 2015 to discuss the findings of the January 2015 Care Quality
Commission (CQC) inspection report.
The DCC is a care home based in Knights Hill Ward and is registered to provide care for older
adults with physical needs and for people with dementia. In November 2014 CQC and Lambeth
Care Management and Contract management made independent unannounced visits to the
DCC. Lambeth Care Management and Contract Management in response to a safeguarding,
and complaints received from Lambeth Healthwatch.
CQC formal report published in January 2015 gave an overall rating for the DCC of
‘inadequate’.
DCC had previously been embargoed by London Borough of Lambeth in 2013. The embargo
was lifted in May 2014.
An embargo on the service means London Borough of Lambeth places an official ban on trade
or other commercial activity with the service, and informs other boroughs using the service of
the embargo. In this case no placements were made at the DCC by Lambeth Council and all
other placing authorities were informed.
Finance summary
This report provides context for the discussion at OSC meeting and has no financial
implications.
Recommendations
Overview and Scrutiny Committtee to review the service with the Dulwich Care Centre interim
management team in attendance at 14 May 2015 meeting.
1.
Context
1.1
The Dulwich Care Centre (DCC) is registered to provide care for older adults with
physical needs and for people with dementia. The DCC can accommodate up to 92
people, split across four floors:
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Lower ground floor – residential care
Ground floor – general nursing care
First floor – provides nursing care for people with dementia
Second floor – provides residential care for people with dementia
At 22 April 2015 there were 58 residents:
1.2
Placing authority
Number of residents
Lambeth
18
Southwark
18
Wandsworth
2
Sutton
2
Brent
1
Croydon
1
Westminster
1
Dorset
1
Hertfordshire
1
Self funders
10
NHS funded continuing care
3
Total
58
Background
The DCC was embargoed in 2013 and the (former) Health and Adult Services Scrutiny
Sub Committee met with the DCC several times to review CQC inspection reports.
Councillors also visited the home. In January 2014 the Health OSC was satisfied that
the required improvements were being made at the DCC. The embargo was lifted in
May 2014 with the proviso that any future concerns in relation to care and management
should be reported.
Lambeth Council have not made any placements at the DCC since the embargo was
lifted in May 2014.
1.3
Current embargo
In November 2014 both CQC and Lambeth Care Management/Contract Management
made independent unannounced visits to the DCC.
CQC inspection reported an overall rating for the DCC as ‘inadequate’, specifically:

Safety of service – inadequate

Effectiveness of service – requires improvement

Care provided by service – requires improvement

Responsiveness of service – inadequate

Leadership of service – requires improvement
An embargo was placed on the service in December 2014 and other boroughs who had
placed at the DCC were informed and requested to assess their clients.
No placing authority or relative have requested a resident be moved from the facility.
1.4
Actions December 2014 – January 2015

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1.5
Lambeth Council assessed their clients, including self funders
All other placing boroughs assessed their clients, including self funders
Care Home Support Team assessed those clients in receipt of a continuing
healthcare package
The South London and Maudsley (SLaM) Specialist Mental Health Intervention
Team (SMIT) visited the home to reviewed a resident with dementia exhibiting
challenging behaviour and observed staff care of people with dementia
Medicines management team reviewed recording and administration of drugs
Initiated performance management meetings between Lambeth
Commissioning/Adult Social Care (ASC) and interim management team at the
DCC with ‘live’ action/improvement plan based on CQC report and ongoing
investigations
Weekly update on action plan provided to Lambeth Commissioning/ASC
Initiate Lambeth Healthwatch inclusion in meetings with relatives, and support to
recruitment of activities coordinators
No placing authority or relative requested a resident be moved from the facility.
Actions ongoing
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Monthly performance management meetings with Lambeth Commissioning/Adult
Social Care and the DCC interim management team, there is a detailed
improvement plan in place which is reviewed each meeting
DCC have put a number of new measures and policies in place to address the
failings outlined in the CQC inspection report and Lambeth Officers have been
provided with the detailed evidence of the measures and policies, and the impact
of these interventions continue to be monitored
Lambeth ASC safeguarding meeting arranged with all relevant boroughs and the
DCC interim management team to review and complete all safeguardings raised
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1.6
Regular reporting to Cabinet Member for Adult Social Care Councillor Meldrum
Lambeth Commissioning/ASC and Healthwatch attendance at meetings between
relatives and the DCC interim management team
The DCC will remain embargoed until the end of June 2015 when performance
management will be reviewed together with CQC reporting. This will determine
the need for continued performance management in Quarter 2, July – September
2015.
The DCC has taken a decision to no longer provide a specialist dementia service
within the facility. As a result, those clients capapable of being cared for within
DCC have been moved to other floors. Those who require dementia specialist
care will be placed in other establishments more suited to their needs. This will
affect three non-Lambeth residents only, and placing boroughs are currently
working with the DCC to facilitate moves to more appropriate care homes.
CQC
CQC made an unannounced inspection at the DCC on 11 February 2015. A formal
report of this visit has not been published, however a draft report has been viewed
indicating improvement across all domains. Further unannounced inspections will occur.
1.7
Lambeth Council
At the initial meeting with the DCC director and regional director on 22 December 2014,
ACS and Commissioning challenged the provider about specific performance issued
raised by CQC, and those found in safeguarding alerts. Requests were made to the
DCC director to provide evidence to support claims at the meeting of how the service
was addressing issues. Concern was expressed that an embargo of the service had
only been lifted earlier in the year.
The DCC director resigned at the end of December 2014, and subsequent monthly
meetings with the interim management team have progressed a comprehensive plan of
action to address all themes found by CQC, safeguarding and Lambeth Healthwatch.
The DCC interim management team have been open and transparent in their approach,
acknowledging all the deficits in service.
The DCC interim management team have been open and transparent with relatives
about the deficits in service, and are regularly meeting and communicating about the
changes being made to the service.
1.8 This is not a Procurement Report.
2.
Proposal and Reasons
2.1
This is a background report for OSC review of service only and there are no proposals or
options for consideration.
3.
Finance
3.1
Not applicable.
4.
Legal and Democracy
4.1
The recommendations in this report support the principles of safeguarding vulnerable
adults in accordance with LB Lambeth’s statutory duties most notably contained within
the Care Act 2014.
5
Consultation and co-production
5.1
Lambeth Healthwatch have been systemtically included in all resident and relatives
meetings and have provided feedback to the DCC interim management team.
5.2
Resident and relatives meetings have been held in January and March/April respectively
by the interim management team for all four suites within the DCC. The meetings have
had representation from Lambeth Commissioning/ASC and Lambeth Healthwatch.
5.3
Lambeth Healthwatch are participating in the recruitment of activities coordinators for the
DCC.
6
Risk management
6.1
Continued performance management of the DCC to ensure safety of residents at the
DCC and until sustained improvement in service is demonstrated.
7
Equalities impact assessment
7.1
No EIA has been completed for this report.
8
Community safety
8.1
There are no community safety concerns pertaining to the Crime & Disorder Act 1998,
Section 17).
9
Organisational implications
9.1
Environmental
None.
9.2
Staffing and accommodation
None.
9.3
Procurement
None.
9.4
Health
Ongoing performance management of the DCC supports the principles of safeguarding
vulnerable adults and ensuring the health and wellbeing of all residents at the centre.
10
Timetable for implementation
10.1
The DCC will remain embargoed until the end of June 2015 when performance
management will be reviewed together with CQC reporting. This will determine the need
for continued performance management in Quarter 2, July – September 2015.
Audit trail
Consultation
Name/Position
Helen Charlesworth-May
Finance
Legal Services
Democratic Services
Councillor
Councillor
Internal Officer Board
Procurement Board
External
Lambeth
cluster/division or
partner
Strategic Director
Business Partnering
Enabling: Integrated
Support
Enabling: Corporate
Affairs
Cabinet Member:
Ward Councillor
Date of meeting
Not applicable
Report history
Original discussion with Cabinet Member
Report deadline
Date final report sent
Report no.
Part II Exempt from Disclosure/confidential
accompanying report?
Key decision report
Date first appeared on forward plan
Key decision reasons
Background information
Appendices
Date Sent
Date
Received
Comments in
para:
30.04.15
27.04.15
27.04.15
01.05.15
30.04.15
30.04.15
None
Section 4
27.04.15
30.04.15
Section 4
N/A
N/A
?
N/A
30.04.2015
13/15-16
No
No
N/A
N/A
None
Care Quality Commission Report January
2015