1. The Role of a Quality and Contracts Officer Toni Bremble

2. The role of a quality monitoring officer in joint commissioning The range of services we monitor The amount of people receiving support from providers that OCC contract with Pre monitoring information that we collect What we look at during a monitoring visit How we listen to clients that are receiving services How we listen to staff who work for these services Any questions

3. Developing & Using Customer Standards in Home Support Quality & Contracts Team Joint Commissioning

4. Background For Older People – 1,900 service users – Avge 10 hours per week – 19,000 hrs per week – 988,000 hrs per annum – Approx £18.7m spend by the council Or – 988,000 hrs per annum – Avge – 30mins per visit – 1.87 million visits per annum

5. Issues Its big business Council is single biggest purchaser in Oxfordshire Increased expectation of service-users Increased media attention on quality of social care However – How do we measure quality? – Who’s view of quality is most important? – What does ‘good’ look like?

6. Traditional Arrangement Contracting for Care – Service Specification – Contract (Terms and Conditions) Monitoring Mainly Based on Outputs Complaints & Safeguarding Report Selective Service-User feedback – 6 face-to-face interviews per provider visit 1,900 service users 6

7. Emerging Challenges (1) Hearsay! – Annual event run since February 2011 – Fronted by LINk and then Healthwatch. – Service users, family & friends, – OCC managers and councillors – Discuss priorities for social care – Feedback from service issues on user experiences – Wanted greater transparency around standards 7

8. Emerging Challenges (2) 'Close to home: What rights older people get when they get care at home‘ (December 2011) The report said that in some cases local authorities were commissioning care visits that were too short to allow the care to be delivered with dignity. 8

9. The Emerging Challenges (3) Hearsay! – 2013 committed to work with service users and providers to develop standards for home care. – 2014 committed to monitor against these standards – 2014 committed to publish the results 9

10. What we wanted to achieve? Improve care standards in Oxfordshire Encourage local ownership of quality, dignity, equality and human rights issues Encourage the co-production of Quality Standards to support this Focus on the Customer and the Provider Embed these in our services & contracts 10

11. Developing the Standards 5 stage process 11 Providers developed and submitted their own Customer Service Standards (Their Offer) Identified common themes. Recirculated to all providers for comment. Brought together service users and providers to review and refine them. Circulation to all 1,900 service users and providers for final comment (330 received) Refined and implemented Standards from 1 st January 2014 Embed in contracts December ’13 This was a challenge for providers

13. How we carried out the survey Developed questionnaire Included reference number Code to identify service user and provider Sent to all service users receiving home support (1,900) 736 responses To help protect user confidentiality we did not report at agency level on providers with less than 10 returns

14. The results Basically home carers - – Are pleasant & treat people with dignity: – Focus on the client – Do what they should and are not rushed – Deliver care to a good standard

15. However They are often late Don't phone to say they will be late Don't ask for feedback about what could be better Need to chat more to the client and their family 75 people asked us to contact them –53 were happy with their care –22 were not happy due to poor quality of care

16. The results RarelySometimesUsuallyAlways 6. When they visit are they pleasant and treat you with dignity and respect? 1.03.021.174.9 5. When they visit you do they focus their attention on you? 2.35.830.661.3 11. Do they help you at a pace that suits you (as opposed to being rushed)? 2.88.633.055.6 PoorAverageVery GoodExcellent 18. Thinking about the answers you have given above, do you think the care provided overall is: 3.718.945.132.3

17. The results RarelySometimesUsuallyAlways 7. Do your care workers arrive on time? 9.420.753.916.1 8. Do your care workers phone you if they are going to be late? 33.523.922.120.6 15. At each visit do they check that you are happy with the support you are given and encourage you to tell us how they can improve? 22.019.028.530.5 14. Do they chat to you about things you are interested in? 6.117.237.639.0

18. ‘ Heat map’ by Question

19. Opportunities - How we can use the information To improve quality of care Recognise good providers To empower service users in their choices To support providers in delivering a better service To dispel myths – e.g. all care is rushed To supplement contract monitoring To promote expansion to other services – Care Homes – Supported Living Services – Personal Assistants

20. Toni Bremble Commissioning & Contracts Officer Toni.bremble@oxfordshire.gov.uk Andrew Colling Quality & Contracts - Service Manager Andrew.colling@oxfordshire.gov.uk 20