Agenda item

(To receive an update on actions and recommendations identified in two recent internal audit reports from Adult Social Care)

The Committee received an update on actions and recommendations identified in two recent internal audit reports which were on Assessment of Needs in Adult Care and the Quality of Workforce Learning and Development.

Representatives from Adult Social Care were in attendance to provide verbal updates to the Committee on progress since the findings of the audit were reported to the meeting of the Audit Committee in March 2018.

It was reported that the outcomes of the Carers Workforce Development Audit was reported to the meeting of the Audit Committee held in March 2018.  It was noted that there was no officer present to address the Committee at that meeting as the lead officer had recently left the authority, therefore it was agreed that an officer would instead attend a meeting in 6 months' time to update on progress since the audit had taken place.

Members were advised that this was an interim update on actions undertaken by the two providers of the Lincolnshire Carers' Service, following the audit of workforce learning and development in January 2018.  It was reported that the Lincolnshire Carers' Service was commissioned to carry out the delegated statutory function of the Carer's Assessment (Care Act 2014) of adult carers for Lincolnshire County Council.  In 2017/18 the service assessment the needs of 2,367 carers.  CSC Serco provided the 'front door' into the service and offered a telephone based service.  Carer's FIRST provided all aspects of face to face support in the community.

The audit focused on the internal quality assurance framework of Carers FIRST and Serco, particularly in relation to carers' assessment.  It looked for evidence of quality assurance in practice, in terms of one to one staff supervision and workforce development.

It was reported that Carers FIRST and Serco Customer Service Centre had both taken immediate steps to comply with recommendations.  Revised contracts had been signed off with both providers to employ additional staff, which would lead to the implementation of the required quality assurance checks.  Members were advised that this was an interim update and the expected resolution date for actions was early autumn 2018.

In terms of the actions being taken to fulfil the Audit recommendations, it was noted that both providers now had a comprehensive workforce development planned for staff, including mandatory elements commissioned/provided in part by the Council (i.e. safeguarding training).  Each provider was either uploading or aimed to upload course certificates onto its database to evidence full resolution.  Members were also advised that Carers FIRST had drafted an internal Quality Assurance Framework Action Plan which included evidence based monitoring across supervision, quality assurance of assessment and observation of practice.  It was also noted that toolkits to quality assure assessments, supervisions and practice observation were currently being trialled by staff.  Finally, members were informed that Serco had a Quality Management System in place and the contact centre carried out monthly call evaluations for each service area, which informed monthly 'one to ones' between staff and team leader.

In conclusion, it was reported that both providers of the Lincolnshire Carers Service were making good progress towards fulfilling the audit recommendations, which then in turn supported the Council's Quality Assurance Framework and Care Act compliance.

Members were provided with the opportunity to ask questions to the officers present in relation to the information contained within the update and some of the points raised during discussion included the following:

·         Attendance sheets were now being retained by both providers, and generation of certificates was now included as part of the training.

·         Officers were confident that a higher level of assurance would be achieved following re-inspection.

·         There was confidence that the changes stated had taken place in Serco as some of these changes had been witnessed by officers from adult social care.

·         It was requested whether in future officers presenting updates on audits could provide a written report.  It was queried whether the updates could set out what the findings of the audit were and what actions had taken place since.

·         Officers were confident that there would be no impact on service users, and it was just that the training that was carried out was now able to be evidenced.

Derek Ward, Director of Public Health was in attendance to provide an update to the Committee on progress since the Assessment of Needs Adult Care audit took place in March 2017.

It was reported that five recommendations were produced as a result of the audit as listed below, and progress against each one was reported:

1.    Adult Care to consider regular monitoring and reporting on checks of the effectiveness of support arrangements within one to two weeks.  Adult Care to consider regular monitoring and reporting on planned light touch reviews within six to eight weeks.

2.    Adult Care to consider regular monitoring and reporting on planned every 12 month reviews.

3.    Adult Care should review whether the currently used 'target start date' is the most appropriate date for measuring whether the assessments have been completed within 28 days performance indicator.  The start date used for assessment completed within 28 days performance indicators should be made clear to the readers of Adult Care Performance Reports.  Adult Care should ensure that the Principal Practitioners could easily access and identify the start date used for assessments completed within the 28 days performance indicator.

4.    With the introduction of Mosaic, management should review the accuracy and adequacy of the 28 days performance monitoring confirming:

Ø  The anomalies are now longer present

Ø  Mosaic includes appropriate data input validation checks

Ø  Users cannot overwrite key dates

5.    Adult Care should ensure that all people are captured in the Information and System Team's Mosaic training records.

Members were provided with the opportunity to ask questions to the officers present in relation to the information contained within the report and update and some of the points raised during discussion included the following:

·         In relation to recommendation two, it was queried whether there was confidence that 100% of customers would have had their annual review when internal audit revisited the service.  Members were advised that there were a number of circumstances which could affect a person having a review such as a change to their care package, and also people may die within the year.  It was noted that currently between 86-87% people were receiving their annual review.  Members were informed that this was now being documented on Mosaic.

·         It was noted that Safeguarding Adults had received limited assurance, and it was queried whether there were plans for the audit team to return and if so was it expected that the audit status would be upgraded.  It was confirmed that the Audit Team would be returning to carry out a follow up visit, and that an audit of the mosaic system was also being carried out, although there were some disagreements regarding what the risks were.  Assurance had been gained that actions were being taken and that controls had been designed in for the switch from AIS to Mosaic.

·         It was noted that error and warning reports would be examined for data completion and accuracy, as well as people processes as well.

·         It was noted that there would always be a need for free text notes within the system.  However, where text could be constrained through drop down boxes and it made sense to do so, this would be done.  It was highlighted that once dates were inputted, they could not be changed.

·         It was commented that becoming more reliant on IT would reduce the   problems of transferring information into new systems.  Mosaic was ahead of where the council infrastructure was.

RESOLVED

            That the Committee note the update on actions arising from the two audit reports.