Decision details

Gill Brown, Chief Executive of Healthwatch Lancashire provided the Committee with a detailed presentation on the evolution of Healthwatch, its responsibilities and strategy, and examples of current and planned work. A copy of her presentation is appended to these minutes.

There was a lengthy discussion about the work of Healthwatch and in particular the pressures facing the care home sector. It was considered important that the sector be offered support and solutions for the difficulties it was facing and to improve services. It was believed that there was potential for the current crisis in the care sector to destabilise the NHS and it was suggested that this might be an important topic to come before this Committee.

Regarding  a specific question about whether the conditions for staff were inspected as part of the 'enter and view' project, it was explained that much depended on what staff were prepared to say and that sometimes they were inhibited by the presence of the care home manager. It was explained that Healthwatch did not just look for things going wrong but also at good practice which would be shared with others.

It was recognised that there were many dedicated care staff working in the care sector and it was suggested that sometimes, where homes were falling short of required standards, it was the care home owners, looking to save money, who were responsible for poor standards. It was considered most important not to shy away from robust questioning to understand what was really happening.

There was concern that often CQC (Care Quality Commission) recommendations and follow-up visits did not lead to sufficient positive changes and too many care homes were in need of improvement or, in some cases, inadequate. The point was made that many care home residents suffered from dementia and were not able to express themselves, and there was also sometimes a fear of intimidation in speaking out. It was therefore important to ensure CQC recommendations were carried out robustly.

The Committee was informed that Healthwatch had met with the CQC inspection team and fed back concerns following their visits and they also referred concerns to commissioners to ensure the home was 'on their radar'. It was emphasised that the 'enter and view' team were very well trained and this included dementia training.

There was concern about where residents could go if the home in which they were staying closed down particularly given the pressure on the NHS and the lack of available beds. It was agreed that this was an important question and there was a serious need for action to address this.

It was suggested that the issues around care services needed to be considered in a holistic way not just care homes, for example district councils should be involved because of their role in housing provision, and studies had shown that remote support via technology in people's homes had significantly reduced the number of GP callouts to those people. It was agreed that there was an opportunity for Lancashire to be innovative in how these issues were approached.

It was suggested that it would be interesting to know what all partners were doing with regard the 'Ageing Well' agenda, for example West Lancashire Borough Council was focussing on loneliness, isolation and dementia.

It was reported that the Health Scrutiny Committee Steering Group was to host a meeting with Registered Care Managers Network, originally intended to discuss falls in care homes, but the meeting would provide an opportunity to consider other issues and to develop a relationship which would help to elicit their most serious challenges.

Gill Brown encouraged the members to raise issues of concern with Healthwatch either as a Committee or on an individual basis.

Gill explained that the 'enter and view' team were currently employed on fixed term contracts until the end of March, as part of a pilot scheme, and she was hopeful that the county council would continue to provide its support, though she recognised that there were some difficult budget decisions to be taken.

Resolved: That the report be noted.