This document provides an overview of patient safety and quality improvement initiatives in Lancashire County Council's regulated care portfolio. It discusses national challenges in care access, quality, workforce, demand and funding. At the local level, it outlines Lancashire's vision, partnership working through the ICS, and a quality strategy focused on care home management, relationships, and tools to support the sector. Key metrics on care home ratings are presented, showing a 10% increase in homes rated good or outstanding since the strategy. Themes, improvement workstreams, and feedback on the quality improvement process are also summarized.

1. Lisa Slack Sue Shannon
Head of Service Senior Quality Improvement Practitioner
Patient Safety and Safeguarding
Regulated Care Perspectives
from
Lancashire County Council
25 September 2019

2. Patient Safety & Adult Safeguarding
Portfolio
• Care Navigation
• Contracts Team – Community
• Contracts Team – Residential
• Quality Improvement
• Infection, Prevention & Control
• Provider Failure
• Adult Safeguarding

3. National Picture
National challenges to sustaining good care;
• access
• quality
• workforce
• demand & capacity
• funding & commissioning

4. Lancashire Position
• The County Council Vision & Market Position
Statement.
• Partnership working with the ICS – CCGs,
CQC, Providers & Healthwatch.

5. Lancashire Quality Strategy
• Key priorities:
– Management and leadership in care homes
– Improved relationships
– Systems and tools that support the sector
• Improving CQC ratings, but we can do better
• Since Strategy has been in place we have seen a
10% increase in number of homes rated good and
outstanding in Lancashire.

6. Lancashire Quality Strategy
September 2019
Residential Social
Care
Lancashire North West England
Inadequate 2% 1% 2%
Requires
Improvement
15% 17% 16%
Good 80% 79% 79%
Outstanding 3% 2% 4%
Total Care Homes 409 1825 15050

7. Lancashire Quality Strategy
0
50
100
150
200
250
300
2017/18 2018/19
No. of residents affectedby care home closure
No. of residents affected by care home closure

8. What do we want to achieve?
Increase in numbers of homes rated Good and
Outstanding in Lancashire
We want to do this by:
• Ensuring that there is equitable choice of quality provision across
Lancashire.
• Sharing and learning from good practice to develop a skilled workforce
and culture change.
• Developing excellent working relationships with providers and strong
leadership.
• Working together to deliver person centred care that makes a positive
difference to people, their families and carers.
• Ensuring that people are supported to maintain activity, their wellbeing
and community connections.

9. Lancashire Radar & Quality Performance
Improvement Process
• The intention of the ‘Radar’ group is to
inform decision making and next steps on
how best to support a provider where
concerns are apparent.
• The QPIP Process, is an early intervention,
supportive in nature and partnership based,
with the aim of improving quality for
residents and their families.

10. Feedback from level 2 Quality and
Performance Improvement Planning
I feel that the QPIP process has
really helped my business and it
has helped me focus on the
improvements that needed
applying to my business.
On the whole the QPIP process was a positive
and enabling experience the team were
professional and supportive throughout. The
level of monitoring and feedback was thorough.
Many hours and team
members were
dedicated to the
success of the home
and it was greatly
appreciated.

11. Themes
• Impact of effective and stable Management on quality
• Issues with staff recruitment and retention (including Manager)
• Medication Management
• Staff training compliance
• Poor quality care planning and review process
• Inaccurate recording on supplementary charts e.g. food and
fluid and repositioning
• Lack of evidence of effective risk assessment and
management
• Provider understanding and application of Mental Capacity Act
principles.

12. Quality Improvement
Workstreams
• A range of collaborative care home forums and practice groups
• New Contract monitoring framework
• Implementation of contract and quality monitoring tool
• Committed to proactive monitoring visits
• Co-ordinate workshops and deliver training in key areas such as person
centred care, sepsis, falls prevention, pressure ulcer prevention
• Produce tools and guidance to share best practice and support
improvements – How and when to raise a safeguarding alert, hydration
toolkit
• My Home Life Professional Support Programme for Care Home
Managers
• Develop monitoring of out of area care homes

13. Any Questions
?
If you would like any further information about the
work being undertaken in Lancashire, and to share
ideas, please contact;-
Contractmgmt.care@lancashire.gov.uk