Agenda and minutes

Health Scrutiny Panel
Wednesday, 10th October, 2018 7.30 pm

Venue: Conference Room, Civic Centre, Silver Street, Enfield, EN1 3XA. View directions

Contact: Elaine Huckell 

No. Item




The Chair welcomed all attendees to the first meeting of the Health Scrutiny Panel for the year. He asked everyone to introduce themselves.  


Apologies were received from Councillor Clare De Silva and for lateness from Councillor Cazimoglu.



Members of the Council are invited to identify any disclosable pecuniary, other pecuniary or non-pecuniary interests relevant to items on the agenda.


Councillor Yusuf mentioned that his mother is in an Enfield care home which is currently being investigated.



To receive a presentation from Martin Haines, Inspection Manager, Care Quality Commission – London Region.


Martin Haines, Inspection Manager of the Care Quality Commission (CQC) presented the item on the role of the CQC in ensuring that health and social care services provide people with safe, effective, compassionate, high-quality care.


He highlighted the following:

  • The CQC has responsibility for the registering, monitoring and inspection of care homes. They speak independently and use their legal powers to ensure standards are maintained.
  • It should be noted that, the majority of people are receiving good quality care.
  • A ‘Mums’ test is used for people to consider whether the service being provided is ‘good enough for my Mum’.
  • There are 170 Adult social care centres registered in Enfield.
  • The CQC gives guidance and sets out clear expectations of what is expected. Work is carried out prior to inspections undertaken, a report will always be prepared giving details of the inspections and findings will be set out.
  • Ratings are provided by the CQC for the services and success is celebrated. They work in partnership with the local authority to tackle failure and steer services by providing guidance.
  • They influence debate by giving their input, for example into Government Green papers.
  • The model of regulation used by the CQC includes registration of care providers.  All care homes must have a registered manager who is registered with the CQC, he/she have legal responsibilities and must meet set standards.
  • Where CQC inspectors find instances of poor care, they ask providers to improve and can use their enforcement powers if necessary.
  • The overall ratings that can be given are:- Outstanding, Good, Requires Improvement or Inadequate.  
  • Thematic reviews are also undertaken by the CQC this currently includes dementia care and nutrition.
  • There are no ‘outstanding’ rated services in Enfield.  It was noted however, that there are less than 2% of care homes rated as outstanding in England.
  • The CQC has enforcement powers, which need to be justified and used appropriately.  When a service is rated as ‘inadequate’ it is placed in special measures and a further inspection is undertaken within six months.  Both private and local authority care homes are treated in the same way.
  • The CQC has a financial team who assess the big providers of care services to ensure that they are financially viable.
  • When inspections are carried out they are unannounced excepting, small home care agencies where it is necessary to ensure people will be present on the inspection day. For those services rated ‘Good’ the following inspections would usually occur every 2½ years, for ‘Requires Improvement’ rated services this would be within a 6 month period.  Inspections may take place sooner, especially if concerns have been raised.  Most care home providers are co-operative and helpful.  It was noted that CQC inspectors do not have powers to go into a person’s own home, permission would be needed for this.
  • The CQC do not investigate individual complaints but when carrying out an inspection of a care home they would be keen to know how the complaints procedure is used and they would check  ...  view the full minutes text for item 794.



To receive a verbal briefing from Sharon Burgess, Head of Safeguarding Adults, LB Enfield


Sharon Burgess, Head of Safeguarding Adults gave a briefing on how Enfield Council responds to inspections and their role in maintaining standards in care homes.


The following was highlighted:


  • The important role of Quality Checkers who visit care homes and speak to people including friends and family.
  • Activity teams are used to improve wellbeing. They work on themes includes visiting pets.
  • When asked how the safeguarding team would help if a service is found to be substandard it was noted that action plans would be put in place and work would be undertaken with care home staff to improve standards. This may include bringing in our own staff, nurses, pharmacists etc.

If there is a safeguarding concern, we would arrange for people to be moved to other homes.  If we are unhappy with the response from the care provider, ultimately we can say we would not place any people in the home and would also encourage other local authorities not to use it. Other authorities would stop their placements.


The following questions/ issues were raised in respect of both items 3 and 4


·         It was asked if we make any random calls to friends and family. CQC said this would only happen as part of the inspection process.

·         Cllr Yusuf was concerned about an incident where a care home manager had stated that if someone ‘made a fuss’ they would arrange for their family member to be moved to another care home.   It was agreed that this was unacceptable, and that issues such as these should be reported to the Safeguarding team and /or the CQC.

·         When asked if we had enough care home beds, it was stated that a third were self- funders, a third were paid for by the Council and the remaining third by other local authorities/ CCG’s.  It was thought Enfield did not need more residential beds, but more nursing care beds.   The recent opening of Bridgewood House has helped in the provision of nursing beds. Prior to this there had been occasions at Christmas time when there had been an insufficient number available.

·         It was stressed that local authorities needed to work together to ensure a fair allocation of beds are provided to prevent the problem of the council having to compete with other local authorities, as this often results in increased prices.

·         There are different perspectives on how a care home is viewed.  However, we need to ensure that if people think the care provided is adequate and we know that it is not, then we must ensure improvements are made.  Similarly, some people may feel that they have no right to make a complaint. We should encourage people to expect a good standard and with the work of the Safeguarding team, ensure that people feel free to complain if their needs are not being met.

·         It was asked if there was a problem with bed blocking and whether the fact that, a third of the allocation of residential home beds in Enfield are  ...  view the full minutes text for item 795.


WORK PROGRAMME 2018/ 19 pdf icon PDF 137 KB

To agree the work programme.


The North Middlesex hospital has been re-inspected, however it was understood that their ratings had not improved.  Andy Ellis would send a copy of the latest report to Members of the Scrutiny Panel.  Action:  Andy Ellis


 It was suggested that this matter be discussed at the next Health Scrutiny panel in January 2019.


It was noted that Chase Farm hospital had not yet had an official launch of its new building.  This would be taking place next year.



A report on North Middlesex Hospital regarding pressures on A & E Services should be reported to the January 2019 meeting of Health Scrutiny Panel rather than in March 2019.  




To receive the minutes of the meeting held on the 15 March 2018.


The minutes of the last meeting were AGREED


Outstanding issues regarding the lack of sufficient GP surgeries in some wards especially Chase Ward and the possibility of Enfield Highway library building to include a health centre.   Action: Andy Ellis



To note the dates of future meetings as follows:


Thursday 17 January 2019 and

Thursday 14 March 2019


The following meeting dates for this municipal year:


Thursday 17 January 2019

Thursday 14 March 2019.