Quality improvement support
Integrated Quality Service (IQS) improvement and escalation policy was published in 2022. This sets out the role of audits and interventions deployed by IQS to promote quality improvement in the care market.
Audits
Provider Assurance Market Management Solution (PAMMS) audits broadly replicate a Care Quality Commission (CQC) inspection, provide a detailed draft report to providers outlining areas for improvement, and award an overall rating when published. Areas of non-compliance are addressed by provider action plans, which IQS monitors via desktop and follow-up threshold crossing visits.
Quality monitoring visits are threshold crossing audits used either to follow up on compliance with areas identified for improvement at PAMMS or CQC inspections or to make focussed enquiries into urgently arising matters, safeguarding concerns or complaints.
Integrated working
Supporting the work of our quality monitoring officers (NCC staff), quality improvement nurses, medicines optimisation pharmacists, infection control nurse specialists (NHS Norfolk and Waveney Integrated Care Board staff) work closely alongside drawing on the health and social care skillsets and specialisms of each.
Subject matter leads
All IQS team members adopt an area(s) of specialism to act as subject matter leads, ensuring the team has contemporary knowledge of best practice and enhancing the quality of support to the care market.
Our subject matter leads have specialism in areas such as:
- Dementia
- Health and safety
- Medicines
- Learning disabilities and autism
- Mental capacity act (MCA)
- Infection control
(This is not an exhaustive list)
Bespoke training and guidance
In response to trends in compliance shortfalls, IQS works with partners to produce training and guidance to support the care market. Recent examples include:
- Fire safety for home care providers (in collaboration with Norfolk Fire and Rescue Service)
- Medication safeguarding guidance (in collaboration with Norfolk Safeguarding Adults Board)
- MCA training for providers (with Norfolk Safeguarding)
Support for procurement and commissioning
IQS has an integral gatekeeping role in assessing and advising on the quality of tenders, escalating serious or serial non-compliance and/or breaches of contract, and taking action in line with the improvement and escalation policy.
Working with external partners
Key links with external partners include:
- Norfolk Care Association (NorCA)
- Norfolk & Suffolk Care Support
- Healthwatch Norfolk
- Care Quality Commission
Routine engagement and activity of mutual interest to care providers commissions and delivers training and identifies projects.
Day opportunities
In 2022-2023, day opportunities settings were introduced into the portfolio of IQS remit. A 'lighter touch' quality monitoring and improvement intervention promotes adherence to contractual duties.
Domestic abuse Settings
In response to the Domestic Abuse Act 2021, IQS developed a comprehensive quality assurance framework to assess the quality of:
- Domestic abuse settings
- Safe houses
- Refuges and outreach services
A programme of audits reviews the quality of provision across the county.
Provider mentor scheme
In 2024 a pilot was launched to deliver intensive quality intervention to non-compliant care providers demonstrating capacity to sustain improvement. A dedicated quality monitoring officer provides the intervention with weekly visits for a pre-defined period. At the end of the support intervention a PAMMS is undertaken by the allocated quality monitoring officers to assess progress.
