Provider Assessment Market Management Solution (PAMMS)
What is PAMMS?
13 Local Authorities (LA) across the South West region, including Torbay, have recently agreed to implement a Provider Assessment and Market Management Solution (PAMMS), supported by the Association of Directors of Adult Social Services (South West ADASS).
The PAMMS tool was co-produced with care providers when the South East regional Local Authorities came together to produce a tool for use that would enable them to consistently measure quality, spend and activity within commissioned services. It is now recognized nationally as a good practice tool, used by 3 regions and 50 local authorities.
Torbay Council and TSDFT, being an integrated care system, hold a joint requirement to:
- Meet their statutory duties under the Care Act 2014 including care market oversight and management;
- Achieve measurable improvements in provider quality and provide evidence of interventions;
- Demonstrate real time market insight and analysis of provider markets quality;
- Enable a common, regional approach, delivering efficiencies and consistency in provider engagement;
- Use technology to enable an intelligence-led, risk based approach to market oversight, allowing for timely interventions.
While PAMMS is a new digital system for us, it is not new activity. TSDFT (in common with other LA areas) already undertakes a wide range of Quality Assurance (QA) activity and contract management approaches with our care providers. What we are trying to achieve through PAMMS is greater regional consistency of approach so that we can fulfil our duties as an integrated Trust for safe commissioning and market assurance in a way that is not arduous for providers and can be managed within available resources to achieve better outcomes for the people who receive Social Care. The system will inform and direct support from TSDFT alongside our contract management processes.
TSDFT have worked closely with a number of local providers in order to implement and test the PAMMS tool with our care market and have already conducted a number of on site and self-assessments within Torbay. This has helped us shape not just the Torbay approach but the regional application of the system including:
- New assessment templates which are more tailored and manageable for our providers and assessors complete in a practical timeframe
- New terminology for the outcomes standards which have now moved away from the CQC rating definitions of “poor, requires improvement, good and excellent” to more contract compliance terminology so there is a clear delineation between a local PAMMS audit and a CQC inspection.
Benefits to providers
- Reduces the need for multi-agency assessments from other Local Authorities
- Evidences service improvements
- Online portal for assessment feedback and co-produced action planning
- Improve local quality ratings which have been developed around QCQ standards, which will enable providers to improve on for their next CQC audit – For example Luton experienced 26% improvement in providers CQC key lines of enquiry outcomes
- Improve care service quality and safety
- Provides evidence to support CQC regulation 17 – good governance and quality assurance
- Peer benchmarking – share best practice and support sector led improvements
- Allows quality ratings to inform brokerage decisions.
Benefits regionally and locally
- Reduces multiple quality assessments and action plans
- Increased capacity within the Quality Assurance Improvement Team (QAIT), allowing the team to focus on care quality and service improvement
- Self-assessment functionality included – allowing Localities to manage quality and risks remotely
- Reduce the impacts of provider failure
- Quality assure all commissioned regulated and non-regulated services
- Demonstrates the impact of interventions by the Local Authority
- Share care market quality intelligence with CQC leads
- Supports local, sub-regional, regional and national collaboration.
What this means for providers
- Each provider will be set up with a PAMMS provider account at no cost to themselves. This will give providers access to their own portal where they can:
- Conduct self-assessments of quality assurance when allocated on PAMMS by QAIT
- Submit evidence in support of upcoming or conducted QA visits
- Review and update interactive action plans with TSDFT QAIT officers following an audit, and submit evidence in support of improvements made
- Review the outcomes of audits and the achieved PAMMS quality ratings
- Each provider will be able to access online training videos on the use of the PAMMS system and the local QAIT can offer further guidance to ensure consistent support
- The quality audits conducted via PAMMS will replace existing local quality practices and enhance and support the existing contract management practices. CQC inspections will continue separately from this and the timing and results from CQC will feed directly into our approach and timeline for local inspections.
What will the outcome of the PAMMS assessment be?
After an assessment is complete, your service will be rated as one of the four below standards:
- Exceeds compliance
- The service is performing exceptionally well and in certain key areas is exceeding the regional standards
- The service is performing well and is meeting the regional standards
- Partially compliant
- The service isn’t performing as well as it should and has failed to meet the regional standards in some key areas
- The service is performing poorly and has failed to meet regional standards in a number of key areas
Note: There is no current intention in the Southwest to ‘publish’ quality ratings to the wider public. Any PAMMS ratings will only be visible to the respective providers and South West local authorities in line with a PAMMS specific Data Sharing Agreement.
What will be assessed?
PAMMS assessments focus on the following key areas or “Standards”:
- Assessment, care planning and review
- Service user experience
- Staff knowledge and understanding
- Staff training and recruitment
- Environment, equipment and general safety
- Leadership, quality assurance and management
A set of questions has been designed and approved as a Southwest region for each of our market areas including:
- Accommodation based services (residential and nursing homes)
- Supported Living services
- Community based services (domiciliary care)
- Non regulated (those services not registered with CQC)
A copy of the PAMMS assessment questions for each service are can be found below:
- PAMMS Non-Regulated Question Set
- PAMMS Supported Living Question Set
- PAMMS Community Based Question Set
- PAMMS Accomodation Based Question Set
Find out more about PAMMS
Watch the PAMMS Quality Assurance YouTube video.
If you have any further queries at this stage, contact the Adult Social Care Commissioning Team at firstname.lastname@example.org
Frequently asked questions
Below are the frequently asked questions which we have received from the market around the PAMMS system, how it works and what it means for our providers and their respective clients:
No this will not replace CQC inspections. The PAMMS audits will be conducted by the contracting authority outside of the usual CQC inspection regime.
The PAMMS system provides the contracting authority a way to measure and manage risk within its Adult Social Care Market and supports contract and quality monitoring of its providers outside the dependency of CQC quality inspections.
Each Local Authority within the Southwest region will implement its own audit regime however the PAMMS audits should happen no more than once in a 12-month period unless a provider is highlighted as a high risk setting and requires more enhanced monitoring.
Depending on the assessment being used the on-site inspections are likely to take between 1 and 1.5 days to conduct an audit. Good preparation beforehand will likely lead to shorted audit timescales.
The PAMMS question set and framework have been developed around the same principles and standards as the CQC framework, so in theory this should not happen and historically the system has not differed from CQC ratings without there being an underlying reason for a shift in quality outcomes.
The Local Authorities in the Southwest who have access to PAMMS will be able to see any finalised overall ratings published on the system. Only providers and their respective audit teams will be able to see the content of a specific audit and this information will remain commercial in confidence. PAMMS ratings will not be published to the public domain.
Each contracting authority will have their own approach to assessments and how many staff and clients they would like to engage with during an audit, however generally it will be in line with the number of care plans assessed. So for example, if 3 care plans are assessed, ideally the three clients for those care plans and a member of staff familiar in the delivery of that care should be made available during the audit. This will need to be discussed with your assessor beforehand and a modicum of flexibility will need to be applied to fit around the size of the service, the staffing arrangements and the clients wishes, needs and capacity.
The contracting authority and CQC should work together to align their inspections so that repeat audits do not happen in quick succession. Two audits may happen close together is if there concerns from the first inspection and a second one is required to ensure the standards have been brought inline with expectations, however there should be adequate time between the two for any corrective actions.
Each contracting authority will have its own appeals process in place if providers are unhappy with the way their audit has been conducted or are unhappy with their rating outcome. The system does hold all results from an audit in draft for a period of time to allow providers and their assessor to comment and agree on results before formalising the ratings which should ensure that the formal ratings are within the expectations of providers.