The Provider Assessment and Market Management Solution (PAMMS) is an online assessment tool. Luton Council use it to help us assess the quality of care delivered by providers of adult social care services.
All the Care Quality Commission (CQC) regulated health and social care services we commission within Luton, will receive an audit using the PAMMS tool. Following our assessment, a summary report and ratings are made publicly available on the PAMMS portal. Reports are widely used by statutory agencies.
Is a PAMMS audit and CQC inspection the same?
They are not the same, however there is a close relationship between the PAMMS assessment and CQC's current inspection requirements.
The PAMMS assessment is a supportive tool that we use. It is intended to help providers prepare for a CQC visit. The assessment report will show any high achieving service areas. Similarly, any areas that are not achieving the same high standards are identified and support is put in place to get positive results.
PAMMS has a consistent approach to quality monitoring through reviewing 16 standards for all commissioned providers enabling themes and trends to be identified.
Why we use PAMMS
We use the PAMMS auditing tool for many reasons:
- it enables providers and our quality team to work together to achieve better outcomes for residents of Luton
- it gives care providers the opportunity to sense-check their internal quality audits against our independent audit
- it provides a standardised and consistent approach to quality across the Eastern region. PAMMS is used by most of the 11 authorities in the East of England
- it enables an objective quality audit to be undertaken. This supports providers in establishing what is working well and what areas may require improvement
- it helps identify where we can provide additional support, signposting or referral to expert teams. For example, infection control, fire safety or diabetes management
- it can lead to improved Care Quality Commission ratings for providers
PAMMS audit
A PAMMS audit is carried out by a Quality Assurance Officer.
The audit includes a site visit lasting between one and two days. We contact providers to arrange a time and date for the visit to take place.
Preparing for the audit
Providers are requested to submit copies of relevant documentation in advance. We will also ask for identified staff and service users' files to be made available during the visit.
Examples of some of the things we might ask to see evidence of:
- Staff have appropriate DBS checks and refresher training
- Staffing is sufficient
- Care and support plans are sufficiently detailed and regularly updated
- Risk assessments are complete
- Daily records are accurate
- Robust procedures are in place
The audit
The quality monitoring officer will want to speak to:
- the manager
- several staff members
- service users (where possible)
- service users’ family
Providers may wish to prepare staff beforehand and think about the best way to engage staff and service users in the visit.
If unsure about what to prepare before the visit, email: hclcqteam@luton.gov.uk
What is assessed
The service will be rated by PAMMS in the following areas, based on the evaluation of the Quality Assurance Officer:
- involvement and information
- personalised care and support
- safeguarding and safety
- suitability of staffing
- quality of management
These are the 16 standards we assess:
- respecting and involving service users
- consent
- care and welfare of service users
- meeting nutritional needs
- co-operating with other providers
- safeguarding people who use the service from abuse
- cleanliness and infection control
- management of medicines
- safety and suitability of premises
- safety, availability and suitability of equipment
- requirements relating to staff recruitment
- staffing and staff deployment
- staff support
- assessing and monitoring the quality-of-service provision
- using information and dealing with complaints
- records
Audit outcome and report
After the audit and before the officer leaves, they will give the provider an initial overview of the visit and a summary of findings.
All information gathered during the visit is then put into the PAMMS system and a draft assessment report is generated. The draft report gives indicative ratings against the assessed standards. The PAMMS system weights the information submitted to give an overall rating.
Providers are then sent a link to review the draft report.
Opportunity to feedback
If a provider does not agree with the assessment, they have 14 days from receipt of the draft electronic report to comment on any points with which are not agreed. Providers can make factual accuracy remarks on specific areas and present additional supporting evidence.
The quality officer will consider the feedback and will amend the report if necessary. If agreement is not reached at this point the provider can request a review.
Request a review
In the event of a continuing dispute about a PAMMS report prior to publication, providers may request a review by the Quality Assurance Manager who will review the report for:
- robust evidence to support ratings
- use of evidence against correct standards
- duplication or re-use of evidence that unfairly skews ratings
- objective fairness, including appropriate consideration of any factual accuracy remarks or supplementary evidence received
- internal integrity, to identify and explain evidence which may be contradictory
After the review, the Quality Assurance manager may:
Consider the report a fair record of the audit and publish it, request that the quality officer make amendments to the report and publish it or make a further referral to Quality and Care placement manager for a decision to publish.
If the matter is referred, the Quality Assurance, Care placement manager will review the report in full, along with any supporting evidence and activity undertaken by the Quality Assurance manager.
The decision of the Quality Assurance, Care placement manager is final.
Summary report
A summary report is published on the PAMMS portal. The summary report includes ratings against the core areas, standards and an overall rating. Ratings are Excellent, Good, Requires Improvement or Poor.
Full report
The full report can only be viewed by approved personal within the service who have a password protected login. The provider will receive an email from adass@connexica.com with details on how to create a password and access the report online. The advice is not to use Edge web browser, we recommend you use Chrome.
The full report will detail any areas for improvement required. You will also receive a Microsoft Word version of the PAMMS report; however, this version will not contain the overall rating.
Follow-up activity
If a provider receives a rating of 'Requires Improvement' or 'Poor' in any core areas within the report, providers are required to complete an action plan within PAMMS within 14 days of publication. The PAMMS online system will show where improvements are required.
The quality officer will work closely with the provider to offer guidance and support to help address identified areas. A remedial action plan needs to be submitted in PAMMS Provider Portal to detail what actions will be taken. Providers have 14 days to complete and submit the plan.The quality officer will contact you if it is not received within this time.
Creating the action plan
The PAMMS system allows providers to enter planned improvements to address each action. In addition to this, providers need to add a timeline and the name of the person who will be responsible for the actions.
Providers cannot submit the action plan in PAMMS until at least one action has been recorded against each issue.
There is a short video guide you can watch on the PAMMS Provider Portal to help you create the plan.
Further action
The quality officer will request evidence that actions have been completed, this may be remotely or by visiting the service. Once the provider and quality officer are assured improvements have been made the action plan will be published as completed stating, “Provider has agreed an action plan with the assessor to put in place remedial actions to address non-compliances identified during the assessment. These actions have all been carried out to the satisfaction of the assessor.”
If a provider requires more support following a rating of Requires Improvement or Poor, the quality assurance team will place the provider under our escalation procedure to allow more monitoring and support until improvements are evidence and sustained.