Provider assessment and market management solution (PAMMS)

The Provider Assessment and Market Management Solution (PAMMS) is an online assessment tool. We 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, will receive an audit using the PAMMS tool.

Following our assessment, a summary report and ratings are made publicly available on the PAMMs Provider Portal. Reports are widely used by statutory agencies.

PAMMS Provider Portal

Is a PAMMS audit and CQC inspection the same?

No. But 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.

If you have any queries about PAMMS, email qaprovidersassd@norfolk.gov.uk 

We use the PAMMS auditing tool for many reasons:

• It enables providers and our Integrated Quality Service to work together to achieve better outcomes for residents of Norfolk
• 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 really 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

A PAMMS audit is carried out by a quality monitoring officer from our Integrated Quality Service.

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 need to provide us with copies of relevant documentation in advance. We will also ask for requested staff and service users' files to be made available for review during the visit. 

Examples of some of the things we might ask to see evidence of:

• Staff has 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 inspection

The quality monitoring officer will want to speak to:

• The manager
• A number of staff members
• Service users (where possible)

Providers may wish to prepare staff beforehand and think about the best way to engage staff and service users in the visit. 

If you are unsure about what to prepare before the visit, email qaprovidersassd@norfolk.gov.uk 

What is assessed

Your service will be rated by PAMMS in the following areas, based on the evaluation of the quality monitoring officer:

• Involvement and information
• Personalised care and support
• Safeguarding and safety
• Suitability of staffing
• Quality of management

These are the 16 standards we assess:

1. Respecting and involving service users
2. Consent 
3. Care and welfare of service users
4. Meeting nutritional needs
5. Co-operating with other providers
6. Safeguarding people who use the service from abuse
7. Cleanliness and infection control
8. Management of medicines
9. Safety and suitability of premises
10. Safety, availability and suitability of equipment
11. Requirements relating to staff recruitment
12. Staffing and staff deployment
13. Staff support
14. Assessing and monitoring the quality of service provision
15. Using information and dealing with complaints 
16. Records  

After the audit and before the officer leaves, they will give you 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 quality monitoring officer is not able to see the ratings until the draft report has been shared with you. The PAMMS system weights the information submitted to give an overall rating.

You will be sent a website link to review the draft report. 

Opportunity to feedback

If you do not agree with our assessment, you have 14 days from receipt of the draft electronic report to comment on any points with which you do not agree. You can make factual accuracy remarks on specific areas and present additional supporting evidence.

The quality monitoring officer will consider your feedback and will amend the report if necessary.

If agreement is not reached at this point you can request a review.

Request a review

In the event of a continuing dispute about a PAMMS report at the point of publication, you may request a review by a senior quality monitoring officer.  We will try to allocate an officer who has no prior knowledge of the audit, but this may not always be possible.

The senior quality monitoring officer 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 senior quality monitoring officer may:

• Consider the report a fair record of the audit and publish it, or
• Request that the quality monitoring officer make amendments to the report and publish it, or
• Refer the matter to the head of Integrated Quality Service for the decision to publish

If the matter is referred, the head of Integrated Quality Service will review the report in full, along with any supporting evidence and activity undertaken by the senior quality monitoring officer.

The decision of the head of Integrated Quality Service is final.

Summary report

A summary report is published on the PAMMS Provider Portal. Anyone can view this. 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 with a password protected login. You will receive an email from adass@connexica.com with details on how to create a password and access the report online. Do not 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 you receive a rating of 'Requires Improvement' or 'Poor' you will need to complete a further action plan within PAMMS. You have 14 days to complete and submit this.

If you receive a rating of 'Requires Improvement' or 'Poor' following the assessment, the PAMMS online system will show where improvements are required. 

The quality monitoring officer will work closely with you to provide guidance and support to help you address these areas. You will need to submit a remedial action plan in PAMMS Provider Portal to tell us what actions you will take. You have 14 days to complete and submit the plan. The quality monitoring officer will contact you if it is not received within this time.

Creating the action plan

The PAMMS system allows you to enter actions you will take to address each issue.

You can also add a timeline and the name of the person who will be responsible for the actions. 

You 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.

Follow-up reinspection

A second PAMMS audit will take place approximately six months after the original report is published.

The quality monitor officer will be in touch and may visit during the interim period to support with improvements to be made.

We would expect your rating to improve due to the actions you have taken.