Residential Care & Nursing Homes Subgroup Highlights | February 2026

Norfolk Care Association Residential Care (Older People 65+) & Nursing Homes Subgroup Meeting held on 10th February 2026, 2:00pm – 3:30pm

Chair: Anne Riches – Regional Manager, Saturn Healthcare

Facilitated by: Caitlin Moll – Operations Manager, Norfolk Care Association

Speaker: Gemma Lea – Commissioning Manager, Complex Community Support, Norfolk County Council

Supported by: Phil Tilney – Social Care Careers Ambassador, Norfolk and Suffolk Care Support

For our 2026 subgroups, we’re trialling a new, provider and discussion-led subgroup model. We’re shifting away from presentations towards peer discussion, shared problem-solving, and direct engagement with commissioners. The intention is to increase participation and value for providers.

Summary of discussion

The discussion covered systemic challenges, including delays in nursing assessments and the complexities of the Continuing Healthcare (CHC) and Funded Nursing Care (FNC). Significant time was dedicated to discussing PAMMS, focusing on perceived inconsistencies and subjectivity in quality monitoring. The session concluded with a look toward future collaboration through in-person events.

Discussion Topics

Nursing Care Assessments and Funding Interfaces

Gemma Lea discussed the ongoing transformation of bedded nursing care and the operational difficulties providers face regarding nursing needs and funding assessments. She highlighted work around the FNC and CHC interface, noting a significant reduction in nursing places across Norfolk over recent years.

• There is a perception that residential homes are increasingly managing complex needs that traditionally would have required nursing care. However, where this can be done safely, sustainably and is consistent with a resident’s wishes to remain it should be supported.
  Wait times for CHC and FNC assessments are excessively long, with providers reporting delays of weeks or even months.
  Providers noted a lack of consistent communication after submitting forms via portals.
• Participants expressed concern that residents frequently pass away before they are ever assessed for funding eligibility, and feel they are forced to carry financial risk by delivering necessary nursing care without guaranteed funding in place.
• Collaborative working on the Trainee Nursing Associate (TNA) programme was identified as a positive route for development.

PAMMS

Providers expressed significant frustration regarding the consistency, fairness, and transparency of PAMMS quality assessments. There is a perceived lack of consistency between different PAMMS assessors, with some reported as having no prior experience in social care.

• Audit findings sometimes conflict with advice from statutory bodies like the Fire Service or Environmental Health.
  The process was described as “rushed” and often based on the subjective opinions of Quality Monitoring Officers (QMOs) rather than clear evidence.
• There is a focus on the negative only and not interested in the positive.
• Providers feel they are sometimes penalised for historical data or issues outside of their control.
• Concern was raised that assessors may be “setting their own rules” that override established guidance from competent authorities.

Collective purchasing

The group explored the potential for collaborative training and group procurement to manage costs and share expertise. Interest in setting up training hubs where providers use their own qualified staff to train local carers rather than buying in external trainers.

Commissioning updates and engagement

Claire Dixon, Commissioning Manager at Norfolk County Council, provided an update regarding market sufficiency and a specific query concerning safeguarding policies within care homes.

• Market Sufficiency and Block Bed Commissioning – Cabinet has approved the commissioning of additional block beds as part of a strategy to ensure market sufficiency.
• Provision: The council is looking to tender for residential provision specifically for respite care, enhanced care, and physical disabilities. Information notices are expected to be published on In-tend by mid-February 2026, with detailed specifications to follow.
  Market Engagement: Two market engagement events will be held to provide further information and allow providers to ask detailed questions about the procurement process.
• The use of block bookings is intended to provide assurance for carers by offering a planned respite service, which is often difficult to achieve through spot placements. These blocks will be smaller than previous iterations and will be spread across various locations in Norfolk to improve accessibility.

A participant raised concerns regarding client choice, questioning whether block beds might be prioritised over a family’s preference for a local home that may not be part of the block contract. Questions were also raised about the cost-effectiveness if block beds remain empty for periods of time.

Claire Dixon emphasised that the strategy is part of a wider range of commissioning options, including direct awards where individual preferences and “usual price” agreements are met. She encouraged providers to bring specific procurement queries to the upcoming formal engagement events.

Policy Query: Claire Dixon asked providers whether they maintain specific policies and staff training for safeguarding children who visit care properties (e.g., for family visits or scheduled activities). Participants confirmed that their existing safeguarding policies and training already encompass visitors, including children, to ensure a safe environment for all.

May in-person provider event

Details were shared about a planned in-person event on 14th May in Norwich, run by Norfolk Care Association. The event will follow a peer-led, discussion-based format rather than traditional presentations.

• Providers will help shape the agenda on the day.
• The event is intended to strengthen cross-provider collaboration across supported living, domiciliary care, and residential care.
• Further details and booking information will be circulated.

General feedback

• Delays in funding assessments (CHC/FNC) are causing significant financial and emotional stress for providers and families. There is consistent poor feedback on NCC responsiveness to assessment queries or requests.
• There is a strong feeling that the PAMMS process needs more oversight and must align better with other regulatory standards.
• Despite challenges, providers remain highly committed to delivering quality care and celebrating small wins for their residents.