Working Together to Improve PAMMS

Over recent months, we’ve heard consistent feedback from Norfolk care providers: the PAMMS assessment process needs to work better for everyone. It should be transparent, supportive, and consistent – but too often, it feels unclear and variable.

That’s why we’ve been working closely with Norfolk County Council (NCC) to open up a constructive dialogue. Our goal is to listen to providers, understand where the pressures are, and work together to co-create practical improvements.

In April, we held our first joint feedback meeting, bringing together social care providers and NCC’s Quality Monitoring Team. The conversation was open, honest, and solution-focused.

We’ve summarised the key themes and suggested actions from that meeting below. From concerns about scoring transparency and inspector consistency, to positive examples of hands-on support from NCC.

NorCA x PAMMS Feedback & Development Meeting

28th April 2026 | 11:00am – 12:30pm

Attendees:

• Louise Brosnan – Assistant Director, Brokerage and Quality, Norfolk County Council
• Paul Jones – Quality Monitoring Officer, Norfolk County Council
• Christine Futter MBE – Chair, Norfolk Care Association
• Jon Clemo – Director, Norfolk Care Association
• Caitlin Moll – Operations Manager, Norfolk Care Association
• The meeting was also attended by a range of social care providers.

PAMMS Guidance Document

• Document is too long and complicated – hard to navigate.
• Marking / scoring criteria is unclear – providers don’t understand how the final result is reached.
• Weighting of different items is not explained.

Inspection Experience and Inspector Approach

• One provider said their most recent experience of an inspection -which took place in 2025 – felt much more comfortable. The inspector seemed to want providers to do well, focused on positives and cooperation.
• Other recent experience was that sometimes it feels like the inspector is looking for everything that’s wrong/missed/forgotten.
• There are inconsistencies between QMOs – some inspect alone, some in pairs.
• Scoring doesn’t feel transparent – there’s no explanation shared on how the result is arrived at.
• It’s not always clear which inspector comments directly affect the PAMMS rating versus which are just suggestions for improvement – this distinction would help providers understand what is mandatory versus aspirational.
• Draft reports are shared but not the rating – makes it very difficult for providers to challenge findings.
• Sometimes QMOs don’t investigate further or follow up with a manager before something goes into a report.

Standardisation of Forms

• Providers have been told to use certain forms, but then the QMO says the form is not sufficient.
• There are inconsistent expectations.
• Issues with links and tools in PAMMS documents – makes use less efficient. (Paul, NCC, noted this has now been addressed and updated.)

Learning and Good Practice Sharing

• Lessons learnt briefings – share good practice across providers.
• Peer review – inspections are peer reviewed by NCC internally (noted as existing process).

NCC’s Suggested Approach

• Paul has been visiting selected care providers weekly for a day, for around 6 months and works with them on whatever they need – speaks to staff and managers, builds relationships.
• Paul looks at the most recent CQC/PAMMS report, creates an action plan, and works through it with the provider.
• At the end of 6 months, there’s a PAMMS visit from a QMO.

Providers recognised this as extremely positive – but there were questions around scalability as there are hundreds of care settings within Norfolk.

Suggested Actions/Requests:

• Can NCC request a more in-depth and clearer document on PAMMS scoring?
• How does NCC’s internal processes check QMO consistency?
• Request for NCC to provide a standardised set of forms/templates for provider use.
• Can NCC send out a lessons learnt briefings from time to time.
• Louise to look at consistency across QMOs.
• Timeliness of support – can NCC and NorCA explore how peer-to-peer resource sharing (e.g., shared templates, good practice, peer support projects) can complement NCC’s formal support, including a review of what resources can be shared across providers?
• Can NCC and NorCA jointly develop a plan for peer-to-peer resource sharing and support, building on NorCA’s existing peer-to-peer project?
• Can NCC put together informative webinars for providers?