Agenda and minutes

The Chairman welcomed everyone to the meeting.

None.

Members of the public wishing to take part should notify the Head of Legal and Democratic Services, in writing or by email indicating the nature and content of their proposed participation no later than 9.00am on the working day before the meeting (in this case 5 November 2019). Enquiries can be made through the telephone number/email address below.

None.

Previously circulated

The Minutes of the meeting on 25 September 2019 were agreed as a correct record and signed by the Chairman.

In attendance for this item were:

Worcestershire Safeguarding Adults Board

Derek Benson, Independent Chair

Bridget Brickley, Board Manager

Worcestershire County Council

Elaine Carolan, Interim Director of Adult Services

Richard Keble, Assistant Director of Adult Services

The Independent Chair and Board Manager of the Worcestershire Safeguarding Adults Board (WSAB) had been invited to update the Panel on progress and developments in safeguarding adults in Worcestershire.

The Chairman invited the WSAB Chair to set out the highlights and challenges of the Board’s work and in doing so, the WSAB Chair also drew attention to the content of the annual report, which included background about the purpose of the annual report, the Board and the context for its work which was underpinned by the six safeguarding principles of the Care Act (2014).

The purpose of the WSAB was assure itself that local safeguarding arrangements and partners act to help protect adults in its area who:

·         have needs for care and support (whether or not the local authority is meeting any of those needs) and;

·         are experiencing, or at risk of abuse or neglect; and

·         as a result of those care and support needs are unable to protect themselves from either the risk of, or the experience of abuse or neglect

Achievements of the WSAB during the year included a more active and engaged partnership, with good representation from the statutory agencies and beyond. The WSAB team had worked hard to get input from those who had experienced safeguarding issues for example advocacy, therefore input had been extended beyond the statutory members.

Objectives for 2018/19 included improving awareness and workshops had been held about the referral process to try and ensure referrals were appropriate and timely. More time was being spent with advocacy groups. Other areas of work included mental health safeguards and Deprivation of Liberty Safeguards (DoLS). In terms of Safeguarding Adults Reviews (SARs), of 8 referred, 5 had been recommended for a SAR and all had led to action plans. A review was also being carried out into the number of rough sleepers in Worcestershire. Information sharing had also improved and there was a self-assurance process for all agencies to go through. The annual report included charts to analyse safeguarding data and types of abuse, as well as WSAB priorities for 2019/20.

There was a growing realisation about exploitation of adults, which was something the Board was considering how to deal with.

The WSAB Chair was confident there was a strong commitment to safeguarding, although workload pressure was recognised as an issue.

A discussion took place and the following main points were made:

·         the WSAB Chair was asked what was most and pleasing and most displeasing for safeguarding in Worcestershire, and he praised the commitment to partnership working which had changed dramatically from when organisations used to work in isolation, although there was still scope for improvement. What was challenging was the fact that safeguarding boards’ remit was focused on a narrow cohort and not the wider population and therefore the Board  ...  view the full minutes text for item 337.

In attendance for this item were:

Worcestershire County Council

Cabinet Member with Responsibility for Adult Social Care

Elaine Carolan, Interim Director of Adult Services

Richard Keble, Assistant Director of Adult Services

Pauline Harris, Programme Manager for Adult Services

The Programme Manager for Adult Services talked through the presentation included in the agenda, which set out the main messages from the series of roadshows which took place over the Summer across Worcestershire.

The context for the roadshows was the Adult Services Business Plan ‘Promoting Independence’, which set out the Council’s vision to ensure residents are healthier, live longer, have a better quality of life and remain independent for as long as possible. The Plan was not just a duty for Adult Services but was threaded through all of its work. The roadshow also formed part of the Adult Services Directorate’s variety of stakeholder engagement events over the past 12 months.

The Programme Manager was aware that many Panel members had participated in the roadshows and reported that staff and the public had appreciated councillors’ involvement. Locations for the roadshows were chosen according to levels of social care being provided and nearly 1000 people had been spoken with.

The campaign objectives were to:

·       prevent, reduce and delay the need for care

·       promote adult social care – what was offered and what isn’t i.e the myth that everybody was eligible for care

·       help people to find out where they could get support in their local community

·       explain what help was available from social workers, citizens advice bureau, financial assessment teams etc, for example help to check benefit entitlements

The focus of the roadshows was to promote messages about active ageing, public health support, planning for care and consideration of the costs of care. An app was available to let you know your position on the life curve, based on tasks such as no longer being able to cut your toenails, which was one of the first signs of ageing. The app, based on this research from the University of Newcastle, had been very well received.

Adult Services was trying to encourage people to plan for care costs and had started work with financial advisors in Worcestershire to signpost people. More people being able to continue to afford their care would reduce pressures on Adult Services’ budgets, as well as help people avoid or delay the need for residential care.

Information and advice were other areas of development and the Panel was shown examples of information available to the public. Many people requesting information at the roadshows were in their forties, and very digitally capable.

The main messages from the roadshows included questions about assistive technology, local community groups, extra care facilities, combatting loneliness, queries about entitlement to care and for leaflets to start conversations with family members. Many people struggled to start these ‘difficult’ conversations with their families and were grateful for the prompt. Another theme was people feeling overwhelmed with carer and family responsibilities.

The Cabinet Member for Adult Social Care (CMR)  ...  view the full minutes text for item 338.

The Panel was updated on performance and financial information for services relating to Adult Care and Well-Being.

Financial Information (Period 6 2019/20)

The Head of Finance referred to the information included in the agenda (appendix 2). Currently an overspend of £2.4m was predicted, which although a significant amount, equated to around 1.8% of the c£136m Adult Social Care net budget. Following a report to cabinet in September to discuss measures to mitigate directorate overspends, Adult Services had been working tirelessly to identify savings, which was a difficult situation, but had reduced the overspend to £2.4m from the previous figure of £3.3m. The forecast overspend included a one-off cost from the previous year’s restructuring for staff exit costs, therefore reducing the recurrent budget pressure to £1.8m.

The Head of Finance explained the most significant variances. The £2.2m overspend of the £33m Older People Residential and Nursing services budget was related to increased prices to provide services, rather than increasing numbers of people, for example wages, inflation and staff agency costs for nurses due to recruitment difficulties. People were coming into care later in life, which was good but meant they may have additional needs.

The £0.8m overspend on Learning Disability Services was again due to people living longer.

The Directorate’s £8.8m savings programme was mostly on target, achieved through working differently and avoiding spending, for example through the 3 Conversation social work model. The overall picture with the overspend was difficult but something officers continued to try to manage.

When asked about plans for the coming year, the Interim Director said that Adult Services would absolutely need to continue to do all it possibly could, so that the most vulnerable residents received services appropriate to them. The whole system was challenged, and while Worcestershire Acute Hospitals Trust was now showing signs of improvement, the continued pressure in this area affected Adult Services. The Directorate believed some demand was being caused by people remaining in hospital for longer in Worcestershire than they would in other hospitals areas, which had a knock-on effect on adult social care and therefore a range of initiatives were being used to manage the demand. The Director, however remained concerned, especially since adverse weather would exacerbate the year-round pressures.

The Assistant Director referred to the work of the onward care team, carried out by the Acute Trust and Health and Care Trust, which started early conversations with patients to identify support needs and accelerate discharge. Currently it was estimated that 2 out of 5 people who went into residential or nursing care started their journey in hospital.

The Vice-Chairman raised the importance of a night service, something which the Interim Director would report back on.

When asked if there was scope to work more with the NHS to help tackle budget pressures, the Adult Services officers said that the Sustainable Transformation Partnership had provided a means to revitalise previous discussions, for example regarding Continuing Healthcare, and there was appetite for shared commissioning from the commissioning network  ...  view the full minutes text for item 339.