Agenda and minutes

The Chairman welcomed everyone to the meeting, including Cllr Mary Rayner as new Vice-Chairman. On behalf of the Panel, the Chairman thanked Cllr Liz Tucker for her contribution as Vice-Chairman which had been very much appreciated and for her support and continued involvement in scrutiny.

None.

Members of the public wishing to take part should notify the Assistant Director for Legal and Governance 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 17 November 2020). Enquiries can be made through the telephone number/email address below.

None.

Previously circulated.

The Minutes of the Meeting held on 22 September 2020 were agreed as a correct record and would be signed by the Chairman.

The following were in attendance:

Paula Furnival, Strategic Director for People

Kerry McCrossan, Service Manager

Cllr Adrian Hardman, Cabinet Member with Responsibility for Adult Social Care (CMR)

The Strategic Director for People referred to the presentation slides in the Agenda and explained that sixth months into her role, the rationale for the new Strategy was to provide a strategic approach and clear objectives for the newly established Directorate and how it worked with others. A triangle was used to show how the Directorate and its partners would co-produce ways of working with citizens to enable them to ‘be well and stay safe’, ‘be independent and connected’ and to ‘be supported’.

In terms of driving best practice and managing demand and costs, various pieces of work had been undertaken, for example the Peopletoo analysis and the recent peer review; the triangle indicated the three tiers of services and the pattern of access in Worcestershire, against best practice and gross budget expenditure of £239m.

For universal and self-service (Tier 1), in Worcestershire 69% of contacts were resolved at this point against the best practice figure of 70%, however for targeted interventions (Tier 2) only 4.9% of contacts were being resolved, against the best practice figure of 20% and 26% cases were progressed to Tier 3, which was more than the 10% that national best practice suggested. The discrepancy between a good operating model and what the Council was achieving was the fact that people’s needs were not being anticipated earlier on.

The aims of the Strategy were to achieve a clear aim which was outcomes focused, co-produced and met needs by maximising the use of resources and the workforce. The aim was to give a clear offer to enable people, easy to access, and to reduce duplication in buildings, systems and processes.

Key drivers for the Strategy had been drawn from the earlier work referred to. The three strategic pillars of change, underpinned by a range of different projects, were a person-centred approach, shaping services and shaping an effective market. Work to look at how customers accessed council services and information included potential use of libraries as a first point of call.

In terms of how the Strategy would be delivered, a series of workstreams had been created through the ‘case for change’ process. Work streams sought to involve a broader range of partners, for example plans to build on progress achieved with the voluntary and community sector (VCS) tackling homelessness during COVID-19, through a longer-term, more sustainable partnership. Workstreams had been approved through the Senior Leadership Team and Cabinet and each would be led by a senior manager. A very important factor was the belief that you do not always need more money to do things better, and often more collaborative working and co-produced plans were the solution. One example was care home admissions from hospital, which had dramatically decreased during COVID-19 – it was explained that while the Directorate had developed relationships with health colleagues over a number of years,  ...  view the full minutes text for item 373.

The following were in attendance:

Paula Furnival, Strategic Director for People

Laura Westwood, Lead Commissioner

Cllr Adrian Hardman, Cabinet Member with Responsibility for Adult Social Care (CMR)

The Lead Commissioner highlighted the main points of the Council’s work to promote and enable independence, which was one of the programmes of work under the Strategy for People and Communities, and which aimed to enable people to live at home for as long as possible.  There were several streams of related activity, including:

·       introduction of Community Reablement Service

·       increasing Shared Lives

·       increasing Extra Care provision

·       increasing Supported Living provision

·       Home First Programme

Reablement

Following an update to the Panel in September, the Community Reablement Service commenced had in October and so far there had been 27 referrals, with 25 interventions being made.

Housing Need Development

The Council was working closely with Worcestershire Strategic Housing Group to develop an accommodation and support plan, not just for social care but across all vulnerable groups. This included ambitious plans to expand the Shared Lives scheme, which was a cost-effective and person-centred way of supporting an individual within a family home.

The current Extra Care Strategy for Worcestershire 2012-2026 was being updated and in view of the decline in growth there was a project to look at what the 65+ age group wanted as well as working with the market to develop services. Extra care supported those over 65 years and was a preventative service which enabled people to access help when needed. 

Supported Living (which was for under 65s) had been relatively successful for those with learning disabilities, and this was now planned to be redesigned and extended to other groups, and a Supported Accommodation Strategy was being developed.

Each piece of work would allow the Council to have better conversations with the market and there were strategic plans to identify plans for each area, which would benefit both the Council through not having to fund housing costs, as well as the individuals, since they would gain access to benefits.

Home First Programme

The Directorate recognised the need to increase the number of individuals being discharged from hospital to home with health or social care support (Pathway 1), with a further increase necessitated by COVID-19 and additional investment had been put in place. Moving forward, capacity would need to be further enhanced.  Work was also underway to engage with the external market and how to deal with increased number of requests for help with arranging their own care when leaving hospital.

The Chairman invited questions and the following main points were raised:

·       The Lead Commissioner explained that extra care was generally for those aged 65+ and provided a mixed economy of housing which were available to buy or to rent and a mix of care, ranging from those who needed funded adult social care, to those who may have no care needs but wanted the option to access care in the future. Schemes tended to be big with onsite facilities. Supported Living at the moment  ...  view the full minutes text for item 374.

The following were in attendance:

Paula Furnival, Strategic Director for People

Steph Simcox, Head of Finance

Kerry McCrossan, Service Manager

Sally Baldry, Principal Management Information Analyst

Cllr Adrian Hardman, Cabinet Member with Responsibility for Adult Social Care (CMR)

Performance Information

The Principal Management Information Analyst summarised the key points for Quarter 2.

Regarding the number of admissions to permanent residential and nursing care, the Panel was reminded that this was part of a national definition, split between older and younger adults, which included 12 week disregards, and was expressed as a rate per 100,00 of the population. Unsurprisingly, due to COVID, the rate for older adults entering care homes had reduced (to 434 from 628 in March), which in terms of numbers of people was 853 in the rolling year to the end of March and across the year ending in September, had reduced to 617.  There was a similar pattern for younger adults, with the rate dropping from 17 per 100,000 to just over 12. Alongside these reductions, more people were receiving homecare and more younger adults were living in supported living arrangements.

There had been a dip in the proportion of people with no ongoing care needs following reablement after hospital discharge, however numbers were now starting to rise and all those coming out of hospital would now be offered some form of reablement. Figures for the number of older people remaining at home following hospital discharge and reablement had also dipped but had picked up from September.

Regarding annual care package reviews performance stood at approximately 85% and varied across teams with learning disability and mental health rated as red.

The Chairman commented that COVID-19 made analysis of performance more difficult and time would reveal whether trends continued.

In-Year Budget Information

The Head of Finance referred to the presentation slides which highlighted the main points from the Quarter 2 forecasted position. Currently, a very minor overspend of £260 was forecast which was a significant improvement on the Quarter 1 position of £2m – the main reasons being tighter control of spend, managing accountability, changes to entry pathways into residential and nursing care and a decrease in projected numbers of people coming into the care system.

Within the overall forecast position, there were variations between different client groups. Older People Services included a full year saving related to implementation of ‘Liberty Protection Safeguards’ (around £1.6m) which had been delayed by Central Government, along with staffing costs. Learning Disability and Mental Health Services were forecast to overspend due to increased average unit costs.

Physical Disabilities Services were due to underspend as activity numbers were lower than budged for, while Provider Services were overspending due to agency and overtime costs.

It was important to note that the forecast position excluded the impact of COVID-19 which would be funded from external funding sources such as the COVID-19 grant (£29m), test and Trace (£2.75m and Infection Control (£7.45m). Relevant areas where COVID-related spend/loss of income had been funded from such external resources  ...  view the full minutes text for item 375.

No amendments were made, however as part of Item 5 (People and Communities Strategy), updates were requested on the projects aligned to the new Strategy.