Agendas, Meetings and Minutes - Agenda and minutes

Agenda and minutes

Venue: County Hall, Worcester

Contact: Emma James /Jo Weston  Overview & Scrutiny Officers

Items
No. Item

418.

Apologies and Welcome

Minutes:

Apologies had been received from Cllr Adrian Kriss.

 

The Chairman welcomed Mark Fitton, Interim Strategic Director of People and thanked Paula Furnival in advance of her leaving the Council at the end of March.

419.

Declarations of Interest

Minutes:

None.

420.

Public Participation

Members of the public wishing to take part should notify the Assistant Director for Legal and Governance in writing or by e-mail indicating both the nature and content of their proposed participation no later than 9am on the working day before the meeting (in this case 14 March 2022).  Further details are available on the Council's website.  Enquiries can also be made through the telephone number/e-mail address listed in this agenda and on the website.

Minutes:

None.

421.

Confirmation of the Minutes of the Previous Meeting

(previously circulated)

Minutes:

The Minutes of the previous meeting held on 14 January 2022 were agreed as a correct record and signed by the Chairman.

422.

Safeguarding Adults pdf icon PDF 150 KB

(indicative timing: 2:05pm – 2:50pm)

Minutes:

The Independent Chair and Board Manager of Worcestershire Safeguarding Adults Board (WSAB) had been invited to present the 2020/21 WSAB Annual Report and discuss developments in safeguarding adults in Worcestershire.

 

The WSAB Chair explained that he was contracted by WSAB for 30 days each year, had been in post since April 2021 and was involved in a number of safeguarding initiatives nationally.  He recognised that Worcestershire’s issues were in line with those experienced nationally – rough sleeping, the role of the lead professional and exploitation.

 

During the reporting period, achievements included the increased awareness of fraud and fraud reporting, agreement to jointly fund a post on exploitation, the development of a complex risk adult framework, the publication of a rough sleeping thematic review and the creation of a reference group of lived experience.  8 referrals had been made and 2 had met the criteria.  6 serious case reviews had been completed and published on the website.

 

Of particular note was a pilot scheme to provide challenge to SAR decision making by providing a rapid review, with the process taking 6 to 8 weeks, rather than up to 2 years.  This pilot provided closure for families and was well received, especially as learning was shared much quicker.

 

Worcestershire data was in line with national data and during 2020/21 there had been more enquiries which met the s42 (safeguarding) criteria.  The Chair urged caution in relation to the data, especially in relation to fraud, as the scale of the issue was much higher, with only 5 to 10% of cases reported.

 

Nationally, staffing was a major challenge, especially in domiciliary care and care settings, and the Chair advocated the need for the care profession to be uplifted.

 

Member questions raised the following main points:

 

·         When asked what the biggest challenge was, the WSAB Chair was very concerned about staffing.  He reported that wages would need to rise above the rate now paid by many retailers and with Home First being advocated as best practice, the care profession would need to be viewed differently

·         The Strategic Director of People agreed and reported that detailed analysis had been carried out which had fed into the budget setting process.  Retail and distribution was in competition with the care sector for staff.  Reference was made to the Scrutiny on Care Work as a Career and the Council had noted that conditions of service was an important part of any contract, not just enhanced rates of pay.  In the last Quarter, £1m had gone into staffing within Worcestershire, which had been funded by the NHS

·         The thematic review into rough sleeping would be monitored by a newly formed Assurance Panel of the WSAB.  Membership included WSAB Partners and external agencies, including Onside Advocacy, and it would scrutinise actions taken and make recommendations.  The Board Manager was pleased with the differing approach.  The Chair welcomed initiatives in other areas, whereby ‘pods’ were used to accommodate rough sleepers rather than the shared facilities which was more usual

·         A Member  ...  view the full minutes text for item 422.

423.

Care Quality Commission (CQC) Assurance Framework for Adult Social Care pdf icon PDF 322 KB

(indicative timing: 2:50pm to 3:20pm)

Additional documents:

Minutes:

The Strategic Director referred the Panel to the Agenda Report, highlighting that the new Care Quality Commission (CQC) assurance framework for adult social care was part of the Health and Care Bill, published 6 July 2021, which set out key legislative proposals to reform the delivery and organisation of health and care services in England, building on the existing Integrated Care Systems (ICS) model.

 

Little was known about the new framework, however, the CQC was planning stakeholder engagement workshops to help establish a baseline for assessing local authorities and was working closely with Directors of Adult Social Services.  It was anticipated that CQC inspection of local authority adult social care would begin from April 2023.   

 

Since 2010, Councils had worked together to support their own performance through ‘Peer Reviews’.  The West Midlands network was active and Worcestershire had benefitted from this approach in January 2020.  In addition, to prepare for CQC assurance, several self-assessment tools had been developed by Worcestershire Officers and shared regionally.  Feedback received was good, which added to the progress made since the 2020 Peer Review.

 

The Government’s Integration White Paper was published on 9 February 2022.  It focussed on integration at place level and aligned with the Health and Social Care Bill, however, it was noted that children’s services were not included and questions on governance, leadership and digital transformation remained unanswered.

 

In the ensuing discussion, the following main points were made:

 

·         When asked in what areas the Council was weakest, the Strategic Director suggested that more evidence of co-production would likely be required.  In addition, long term funding of adult social care, however, this was an area of concern for all Councils.  It was anticipated that comparisons would be made with similar local authorities and the use of the Council Tax Levy would be a contributing factor

·         The Cabinet Member with Responsibility added his concern about the budget, especially the introduction of the cap on care costs.  In Worcestershire, 60% of residents were self funders and this would result in a considerable challenge.  It was noted that other authorities, such as Nottinghamshire, had a higher Council Tax

·         Concern was raised around the proposals of measuring shared outcomes across the ICS, rather than outputs, which would come into force from April 2023.  The notion of the right healthcare and the right care at the right time would focus partners to collaborate

·         The White Paper included, under Leadership, the appointment of a single person accountable for the delivery of a shared plan and outcomes in each place or area, agreed by relevant local authorities and Integrated Care Board.  The Strategic Director commented that there was no further detail, nor whether the position would be executive or non-executive

·         When asked whether the relationship between the CQC and the Council would change, it was reported that it would likely evolve and become more of a partnership model, especially as the CQC workforce would change due to the inspection regime

·         The ICS was a long term initiative, with the ability  ...  view the full minutes text for item 423.

424.

Performance and In-Year Budget Monitoring pdf icon PDF 134 KB

(indicative timing: 3:20pm – 4.05pm)

Additional documents:

Minutes:

As part of the Agenda, the Panel had received an update on Quarter 3 Performance and Budget in relation to the remit of the Panel.

 

Budget

The Head of Finance reported that at the end of Quarter 3, the forecasted end of year budget in relation to services covered by the Panel was broadly a breakeven position, with a variance of -£37,000.  Increased unit costs and an increase in activity were a cause for concern.  Lobbying of Government was taking place for the continuation of the NHS Hospital Discharge Grant, with funding currently being claimed via this stream.  The Council was continuing to work proactively with Health Partners to manage joint funding and an updated s117 policy was approved by February Cabinet.

 

Performance

The Management Information Analyst summarised the performance information provided.  There were more admissions compared to national data, however, the direction of travel was promising and all action plans were focussed on alternatives to long term care.  The scrutiny of Continuing Heath Care funding had been useful.  Reablement services had strong performance and there was an improving picture of performance since Mental Health services had returned to the Council. 

 

During Member discussion, key points included:

 

·         In relation to Mental Health staffing savings, it was clarified that following the move of staff from Herefordshire and Worcestershire Health and Care Trust to the Council, there was a temporary underspend

·         When asked if vacancies were keeping the overspend lower, it was reported that service demand was higher than the budget and unit costs were also higher for the activity undertaken   

·         Following the last meeting, thanks were given to Officers for providing additional information which provided clarity to the performance information presented

·         When asked why the number of Annual Care Package Reviews completed was poor, the Strategic Director reported that there were clear expectations on the number required to be completed each month.  It was stressed that the target was very high, rightly so, but there was no reason why a review should not take place

·         Clarity was given that admissions to permanent care per 100,000 for those aged 18-64 was reported on a rolling yearly basis, for example 68 in December 2021, was the figure for the 12 month period January to December 2021.  It was noted that the cohort was relatively small as families often used other services first, such as supported living and Shared Lives.  Currently, 2,600 individuals aged 18 to 64 were supported by the Council.

425.

Work Programme pdf icon PDF 131 KB

(indicative timing: 4:05pm – 4:15pm)

Additional documents:

Minutes:

From the existing Work Programme, the Panel agreed to schedule the following Items to its May Agenda:

 

·         Direct Payments

·         Independence Focussed Domiciliary Care Service in Worcestershire.