Agenda and minutes

The Chairman welcomed everyone to the meeting, including Cllr Brandon Clayton, Chairman of the Health Overview and Scrutiny Committee (HOSC) and Cllr Alan Amos, the Vice Chairman of the Overview and Scrutiny Performance Board (OSPB).

None.

Members of the public wishing to take part should notify the Democratic Governance and Scrutiny Manager in writing or by e-mail indicating both the nature and content of their proposed participation no later than 9.00am on the working day before the meeting (in this case Friday 4 November 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.

None.

Previously circulated

The Minutes of the Meeting held on 28 September 2022 were agreed as a correct record and signed by the Chairman.

(Indicative timing 2:05 – 3:00pm)

The Cabinet Member with Responsibility (CMR) for Adult Social Care and Senior Officers from the People Directorate were welcomed to the meeting.  Panel Members were reminded of the main points within the Agenda, including:

·         all of Worcestershire’s health and social care partners were committed to delivering good quality person centred care

·         an Intermediate Care Service had been in development for 12 months, on an interim basis.  Partners collectively challenged what ‘good’ looked like, reasons for delays and what barriers were stopping progress.  It was clear that System pressure was year round, not just during the winter months and the interim model would continue whilst long term plans were developed

·         the Onward Care Team (OCT) model was due for review after being in place for 12 months.  Although a vital service, sitting on the front door of urgent care, it was important to challenge whether any further improvements to the OCT could be made.  The hospital based Team covered both health and social work staff and was responsible for short term discharge planning, supporting individuals and signposting to consider all discharge options  

·         the Reablement Service supported people leaving hospital to recover at home (Pathway 1) and had an element of admission avoidance as a ‘service of last resort’ on occurrences of existing care provider failure.  Although very successful, there were challenges around recruitment, especially as front line roles were attractive to those already employed in other areas of the care market.  Of 100 new posts created through additional funding, 60% had been filled within 6 months.  This success had earned national recognition and other local authorities were keen to learn how it had been achieved

·         further challenges related to increased demand, the requirement for additional domiciliary care hours, the need for staff to double up for some patients and the logistics of a large, mainly rural County

·         ‘Right to Reside’ was when a patient no longer met the national criteria to reside in a community hospital and had replaced ‘Delayed Transfers of Care (DTOC), which Panel Members would have heard previously.  If barriers to community hospital discharge (Pathway 2) were identified, such as equipment needs, family circumstances or agreeing eligibility for NHS Continuing Healthcare (CHC), System partners would work with individuals and families to devise discharge plans.  It was noted however that delays could also occur if resource was shifted to promote Pathway 1 discharges from acute settings

·         Intensive Assessment and Rehabilitation (IAR), Pathway 3, was provided at Worcester City Inpatient Unit, where up to 21 beds could be used for patients who were assessed in acute hospitals as being unable to have their care and support needs met in their own environment and had no rehabilitation goals identified at that point in their recovery.  Patient flow could be an issue due to the complex nature of rehabilitation needs.  The chance of long term care was much higher, but those conversations did not take place in an acute setting.  In addition, a small number of Discharge to Assess (DTA) beds, also  ...  view the full minutes text for item 452.

(Indicative timing 3:00 – 3:30pm)

Members had received performance information relating to Quarter 2 (July to September 2022).  In response to a previous request, further detail had been added to the dashboard.

Of the 5 Key Priorities reported, the Directorate had no major concerns on performance at the end of Quarter 2 and there was some good performance to report.  In relation to the performance of annual care package reviews completed, there had been some workforce issues however these were now being undertaken at the rate expected.

Panel Members were invited to ask questions and the following points were raised:

·         Although positive, a Member asked why admissions to permanent care per 100,000 (65+) had dropped monthly from April to August 2022.  In response it was suggested that the COVID-19 pandemic had seen some decreases, however, now more people were discharged home with support, rather than a discharge to assess placement.  Some people were also choosing live in carers, which could at times be more cost effective

·         A Member asked whether the 95% target of annual care package reviews completed was too high if it was not achievable.  It was explained that the target had been reached previously but was currently one area where workforce could be diverted to other duties if required.  Levels of risk were closely monitored and certain reviews could be undertaken remotely.  The Strategic Director advised that the 95% target was appropriate

·         A Member asked whether the Council looked outside of the UK at best practice, citing an example in Israel.  The Strategic Director gave examples of ‘retirement village’ models which had been adopted in the UK and suggested that different ways of working could be investigated if social care reforms were implemented as there would be a lack of social workers nationally to undertake the work proposed.

(Indicative timing 3:30 – 3:35pm)

The Panel agreed with the CMR’s suggestion to add ‘Update on Adult Social Care Reforms’ to the March 2023 Agenda.  A Member asked for early consideration of the ‘All Age Disability Service’, however it was agreed to leave as June/July 2023 in order that a full year could be reported on.