Agenda and minutes

Apologies for absence were received from the Chair Councillor Cleaver. Councillor Joshi as Vice Chair, took the Chair for the meeting.

Apologies for absence were also received from Councillor Chaplin.

Members are asked to declare any interests they may have in the business to be discussed.

Councillor Joshi declared an Other Disclosable Interest in that his wife worked for the Reablement Service in Leicester City Council.

In accordance with the Council’s Code of Conduct, this interest was not considered so significant that it was likely to prejudice the Councillor’s judgement of the public interest. Councillor Joshi was not therefore required to withdraw from the meeting during consideration and discussion of the agenda items.

The minutes of the meeting of the Adult Social Care Scrutiny Commission held on 4 December 2018 have been circulated and the Commission is asked to confirm them as a correct record.

AGREED:

that the minutes of the previous meeting of the Adult Social Care Scrutiny Commission held 4 December 2018 be confirmed as a correct record.

The Monitoring Officer to report on any petitions received.

The Monitoring Officer reported that no petitions had been received.

The Monitoring Officer to report on any questions, representations or statements of case.

The Monitoring Officer reported that no questions, representations or statements of case had been received.

The Director of Finance submits a report setting out the City Mayor’s proposed budget for 2019/20 to 2021/22.

The Adult Social Care Scrutiny Commission is recommended to pass any comments to the Overview Select Committee as part of its consideration of the report before it is presented to the Council meeting on 20 February 2019.

The Director of Finance submitted a report that set out the City Mayor’s proposed budget for 2019/20 to 2021/22. The Adult Social Care Scrutiny Commission was asked to pass any comments to the Overview Select Committee as part its consideration of the report prior to it being presented to Council on 20 February 2019.

The Strategic Director, Social Care and Education referred to the Adult Social Care element of the budget and said that there were continued growth pressures in Adult Social Care in Leicester and across England as a whole.  The pressures arose from an increase in people’s needs and frailty, but pressures also arose in adult mental health where people suffered disproportionately more in Leicester compared to nationally.

Members heard that the Green Paper, which will set out additional funding for Adult Social Care had been delayed five times and had still not been released. There was no certainty as to what would happen in approximately 13 months’ time, when the current allocation of additional funding for Adult Social Care ran out. Members expressed very strong concerns at the extremely difficult situation and the pressure the service faced because of the delay in the Green Paper and the uncertainty about future funding.

The Strategic Director explained that Spending Review Four was underway and the service had already delivered some of the required savings, but savings and efficiencies would not solve the problem after 2020 if the Government did not allocate additional funding to Adult Social Care.

During the ensuing discussion, comments and queries were raised which included the following:

·      The Chair stated that the largest proportion of council money was allocated to the City Council’s essential Adult Social Care services. The general budget strategy of the Council meant that the  service in Leicester had been supported more than many other Adult Social Care services elsewhere in the country.  The Chair added that the continuous austerity the country was experiencing made the decisions around budgeting especially difficult.

·      It was noted with some concern that the current round of Better Care Funding was due to end after 2019/2020 and an officer explained that they were waiting to hear more about the fund in the Green Paper. The Strategic Director commented that the Association of Adult Social Care Directors had consistently applied pressure to the Government to release the information regarding Adult Social Care funding. He thought it unlikely that the Better Care Fund would not be replaced with something else, but they did not know what and had no indication of when the announcement would be coming.

·      The Assistant City Mayor for Adult Social Care stated that there was a lot of talk about elderly people, but approximately one third of the budget was spent on people with mental health issues or learning disabilities. Adult Social Care provided a good service, but in respect of people with learning disabilities, there were parts of the service she would like to deliver differently and for which more resources were needed.

·      The Assistant  ...  view the full minutes text for item 67.

The Learning and Development Manager will deliver a presentation for noting to the Adult Social Care Scrutiny Commission on Learning and Development in Adult Social Care.

The Committee received a presentation on Learning and Development in Adult Social Care; a copy of which had been included in the agenda.

Members considered the presentation and during the ensuing discussion, the comments and queries raised and the subsequent responses, included the following:

·      Councillor Dempster, Assistant City Mayor for Adult Social Care said that the area of work around learning and development was extremely important. The Council needed to recruit and retain social workers and there were issues around recruitment across the country, not just in Leicester.  It was important that Social Care delivered this specialist service, rather than it being delivered corporately, and that it was reviewed to ensure it met the needs of the service.

·      In response to a query about the ‘My Time peer review’ Members heard that this enabled practitioners from Leicester and other authorities to meet up and provide feedback to each other and enabled good practice to be shared.

·      Members heard that the Adult Social Care service was looking at offering a social work degree apprenticeship. This would enable officers such as care management staff who were very skilled and whose work included some social work, to be released one day a week to attend university. They would receive on the job training and at the end of three years would gain a social work qualification.

·      In response to a question as to how the learning and development plan would address the shift towards integrated locality teams, Members heard that plan was designed to address the Council’s internal needs rather than the shift towards the locality teams.

·      Members heard that the Safeguarding Adults Board included an engagement officer who was going out into the communities to talk about safeguarding. By doing this, the officer was able to reach people who had English as a second language. Members heard that this was not purely the responsibility of social workers because safeguarding was everyone’s responsibility.  Mr Micheal Smith, Healthwatch said that Healthwatch were involved in Leicester City Council’s Adult Safeguarding Board and he praised the work that the City Council were achieving in this area.

·      In response to a question about the workforce, Members heard that it was broadly representative of people in the community, but a barrier had been identified at Grade 11 of the pay scale. The Director of Social Care and Children offered to bring a report on this back to the Commission and the Chair responded that this would be helpful.

The Chair drew the discussion to a close and asked Members to note the report with a recommendation for the report to be brought back to the Commission in a year.

AGREED:

that the Learning and Development Plan be noted, and an update be brought back to the Commission in a year.

The Strategic Director for Social Care and Education submits a report to the Adult Social Care Scrutiny Commission which brings together information on various dimensions of adult social care performances for the second quarter of 2018/19. The Commission is recommended to note the areas of positive achievement and areas for improvement as highlighted in the report.

The Strategic Director of Social Care and Education submitted a report that brought together information on various dimensions of adult social care performance for the second quarter of 2018/19.  The Strategic Director presented the report and the Assistant City Mayor for Adult Social Care expressed a view that as it was only a quarterly report, it might not be generally very helpful to Members whereas the annual report provided the overall picture.

In response to concerns that some of the service users may speak or understand little English, the Strategic Director explained that interpreters were used where appropriate, as it was important that people understood the process. However, if a member of staff was fluent in the required language they would not need the services of an interpreter.

The Chair drew the discussion to a close and asked the Commission to note the report and commend the staff for their hard work.  The Chair also suggested that the concerns raised in the report be acknowledged along with the provisions put in place to ensure those services improve.

AGREED:

that the Commission note the report, commends the hard work carried out, acknowledges the concerns raised in the report and provisions put in place to ensure those services improve.

The Strategic Director for Social Care and Education submits a report to the Adult Social Care Scrutiny Commission with a draft copy of the Joint Health and Social Care Disability Strategy, which seeks comment / feedback on the draft strategy and consultation materials. The Commission is recommended to note the draft strategy and to provide comment / feedback on both the draft strategy and consultation materials.

The Strategic Director for Social Care and Education submitted a report `and the draft Health and Social Care Learning Disability Strategy to the Commission. As part of the report, Members received a power-point presentation a copy of which is attached to these minutes.

The Chair asked whether easy to read explanatory information would be sent with the questionnaires. The Director of Adult Social Care and Commissioning said that an easy to read document would be provided. However, it was acknowledged that some people would not be able to read that document, in which case support would be given to help those individuals understand what the questionnaire was about.

Mr Micheal Smith, Healthwatch said that Healthwatch wanted to add their support to the consultation.

The Chair asked Members to note the report and presentation and asked for the consultation findings to be brought to the Commission in the new municipal year.

AGREED:

that the Commission note the report and presentation and request that the consultation findings be brought to the Commission in the new municipal year.

The Strategic Director for Social Care and Education submits a report to the Adult Social Care Scrutiny Commission which presents the full picture of the performance for the Adult Social Care Outcome Framework in 2017/18. The Commission is recommended to note the areas of positive achievement and areas for improvement as highlighted in the report.

The Strategic Director for Social Care and Education submitted a report that presented the full picture of the performance of the Adult Social Care Outcome Framework in 2017/18. The Strategic Director presented the report and during the ensuing discussion, Members raised comments and queries which were responded to by officers. These included the following:

·      The Chair noted that there was a reference to SALT and questioned what this stood for. The Strategic Director explained that SALT referred to short and long-term support. An individual’s journey on the adult social care pathway was mapped and it could be seen, for example, the number of people receiving short term support who became recipients of long term support.

·      The Assistant City Mayor for Adult Social Care thanked Adult Social Care officers for the improvements they were making year on year, including improvements to service delivery despite the significant budget pressures. She said that the current situation was very different to that in 2013 and the Strategic Director added that staff had worked very hard to improve service performance since that time.

·      Members heard that Leicester had also achieved very good results relating to Delayed Transfers of Care (DTOC) but authorities like Leicester who were performing very well on this measure were penalised by having even higher targets set.

·      A concern was raised that some issues appeared to be the responsibility of the Leicestershire Partnership Trust rather than Adult Social Care, such as the indicator for the number of people with a learning difficulty who were in paid employment. The Strategic Director agreed and said this indicator needed to be changed at a national level, but it was something that the Government needed to do.

The Chair drew the discussion to a close and congratulated the staff in Adult Social Care for the improvements to the service they were making. It was suggested and agreed that an email would be sent to all staff in Adult Social Care on behalf of the Scrutiny Commission to thank them for their hard work.

AGREED:

1)    that the Adult Social Care Scrutiny Commission note the report and progress made; and

2)      that an email be sent from the Commission to all staff in Adult Social Care to thank them for their hard work and dedication towards ensuring that people’s experience of using the service are improving.

The Strategic Director for Social Care and Education submits a report to the Adult Social Care Scrutiny Commission which brings together key findings from the national survey of Adult Social Care service users carried out in 2017/18. The Commission is recommended to note the areas of positive achievement and areas for improvement as highlighted in the report.

The Strategic Director, Social Care and Education submitted a report which presented the key findings from the national survey of Adult Social Care service users carried out in 2017/18. The Strategic Director presented the report and during the ensuing discussion Members raised comments and queries which were responded to by officers. These included the following:

·      As part of the survey, people were asked about their perception of their health and the Chair noted that in relation to the number of people who reported very bad health, Leicester was the fourth worst in England. The Chair asked what could be done to improve that situation.

The Strategic Director expressed a view that this was an issue for the health authorities. Public Health however was working hard with the NHS on health prevention and carrying out a considerable amount of work on diabetes.

·      It was noted that in relation to people who had reported extreme pain or discomfort, Leicester was the 7^th worst in England and the Assistant City Mayor of Adult Social Care expressed concerns for people living with arthritis. She said that that there was a variety of therapies to help arthritis sufferers, but those therapies were not available in Leicester.

·      The Assistant City Mayor said that she was aware of one surgery in the city, where patients had to wait four weeks for a routine blood test and she expressed a view that sometimes people’s health declined because the service they were being given was not good enough.

·      A Member expressed further concerns about poor air quality in the city which resulted in respiratory complaints. 

·      It was acknowledged that GPs were under pressure. Comments were made that it was hoped that people would try to take more care about their health, but also that the NHS would help people at the appropriate time.

·      Mr Micheal Smith, Healthwatch said that there were some GP practices which were not performing well, but others which were very good. There was a significant number of people with multi morbidity issues and this had a knock-on effect.

The Chair drew the discussion to close commenting that the NHS was under-funded and under-resourced. Members were asked to note the report.

AGREED:

that the report be noted.

The current work programme for the Commission is attached.  The Commission is asked to consider this and make comments and/or amendments as it considers necessary.

Members were asked to note and comment on the Adult Social Care Scrutiny Commission work programme.

The Chair stated that an additional meeting of the Commission had been arranged for 19 March 2019 to consider the Green Paper, but as yet there was no information as to when that would be published.

The Strategic Director requested that the outcome of the Adult Social Care Test and Assurance of the Department be added to the work programme for the next meeting.

The meeting closed at 7.35 pm.