Agenda and minutes

The Chair led introductions and advised this was a virtual meeting as permitted under section 78 of the Coronavirus Act 202 to enable meetings to take place whilst observing social distancing measures. The procedure for the meeting was also outlined to those present.

There were no apologies for absence.

The Chair held a moments silence in memory of His Royal Highness The Prince Philip, Duke of Edinburgh who passed on 9^th April 2021.

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

Members of the commission were asked to declare any interests they may have in the business on the agenda.

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

Councillor March declared an Other Disclosable Interest in that she had caring responsibilities for an older family member.

In accordance with the Council’s Code of Conduct neither interest was considered so significant that it was likely to prejudice the Councillors’ judgement of the public interest and therefore neither Councillor was required to withdraw from the meeting during consideration of any items on the agenda.

There were no other declarations of interest made.

The minutes of the meeting of the Adult Social Care Scrutiny Commission held on 9 March 2021be confirmed as a correct record.

Item 93 Draft General Fund Budget and Draft Capital Budget 2021/22

A point was raised that the minutes of the last meeting did not give a full reflection of the discussion around the procurement and commissioning plans for 2021 to 2022 in that there was a specific request to bring forward regular updates with regard to domiciliary care and care packages as a specific issue since that included a particularly large increase in contractual costs.

Item 106 Supported Living and Extra Care Housing

In relation to progress with the new development at Tilling Road it was noted that there were still ongoing negotiations with the builders which would hopefully conclude in the next week and officers would provide a more detailed update to the next meeting.

Noted that additional information in relation to the community opportunities item had been provided by officers and circulated to Members by email.

AGREED:

That the minutes of the meeting held on 9^th March 2021 be confirmed as an accurate record subject to the clarification on the position of bringing forth regular updates around domiciliary care to future meetings as above.

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 statement of case had been received.

The Strategic Director for Social Care and Education will provide an update on the Dementia Strategy.

Members of the Commission are recommended to receive the presentation and pass any comments to the Strategic Director for Social Care and Education.

The Strategic Director for Social Care and Education presented an update on the Dementia Strategy.

The Head of Commissioning for Social Care and Education introduced the report reminding Members of the background to the Joint Dementia strategy which was owned by the LLR Dementia Programme Board that sat under the All Age Mental Health & Dementia Design Group.

The purpose now was to update the strategy which had been in place since 2019 and Members attention was drawn to several key statistics in the presentation.

Members noted that:

·         Historically it was difficult to capture those diagnosed with dementia and locally huge improvements had been made on that with greater accuracy,  it was known that locally about 76% of people presenting with symptoms have a diagnosis of dementia.

·         The Covid pandemic had hugely impacted on diagnosis rates for dementia and those coming forward onto the pathway had dropped as direct result.

·         The strategic vision was for Leicester, Leicestershire and Rutland (LLR) to be places where people can live well with several guiding principles to help achieve that, namely – Preventing Well; Diagnosing Well; Supporting Well; Living Well and Dying Well. The aim was to create a care system that worked together to provide access to compassionate care and support through diagnosis to end of life for every person with dementia, their carers, and families.

There were several actions being taken towards Implementation and Achievement, i.e. Pathway - one action was to review and promote  a memory assessment pathway and referral processes as previously this was very fragmented, people could still enter the pathway at various points but work had been done to improve awareness of dementia so when anyone presents with concern about memory with medical services, when diagnosis given or dementia ruled out then that person is put on pathway which provides advice, guidance, support and residential care information.

Another action involved working with care homes to pilot and roll out the Dementia Friendly general practice template which was a diagnosis toolkit which would help a lot of those in residential care with dementia but no formal diagnosis.

Members noted that engaging people living with dementia and their carers was important as it helped inform the work, prepare services, and ensure the right support was in place for people with dementia and in terms of training, staff and facilities available to them. Attention was then drawn to a future piece of work to review current care and support standards used across LLR regarding nursing care and colleagues working within groups in LLR will move this forward to include in the new strategy.

Members discussed the presentation which included the following comments:

Dementia Cafes had operated in Leicester for several years but due to Covid they had been closed, these were a very useful tool for people giving them access to a lot of information as well as a sense of belonging and support. Members were pleased to note plans to reopen and start face to face services later this month, especially  ...  view the full minutes text for item 115.

The Strategic Director for Social Care and Education will share the draft Mental Health Strategy for comment.

Members of the Commission are recommended to receive the report and pass any comments to the Strategic Director for Social Care and Education.

The Strategic Director Social Care and Education submitted a report providing Members of the Commission an opportunity to comment on the draft Leicester City Joint Integrated Commissioning Strategy for Adult Mental Health – 2021 to 2025.

The Head of Commissioning, Adult Social Care and the Lead Commissioner, Adult Social Care introduced the report.

Members noted that:

·         Mental health was now recognised as the largest single cause of disability in UK.

·         The report set out a draft strategy attempting to bring mental health into parity with physical health.

·         The draft strategy was informed by the Five Year Forward View for Mental Health published by the government in 2016 and builds on the first strategy in place from 2015-2019.

·         The draft strategy focused on three key themes, Prevention, Accommodation, and Employment Education and Volunteering.

·         Work had been carried out with public health colleagues around the impact of Covid upon people’s mental health and the predicted impact of that on services which would be included in the next draft version. There was expected to be an increase in people with mental health issues of 10-20% as result of Covid, so the strategy needed to be finalised around that, to inform and monitor services.

·         The strategy included an action plan with the same three key themes, this focused on making improvements across health and social care and with services we support that deliver in the community. There would also be a pathfinder led by health in conjunction with partners.

Members welcomed the opportunity to consider and discuss the draft strategy.

In terms of the cross over between addiction and mental health issues and how the strategy addressed that, it was recognised that a lot of the people being supported were also known as dual diagnosis with their mental health being affected by some form of addiction, there were services funded to help those with substance misuse and their mental health issues too. Public health officers were also part of the Mental Health Partnership Board and, another element in the strategy was around housing and people coming through the homelessness route or through health services/hospital route.

There was discussion around suicide prevention which included timeliness to intervention and whether there were resources to be responsive at that most vulnerable time such as a rapid response team. It was advised that the public health team were leading on work relating to suicide prevention noting there were services supporting people on that pathway with good work being done.

A member of the commission commented that the police had a crisis negotiating team as they sadly had to deal with people on many occasions threatening suicide in a public way and it was suggested that officers should talk to that crisis team to learn or debrief. It was confirmed that at an operational level officers did connect with crisis response teams and through the suicide prevention group broader themes were considered. Officers welcomed the suggestions and agreed to consider how the more granular detail in terms of a  ...  view the full minutes text for item 116.

Members will receive a verbal update on progress relating to the recommendations of approved scrutiny review report. Leicester Skills Development Group representative (LSDG) will update commission members on their work and plans for the future.

Members of the Commission received a verbal update on progress relating to recommendations arising from the scrutiny review into Social Care External Workforce.

Members were reminded that they had received an Executive response to the review at a previous scrutiny meeting on 19 January 2021.

The Vice Chair commented that this update was sought because there was concern that the response to the scrutiny review placed a large amount of responsibility upon Leicester/shire Social Care Development Group (LSCDG) and she was keen for this to be here to understand how the responsibilities identified in the review were going to be actioned and brought forward.

The Strategic Director for Social Care and Education briefly explained that in certain sectors of Adult Social Care separate organisations were commissioned to do work in workforce development. However, the LSCDG wasn’t a separate body, it was a legal partnership between this local authority, the County and Rutland working with other partners across the system to provide training for external care workforce.

A representative from the Leicester/shire Social Care Development Group (LSCDG) was present and gave an update around Adult Social Care workforce planning for the future.

Members noted that:

·         LSDG was a legal partnership between Leicester City Council, Leicestershire County Council and Rutland County Council to work together as one collaborative partnership.

·         The main function was to support the workforce and raise quality, e.g. there was a training plan that includes safeguarding, leadership skills, moving and handling etc, but with the pandemic there had been a move to digital to replace class based activities.

·         LSCDG worked closely with contract and commissioning staff across the 3 local authorities and Skills for Care, its sub regional workforce group provided the main direction.

The update in relation to specific points in the “Response to the Adult Social Care Scrutiny Commission Task Group Meeting – Social Care Workforce” report included the following comments:

·         Point 4 Quality of care and improving retention rates – LSDG had received a report on career pathways today this would be worked through to identify how best that can be implemented and a further update provided at a later date.

·         Point 5 Finding Community and cooperative solutions – the LSDG sub regional workforce group was due to meet in June to motion this recommendation from the report and if agreed that piece of work could then be taken forward.

·         Point 8 Attracting younger people to adult social care careers – this was part of the careers pathway work already being done and through the Inspire to Care Programme workshops and engagement activity were taking place,

·         Point 10 Workforce plans - some local workforce plans and packs had been created with aspiration for local authorities to create an action plan and report back, meetings had been arranged to look at how that work could be done together rather than separately.

·         Points 11, 12 and 13 were inter related around investing in training and development and upskilling of staff so were being taken together; LSDG  ...  view the full minutes text for item 117.

The Strategic Director for Social Care and Education will provide a verbal update on the latest position relating to LCCL.

The Strategic Director for Social Care and Education gave a verbal update on the latest position relating to Leicestershire County Care Ltd (LCCL).

Members of the Commission were reminded that the LCCL position had been discussed a number of times over the past year, and a representative had spoken at the scrutiny meeting on 19 January 2021 giving assurances that the outstanding £200,000 due to the council would be paid by the end of the financial year 2020-21.

It was noted that:

·         The monies owed were originally due to be fully repaid at end Autumn 2020 at which point LCCL sought deferment and with some reluctance on the part of the council the view was taken to allow them to defer that payment taking account of the significant pressure LCCL were under due to Covid etc

·         The council were given a firm guarantee the remainder due would be received by 31 March but that was not received, and the council had sought through several routes to make contact with LCCL but without any response.

·         The council were now in position of starting process legally to recover the £200,000.

·         The council held a charge on one of the LCCL properties and could seek possession, however the council was considered what the most effective process would be to secure payment of the debt without causing issue for any residents or staff.

·         It was guaranteed that the council would receive full payment either taking back payments the council gave monthly or as a last resort repossession of one of the buildings.

Members of the commission noted the comments and it was publicly noted that the council were very disappointed given the firm assurances given by the company to this commission and very concerned and disappointed that payment had not been made and that there has been no response to numerous attempts to contact them. Members were satisfied that there were measures that could be taken by the council to secure the debt.

Members expressed their disappointment and concerns at the lack of payment and especially at the lack of response and were troubled by what this implied in terms of the leadership of a company such as LCCL that was responsible for care of people.

Members raised concern about the ongoing financial stability of the company and whether there was assurance in the standard of care in immediate term being given. Members also sought clarification on whether this whole issue highlighted failings in a market intervention because ultimately the council would step in. Responding, officers advised that there had been a strong national push in recent years for residential care and nursing care to be provided by commercial organisations and there were strengths that can come from such commercial arrangements. However, the local authority was ultimately the responsible body and if the company that runs a care home went out of business the implications for those residents and their families were very significant so there were issues where a “for profit organisation for  ...  view the full minutes text for item 118.

The Strategic Director for Social Care and Education will provide a verbal update on the latest Covid-19 updates.

The Strategic Director for Social Care and Education gave a verbal update on the latest position regarding Covid-19and its impact upon services.

Councillor Kitterick and Councillor Thalukdar left the meeting during this item – the meeting remained quorate.

It was noted that:

·         There had been positive take up of vaccination in care homes with health colleagues working hard to ensure residents and staff were vaccinated, latest figures showed that currently of homes that provide care for older people 93% had received their 1^st doses and 76% staff received 1^st dose, however in care homes for people of working age the numbers were lower.

·         2^nd doses had been offered at all care homes for older people although data was not yet complete it suggested 69% of those in “older” care homes and 64% in work age homes have had second dose.

·         There was a comprehensive system in place for testing across the adult care system generally with staff receiving a PCR test weekly and access to LFT Tests twice a week; LTF testing was also in place for visitors.

·         Week of 18 April testing in care homes produced 13 positive results (11 staff, 2 residents), that figure has been relatively stable over past month and was same level as reported in Aug/Sept 2020 compared to end January 2021 where it stood at over 270 positive tests per week. Of the 13 only 2 are residents the rest are staff.

·         Work continued with providers to reinforce the importance of regular testing as numbers come down.

The Chair thanked the Strategic Director for the comprehensive update and on behalf of commission thanked all staff and front line staff working hard throughout the pandemic and noted progress being made.

The Chair concluded that his thoughts and prayers go to families who have lost people through this pandemic and expressed thanks to all council members who have worked tirelessly throughout.

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 of the Commission were invited to consider content of the work programme and were invited to make suggestions for additions as appropriate to be brought to meetings in the new municipal year.

Noted this was the last commission meeting of the municipal year and further meeting dates would be circulated in due course.

The Chair commented that it had been a pleasure for him to Chair this Commission over the past two years and he thanked all members of the commission for their attendance and commitment to the work of the commission and for their excellent debate throughout meetings.

The Chair also thanked the Executive Member, Adult Social Care officers as well as Democratic Support officers and Scrutiny Support officers.

There being no further business the meeting closed at: 20.23