Agenda and minutes

Councillor Joshi as Chair led on introductions.

There were no apologies for absence.

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

Councillor Joshi declared that his wife worked in the Reablement Team for Leicester City Council.

The minutes of the meeting of the Adult Social Care Scrutiny Commission held on 18 AUGUST 2022 have been circulated and the Commission is asked to confirm them as a correct record.

The Chair suggested that a Members briefing session be arranged following the Health and Care Reforms item and delays on the White Paper and to help understand the market stability plans and fair cost of care plans. The Strategic Director for Social Care and Education noted that this situation could change and that the government had announced some key elements of the reforms had been postponed for 2 years. The Introduction of Care Accounts and Care Cap and the changes to the means test which was more important to Leicester were parts of the reforms that had been delayed.

Additionally, under section 18.3 of the Care Act which allowed for self-funders to request the authority to buy their care for them at the rate the local authority pays had not been commenced. Therefore, the Fair Cost of Care work had also changed as there was no longer the pressure for local authority fee rates to be increased in order so that, there was no differential between self-funders and the local authority rates and as a result, the government would not be allocating the funding that would have been allocated for that particular purpose.

Overall, with key parts of the reforms postponed, it was not clear at this stage if the local authority would need to provide a market sustainability plan but the department will do so anyway. As a result, it was suggested that it would none the less be helpful to provide a briefing session for Members as a lot of the reform programme would still be going ahead.

Members of the Commission welcomed this, as it would bring Members up to speed in an area where there were constant changes. Additionally, Members of the Commission also suggested that in advance of the budget, the briefing session should also cover aspects of the budget.

The Strategic Director for Social Care and Education took the opportunity to update the Commission following the Autumn Statement where £2.7 Billion of funding had been announced for Adult Social Care next year. Funding that was going to be allocated for reforms had been taken to increase fees, a majority of the funds were from the Better Care Fund which went to the NHS and the Adult Social Care service would work with the NHS on allocating this funding. Some of the additional funds also came from the Social Care Grant and it was important to recognise that this was for adults and children and was a non-ringfenced grant.

The Strategic Director for Social Care and Education further noted that, although, the DHSC Officials had been talking as if all of the money was going to go to adult social care, this was not the case and that although there was an element of the funding that was ringfenced to Adult Social Care, there was a large amount that was based on the presumption that councils would put up Council Tax by the additional 2%. DHSC have assumed that councils would have raised Council Tax  ...  view the full minutes text for item 12.

The Monitoring Officer to report on any petitions received.

The Monitoring Officer noted that none had been received.

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

The Monitoring Officer noted that none had been received.

The Chair noted that although not associated to the Adult Social Care Scrutiny Commission, learning about a decision that had been taken to close the site at Evington House was deeply concerning and suggested that lack of consultation and the lack of scrutiny was unacceptable and that Members should have been notified of this before a decision was taken.

The Chair thanked Councillor March for bringing to the attention of the Commission the Home Care consultation and expressed his concerns that the Commission were not informed of this from the earliest stage of the process.

The Deputy City Mayor for Social Care and Anti-Poverty noted that the Home Care engagement exercise as part of the engagement process before commissioning had begun but was at a very early stage and noted that the Adult Social Care Scrutiny Commission would be involved from the earliest stage.

The Chair thanked the Deputy City Mayor for the clarification.

The Strategic Director for Social Care and Education, submits a report to provide the Adult Social Care Scrutiny Commission with an overview of the rising cost of living impacts on Adult Social Care and the responses supporting this.

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

The Deputy City Mayor for Social Care and Anti-Poverty introduced the item and noted that this was a challenging report and the impact of the cost of living had and the level of response was limited due to resources.

The Strategic Director for Social Care and Education noted that the people who draw on social care would be the most affected by the cost of living crisis. The funding that had been provided to address this would just about enough to meet the inflationary pressures but would not allow the service to catch up.

The Director for Adult Social Care and Commissioning provided an overview of the report focussing on the impacts on Adult Social Care.

As part of the discussions, it was noted that:

·         There was a £500 workers reward scheme for carers working for CQC registered organisations with about 80% of staff in care homes and domiciliary care benefitted from this bonus and felt valued for their work

·         Signposting, advising and referrals were also a means of support for those who were struggling with the cost of living crisis to the services available to support

·         The Citizens Advice Bureau providing support and triaging priority cases with additional staff in place to get out into the communities for outreach work

·         About £4million was provided through grants in Leicester with 97% of care home staff and 89% of homecare staff benefitted providing valuable feedback

·         Members of the Commission felt that family members who provide care for loved ones missed out on the available grant and Officers noted that the grant money did have some eligibility criteria and this year’s scheme was targeted at hospital discharge although the funds were limited

·         A range of avenues were used to deliver services to those who were digitally excluded through the Communications Team, information sent out with staff and care providers and using partner organisations to also support

·         Information on the bid for Reform Grant was not available but it was noted that there was a limit on individual bids which were advertised through mailing groups and would be available on the council’s website

·         The Deputy City Mayor for Social Care and Anti-Poverty suggested Members were welcomed to provide any feedback they may have on experience of constituents with the Citizens Advice Bureau to feed into the regular practice management sessions

In further discussions it was noted that the allocation for discharge funds were £1.3million which was a combined sum for Leicester, Leicestershire and Rutland and the timeline for the deadline of the distribution of the funds was 16 December. Future details on this could be provided following the introduction of the retention reward scheme in xmas as this was a suggested time around when people leave their roles.

Members of the Commission raised their concerns with the mental impact of the current situation and suggested it was not just a financial impact and shared their concerns that many in the adult social care service may already be impacted and the need for more  ...  view the full minutes text for item 16.

The Strategic Director for Social Care and Education submits a report to provide the Adult Social Care Scrutiny Commission with an overview of preparation for the Care Quality Commission’s (CQC) Adult Social Care assurance process, which is currently expected to commence in April 2023.

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

The Deputy City Mayor for Social Care and Anti-Poverty introduced the item and noted that it was beneficial to understand how we compare with other places.

The Strategic Director for Social Care and Education noted that this was the first time in a decade that the local health authority functions in Adult Social Care would be inspected and ministers were keen to see this happen. It was noted that there were real challenges about this as the CQC was being asked to assess on an absolute standard and a methodology had been set which was not dependent on the different situation different authorities may be in.

The Director of Adult Social Care and Safeguarding provided an overview of the report and noted that the inspections would begin in April 2023 and that the service were as prepared as could be and there was a national pilot to help councils prepare but there were uncertainties on how these would run.

As part of the discussions, it was noted that:

·         There was a draft set of guidance available, but the process was unclear and there had not been an opportunity to make comparisons to others, but the council were aware of the challenges

·         Sector led improvements were very active in the region and there had been a peer review at the end of September 2022. The Strength Based Practice was looked into and resulted in very good feedback on areas of strength and areas where there could be improvements

·         Strategies in place regarding ‘Making It Real’ had produced a co-production framework that helped identify good practice and the experience of people was embedded in the delivery of service and developing strategies for the future

·         Self-Assessment was a possibility, with robust data set from the liquid logic care records system enabling all questions to be answered and the service were expecting both to be completed

·         ADASS were confident that the service would be able to reach the points raised at 4.10 in the report.

The Commission shared their support for the service in preparation for April 2023.

AGREED:

1)    That the Commission be updated in the future, and;

2)      That the comments raised by Members of the Commission be considered.

Councillor March, the former Vice Chair of the commission, will present the report of the Task Group review of “Understanding the Increasing Cost of Care Packages within Adult Social Care budgetary pressures”. 

Members of the Commission are recommended to receive the report and comment as appropriate.

The Chair took the Opportunity to thank Councillor March and those who participated as part of the Task Group.

Councillor March introduced the report and drew Members’ attention to the recommendations.

Members of the Commission thanked Councillor March for the work in producing the detailed report and findings.

The Deputy City Mayor thanked Councillor March and recognised the work that had gone in to produce the report and findings and suggested that this be sent to the relevant government department with the recommendations derived from the review.

AGREED

1)    That the Members of the Commission endorse the recommendations

2)    That the report be submitted to the Overview Select Committee for endorsement

3)    That the Commission request a response back from the Executive in early 2023.

The Strategic Director for Social Care and Education submits a report on the Carers Strategy.

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

The Deputy City Mayor for Social Care and Anti-Poverty introduced the item.

The Lead Commissioner provided the Commission with an overview of the Carers Strategy.

The Chair thanked the Officer for the comprehensive report and made a suggestion for a carers roadshow and what the Commission felt on this for the future. Officers noted that this was something that happened in the past but no longer took place due to resource and capacity issues. The only realistic approach was to go out into the communities, but this could be something for the future.

As part of the discussions, Members of the Commission noted that it was good to see the refreshed strategy and that the report showed how people supported society. Members of the Commission also wanted to take the opportunity to commend Officers for the Mobilise app which had very good data and the work done to adapt the service.

In response to Member queries around the commitment to funds, it was noted that there was an element of joint funding, but different departments support joint working ethos but funded separately and Members took the opportunity to commend Officers for the aspects outlined in the report as they were progressive, that the inclusion of BAME Groups was addressed and noted that Members would like to see a wider inclusion in the future.

It was further noted that the Young Carers service had been bought back in house which had led to an increase in the number of people supported from 15 to 300 and additional work was being delivered to co-design the training material used by professionals.

The Chair took the opportunity to thank the everyone for their work.

AGREED:

1)    That the comments made by the Commission be considered, and

2)    That the Strategic Director for Social Care and Education be requested to provide an update to the Commission in the future.

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.

Councillor March suggested that the following items be added to the work programme:

·         Assured Plans and Market Sustainability

·         Fair Cost of Care Reforms

·         Joint Adult Social Care and Health and Wellbeing Scrutiny Commission to look at Mental Health.

AGREED:

1)    That the items suggested, be added to the work programme, and

2)    That the work programme be noted.  

There being no items of urgent business, the meeting closed at 7:37pm.