Agenda and minutes

Apologies for absence were received from Councillor Joshi and from Philip Parkinson, (Chair of Health Watch Leicester).

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

Councillor Fonseca declared an Other Disclosable Interest in the general business of the meeting, in that his son worked for a charity involved in adult social care.

Councillor Willmott declared an Other Disclosable Interest in the general business of the meeting, in that a relative used adult social services.

Councillor Dr Moore declared an Other Disclosable Interest in agenda item 6, “Mental Health Care”, as she had close family members who had used mental health services.

In accordance with the Council’s Code of Conduct, these interests were not considered so significant that they were likely to prejudice the Councillors’ judgement of the public interest.  They were not, therefore, required to withdraw from the meeting.

The minutes of the meeting of the Adult Social Care Commission held on 7 November 2013 are attached and the Commission is to confirm them as a correct record.

RESOLVED:

That the minutes of the meeting of the Adult Social Care Scrutiny commission held on 7 November 2013 be approved 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 received.   

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

Councillor Cooke, Chair of the Health and Wellbeing Scrutiny Commission, has been invited to this meeting to present an overview of that Commission’s review of the mental health of working age adults in Leicester and progress with its recommendations.  A copy of the report of that review is attached at Appendix B1 for information.

The Commission is recommended to receive this update and consider what further work this Commission needs to do following the review, including any work considered desirable on the care of those with dementia.

The “Leicester, Leicestershire and Rutland Joint Dementia Commissioning Strategy 2011-2014” and the “Joint Specific Needs Assessment: Dementia In Leicester” are attached at Appendices B2 and B3 respectively as background information.

The Commission noted that Councillor Cooke, Chair of the Health and Wellbeing Scrutiny Commission, had been invited to the meeting to present an overview of that Commission’s review of the mental health services for working age adults in Leicester, but was unable to attend the meeting.

Councillor Dr Moore reminded Members of the interest she had declared in this item.

The Commission suggested that it would be useful to establish timescales for the commissioning priorities identified in the report in to timescales, so that an indication could be obtained of what would be done and how.  This could be assisted by making the recommendations more precise, so that achievements could be evaluated with greater accuracy.

Members were reminded that, since the review report had been produced, the Health and Wellbeing Scrutiny Commission had undertaken a review of the Bradgate Unit, which currently provided mental health services.  It therefore was suggested that the Adult Social Care Scrutiny Commission could review dementia services.  This could focus on older vulnerable people, in order to not repeat the work done by the Health and Wellbeing Scrutiny Commission.

RESOLVED:

That it be agreed at the next meeting of this Commission how the review of services for people with dementia will be reviewed and where this review should be included in the Commission’s work programme.

Representations will be made to the Commission following the recent consultation on proposed changes to housing related support services and how people would be affected if those changes happened.  The Commission is recommended to receive these representations.

a)         Representations

At the invitation of the Chair, the Commission received representations from the following people on proposed changes to housing related support services and how people would be affected if those changes happened.

i)          Alistair Jackson – Chief Executive of Leicester Quaker Housing Association

Alistair Jackson introduced himself to the Commission, explaining that Leicester Quaker Housing Association offered approximately 70 units of sheltered housing, plus a care home and day centre specialising in dementia care.  Residents at John Woolman House were able to live independently in sheltered housing.  Without the support services provided, many of these people would have to live in more expensive accommodation and some would be living on the streets.

It was understood that the Council had to make cuts in its services and so was considering how it needed to change the services it provided.  Under the current proposal, the Leicester Quaker Housing Association would no longer manage the services offered.  Instead, the Council would operate a centrally managed service, which would be phoned when a need arose and an officer would attend.

Tenants unanimously wanted to keep the current service and management system, as tenants knew the sheltered housing officers, and the housing officers had full knowledge of the tenants.  The officers worked 8 hours a day and Saturday mornings, so were available when needed by the tenants.  Under the new model, officers would only be present for a few hours in the week, at pre-set days and times.  This would reduce the flexibility that the current service had to respond to tenants’ needs and could result in crisis situations not being dealt with as effectively as they could be at present.

Alistair Jackson gave examples of the sort of work currently done with tenants.  These showed the ability of officers to work with people to enquire beyond immediate problems to identify reasons for those problems that were not immediately obvious.  They also were able to work closely with tenants to manage behaviour that otherwise could jeopardise their tenancy.

Leicester Quaker Housing Association was happy to continue to provide its current services and the tenants wanted the Association to do this.  This would give the Council the savings it needed, while giving the tenants a good quality of life.  It also would keep them out of hostels and off the streets, so the Council would not have to increase the budgets for work in those areas.

In reply to questions from the Commission, Alistair Jackson confirmed that, if there were funding cuts, the Association would need to be more focussed about how it defined tenants’ vulnerabilities and how these were dealt with.  It also would review its business model, in order to keep staff and find other ways of funding its work.

The Commission expressed concern that:-

·                     If the service was centralised, the required savings would not be achieved if the same service was not provided for all of its sheltered accommodation;

·                     A way of protecting the most vulnerable people affected by these  ...  view the full minutes text for item 68.

The Scoping Document for the review of Domiciliary Care is attached.  The Commission is recommended to approve the Scoping Document and agree how the review should be progressed.

Background information on the tendering process is attached in the exempt part of the agenda for Members only.

The Commission received the scoping document for the review of Domiciliary Care.  It also noted that background information on the domiciliary care tendering process was included in the exempt part of the agenda.  Concern was expressed at the large volume of information that had been included, and that there was no index and some of the pages did not appear to contain much, if any, information.

The Commission raised the following comments and questions during discussion of the scoping document:-

·           Zero hours contracts should not be being used;

·           The aspirations contained in the service specification document were good, but could be hard to implement, as low paid staff could be less motivated towards them;

·            Rather than just assess people’s very basic needs and provide a level of service that met them, people should be given the service they wanted.  For example, they may want to visit a day centre, or go shopping, but if this was beyond their basic needs this level of service would not be provided;

·           If a service user was difficult, or refused to accept care, or the care provider felt unable to continue to provide care for someone, the Council would work with the user, and their family if appropriate, to manage such situations.  The Council’s statutory duty to provide care and support would remain, but carers could not be required to work with an individual in these situations.  If this developed to the extent that an agency could not continue to provide a person’s care, alternatives could be examined, such as establishing a tailor-made service from the user’s personal budget, or linking the user to a personal assistant;

·           How was the break-down of time for visits worked out? Information also was needed on what was included as activities and how time was allocated to these, as there currently appeared to be a mismatch between aspirations and outcomes;

·           Approximately 6% of users had 15 minute visits allocated to them.  However, these could be part of a package that included other visits on the same day of different durations.  The Commission requested that the actual number of people receiving 15 minute visits be provided;

·           Work was underway to phase out 15 minute visits over the next 12 months, as users’ reviews were completed;

·           Information was requested on who the providers were;

·           A quality assurance framework was built in to the Domiciliary Care framework.  This could be made available to the Commission;

·           The Commission asked whether any form of “mystery shopping” was done and, if so, how often and what sample size was used.  It also requested that information be provided on whether service users were asked for feedback on their care;

·           It would be useful for the Commission to hear the experiences of users of domiciliary care and / or their families, in order to get a broad overview of the service;

·           Some users could be concerned about spending money.  This could cause problems if their families were unaware of the user’s resources, or the user had  ...  view the full minutes text for item 69.

The Director for Care Services and Commissioning (Adult Social Care) submits a report setting out an indicative timetable for the actions needed to support existing residents living in the Council’s Elderly Persons Homes that are due to be closed.  The Commission is recommended to note the report and comment as appropriate.

The Director for Care Services and Commissioning (Adult Social Care) submitted a report setting out an indicative timetable for the actions needed to support existing residents living in the Council’s Elderly Persons Homes that were due to be closed.

The Director for Care Services and Commissioning (Adult Social Care) advised the Commission that, once individual assessments had started, an overview would be provided for each resident, so that Members could see how the moves from homes that were closing were progressing.

In response to questions raised during discussion on the report, it was noted that:-

·           Officers had identified residents placed in city homes by Leicestershire County Council.  Details of these could be made available;

·           Some residents had indicated that they would prefer to move as soon as possible, but residents’ assessments had not started yet;

·           Residents’ moving plans would be reviewed as they progressed through the process;

·           No detailed discussions had been held yet with family members regarding preparing residents’ new accommodation with appropriate equipment and/or furniture prior to their move;

·           Work was underway to make sure that governance was in place so that a proposal for intermediate care could be drawn up, but a formal proposal had not been drafted yet;

·           Due to the absence of the Assistant Mayor (Adult Social Care) due to ill health, it had not been possible to progress the establishment of an Elderly Persons’ Commission; and

·           Options for the structure of Intermediate Care provision would be included in a report to the Executive.  Enough detail would be included to see the requirements and implications of each alternative.  A preferred option would be identified and details provided of how it was anticipated that it would be delivered.

RESOLVED:

That consideration of the options for Intermediate Care provision be included in the Commission’s work programme.

The Director for Care Services and Commissioning (Adult Social Care) submits a report setting out the results of a statutory consultation on a proposal to stop the Council’s current mobile meals service and helping people to prepare or obtain meals in alternative and more flexible ways.  The Commission is recommended to note the report and comment as appropriate.

The Director for Care Services and Commissioning (Adult Social Care) submitted a report setting out the results of a statutory consultation on a proposal to stop the Council’s current mobile meals service and help people to prepare or obtain meals in alternative and more flexible ways.

In response to questions from the Commission, the Director for Care Services and Commissioning (Adult Social Care) advised that the consultation did not explicitly ask people if they did not want to lose the mobile meals service.  Instead, it asked how stopping the service would affect them and what the impact of obtaining a meal in an alternative way would be. 

The direct question was not asked, as the Council had to move to providing service users with personal budgets and people were choosing other options, so the current service was not financially viable.  In order to assess the impact of the changes, respondents therefore had been asked if they had any views about the fairness of the changes and the ability of a new service to still give help to those who needed it.

The consultation findings showed that people still wanted a hot meal, but there were issues about quality.  For this reason, one of the options for the service was to provide a managed service through the Council from a Framework Agreement that included nutritional and quality standards.  This would mean that the Council could buy meals where wanted, meaning that recipients would not have to manage the financial aspects of this.

Members stated that it appeared that the consultation had been worded to obtain a preference for this option.  This in turn made it appear that the consultation was about meeting a budget savings target, not about providing a service. 

Members also asked what would happen to staff if no providers tendered for the contracts and so staff could not be transferred under the Protection of Employment (Transfer of Undertakings) Regulations (TUPE).  In reply, it was explained that the possibility of costs increasing and staff being transferred to a new provider were acknowledged as potential risks.  Soft market testing had indicated that there were providers who could provide the service required within the budget, so it was felt that the risk could be managed.  The full cost of the meals provided, and the subsidy paid by the Council, had been identified in the consultation so that service users were aware of those costs.

The Commission expressed concern that consultees had not been given the option of not changing anything.  This meant that the consultation would not achieve a full range of answers and gave the appearance of trying to skew answers in favour of certain outcomes.  The Commission also expressed concern that no pilot had been undertaken.  Officers confirmed that this consultation had been discussed with the Council’s corporate unit dealing with consultations to ensure that the consultation was balanced and fair.

The Commission also was concerned that, from the information presented, the majority response from the  ...  view the full minutes text for item 71.

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 expressed concern that it had not been possible to progress some of the Commission’s work programme in the absence of the Assistant Mayor (Adult Social Care) due to ill health and queried whether her portfolio responsibilities could be managed by another Executive member in her absence.

NOTED:

That a meeting of the Shared Lives review task group will be held on Friday 13 December 2013, which Liz Kendall MP will attend.

RESOLVED:

1)    That the Chair of this Commission be asked to liaise with the City Mayor and/or Deputy City Mayor to determine if the portfolio responsibilities of the Assistant Mayor (Adult Social Care) can be managed by another Executive member in her absence;

2)    That the Chair and Vice-Chair of this Commission review how the work programme of this Commission can be managed in view of the outcome of the consultations referred to in resolution 1) above; and

3)    That consideration of Housing Related Support Services be deferred to February 2014.

AGENDA

MEMBERS OF THE PUBLIC TO NOTE

Under the law, the Commission is entitled to consider certain items in private.  Members of the public will be asked to leave the meeting when such items are discussed.

The Commission is recommended to consider the following report in private, on the grounds that it contains ‘exempt’ information as defined by the Local Government (Access to Information) Act 1985, as amended and consequently that the Commission makes the following resolution:-

“that the press and public be excluded during consideration of the following reports in accordance with the provisions of Section 100A(4) of the Local Government Act 1972, as amended, because it involves the likely disclosure of 'exempt' information, as defined in the Paragraph detailed below of Part 1 of Schedule 12A of the Act and taking all the circumstances into account, it is considered that the public interest in maintaining the information as exempt outweighs the public interest in disclosing the information

Paragraph 3

Information relating to the financial or business affairs of any particular person (including the authority holding that information)”

The Commission did not consider it necessary to consider the item below in private.  Members of the public therefore were not asked to leave the meeting.

Attached is background information regarding the proposed review of Domiciliary Care.  The Commission is recommended to note this information.

NOTED:

The background information provided regarding the proposed review of Domiciliary Care, (see minute number 69 above).

The meeting closed at 8.32 pm