Agenda and minutes

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 an Other Disclosable Interest in the general business of the meeting in that his wife worked for the City Council’s Adult Social Care Reablement service.  He also declared an Other Disclosable Interest in the general business of the meeting in that he worked for a voluntary organisation for people with mental health issues.

Councillor Fonseca declared an Other Disclosable Interest in respect of item 6 “Domiciliary Care Review” as he knew a carer that attended an individual who would be giving evidence as part of the review.

Although not a member of the Commission, Councillor Patel declared an Other Disclosable Interest in the general business of the meeting in that her sister worked for the City Council’s Adult Social Care and Safeguarding division.  She also declared an Other Disclosable Interest in the general business of the meeting in that her mother received a small social care package from the City Council’s Adult Social Care and Safeguarding division.

As a Standing Invitee to the Commission, Mr Philip Parkinson (Healthwatch invited representative) declared an Other Disclosable Interest in the general business of the meeting in that he had a relative in receipt of a social care package.

In accordance with the Council’s Code of Conduct, these interests were not considered so significant that they were likely to prejudice the respective people’s 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 6 March 2014 are attached and the Commission is asked to confirm them as a correct record.

RESOLVED:

that the Minutes of the meeting of the Adult Social Care Scrutiny Commission held on 6 March 2014 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 received.   

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

Carers and recipients of domiciliary care have been invited to tell the Commission of their experiences of domiciliary care.  The Commission is recommended to receive this evidence and comment as appropriate.

Members are advised that some of this evidence will be presented verbally at the meeting, but some is attached at Appendix B.

The Chair reminded the Commission of the rationale of the review and advised that carers and recipients of care had been invited to give evidence of their experience of domiciliary care.

It was reported that two care managers invited to give evidence had indicated that they were unable to attend and had their apologies for absence noted.

The Chair referred to the written evidence provided arising from an informal meeting and discussions held with carers at Danbury Gardens, with managers from a private care provider, and following a visit to meet and observe care workers.  It was noted that the husband of the lady receiving care at that home visit was in attendance to give his own evidence.  Copies of the Chair’s notes were circulated for the Commission’s attention.

A carer (now retired), and an individual in recipient of care for his wife, were in attendance.

The Chair invited the individual in receipt of care to give evidence of his experiences of the domiciliary care service.

He advised the Commission of the care required for his wife and the decision made by the family to take up a direct payment, so they could choose the domiciliary care provider themselves to deliver the care package.

It was reported that a converted room had allowed for proper implementation of the care plan, although difficulties with some care providers had been experienced, particularly with the turn-over of carers visiting his wife. The relationship between staff was also considered important when working together and having handovers. The Commission noted the requirement for care providers to ensure, as much as possible, that consistency was maintained in the carers being sent to individuals.  The Chair referred to her notes of the visit which emphasised this requirement.  It was considered that if changes were necessary, prior notice should be given.

He stated that the greatest difficulty he faced was in accessing the service and it was only because he knew people in the service that he knew the correct avenues to follow to ensure that his wife received the correct level of care.

The Chair expressed her thanks for the evidence submitted and referred to the model of care which had been demonstrated to be satisfactory, subject to adequate controls being in place, including suitable advocacy arrangements and commitment from the care managers.

The Chair asked Commission members to note the written evidence submitted, following a media appeal and clarified the two case studies listed had been raised on BBC Radio Leicester.

The Chair then invited a carer, (who had retired in 2011), to present written evidence of her experiences in domiciliary care. She highlighted particular issues including poor training and support, little travel time which  was unpaid, not enough information provided about clients, an unreliable logging system which did not record hours fully and a bullying culture by companies on their staff.

Asked why she had found it necessary to leave the service, she stated that largely it was due to the daily pressures. She  ...  view the full minutes text for item 118.

The Director for Care Services and Commissioning (Adult Social Care) submits a report outlining progress with individual residents’ moves to alternative accommodation, where their current homes are to be closed in phase 1.  The Commission is recommended to note the report and comment as appropriate.

Please note: The request for a judicial review of the decision to close elderly persons’ homes will not be discussed at this meeting.

The Commission received a report which provided an indicative timetable of actions needed to support existing residents in the Council’s Elderly Persons Homes.

The Vice-Chair questioned if the residents of Herrick Lodge Elderly Persons Home would still move before the end of the judicial review.  It was clarified that, as for all of the Homes to be closed in Phase 1 (Herrick Lodge, Elizabeth House and Nuffield House) no residents were being forced to move and they would have done so on a voluntary basis.

In reply to a further question it was clarified that the ‘Moving Plan’ process had so far been successful and the data in the report was updated verbally.  It was confirmed that Elizabeth House was nearly empty with only three remaining residents and some receiving respite care.  As those receiving respite care were there on a short term basis this would not affect the closure of the home once permanent residents had moved on.

The Commission noted the update.

The Director for Care Services and Commissioning (Adult Social Care) will give a verbal update on progress with identifying alternative facilities for the current users of the Douglas Bader day care centre.  The Commission is recommended to note the update and comment as appropriate.

The Director of Care Services and Commissioning provided a verbal update on the progress made since the decision was made to close the centre.

It was noted that meetings had been convened with the 42 users, involving carers, family members and support workers, to explain how individuals would be supported to move to other services or to access community based options. It was explained that assessments would be completed by dedicated social workers, who would work with family and carers to ensure the smooth transition to other services.  It was reported that the process would indicate whether day care or community based care was most appropriate.

It was confirmed that a more detailed update would be submitted to the next meeting of the Commission.

The Commission noted the update.

The Director for Care Services and Commissioning (Adult Social Care) will provide a verbal update on progress with decisions onadult social care non-statutory support services.  The Commission is recommended to note the update and comment as appropriate.

The Director for Care Services and Commissioning reported on the amended proposals following statutory consultation.

It was reported that for alarm provision, funding would continue for existing service users who did not have access to any on-site support, but no new people would be funded in the future.

For service users living in Sheltered Schemes with on-site support, funding for the alarm system would no longer be available.  However, it was also explained that the proposed core on-site support hours had been  recalculated and increased and the figures discussed with the  providers, who had broadly supported the proposed new subsidy contribution from the Council.

It was also explained that people in receipt of an alarm only service or living in the Sheltered schemes could also be considered for additional floating support, if they met the requirement of the assessment criteria.

The Assistant City Mayor (Adult Social Care) clarified that the intended decision had been accepted by providers and that, following the consultation period, reflected the best option available.

In response to a question it was reported that the take-up of the Leicester Care Service could be reported in due course.

RESOLVED:

i)             to note the progress and proposals with the re-modelling of the services;

ii)            to thank the City Mayor for the amended proposals following consideration of the points raised by the Scrutiny Commission and consultation; and

iii)           to receive an update on the number of people opting to move to the Leicester Care Service.

The Director for Care Services and Commissioning (Adult Social Care) will provide a verbal update on progress with decisions on the mobile meals service.  The Commission is recommended to note the update and comment as appropriate.

The Chair agreed to accept this item as urgent business in accordance with Scrutiny Procedure Rule 14, (Part 4E of the Council’s Constitution).

The item was accepted in order to undertake scrutiny of the Mobile Meals Provision, which was considered necessary prior to the next ordinary meeting of the Commission.

It was reported that a mobile meals scoping document had been agreed with the Chair of the Commission to address the following three specific issues

·         To promote the ‘in-house’ service to existing Adult Social Care (ASC) users, eligible for statutory support;

·         To develop the service provided by ASC, so it could be used for anyone; and

·         To develop the service to create a sustainable business, which could be used by anyone, including people eligible for ASC support.

The Commission was advised that increasing the number of meals sold to self-funders could have some impact on reducing unit costs, but this would be minimal because the Council was not permitted to make a profit from such sales.  The charge to self-funders therefore would need to decrease.

The Commission was advised that meals sold to eligible service users were heavily subsidised, so that any increased sales would lead to additional costs to the Council.  This would mean that the approved budget savings would not be made.

The Commission also was advised that in-house costs would be higher than those of external providers, due mainly to staff terms and conditions.  Given the competitive nature of the market, it would be hard for the in-house service to reverse the falling numbers of meals sold.

The Commission discussed the costs of meals and noted with disappointment the difficulties arising from the lack of positive economies of scale to reduce costs.  It was noted that staffing and transport were the factors which had led to the proposal to discontinue the service.

The Chair circulated a graph showing the numbers of meals relative to the individual costs of providing the service.  It was noted that only a marginal difference in cost existed if the numbers of meals increased. The Chair asked that the work to look at making the service financially viable was not lost and should be included as part of the decision notice communicated by the Executive.

The Assistant City Mayor (Adult Social Care) reported on the rationale to discontinue the service but asked members to note the framework contract arrangements allowing for the future provision of a managed service.

The Commission noted the update.

The Assistant Mayor (Adult Social Care) will provide a verbal update on progress in establishing an Older Persons’ Commission.  This Commission is recommended to note the update and comment as appropriate.

The Assistant City Mayor (Adult Social Care) reported on the progress in establishing an Older Persons Commission.

It was clarified that the Commission would initially consider issues that affected older people, primarily the ‘Ageing well in Leicester’ Strategy. 

The proposed membership of the new Commission was explained with a view to having no more than 10 members, including national organisations working with older people, the Department of Health, private sector service providers, university representatives, and local Members of Parliament.

It was reported that further information on the Older Persons’ Commission would be submitted to the next meeting.

The Commission noted the update.

a)     A verbal update on possible joint Scrutiny Commission working arrangements regarding the Better Care Fund will be given at the meeting.  The Commission is recommended to note the update and comment as appropriate.

b)     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.

The Commission referred to the draft Work Programme.

The Chair reported that the draft report on the Domiciliary Care Review would be submitted to the meeting on 15 May 2014.

The Director of Adult Social Care and Safeguarding also indicated that the report due on Intermediate Care (15 May 2014) would be a verbal update

In response to a question about the decision to continue with the existing adult social care eligibility thresholds, the Director of Adult Social Care and Safeguarding confirmed that the thresholds had not changed, but there could be a national scheme as part of the revisions to the Care and Support Bill.  It was agreed that information relating to the eligibility thresholds would be reported to the next Commission meeting.

The Chair referred to a seminar she had attended recently with the Vice-Chair and a Commission member concerning the Better Care Fund.  A summary of the briefing notes and findings arising from the seminar were read by the Chair.   Following this meeting it was agreed that this Commission would look at the preventative measures of the plan to be scheduled at a future meeting.

RESOLVED:

that the updates as described above be noted and the draft Work Programme be approved.

The meeting closed at 9.00 pm.