Agenda and minutes

An apology for absence was received from Ms Pat Hobbs, Healthwatch. David Henson was present in her place.

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

No declarations of interest were made.

The minutes of the meeting of the Adult Social Care Commission held on 3 May 2016 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 3 May 2016 be confirmed as a correct record.

Members are asked to note the Scrutiny Commission’s Terms of Reference as attached in Appendix A.

AGREED:

                   that the Scrutiny Commission’s Terms of Reference be noted.                  

Members are asked to note membership of the Commission as detailed on the front of the agenda.

AGREED:

that the membership of the Adult Social Care Scrutiny Commission for 2016/17 be noted.

Members are asked to note the dates of meetings of the Adult Social Care Scrutiny Commission as detailed below. All meetings to commence at 5.30 pm.

Thursday 8 September 2016

Tuesday 25 October 2016

Monday 12 December 2016

Tuesday 7 February 2017

Tuesday 4 April 2017

AGREED:

that the dates of the meetings of the Adult Social Care Scrutiny Commission for 2016/17 be noted.

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 Democratic Support Officer will present a short overview of some of the procedural aspects of how the Commission works. The Commission is recommended to note the information and comment as appropriate.

The Democratic Support Officer delivered a presentation which outlined some of the procedural aspects of how the Commission worked.   A copy of the presentation is attached at the back of these minutes.

The Strategic Director for Adult Social Care submits a report that provides the Adult Social Care Scrutiny Commission with an overview of the Commissioning Intentions for Adult Social Care (2016/17).  The Commission is asked to note the content of the report and the commissioning intentions for Adult Social Care services.

The Strategic Director for Adult Social Care submitted a report that provided an overview of commissioning intentions for Adult Social Care for 2016/17.

The Head of Commissioning presented the report and advised that the intentions supported the delivery of the Department’s six strategic priorities as set out in Paragraph 4 of the report.

Members considered the report and raised a number of comments and queries, including the following:

·      A Member expressed a concern that whilst there was much to agree with in the report, it was generally lacking in details.  The Commission needed more details and early enough for Members to provide their input and make a difference. Reference was made to the intention to improve support for young people, with care and support needs, in transition into adulthood. More details on the plans for achieving this were requested.

The Head of Commission explained that this was a high level overview. Detail sat beneath this, noting that some plans would be more advanced than others, depending on timelines. The Chair asked that commissioning activities be brought to the Scrutiny Commission in time for Members to provide their input. A further request was made by a Member for an upcoming list of Delivery Plans to be made available to Scrutiny, so that Members could decide what they would like to discuss at the Commission. The Chair explained that discussions were regularly held with the Strategic Director to advise on forthcoming plans and issues which affected Adult Social Care.

·      A Member asked about the age in which a young person was classed as moving into adulthood; she stated that the Child and Adolescent Mental Health Service (CAMHS) stopped working with young people at the age of 16 years.

Members were advised that there was not a consistent approach within the current system, as to the age when a young person would start a transition into adult services. This was something that needed to be looked at. The Chair commented that this might be a piece of work that Scrutiny could look at.

David Henson, the Healthwatch representative commented that the organisation also had some concerns relating to transition, which had been raised with the Director of Adult Social Care. He said that it was important to gather the evidence which could inform the commissioning intentions going forward.

·      In relation to transition to adulthood, a Member queried how many young people became independent.  The Director of Adult Social Care and Safeguarding responded that there were different levels of independence; there would be a report forthcoming which would consider how best to develop the council’s approach to transition.

·      In response to a query relating to the budget and the commissioning intentions, the Deputy City Mayor responded that the intentions were guided by the six strategic priorities. The budget situation presented significant challenges but it should not prevent the council from delivering those objectives.  The objectives were ambitious and sometimes difficult decisions had to be made. He added that it was right to help people  ...  view the full minutes text for item 10.

The Strategic Director, Adult Social Care submits a report that provides the Commission with an update on the quality of care across the services provided by the independent sector organisations, on behalf of the Council, for a range of vulnerable adults for 2015. The Commission is asked to note the content of the report and comment as it sees fit.

The Strategic Director, Adult Social Care submitted a report that provided the Commission with an update on the quality of care services provided by the independent sector organisations on behalf of the council for a range of vulnerable adults for 2015.

The Deputy City Mayor introduced the report explaining that this was a supplement to the quality assurance carried out by the Care Quality Commission (CQC) and was part of the council’s manifesto pledge to more closely monitor what was happening in care services.

During the ensuing discussion on the report, a number of comments and queries were raised including the following:

·      It was noted that the providers were mostly compliant or good; was any support given to help providers achieve an excellent rating?

Officers explained that the Assurance Framework was about continuous improvement and examples of good practice were shared amongst contracted providers. The innovative way that services were being delivered in care homes were taken into account when an excellent rating was granted. Whilst the council encouraged providers to achieve higher ratings in their assessments, it does not stipulate what they should be.

·      It was noted that some of the care homes had inspections outstanding. The Head of Contracts and Assurance confirmed that since the time of writing the report, all those outstanding inspections had commenced.

·      In respect of the 12% of providers who were judged to be non-compliant, Members heard that the providers were given an action plan for completion within a set timeframe. If those actions were not completed, the council would take appropriate action. In response to a query, the Deputy City Mayor stated that the council were not adverse to taking final action and removing the contract from the provider where appropriate.

·      Officers were asked whether the council drew up the contracts for the providers; they confirmed that they did and that they worked with providers on the quality assurance framework.

·      A Member questioned whether providers were expected to submit a compliance report in between visits. Members heard that an annual report was produced in conjunction with the Provider (QAF report); performance was monitored on an ongoing basis and the council acted on intelligence received. The Member expressed a view that the provider should submit a report every six months.

·      Members questioned whether all care homes were currently compliant. The Head of Contracts and Assurance responded that ratings on some homes were still outstanding, but every provider would have a quality assurance rating by the end of the year. The Deputy City Mayor stated that one non-compliant provider was one too many; however things sometimes went wrong and there was a need to understand this and take very prompt action.  The report set out robust procedures to do so when appropriate.

·      In response to a question, the Deputy City Mayor stated that they had not looked at whether there was any correlation between homes that were non-compliant and wages paid to staff. This was an area that Scrutiny might wish to look at. 

·      David  ...  view the full minutes text for item 11.

The Strategic Director, Adult Social Care submits a report that provides the Commission with an overview of the work in progress to re-procure domiciliary care support services in readiness for the expiry of existing contracts in October 2017. The Commission is recommended to note the content of the report and comment in advance of the formal procurement process commencing in October 2016.

The Strategic Director for Adult Social Care submitted a report that provided the Scrutiny Commission with an overview of the work in progress to re-procure domiciliary care support services in readiness for the expiry of existing contracts in October 2017. The review also provided an opportunity to jointly procure services in conjunction with the Leicester Clinical Commissioning Group (CCG) who also currently purchased a significant amount of domiciliary care support each year. The CCG were paying for the stakeholder and provider engagement currently underway.

The Deputy City Mayor introduced the report and asked for the Commission to agree the procurement specifications before the formal process commenced. The process was in its early days and there would be time for the report to come back to the Commission before the formal process of procurement started. The Director of Adult Social Care and Safeguarding City confirmed that it would be possible to facilitate further discussions on this with the Commission, noting the timeframe for procurement commencing in the Autumn. 

In response to a query, the Head of Contracts and Assurance responded that there were 17 providers for domiciliary care; those that were assessed to be non-compliant had an action plan in place and improvements were being monitored.

The Vice Chair requested a future paper to demonstrate the impact of the real living wage (as opposed to the statutory living wage). She stated that it would be useful to know how other local authorities had adapted to this.

The Head of Commissioning explained that they were currently in the process of engaging with service users and families; there were no findings yet as the process was ongoing. In response to a query, the Officer confirmed that the Commissioning Services, when looking at procurement, took into account how quickly the would-be provider could respond and implement a care package.

A Member raised a query regarding the commissioning budget and was informed that the budget was not capped but was driven by the need of service users.     

A Member commented that it would have been preferable if the Commission had been given an opportunity to consider and input on the engagement process prior to it going live.

AGREED:

1)  that the report be noted;

2)  that the Commission to be given further opportunity to comment on the re-procurement of domiciliary care support services; and

3)  that a report on the living wage be brought to a future meeting of the Commission.

The Commission is asked to consider a draft Scoping Document into a review of ‘End of Life Social Care’. The purpose of the review is for the Commission to seek assurances that the Council’s Adult Social Care Services are contributing to a good end of life care, taking into account people’s wishes and needs.

The Commission was asked to consider a draft Scoping Document into a Task Group review of End of Life Social Care.

The Chair presented the scoping document stating that end of life care was important in ensuring that people were allowed to end their lives comfortably and in accordance with their wishes. The review would consider how the Council’s Adult Social Care services delivered this service, and make recommendations where appropriate.

A Member commented that she was pleased that the methodology would look at how staff in care and residential homes were equipped and trained to deal with end of life issues and difficult conversations.

Suggestions were made that it would be useful to contact LOROS, MacMillan and the Marie Curie Organisation to gain their insights into the issue. A comment was also made that there was a need to look at the pathway to the end of life, to make the overall experience as smooth as possible.

The Director of Adult Social Care and Safeguarding commented that the task group review and further insights into this area were very much welcomed.  

The following Members indicated their intention to join the Chair on the Task Group:  Councillors Chaplin, Dempster, Hunter, Khote and Thalukdar.

AGREED:

                   that the scoping document into End of Life Social Care be agreed.

The current draft 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 consider and comment on the Draft Adult Social Care Scrutiny Commission Work Programme.

In response to a question, the Scrutiny Policy Officer explained that the Better Care Fund update was included in the work programme; this would be a joint piece of work with the Health Scrutiny Commission.

The Vice Chair drew Members’ attention to the Big Knit for Age UK, whereby people were asked to knit miniature hats for smoothie bottles; 25p would be donated to Age UK for each miniature hat knitted.  Members also heard that the Leicester Royal Infirmary had launched an appeal for people to knit ‘Twiddle Muffs’ for dementia patients. Members were asked to promote the two appeals.

AGREED:

that the work programme and the appeals for Age UK and the Leicester Royal Infirmary be noted.

The meeting closed at 7.40pm