Agenda and minutes

Apologies for absence were received from Councillors Hunter and Thalukdar.

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 8 September 2016 have been circulated and the Commission is asked to confirm them as a correct record.

RESOLVED:

that the minutes of the previous meeting of the Adult Social Care Scrutiny Commission held 8 September 2016 be confirmed as a correct record.

The Monitoring Officer to report on the receipt of any petitions submitted in accordance with the Council’s procedures.

The Monitoring Officer reported that no petitions had been received.

The Monitoring Officer to report on any questions, representations or statements of case in accordance with the Council’s procedures.

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

Jane Geraghty, Independent Chair of the Leicester Safeguarding Adults Board will present the Board’s Annual Report for 2015/16.  The Commission is asked to note and comment on the report as appropriate.

The Strategic Director, Adult Social Care submitted the Annual Report of the Leicester Safeguarding Adult Board (LSAB). The Chair welcomed Jane Geraghty, the Independent Chair of the Board to the meeting and invited her to present the report to the Commission.

Ms Geraghty explained that she had been appointed as Independent Chair of the Board in December 2015 and therefore this was her first annual report. During this period she had spent a considerable amount of time looking at governance details to ensure that the Board was fit for purpose.

 The Board’s first ‘Away Day’ had recently been held which focussed on implementation of the safeguarding obligations within the Care Act and trying to ensure that there was a clear safeguarding pathway for vulnerable adults across the whole system in the City.   An area that caused concern was relating to the number of repeat enquiries and the growth in Deprivation of Liberty Safeguards (DoLS), though Members heard that the latter was a national rather than a local issue.  The Board now had a clear set of priorities but it was acknowledged that there was work to be done.

The Chair extended her thanks to Ms Geraghty and commented that the report was excellent.

A number of questions and comments were raised as follows:

·      It was noted that there were still a large number of people waiting for assessment for the DoLS and further information was sought on this issue.

The Strategic Director responded and explained that the Local Authority was responsible for DoLS and there had been a significant increase in the number of cases following the ruling in the Cheshire West Case. The Government had not increased funding to local authorities to deal with the increase in DoLS, because they said that this was not a new responsibility for local authorities to deal with. This decision was currently being challenged and four local authorities were taking the Secretary of State to Court. The outcome of this judicial review was awaited and it was hoped that there would be an increase in funding to local authorities if the judicial review was successful.  It was not known when the judgement might be made public.

·      Ms Geraghty was asked whether she was confident that all procedures were in place in the event of there being a safeguarding issue and Ms Geraghty responded that it would be very difficult for any organisation to state that they were confident that their systems could cope with any eventuality. She was however very impressed with the contribution of all the partners as they worked together on the LSAB.  In response to a question about any potential weaknesses in the system, she explained that while the Board knew what questions to ask, they but did not always have the answers to those questions. There was however a peer review to challenge the Board and also a great deal of qualitative information to inform monitoring.

·      The Chair asked whether there was a contact list  ...  view the full minutes text for item 32.

Sam Larke, Programme Lead, Vista, will deliver a presentation to the Commission, on Leicester Ageing Together.

Sam Larke, Programme Lead, Vista was in attendance to deliver a presentation to the Commission on ‘Leicester Ageing Together’. A copy of this presentation is attached at the back of these minutes.

The Chair thanked Mr Larke for the presentation and asked him what he thought were the top achievements for the project.  Mr Larke responded that a great deal of work was taking place relating to sustainability to keep projects alive once funding had finished. He commented on how well all the partners were working together.

It was noted that five wards within the city were chosen for involvement with the project although there was also citywide coverage on certain issues. These wards were Spinney Hills, Belgrave, Wycliffe, Thurncourt and Evington and a query was raised as to why those particular wards were chosen. The Lead Commissioner, Dementia, Adult Social Care and Commissioning, was invited to the table to respond. She explained that the set criteria necessitated the requirement to identify where the target beneficiaries lived. They looked at a population needs analysis, indices of deprivation and in addition there was a considerable amount of community engagement. A Member pointed out that there were no wards from the west of the city within the project, and the Lead Commissioner responded that a great deal was learned from the project which could be applied citywide. 

A Member asked about the type of activities that were taking place and Mr Larke responded that these included ‘Men’s Sheds’ and ‘Singing for the Brain’. A Member added that there was deprivation in the ward she represented, but residents there could attend activities in those specified wards.  It was agreed that further details of the activities offered would be emailed to the Scrutiny Policy Officer.

A Member commended the project and efforts to make it sustainable, but expressed concern that there would be expectations for the council to continue to provide those activities once funding had finished. She commented that this could cause problems as in her view it was unlikely that the council’s financial situation would improve. Mr Larke explained that Leicester Ageing Together was exploring different models of sustainability.

The Chair thanked Mr Larke for his presentation and asked Members to note the report.

AGREED:

                   that the report be noted.

The Strategic Director, Adult Social Care, submits a report that presents the Leicester Adult Social Care Local Account for 2015/16. The report summarises key developments, achievements and performance over the course of the year and sets out future plans in response to the challenges faced.

The Commission is recommended to note and comment on the report.

The Strategic Director, Adult Social Care submitted a report that presented the Leicester Adult Social Care Local Account for 2015/16. The report summarised key developments, achievements and performance over the course of the year and set out future plans in response to challenges faced.

Members raised a number of comments and queries on the report to which responses were given. These included the following:

·      A Member praised the Shared Lives scheme and asked whether there were plans to increase the number of service users. The Strategic Director responded that there was no fixed upper limit on how many people could be supported under the scheme, but it took a special type of person who would want to be a carer and welcome other people into their own home. There were campaigns to attract more carers, one of which had just been held. A Member suggested that a ‘drip drip’ feed would be more successful than occasional campaigns and  asked whether the officer with responsibility for publicity schemes for fostering children might have capacity to do something similar for Shared Lives.

·      In response to a query relating to Independent Living Support, Members heard that this was a very specific service which was contracted out. The council were looking at how effective this was and as such it was an area of review.  Service users would be consulted as part of this review.

·      The Chair commented that some people were selling their homes to move in with their parents in order to care for them, or were making adaptations to their homes to accommodate their parents. She asked whether the council could do anything to encourage this. The Strategic Director explained that they would always support such initiatives and they also worked with the Housing Service to try to help where appropriate. However, there may be financial considerations for families to consider. Carers involved in the Shared Lives scheme, received a payment from the local authority, but this payment did not apply to families caring for one of their own.

·      A Member questioned whether reviews and re-assessments were on track. The Strategic Director explained that the aim was that by the end of the year, there would be no outstanding reviews exceeding a period of 15 months. However, because of the current financial and resourcing pressures and a fluctuating demand and workload, this might not be achievable. Efforts would be made to achieve that aim as quickly as possible on a sustainable basis.  

A Member suggested that a firm target should be set and the Commission heard that this was a firm and very ambitious target. There were pressures within the department, but the Strategic Director added that ambitious targets should be set to help the service achieve high standards.  A Member expressed some surprise that the setting of a target was acknowledged, when previously the Commission had been informed that this was unnecessary. The Strategic Director responded that he had set a target, after his appointment to this post, because  ...  view the full minutes text for item 34.

The Strategic Director, Adult Social Care, submits a report that provides the Adult Social Care Scrutiny Commission with an overview of the proposal to change the way dementia support is provided for people diagnosed with the condition.  The Commission is asked to note the report and provide feedback on the proposal.

The Strategic Director, Adult Social Care submitted a report that provided the Commission with an overview of the proposal to change the way dementia support was provided for people diagnosed with the condition. The Commission heard that the new proposal would provide one co-ordinated approach across the NHS and Social Care for Leicester, Leicestershire and Rutland.

Members raised comments and queries to which responses were given. These included the following:

·      In response to a concern that the amalgamation might result in some services being lost, Members heard that services would not be lost but would be delivered in a collaborative way across the county. This might lead to a more robust and sustainable system. The service would also provide a better and more holistic offer which would be easier to access. It was also expected that there would be better outcomes.

·      A Member asked as to the size of the market for potential providers, and was advised that the potential market was not large. Four providers had come forward in a previous commissioning exercise.

·      In response to a concern about staffing, the Strategic Director explained that the authority had a responsibility to ensure that any staff recruited had the necessary skills for their role.

The Chair concluded the discussion stressing that it was important that people learned about dementia.

AGREED:

                   that the report be noted.

The Adult Social Care Scrutiny Commission will receive the Executive’s response to the Commission’s review on Adult Social Care Community Screening and Assessment.

The Deputy City Mayor, with responsibility for Adult Social Care, Health Integration and Wellbeing, provided a verbal response to the Commission’s review on Community Screening.  The Deputy City Mayor explained that the Chair of the Commission had presented the report to the Executive and he had intended to provide a written response, but unfortunately the typed notes of that meeting were lost due to I.T. problems.

The Deputy City Mayor responded to the recommendations within the report as follows:

·      With reference to a communications strategy to raise awareness of the web portal; this was an ongoing piece of work as the portal was now ‘live’. The Deputy City Mayor added that it would be useful to have details of usage of the portal

.

·      Work was on-going relating to the recommendation for front line staff to be given the correct information to enable them to make appropriate referrals. Staff were encouraged to signpost to the portal.

·      The Deputy City Mayor commented that he did not agree with the recommendation for a ‘staff to staff’ hotline to be set up, as this undermined the purpose of the portal. He added that if there was an emergency, there was a need to ensure that staff would know what to do and how best to contact the appropriate people.

·      A Member questioned if there was a procedure in place for those people who did not want to use the portal. The Deputy City Mayor responded that there would still be the option of face to face contact, although some local authorities were no longer providing this. The Commission heard that there was a Contact Response Team and there was no desire to reduce that service as it would be needed in the event of a serious emergency.

The Chair suggested that it would be useful for further work be carried out to raise awareness of the portal; for example, this might include the use of the television screens in G.P.s surgeries. The Chair requested that a further update on progress on actions made in response to the review’s recommendations, be brought back to the Commission.

AGREED:

1)    that the Executive response to the Commission’s review on Community Screening be noted; and

2)    that the Commission request a further update detailing progress on actions taken in response to the review’s recommendations.

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.

No changes or additions to the Commission’s work programme were requested but the Chair asked Members to contact the Scrutiny Policy Officer if they had any comments or suggestions for amendments.

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

Kingfisher Unit: Future Options.

The Chair stated that she had agreed to accept the item as urgent business in order for the Scrutiny Commission to have the opportunity to consider and comment on the report, prior to a decision being taken by the Executive. A delay would result in a failure to achieve the required savings, which were necessary given the cuts faced by the Council.

The Chair has agreed to take the attached report as an item of Urgent Business.

The Strategic Director submits an Executive Decision Report that seeks Lead Member confirmation of the preferred way forward for the delivery of intermediate and short term care, currently provided in part via the Kingfisher Unit.

The Adult Social Care Scrutiny Commission is asked to note the options appraisal, the preferred option and make any comments.

The Strategic Director submitted a report that sought Lead Member confirmation of the preferred way forward for the delivery of intermediate and short term care, currently provided in the part via the Kingfisher Unit.

A concern was raised as to the role the Commission had in respect of any decision the Executive made on the options available.  There appeared to be no mention of Scrutiny within the report.  Concerns were also raised that many of the reports that came to Scrutiny Commissions across the Council no longer had the timelines and chronology for when and where the reports would be considered.

In response, Members were advised that the report included recommendations for Scrutiny; however in respect of timing, the Deputy City Mayor explained that the report had been brought to this meeting at his request. He accepted that the chronology had not been handled in the best way, but he wanted the Commission to have the opportunity to consider and comment on the options and the next meeting would not be held until December. Commission Members asked the Deputy City Mayor to talk to the Executive about how a more effective interface with Scrutiny could be ensured.

A Member asked about the role of Intermediate Care and how it fitted in with the options outlined in the report. Concerns were expressed that there appeared to be serious legal implications on both options. The Deputy City Mayor responded that the policy relating to Intermediate Care was being questioned. Intermediate Care essentially offered reablement, which could be facilitated in people’s own home. The NHS Intermediate Care as provided in a NHS facility would still continue, but the view was that the Intermediate Care that the local authority provided was best focussed in people’s home.  Data and outcomes had been studied and it had been shown that there were better outcomes when this was delivered in a home environment. There were clear risks with Option 2 and it was the Deputy City Mayor’s intention to sign a decision notice for Option 1.

In response to a question, the Deputy City Mayor confirmed that by agreeing to Option 1, a clear saving would be made.   He acknowledged that up to 10-12 intermediate care beds were likely to be needed, but these could be commissioned across the market.

A Member commented that this was about making savings and also securing the best value. The rationale for the decision was sound and in the best interests of the majority of residents in the City.

AGREED:

that the Commission note the options appraisal and agree to the preferred Option 1, to close the Kingfisher Unit and purchase up to 10-12 short-term beds from current providers in the local market.

The meeting closed at 8.25 pm