Agenda and minutes

Apologies for absence were received from Councillor Palmer, Deputy City Mayor with responsibility for Adult Social Care, Health Integration and Wellbeing, and Rachna Vyas, Deputy Director of Strategy and Planning, Leicester City Clinical Commissioning Group.

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

There were no declarations of interest.

The Chair made the following announcements:

Network for Change

The Deputy City Mayor had met with the Chief Executive for Network for Change and had encouraged the organisation to make an application for support from the Council’s VCS Urgent Support Fund, Since then, the application had been received and formally approved.

The Deputy City Mayor had also approached the Leicester City Clinical Commissioning Group (CCG) who have a contract with Network for Change and had met with their Chief Executive to explore what additional support the CCG might be able to provide.  The CCG had confirmed however that they were unable to provide support outside their current contract.

The Chair added that she wished to acknowledge that the financial challenge facing Network for Change remained complex and difficult and she hoped that a long term sustainable solution could be found so that the organisation could continue with its important and valued work.

Leicester Museums

Leicester Museums would be displaying their latest acquisition, a 1908 Clyde motor car made in Leicester, at Abbey Pumping Station from February 2017. It was intended to host three visits by local groups which supported children with Autism Spectrum Disorder and other communication difficulties, to see the car and find out more about it. This would be advertised to local groups in the New Year, but in the meantime, groups seeking further information should contact Sarah Levitt, Head of Arts and Museums by emailing: sarah.levitt@leicester.gov.uk

The minutes of the meeting of the Adult Social Care Scrutiny Commission held on 25 October 2016 have been circulated and the Commission is asked to confirm them as a correct record.

Members were asked to confirm the minutes of the meeting of the Adult Social Care Scrutiny Commission held 25 October 2016.

The Vice Chair requested amendments to the minutes as follows:

Item 32. Leicester Safeguarding Adults Board Annual Report

To add the following additional text to page 4, the end of para 3:

The Vice Chair commented that it would be useful if there was more explanation in the report relating to the role of Councillors on the Board

Item 34. Local Account for 2015/16

To add the following additional text to page 6, end of bullet point 2:

The Vice Chair commented that it would be helpful if reports brought to the meeting included the amendments as previously requested. This particular report had not been changed to reflect some amendments that were previously agreed.

AGREED:

that the minutes of the meeting held 25 October 2016, subject to the above amendments, 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.

The Director, Adult Social Care and Safeguarding submits a report that notes the position of the Better Care Fund (BCF) activity and performance at Quarter Two of 2016/17. This is a partnership plan and the Deputy Director of Strategy for the Clinical Commissioning Group will be in attendance to answer questions from Members. The Commission is asked to note the contents of the report and make any comments.

The Director of Adult Social Care and Safeguarding submitted an update report, which noted the position of the Better Care Fund activity and performance at Q2 of 2016 / 17.

Members considered the report and officers responded to a number of queries and comments raised during the discussion:

·      The Mental Health Housing Team was commissioned by the Clinical Commissioning Group (CCG); they gave practical support to people in Mental Health hospitals to prepare them for discharge.

·      The figure for emergency admissions in the city was lower than in the county; which, it was believed was due to the success of the Better Care Fund (BCF). The work that was taking place with the clinical response team   was proving to be effective. The Strategic Director for Adult Social Care stated that he believed that the BCF in Leicester was working very well and that from available information nationally, the Department had secured in the BCF, the fifth highest funding allocation from the NHS for this fund.

·      In response to a query relating to the recovery action plan and concerns that no improvement had been made when completing health assessments, the Director of Adult Social Care and Safeguarding stated that she would refer that query to the Deputy Director of Strategy and Planning, Leicester City CCG.

·      Members heard that some money was allocated against service delivery. This was previously funded via CCG budgets prior to the BCF, but was now funded within BCF and appeared not to be subject to performance monitoring. The apparent lack of performance monitoring was queried by Members, but the Director explained that because funding came to the local authority prior to the BCF, this was monitored through a different target and mechanism from the BCF performance framework.   A member requested that in future, the report should include additional information for items that were not part of the BCF. Members sought assurances that those items were also giving value for money.

·      Members heard that there was some uncommitted money that had not been specified for a particular scheme, but would be used where there were budget pressures.

·      A Member requested more information on Section 3.5.2 (Delayed Transfer of Care), which stated that an analysis of the reasons for Leicester Partnership Trust Mental Health delays largely pointed to patients awaiting completion of health assessments.   A further concern was raised that a key issue had been raised with the CCG Commissioners relating to the lack of available trained staff within the Continuing Health Care system to complete assessments in a timely manner. Assurances were sought that action was being taken to rectify this. The Commission was advised that a response would be sought from the Deputy Director of Strategy and Planning, Leicester City CCG.

·      A concern was raised that the introduction of the Sustainability and Transformation Plan (STP) might impact on the work of the BCF in Leicester.   The Strategic Director responded that they would work with colleagues in the Leicester City CCG to try to ensure that the developing  ...  view the full minutes text for item 47.

The Strategic Director, Adult Social Care, submits a report that provides the Adult Social Care Scrutiny Commission with an update on the progress to close the Kingfisher Unit by 31 March 2017.  The Commission is recommended to note the contents of the report.

The Director of Adult Social Care and Safeguarding submitted a report that provided the Commission with an update on progress to close the Kingfisher Unit by 31 March 2017.

The Commission considered the update and a Member raised a concern over a report in the media which stated that social care providers were reluctant to work with local governments. The Strategic Director explained that this currently related predominately to providers of domiciliary care and there was no indication that this reflected the situation in Leicester.  In respect of residential nursing homes, the market was changing and there were empty beds in Leicester which was possibly due to an over provision.  If any providers opted out of the market and there were resulting closures, the council would want those closures to be carried out in a managed way.

The Strategic Director was asked whether it would be appropriate for the council to issue a statement in order to build confidence in the domiciliary care market. The Commission were advised that following problems experienced by the county council when a provider withdrew from the market, the city council had responded to the media that the situation in Leicester was very different to that in the county. However as the city council were shortly due to embark on a procurement exercise, it would not be appropriate to give a further statement on this.

The Director of Social Care and Safeguarding assured the Commission that the work on closure of the Kingfisher Unit was on track against the timelines set.

AGREED:

                   that the progress report be noted.

The Strategic Director, Adult Social Care submits a report that provides an update on progress and future development plans for the Adult Social Care (ASC) Portal which was launched on 12 April 2016.

The Commission is recommended to note the report and to provide feedback and suggestions on the implementation of the portal.

The Strategic Director, Adult Social Care submitted a report that provided an update on progress and future development plans for the Adult Social Care Portal which was launched in April 2016.

The Chair asked if support was provided for those people who found it difficult to navigate the system and whether those people were aware that help was available.  The Commission heard that organisations had been shown how the portal worked and approximately 5000 leaflets had been made available through GP surgeries, Dentists and voluntary organisations. In response to a suggestion from the Chair, the Strategic Director stated that there was a limit as to how many leaflets they could circulate, because of the cost implication, but if Members suggested a particular venue where they thought printed leaflets were needed, this could be considered.   The Chair suggested that there should be a training session to help those officers who were out in the community, so that they could in turn cascade their knowledge to others.

In response to a query regarding users of the portal who abandoned their transactions before completion, the Strategic Director responded that some people might find the technology difficult, but others might terminate the enquiry once they realised that a financial contribution towards care would be required. There was information on the front page of the portal which advised users that it was likely that a financial contribution towards care would be needed. 

David Henson, representative from Healthwatch stated that it might be possible to publicise the ASC Portal on their new website, which was just being finalised. He offered to talk to officers further about this.

The Strategic Director stated that the Portal was a contributing part of the council’s wider channel shift programme and a Member commented that it took time for people to get used to the change and sometimes they needed help.  The Strategic Director explained that members of the public could still telephone in with their queries but the council were trying to encourage people to use the Portal to find out information.  He added that people in their 40s and 50s, who might be enquiring on behalf of their parents, were often very familiar with using the internet and would find it a useful and convenient way to find out information and seek assistance.  

Members heard that information on the Portal would be streamed out to televisions in GP surgeries; there would also be promotions on bus shelters and information on GP computers.

In response to a request for a demonstration of the ASC Portal, the Strategic Director responded that the Commission had already received a demonstration, but it might be possible to arrange a pre-scrutiny demonstration before the April meeting of the Commission where other people could be invited.

AGREED:

that the update be noted and a further update be brought to the Commission in six months’ time.

The Director of Care Services and Commissioning, Adult Social Care, submits a report relating to the 2016 Adult Autism Self-Assessment – Evaluation Progress in Local Authorities along with the Partner Agencies. The Leicester Leicestershire and Rutland Autism Strategy 2014-2019 Delivery Action Plan is also attached.

The Commission is asked to:

1)    accept and validate the Autism Self–Assessment submission, and

2)    Support the recommendations for future work to ensure the Council along with partner agencies are able to meet their legal responsibilities and raise standards.

The Director for Care Services and Commissioning submitted a report relating to the 2016 Adult Autism Self-Assessment, evaluation progress in Local Authorities along with partner agencies.

The Lead Commissioner for Mental Health and Learning Disability presented the report, and the Chair invited questions and comments from Members.

A Member commented that in some communities, there was a belief that autism was linked to witchcraft and people resorted to the use of faith healers. Concerns were expressed that this resulted in harm to the person with autism. It was a serious condition and more action was needed to raise awareness.   The Lead Commissioner responded that one of the areas identified in the self-assessment, was that more work needed to be undertaken with some ethnic groups and communities to further raise awareness of the condition. This work was included on the Action Plan, however the Council needed to work with partners as they could not deliver the Plan on their own.

Members asked whether there would be extra funding from the Government to help people with autism.  The Strategic Director, Adult Social Care responded that this was highly unlikely to happen given the current pressures on local government, health and social care funding.

In response to a question, the Lead Commissioner explained that statistics appeared to demonstrate that the national prevalence of autism was around 1 in a 100 people. She did not have to hand the specific prevalence rate for Leicester but would circulate that figure to Members.

Members discussed the transition process for children with autism as they grew into adulthood. The Lead Commissioner explained that there was a transition team to work with young people, with disabilities and their families. It was noted that the effectiveness of the transition process was reliant on good communication, partnership working and early identification of individuals.  The Strategic Director stated that transition legally took place when the young person turned 18 years of age. However, it was very advantageous to start the transition planning process earlier, ideally with conversations taking place when the young person was around 14 years of age.

 A Member stated that she was pleased to hear about the transition process for young people, but commented that it could be difficult for parents when their legal parental responsibility ended once their child turned 18 years of age. .A suggestion was made that the issue of transition should be referred to the Children, Young People and Schools (CYPS) Scrutiny Commission. The Strategic Director commented that he would be bringing a report to the Deputy City Mayor on transition, and he had already had discussions and initial agreement with the Strategic Director of Children Services about how the two departments could improve the current transition processes.   A suggestion was made that it might be helpful if the Adult Social Care and the CYPS Scrutiny Commissions held a joint meeting to discuss transition arrangements, and subject to agreement from the Chair of CYPS, this meeting could ideally take place early in May 2017.  ...  view the full minutes text for item 50.

The Chair of the Adult Social Care Scrutiny Commission will lead a discussion about how we communicate with people on the autistic spectrum and how to raise awareness of autism. Representatives from local groups that deal with issues relating to autism have been invited to contribute to the discussion.

The Chair introduced a discussion on communication in relation to autism. Members heard that autism was relatively misunderstood and people diagnosed with autism faced a struggle was communication. In addition, understanding around this issue was still poor. The Chair hoped to see greater work to improve communication and to raise awareness around this issue.

The Chair stated that she had been in contact with Local Offer Live at Curve Theatre where it was hoped to launch a rap song by a local artist named Laky C.  The aim of this was to promote local knowledge on how to communicate with people living with autism. It was hoped that proceeds of the rap would go to the Autistic Society and Carers’ Forum. The Chair also hoped to promote the rap via Leicester City Football Club and see if they would promote this amongst their fans.

The Chair added that she hoped to get in contact with Marks and Spencer in relation to their initiative in removing the labels on a clothing range specifically for people with autism. Research had shown that people with autism, found such labels very irritating.

The Chair then introduced Shelagh Wilson and Chris Covill from the Monday Club, John Singh from the Leicester City Clinical Commissioning Group and Stefan Dziewanowski from the National Autism Society and invited them to participate in the discussion. 

During the ensuing discussion, the following points were made:

·      The Monday Club had been running for approximately 20 Years and had been started by parents of children with Asperger Syndrome. 

·      Research showed that people with Asperger Syndrome had a shorter life expectancy than other people, so the club tried to provide a pathway to health and wellbeing.

·      Shelagh and Chris outlined the ethos of the club and the activities that were on offer for their members.  Money had been received from the Big Lottery, but funding was a problem and a cause for worry amongst members. Thanks were given for the funding that had been received from the city council and hopes were expressed that this would continue.  The Chair advised that the Monday Club could apply for funding from ward community budgets; further information on this was available on the city council’s website. In response to a question as to whether the council could do anything to support the Monday Club, Shelagh requested additional funding.

·      The Chair requested details of the Monday Club, so that they could be shared with Ward Councillors. She suggested that they may also have ideas as to alternative funding streams.

·      Stefan stated that the National Autism Society received many telephone calls from parents seeking information and help and more people were being signposted to the society.  Official statistics demonstrated that just over one in one hundred people had autism and an increasing number of adults were being diagnosed in later life.  They were just at the beginning of trying to understand more about the difficulties around diagnosing autism in women.

·      The Commission heard that transition was not always  ...  view the full minutes text for item 51.

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 heard that the next meeting of the Commission had been brought forward to Tuesday 24 January 2017, in order that the 2017/18 budget could be discussed prior to its consideration at the meeting of the Overview Select Committee in February.

AGREED:

                   that the work programme be noted.

The meeting closed at 8. 40pm.