Agenda and minutes

Apologies for absence were received from Councillor Thalukdar and Councillor Palmer, Deputy City Mayor with responsibility for Adult Social Care, Heath, Integration and Wellbeing.  The Chair, Councillor Newcombe had also submitted his apologies and the Vice Chair Councillor Cleaver, took the Chair for the meeting.

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

Micheal Smith, declared that as the Healthwatch representative he would withdraw from the meeting if during agenda item 11, Adult Social Care Procurement Plan 2017/18, there was any discussion relating to Healthwatch. Mr Smith added that he was also a member of the Leicester Safeguarding Adults Board

The Chair made no announcements.

The minutes of the meeting of the Adult Social Care Commission held on 29 June 2017 have been circulated and the Commission is asked to confirm them as a correct record.

AGREED:

that the minutes of the meeting of the Adult Social Care Scrutiny Commission held 29 June 2017 be confirmed as a correct record.

The Commission will be asked to note an update on progress on actions agreed at the previous meeting. This will include an update on the Task Group Review into End of Life Care; a briefing note is attached for information.

Members were asked to note an update as attached to the agenda in Appendix A, on the progress made in the Task Group review into End of Life Care.

AGREED:

that the update on progress made into the End of Life Care Task Group Review 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 Director of Adult Social Care and Safeguarding submits a report that sets out the new requirements of the Better Care Fund (BCF) for 2017-2019.

The Commission is asked the note the update and comment as it sees fit.

The Director of Adult Social Care and Safeguarding submitted a report that set out the new requirements of the Better Care Fund (BCF) for 2017-19. The Director and Rachna Vyas, Deputy Director of Strategy, Leicester City Clinical Commissioning Group (CCG) introduced the two year plan.  The Commission heard that the authority was building on the scheme’s previous successes and the allocation of funding depended on a scheme’s performance.

Members considered the report and during the ensuing discussion, the following comments and queries were raised:

·      It was noted that the statistics for Leicester indicated that the City was 10% over plan for Emergency Department (ED) attendances. Members heard that this was old data within the 16/17 update appendix, and current data indicated that attendance had stabilised.  There had been a small rise in the number of children being admitted into the ED; this was in part due to the new Children’s ED and an increase had been expected and planned for.

·      The issue relating to double counting of patients (patients who were seen in the Urgent Care Centre and then again in the ED) had arisen due to disparate IT systems, but this was being rectified.

·      A Member referred to the Sustainability and Transformation Plan (STP) and expressed some concern as to its effect on the BCF and how it would be managed. The Strategic Director for Adult Social Care explained that the BCF had running for four years; in Leicester, the BCF schemes were working well for individuals and were effective in keeping people out of hospital. The Council would protect and continue to put resources into the fund. However, the BCF was part of the wider STP; Leicester had some influence in the scheme and needed to promote the scheme to ensure future funding. A Member suggested that it might be useful for the Adult Social Care Scrutiny Commission to write to the STP Board to seek assurance about the future of the BCF.

·      Micheal Smith commented that Healthwatch had witnessed effective interaction in the Admissions and the Emergency Department and its preventative work to reduce future admissions. The Deputy Director of Strategy, Leicester City CCG added that some colleagues from the County had noticed how effective the City Council strategies were and had requested further details.

·      A Member referred to the reasons for LPT Mental Health delays which pointed largely to patients awaiting completion of health assessments. The appended 16/17 update report stated that no improvement had yet been seen, but the Deputy Director of Strategy commented that since then, the situation had improved.

·      The Strategic Director explained that in relation to delayed discharges, there was an issue around the availability of appropriate housing. Suitable accommodation could not always be found for some patients whose needs were particularly challenging. Concerns were expressed that it would not be helpful for patients to be kept in a hospital setting because appropriate accommodation could not be found. It was questioned what was happening nationally and it was suggested for the Scrutiny  ...  view the full minutes text for item 24.

The Strategic Director, Adult Social Care submits a report that brings together information on various dimensions of Adult Social Care (ASC) performance in the final quarter of 2016/17. The report may be treated as a provisional year- end report; a final year-end report will be produced late Autumn 2017.  The Commission is requested to note the areas of positive achievement and areas for improvement as highlighted in the report.

The Strategic Director, Adult Social Care submitted a report that brought together information on various dimensions of Adult Social Care (ASC) performance in the final quarter of 2016/17. The Strategic Director introduced the report and explained that overall, while not all the targets had been met, those that had been met had been very challenging.  Productivity had increased and people’s satisfaction with their experience was very high at almost 98%. The Chair commented that excellent work had taken place within the department.

Members considered the report and comments and questions raised included the following:

·      In response to a query around admissions to residential care, the Strategic Director explained that they were working to reduce admissions to residential care but there was a challenge to identify appropriate community provision; for some people with complex needs, community provision was not tenable. A Member referred to an earlier decision to close elderly persons’ homes and queried whether the council had been right to do this. The Strategic Director responded that there were no fewer beds and some homes had remained open and were being successfully run under different management. 

·      In relation to the length of stay in care homes, Leicester was below the national average for the length of stay. This was a positive measure which demonstrated that people were being admitted at the right time rather than earlier than necessary.

·      It was noted that people were living longer, though some people lived longer with a lower quality of life; the Strategic Director said that the aim was to help people to live longer with a better quality of life.

·      In response to queries relating to the workforce and absenteeism, the Commission heard that stress and mental health wellbeing was the biggest factor in staff absences. Strategies included looking at what might help people at work and making work a good place to be. If someone was off work with a stress related illness, it was much more difficult to get them back to work. The Chair suggested that it might be appropriate for Scrutiny to consider what other organisations did to help their staff manage stress.

·      A Member commented that the report showed a slightly higher call abandonment rate in Quarter 4 (measure ABP1c) and heard that while there had been a relative minor shift, Leicester’s figures were very low compared to the national standard. Calls were recorded and reviewed which enabled feedback, whether good or not to be given.

·      It was noted that the Quarter 4 measure APB1b showed a significant increase in the number of ‘other contacts’.  The Commission requested more information on this measure.

·      The Strategic Director expressed concerns that in Leicester, the general health of the population was less good than in other areas with some young people today likely to need adult social care support when s/he reached their forties or fifties. Once people were receiving adult social care support, they were likely to remain in the system for the rest of their lives.  The Chair commented  ...  view the full minutes text for item 25.

The Strategic Director, Adult Social Care and Health submits a report that provides the Scrutiny Commission with a high-level summary of actions / improvements initiated as either a direct result of, or informed by, recommendations from the three Peer Challenges that the department has engaged with over the last two years. The Commission is requested to note the report and comment on the value of the Peer Challenge process for Adult Social Care

The Strategic Director, Adult Social Care submitted a report that provided the Commission with a high level summary of actions / improvements initiated as either a direct result of, or informed by , recommendations from the three Peer Challenges that the department had engaged with over the last two years. Any actions arising from the Peer Challenges had been embedded into existing plans, as opposed to creating three separate plans.

The Business Improvement Manager, Adult Social Care and Safeguarding commented that  it had been beneficial in obtaining advice and views from the three separate peer reviews and a considerable amount of good practice had been identified. He was confident that the peer reviews were contributing to the department’s own improvement journey.

In response to a question, the Strategic Director confirmed that the department was willing to share its good practice and he, the Director for Adult Social Care and Safeguarding and other senior staff had carried out peer reviews in other local authorities.  This also provided an opportunity to see the practice at other local authorities which could in turn, contribute to Leicester’s own practice and procedures.

The Strategic Director explained that a strategic plan for the Leicester Safeguarding Adults Board had been drafted and he believed that staff understood that the strategic priorities were about supporting and protecting people when they were at their most vulnerable.

In response to a question, the Strategic Director explained that there had been no surprises from the feedback of the peer review and if managers knew their department and what was happening, there should not be any surprises.

The Commission heard that the work the department had carried out relating to the delayed transfer of care was considered to be exceptional and the Director for Adult Social Care and Safeguarding was now involved in the regional peer reviews.  This work reflected very well on the department and Leicester City Council.

The Chair commented that she had spent some time with staff during a peer review and understood that it could be a stressful time for them. She expressed a hope that the Directors would ensure that their staff felt valued.

AGREED:

1)    that the report be noted; and

2)    that the peer review section of the report relating to the Leicester Safeguarding Adult Board (LSAB)  be brought to the Commission for consideration alongside the LSAB Annual Report.

The Strategic Director, Adult Social Care and Health submits a report that provides the Adult Social Care Scrutiny Commission with an overview of the forthcoming Adult Social Care (ASC) procurement activities that need to be in place for 2018 as detailed in Appendix 1 of the report.

The Strategic Director, Adult Social Care submitted a report that provided the Commission with an overview of the forthcoming Adult Social Care (ASC) procurement activities that needed to be in place for 2018.

The Head of Commissioning presented the report and in response to a request for more detail, the Chair asked that a small amount of information on each of the procurement plans be brought to the next meeting.

The Chair asked Members to email her, and copy in the Scrutiny Policy Officer, indicating which of the procurement plans they were particularly interested in. Three of the plans would then be chosen for detailed consideration by the Commission.  Members were asked not to include any of the procurement plans that were currently paused. 

AGREED:

1)    that the report be noted;

2)    that a small amount of information be brought back to the Commission on each of the procurement plans; and

3)    that Members email the Chair and Scrutiny Policy Officer, indicating which of the plans they would like to be brought back to the Commission for more detailed consideration. 

The Commission will receive a verbal update on progress relating to Domiciliary Care Procurement. The Commission is asked to note the update and comment as it sees fit.

The Head of Commissioning provided a verbal update on the domiciliary care procurement exercise.

Members heard that the Council currently commissioned domiciliary care but those contracts ceased in October.  There had been a good response to the commissioning exercise which commenced in October 2016 and 26 providers had been selected.  A major factor in making those selections had been the quality of the provision and 13 of those selected were already on the Council’s framework.

All service users had been given a choice about their care and many had chosen direct payments which meant that they could remain with their existing provider if they wished.

Officers had visited all the providers; checked their policies and ascertained that they had the capacity to take on the contract.  The new contracts would go live on 9 October 2017 and would be monitored to ensure that all the required standards would be adhered to. The Head of Commissioning commented that she thought that the domiciliary care procurement had been a very successful joint exercise with the Leicester City Clinical Commissioning Group.

Members commented that they wanted to know that service users were satisfied with the new arrangements and were pleased that officers were already checking that this was the case.

AGREED:

                   that the update on domiciliary care procurement be noted.

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 were asked to consider and comment on the Adult Social Care Scrutiny Commission work programme.

Members heard that the Leicester Safeguarding Annual Report would be added to the work programme for the December meeting.

A Member requested that a verbal update on the Voluntary Care Services be added to the work programme and the Strategic Director responded that they may be in a position to provide an update at the December meeting.

 Micheal Smith, Healthwatch advised that there was a new Chief Executive at Healthwatch and she would be pleased for an opportunity to meet up with the Chair. The Chair responded that she would welcome this opportunity.

AGREED:

that the work programme be amended to incorporate Members comments.

The meeting closed at 8.30 pm.