Agenda and minutes

Apologies were received from Councillors Aldred and Dr. Chowdhury. Councillor Cutkelvin was present as a substitute for Councillor Aldred.

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

There were no declarations of interest made.

The Minutes of the following meetings of the Adult Social Care Scrutiny Commission are attached, and Members are asked to confirm them as correct records of the respective meetings:

a)    the meeting held on 12 December 2017 (Appendix A1); and

b)    the meeting held on 23 January 2018 (Appendix A2) (inquorate for consideration of minutes).

AGREED:

That the minutes of the meeting of the Adult Social Care Scrutiny Commission held on 12 December 2017 and 23 January 2018 be confirmed as correct records.

There was nothing further to add to the actions.

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 Strategic Director for Adult Social Care and Health submits a report to provide an update to the Commission on the two LLR Joint Strategies for Dementia and Carers which are in the consultation phase.

The Commission is recommended to note the report and are invited to comment.

The Strategic Director for Adult Social Care and Health submitted a report to provide an update to the Commission on the two LLR Joint Strategies for Dementia and Carers which were in the consultation phase.

Bev White, Lead Commissioner, delivered a presentation on the draft LLR Living Well with Dementia Strategy 2019-2022 (attached to the minutes), and attention was drawn to the following points:

·         The draft Strategy had been through governance processes with partner organisations and consultation on the draft would begin the first week in April 2018;

·         The Strategy set out the ambition to support people to live well with dementia, in line with the national strategic direction, with reforms to be achieved by 2020;

·         Priorities identified were:

o   to improve health care

o   to promote awareness and understanding

o   research

·         The strategy was for people with memory problems or who had a dementia diagnosis, and support for families, carers and organisations;

·         Partner organisations would deliver individual action plans. LCC would also develop its own action plan, and would be brought to a future meeting of the Scrutiny Commission;

·         Plans would be overseen by the Dementia Programme Board;

·         The vision, guiding principles and aim of the strategy were outlined. It was noted the Dementia Support Service was one product of the Strategy;

·         Actions detailed in the Strategy were subject to consultation and still draft. Actions would drop down into individual actions plans, depending on the nature of the action and the organisation;

·         The pilot of actions with care homes sat under the ‘diagnosing well’ principle, and was a tool for care home staff to work with residents they thought might have dementia, and informed the Commissioners of what support was needed;

·         Included in the Strategic Action Plan, but if it dropped into LCCs action plan, the Local Authority Commissioners would need to work with the care home providers in the city;

·         Part of the Commissioner’s role was to work with contracts and insurance. Working in a difficult financial climate, it was essential to link up and make the best use of resources.

The draft LLR Carers Strategy 2018-2021 was presented (attached to the minutes), and the following points were made:

·         A link was included to the consultation website, which would run until 22 April 2018;

·         Consultation on the Strategy was hosted by Leicestershire County Council, who would provide information for the City to analyse;

·         LCC will develop a city wide action plan taking the actions contained within the Strategy and detailing how these will be delivered in the City. The action plan will also contain priorities for carers from other strategies, e.g. mental health.

·         It had been developed using survey and performance data and updates from the National Carers Policy Network, national and local good practice;

·         Authorities were waiting for the National Adult Social Care Green Paper which would include actions on carers;

·         The city’s Action Plan would be brought to a future meeting of the Commission to see how it was performing on actions;

·         The definition of a  ...  view the full minutes text for item 83.

The Strategic Director for Adult Social Care and Health submits a report to provide the Commission with an overview of the process to jointly commission/procure a new domiciliary support service across health and social care, and on how the new services have been operating since October 2017.

The Commission is recommended to note the report.

The Strategic Director for Adult Social Care and Health submitted a report to provide the Commission with an overview of the process to jointly commission/procure a new domiciliary support service across health and social care, and on how the new services had been operating since October 2017.

Sally Vallance, Joint Integrated Commissioning Board Lead, delivered a presentation (attached to the minutes), and attention was drawn to the following points, and questions from Members answered:

·         Commissioning had been a four-stage process of information gathering, planning, making it happen, and review;

·         Over 600 people had responded to say what proprieties for a domiciliary support service were. Providers of care were also part of discussion on how the system could be improved and were pleased to be engaged at an early stage;

·         Key messages from engagement were the importance of continuity of care, carers arriving on time and carers being strong communicators, friendly and naturally caring;

·         It made sense to commission with health as sometimes there was competition between agencies which could increase prices;

·         The chosen model was that the Council would lead on procurement, arranging brokerage of placements in care organisations on behalf of both health and the authority, contract management, and quality assurance;

·         The second stage of planning ensured a smooth transition to the new providers. Legal documents (such as contracts and agreements) were written by both organisations and included things most important for service users;

·         A lot of work was undertaken on the selecting of the right care providers;

·         A written agreement between the Council and CCG mapped out arrangements between them;

·         500 service users facing a change were supported;

·         When making the change all service users had been transferred safely. Numbers of people that had been a struggle to place were very low compared to previous years, which showed the strength of the model;

·         There was a good working relationship between providers and health, and continued to work collectively to address issues;

·         All with a stake in the service had helped with the success of the change, which had taken approximately two years;

·         The average time for people awaiting care was 9.6 days. in terms of those where it was a struggle to make a placement, individual assessments were undertaken and their needs met by other services, for example, the community re-ablement service would be involved;

·         As part of work undertaken, the department included costs around training and the National Minimum Wage, and established a baseline. When considering the increase for 2018/19, the National Living Wage would be taken into account as part of the budget. Members asked for clarity detail on whether it was an uplift of the Living Wage or Minimum Wage to ensure those working were recognised for their work. It was clarified that National Living Wage and National Minimum Wage were covered by the uplift;

·         The Local Authority led on buying services, and that cost was charged back to Health. Costs around contract management and quality assurance were recharged to the CCG;

·         A service  ...  view the full minutes text for item 84.

The Strategic Director for Adult Social Care and Health submits a report to outline the aims, ambitions and progress of the Leicester Ageing Together programme.

The Commission is invited to note the report, and provide comments as it sees fit.

Ruth Rigby, Programme Lead (Leicester Ageing Together) submitted a report to the Commission the outline the aims, ambitions and progress of the Leicester Ageing Together programme. The following points were made:

·         The Big Lottery-funded programme hosted by Vista had now worked with 5,100 people over 3 of four years and it was anticipated the target of over 6,000 would be met;

·         The project is working to reduce social isolation and loneliness amongst people over 50, and was gathering as much information as it could about what works;

·         The programme had undertaken a significant amount of work in capturing learning;

·         A series of learning events would be opened, one to be held every two-three months until the end of the programme. Councillor Dempster, Assistant City Mayor for Adult Social Care and Wellbeing, will open the first of these events at De Montfort University on 18^th May. An invitation was given for Members of the Scrutiny Commission to attend;

·         There would also be a Learning Library with an online resource of reports and videos of events;

·         There were questions around the programme legacy and sustainability. During the course of the programme. It was explained that the programme fully understood the Council’s and CCG financial position, bit over 1,000 volunteers were recruited through a workforce development programme, a significant number of who wanted to develop further work skills, which would support the long term sustainability of the individual projects;

·         The programme was working with DMU to support community members to further develop their skills as researchers. Talks had taken place with DMU for community researchers to graduate in some way from the University. This work was ongoing;

·         With regards to sustainability, there had been some services that had demonstrated a significant impact on isolation and loneliness, and the programme was keen to help those organisations identify further funding through Support and Review processes;

·         Activities had been focussed on assisting organisations to identify primarily charitable resources as it is recognised there was not a significant pot of money in the statutory sector.

·         Any future services would not necessarily be the same as the current range of services;

·         53% or the people that had been worked with were Asian, and a further 10% Caribbean. Women only sessions were held, taking in account specific cultural needs within the Muslim community;

·         Wards selected were chosen in conjunction with the City Council. City-wide services had targeted people with hearing loss, people confined at home and people leaving hospital. The support for people leaving hospital was provided by the CCG, alongside Leicester Ageing Together;

·         There was also a service aimed at working with people with disabilities to give them IT skills. The project had now terminated.

The Chair welcomed the update and acknowledged the hard work undertaken to support the people in the city.

AGREED:

1.    That the report be received and welcomed.

The Strategic Director for Adult Social Care and Health submits a report to provide the Commission with an overview of the re-procurement of the Direct Payment Support Service framework. The Commission is recommended to note the report and provide any feedback.

The Strategic Director for Adult Social Care and Health submitted a report which provided the Commission with an overview of the re-procurement of the Direct Payment Support Service framework. The Commission was recommended to note the report and provide any feedback.

The following points were made:

·         Having been through a competitive procurement exercise, the framework had been established for four years from 1^st April 2018, and successful bidders were Mosaic and Purple Conversation;

·         The Direct Payment Support Service (DPSS) supported people who chose to receive direct payments to purchase and manage their care. The service was in the process of transferring people over to Mosaic or Purple Conversation;

Members raised concern over data held by the providers who did not win under the competitive tending process and were informed that all contracts with the previous providers had a clause regarding data protection, and it was the responsibility of the provider to delete the data. If there were any issues over organisations disposing of personal data, the Council would provide support if needed.

The Chair thanked the officer for the update.

AGREED:

1.    That the report be noted.

The Strategic Director of Adult Social Care and Health submits a report which brings together information on various dimensions of adult social care (ASC) performance in the third quarter (first nine months) of 2017/18. The Commission is requested to note the areas of positive achievement and areas for improvement.

The Strategic Director of Adult Social Care and Health submitted a report which brought together information on various dimensions of adult social care (ASC) performance in the third quarter (first nine months) of 2017/18. The Commission was requested to note the areas of positive achievement and areas for improvement.

The Director of Adult Social Care and Safeguarding presented the report, and made the following additional points and answered questions from Members:

·         In summary, performance had improved compared to 2016/17;

·         Some data for measures in Priority 5 (Transitions) could now be reported though further work on data quality assurance was required;

·         Admissions to residential and nursing care remained higher than planned, but the Council’s activity in terms of the proportion of people supported at home rather than in a care home compared favourably to other authorities, and numbers were reflective of higher need;

·         There had been a significant improvement in workforce performance, with sickness levels reduced by 15%. Absence management procedures were robust and could include referral to IPRS, or AMICA. Figures included those engaged in physical activity at work and could include small numbers of people on long term sick which would affect figures. There was also a need to support people facing issues, either at work or home life, but it was sometime appropriate that people left the organisation if necessary;

·         The national performance framework for ASC (ASCOF) published data for 2016/17 showed the authority compared favourably with other authorities with social care responsibilities in relation to self-directed support;

·         There was pressure from the number of people receiving some support after contact, though fewer people were in receipt of long-term support;

·         Results from assessment forms show customer feedback on interactions remained positive;

·         There were some challenges to be faced, for example, the number of people at home 91 days after re-ablement had worsened during Q3;

·         It was explained that re-ablement was for people with physical / functional difficulties. Enablement for people with learning / mental health difficulties or other needs impacting on their ability to connect and live independently within their community. Working with people in hospital, Adult Social Care staff decided on the correct pathway, and took part in ward rounds and conducting assessments;

·         It was expected that a proportion of people over the age of 85 would pass away within 12 months following a stay in hospital. ASC had to maintain an oversight to ensure people entering the re-ablement pathway could be re-abled, if not fully independent, if it was not more appropriate to access other service such as mainstream domiciliary care;

·         It was noted that a data error had been identified after the dispatch of papers, in relation to Enablement outcomes, with the actual figures being higher (better) than reported. This would be amended in future reports;

·         With regards to the number of alerts received in Q3 2017/18 of 578, there was nothing to suggest that the figure was an outlier against other regional benchmarks, and was not substantially different to the previous  ...  view the full minutes text for item 87.

The Scrutiny Policy Officer will provide a verbal update on the End of Life Task Group.

The Chair informed the meeting that the report was almost complete and would be emailed to the Scrutiny Commission Members for comment, to enable completion in time for the Overview Select Committee meeting on 5^th April 2018.

AGREED:

1.    That the report be circulated for comment to the Adult Social Care Commission Members.

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.

All Members of the Commission were invited to pass suggestions of items for inclusion of the work programme to the Chair. The following additional items were requested for inclusion:

·         Autism

·         Procurement for Adult Social Care services

·         Impacts of the Transformation Programme for the health services across the City, County and Rutland, on the social services for those authorities and the STP

AGREED:

1.    That the Adult Social Care Scrutiny Commission Work Programme be noted.

The meeting closed at 8.02pm.