Agenda and minutes

Apologies were received from Councillors Chaplin and Joshi, Mr Michael Smith from Healthwatch, and Mr Stefan Douglas, Leicestershire Fire and Rescue Service.

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 Scrutiny Commission held on 22^nd January 2019 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 on 22^nd January 2019 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.

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

The Chair agreed to hear the agenda items out of order.

The Strategic Director for Social Care and Education has sent invitations to the Clinical Commissioning Group, Age UK and Fire Service to attend the meeting to come and speak about what they can do, with regards to prevention, falls, fire and home safety.

The Strategic Director for Social Care and Education had invited the Clinical Commissioning Group, Age UK and Leicestershire Fire and Rescue Service to the meeting to speak about what they could do with regards to prevention, falls and home safety. Apologies were received from Age UK and the Fire Service. Information from the Fire Service is attached to the minutes for information.

Age UK had provided a statement prior to the meeting, in that they did not receive any funding for the type of work referred to and had no dedicated department or person to deliver the service. All staff received health advice on safety and other related training and so were in a position to offer advice and help where needed. It was further noted that up until recently Age UK hosted a falls clinic from a building in Melton Mowbray and had a UHL consultant on the Board whose specialism was falls and trips.

Mr Mark Pierce, Senior Strategy and Implementation Manager (CCG) was present and provided an overview of the system of care commissioned with Adult Social Care for those at risk, or who had previously had a number of falls. A falls prevention leaflet approved for use in the city is attached for information. The following information was provided:

·         Older people fell for a wide variety of reasons. Services not immediately connected to falls prevention were just as important in support, and there were range of medical and non-medical interventions.

·         The Local Authority had statutory responsibilities, for example, good state of pavements to prevent the infirm from falling.

·         For patients who had a trip hazard, a range of services would be commissioned i.e. practical help at home for minor home adaptations, smoothing of services (removal of rugs, etc.) good lighting at night, assistive technology service, either stand alone or plug in, sensors to show a front door had been left open.

·         There were over 5,000 types of devices – 2,500 people were using them.

·         A home-based assessment for environmental checks was carried out for 1,800 people each year. Assessors would also check whether home care was needed.

·         An integrated crisis response service, hosted by the Better Care Fund, had an average response time of 28 minutes, and was crucial in terms of keeping people at home and independent. A pendant alarm could be pressed and had a better response time than EMAS.

·         Patients also fall due to poor balance or heart problems. All GPs were familiar with assessing patients. For those where an initial assessment was not clear, commissioned in the city was a falls specialist at Leicester General Hospital, and included services such as Occupational Health in one place to assess. Balance training for core strength was given, and community-based services, for example gyms, could provide extended periods of physiotherapy, to increase balance.

·         Another group of patients in residential or nursing homes were of higher risk and had a tendency to fall more commonly given the degree of dependency. Further commissioned through LPT was a  ...  view the full minutes text for item 80.

The Strategic Director for Social Care and Education submits a report for noting to the Commission which provides an update on the outcomes of the Leicester Ageing Together programme.

The Strategic Director for Social Care and Education submitted a report for noting to the Commission which provided an update on the outcomes of the Leicester Ageing Together (LAT) programme.

Ruth Rigby, Programme Lead, LAT was present, and provided the following information:

·         The lottery funded programme was coming to an end of its four-year programme.

·         There was clear evidence that interventions had reduced social isolation and loneliness amongst people aged 50+ and had increased peoples’ sense of wellbeing.

·         Appendix 1 to the report provided a list of interventions, and a lot of activities continued to be led by members of the community independently of funding or only receiving small amounts.

·         Community Connectors were working with the strengths already in communities and supporting them to develop their own solutions. It was reported that this could be extended if core funding for the Community Connectors could be secured. LAT has various bids for funding in progress.

·         If funding for the Community Connectors is secured, then ASC could assist with the start-up funding for new groups, this is likely to be up to £100.00 per group.

·         The use of Social Value arising from ASC contracts could  also be offered , for example, free room hire, which were hugely valuable to some of the groups supported.

·         LAT provided social contact and a 1:1 support befriending type service. It was also looking at project called ‘Give and Take’ – volunteers working with individuals who required support. It was thought the mix of Community Connectors and Give and Take workers would hopefully provide a good fit for the statutory work colleagues were doing.

·         Getting people to continue to learn as they aged linked well with community development work and gave people confidence and skills. There was currently no funding for learning, and LAT were looking for partners, for example, WEA, LASALs.

The Director for Adult Social Care and Commissioning expanded on work planned with the LAT programme. In contracts organisations were asked to put tenders forward to state what social value they provided. Having spoken to LAT it had been agreed with the Executive to use social value to look at a pilot area in July 2019 for a year working with community connectors. The Chair asked that other areas which showed extreme poverty, loneliness and isolation be looked at and not clustered together. It was reported that previous areas had been gained from Big Lottery, based on looking at the demographics and more deprived areas of the city, though acknowledgement was made to other areas of need. It was further noted that future funding alluded to conditions and might refer to geography. It was recognised there would be a limited number of Community Connectors across the city and was a matter of best use of resources. Members said there were a lot of wards that had had little input and perhaps knew nothing of the service, and there had been no impact in the west of the city. It was noted there were potentially a  ...  view the full minutes text for item 81.

The Strategic Director of Social Care and Education will provide a verbal update for information to the Scrutiny Commission on the Learning Disabilities Strategy and Employment Opportunities.

Tom Elkington, Business Change Commissioning Manager, delivered a presentation on the Joint Health and Social Care Learning Disability Strategy: Consultation Update (attached to the minutes for information).

The following points were highlighted:

·         Consultation would run until 23^rd April 2019.

·         Consultation would take place at several venues across the city but it has not been possible to visit every ward. The Chair asked that consultation take place in all areas on rotation in different venues to gain maximum input.

·         Access to public transport needed to be included in the strategy. It had been noted that people with walking aids were not always able to get on a bus and had been taken back as an action.

·         Leicester did well with the number of people having a health check, but the point of a health check was an action plan, which was not happening across the board – there were inconsistent experiences of health services.

·         Other events would also see colleagues speaking to Leicestershire Partnership trust and Leicester College to find out what they would like to see included in the strategy.

·         Information on the consultation survey would be forwarded on to Ward Members with an explanation, to enable Members to relay the information to constituents.

The Assistant City Mayor, Adult Social Care and Wellbeing, thanked the officer for the presentation. She stated that as a member on the Learning Disabilities Board she had found it hugely beneficial, and that the Chair of the Board themselves had a learning disability. She suggested that every division in the city council could look to provide a job opportunity for a person with a learning disability, and that it could be looked at as part of the procurement process.

The Chair noted the comments made by the Assistant Mayor and put it to the Commission that a recommendation be made that council look at providing job opportunities for people with learning disabilities, and that it be put to the City Mayor as a business commitment.

The Chair thanked the officer and his method of presenting.

AGREED:

1.    That the presentation and comments made be noted.

2.    Details of the consultation would be sent to all Ward Councillors so that they could relay information to constituents.

3.    That consultation events be held in rotation geographically to gain maximum input.

4.    That all departments in the city council look to provide a job opportunity for someone with a learning disability, and it be put to the City Mayor as a business commitment.

The Assistant City Mayor, Adult Social Care and Wellbeing, will provide for information an update on Independent Living Support – Supported Housing Service.

The Assistant City Mayor, Adult Social Care and Wellbeing wanted to bring to the Commission’s attention that participants in the consultation had been listened to, and that organisations across the city were negotiated with to try and reach the right decision for the residents of the city.

It had been necessary to deliver savings, and there had been some difficulties. The Assistant City Mayor gave thanks to the officers who had persevered with organisations and had managed to reach an agreement.

AGREED:

1.    That the update be noted.

The Strategic Director for Social Care and Education will deliver a presentation to provide the Scrutiny Commission with an update on the Adult Social Care Annual Operating Plan 2018/19.

The Strategic Director for Social Care and Education, delivered a presentation on the Adult Social Care Annual Operating Plan for 2018/19 (attached for information).

The following additional points were made:

·         Training on the Mental Capacity Act was being developed, and there had been significant improvement.

·         Under safeguarding, providers, for example nursing homes, could report issues online, and had improved the flow in information coming into ASC.

·         It was important that an individual had their views taken into account.

·         Work was underway to make sure all staff and partners worked to the same competency framework.

·         A Team Manager had moved into the post of Practice Implementation Lead.

·         Shared Lives had been scoped in as an alternative to residential care.

·         The use of Assistive Technology would be maximised, for example, a community alarm scheme, gas emissions readers.

·         A new Accommodation Board had been established to oversee residential care. A review of fees had been undertaken successfully with the nursing home sector, with no legal challenge or dissention from homes.

·         The Transitions Strategy launched on 6 March 2019 had good representation across the health and social care sector across the city.

·         Good enough within resources – a number of things had been flagged and the QA system and audits demonstrated improvement.

·         Savings for 19/20 had been delivered in 18/19, which would offset growth pressure which will manifest itself in 2021, and there would be no more savings to be made.

·         The Enablement Service was critical to get people back on their feet and able to care for themselves.

The Chair thanked the Strategic Director for the presentation.

It was confirmed with the Chair that knowing that people might need ASC services, every financial assessment undertaken went through a screening service to determine individuals were getting all of the benefit they were entitled to.

The Chair said it was important that every member should know about safeguarding training. It was noted that safeguarding training was mandatory for staff in the department, and that specialist training was taken where necessary to work with distinct groups of people.

The Chair thanked the Assistant City Mayor, the Strategic Director and Directors for their work. She added that officers in the department worked incredibly hard and that a very strong message of support from the Scrutiny Commission be forwarded to officers.

AGREED:

1.    That the information delivered in the presentation be noted.

The Strategic Director for Social Care and Education submits a report which summarises the process and outcome of the Local Authority Test of Assurance undertaken by the Local Government Association (LGA) in November 2018. The Scrutiny Commission is recommended to note the outcome of the Test of Assurance and pass any comments to the Strategic Director for Social Care and Education.

The Strategic Director for Social Care and Education submitted a report for noting which summarised the process and outcome of the Local Authority Test of Assurance taken by the Local Government Association (LGA) in November 2018.

The Strategic Director reported that the test of assurance was taken following combined Director of Children’s Services and Director of Adult Social Services roles to ensure that the post holder and department could meet requirements.

The following points highlighted in the report were:

·         The combined departmental structure worked well.

·         Statutory duties were met relating to the roles of the Director of Children’s Services and the Director of Adult Social Care Services.

·         Leadership and partnerships were operating well.

·         Effective governance arrangements and delivery mechanisms were in place.

·         Staff had a shared and common purpose.

The Chair asked that Members submit questions on the report to the Strategic Director for Social Care and Education, and a response to the questions would be circulated to Scrutiny Members.

AGREED:

1.    That the report be noted.

2.    Members submit questions they may wish to raise with the Strategic Director of Social Care and Education, and a response to any questions to be circulated to Scrutiny Members.

The Strategic Director for Social Care and Education submits a report for noting to the Scrutiny Commission which provides the Executive response to the Adult Social Care Scrutiny Commission’s task group report presented at the meeting of the Commission on 16^th October 2018.

The Strategic Director for Social Care and Education submitted a report for noting to the Scrutiny Commission which provided the Executive response to the Commission’s Task Group report presented at the meeting of the Commission on 16^th October 2018.

The Chair stated she was please to see that the Executive had taken on board the recommendations in the report and had endorsed each one. She was also pleased to read that the service intended to conduct reviews in relation to End of Life and Independent Living, which provided opportunities to monitor the achievement of the recommendations.

The Chair asked that the service continue to work towards the recommendations endorsed as part of day-to-day functioning.

AGREED:

1.    That the report be noted.

2.    That the service continue to work towards the recommendation endorsed as part of day-to-day functioning.

The Strategic Director for Social Care and Education submits a report to the Commission which brings together information on various dimensions of adult social care (ASC) performance. The Commission is requested to note the areas of positive achievement and areas for improvement.

The Strategic Director for Social Care and Education submitted a report to the Commission for noting which brought together information on various dimensions of adult social care performance.

The report had been read by the Commission Members.

The Chair raised a question under 3.2.5 in the report, Keeping People Safe. She asked that the safeguarding procedure from initial concern being alerted to outcomes being met be explained, as the information did not provide enough information to be able to see where exactly cases were being dropped, and the percentage of concerns that hadn’t been addressed.

The Assistant City Mayor for Adult Social Care said it was imperative that if a Member of Scrutiny raise a safeguarding issue it be addressed.

The Director of Adult Social Care and Safeguarding said the aim was to make a threshold decision quickly, but other information might need to be investigated. She added it was not always possible to complete a case within 24 hours, for example, the individual might be in hospital and it would not appropriate to speak to them, but they would be safe.

Further work was required on Liquid Logic to complete. The process was being looked at the ensure when closing a safeguarding enquiry, other work might be continuing but the person would be safe.

The Chair thanked the Director for the explanation.

The Assistance City Mayor asked that training for Members on safeguarding and its impact be arranged as a priority. The Strategic Director for Social Care and Education reiterated the importance of Members being aware of children’s and adult’s safeguarding.

The Chair acknowledged that Safeguarding training was provided as part of the Member Development Programme, and that Elected Members should attend.

The Chair congratulated staff on the successes in Quarter 3, in particular the quality of life score, which had hit its highest score. She added it was good to see the highest percentage of service users feeling they had control over their daily life.

The Chair recommended that complete, in-depth data on workforce management be brought to the Scrutiny Commission in the new Municipal Year.

AGREED:

1.    That the report be noted.

2.    Elected Members be encouraged to attend the Safeguarding training as part of the Member Development Programme.

3.    In-depth data on workforce management be brought to the Scrutiny Commission in the new Municipal Year.

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 note and comment on the Adult Social Care Scrutiny Commission work programme.

The Strategic Director Social Care and Education, Director for Adult Social Care & Safeguarding, and Director for Adult Social Care & Commissioning gave thanks to the Chair for her challenge and thoughtfulness during her time as Chair.

It was also acknowledged that it was the last meeting for Megan Law, Scrutiny Policy Officer, and she was thanked for all of her work in support of the Commission and Chair.

The Assistant City Mayor gave thanks to the Commission Members, officers supporting the Commission, the Strategic Director, Directors, and all members of staff who have attended the meetings to present reports. She added her job had been made much easier by the fact they were truly brilliant officers, knowledgeable and competent, and such the city was lucky to have them.

There being no other items of urgent business, the meeting closed at 7.43pm.