Agenda and minutes

Apologies were received from the Chair Councillor Joshi. Councillor March as Vice Chair to the Chair for the meeting.

Apologies for absence were also received from Councillor Khote and Ruth Lake.

Members wished Councillor Khote a speedy recovery.

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 17 December 2019 are attaced and the Commission is asked to confirm them as a correct record.

Minute 37: Minutes of the Previous Meeting

Members of the Commission were asked to form a small reference group to test the new format of the Adult Social Care Integrated Performance Report. Members who wanted to be involved were asked to notify the Scrutiny Policy Officer – Councillors Batool, Kaur Saini and Kitterick.

AGREED:

That the meeting be co-ordinated through Scrutiny Policy Officer support.

Minute 42: Communications and Information Co-ordinator – Update

It was recommended that the Communications and Information Co-ordinator liaise with Ward Councillors to better understand communities across the city. The action would be carried forward to the next meeting of the Scrutiny Commission.

AGREED:

That the minutes of the meeting of Adult Social Care Scrutiny Commission held on 17 December 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 Director for Adult Social Care and Commissioning submits a report to provide the Adult Social Care Scrutiny Commission with an update on the Joint Social Care and Health Recognising, Valuing and Supporting Carers in Leicester, Leicestershire and Rutland Carer Strategy 2018 to 2021.

The Commission is recommended to note the report and provide feedback and comments to the Director for Adult Social Care and Commissioning.

The Director for Adult Social Care and Commissioning submitted an update on the Joint Social Care and Health Recognising, Valuing and Supporting Carers in Leicester, Leicestershire and Rutland Carer Strategy 2018 to 2021. Commission Members were recommended to note the report and provide feedback.

The Director for Adult Social Care and Commissioning presented the report and introduced Cheryl Clegg from Age UK, Leicestershire and Rutland, and Philippa Stanbridge from Leicester Carers Support Service.

It was noted that the Strategy provided a shared vision with eight guiding principles. It was further noted the delivery plan was in final draft form and was on target to be published early March 2020. Production of the plan had started during Carers Week June 2019 and relevant organisations and carers had provided input towards its development.

Delivery of the plan was outlined in the report. It was noted that methods and approaches to measure impacts and achievements were detailed in the Carers Strategy and would be measured every year against national indicators.

Cheryl Clegg provided an outline of the Leicester Carers Support Service (attached for information) based in Clarence House which had been the main support service for carers, provided on behalf of the Council for carers over the age of 18 since 1 July 2019. It was noted that carers under 18 were supported through Barnardo’s on behalf of the Council.

A leaflet was circulated to the Commission Members (attached for information) which outlined a variety of services and support, including information and advice, carers cafes, group activities and peer support groups. Carer learning and training ran sessions such as Mindfulness and wellbeing activities. A recent presentation had been given on alcohol and substance misuse. It was stated that carers could be in complex situations, and many carers were not in the best of health themselves. The Leicester Carers Support Service offered emotional support to all carers.

Carers could drop into the hub at any time for information and support. It was noted that carers came from all backgrounds, were wide ranging in age, with some new to the role, and others may have been caring for many years, and could be supporting one person or multiple people. Activities took place at Clarence House and around the city. Members were told that intensive support was given to 339 carers and numbers were increasing, with an average of 30+ people a week visiting the carers’ hub. The Service also took direct referrals.

Members were informed that one group had been started in response to demand. The Cared for Carers Group was slightly different and supported carers who could not leave the person they were caring for. The group was growing in size and was proving invaluable.

The Service continued to hold a number of outreach sessions which were advertised, and staff were present to provide information and advice on the support available. It was noted that carers often did not identify that they were in a caring role initially until questioning drew out information on  ...  view the full minutes text for item 50.

The Director of Finance submits a report setting out the City Mayor’s proposed budget for 2020/21 to 2021/22.

The Commission is recommended to consider and comment on the Adult Social Care of the budget. The Commission’s comments will be forwarded to the Overview Select Committee as part of its consideration of the report before it is presented to the Council meeting on 19 February 2020.

The Director of Finance submitted a report setting out the City Mayor’s proposed budget for 2020/21 to 2021/22. The Commission was recommended to consider and comment on the Adult Social Care element of the budget. The Commission’s comments would be forwarded to the Overview Select Committee as part of its consideration of the report before presentation to the meeting of Council on 19^th February 2020.

Councillor Russell, Deputy City Mayor, Social Care and Anti-Poverty introduced the report. The Commission was asked to note the budget presented was for one year, with no financial certainty beyond 2020/21, leaving the budget for Adult Social Care vulnerable. It was further noted that steadily increasing demand, with increased costs had made it a volatile service budget area.

Martin Judson, Head of Finance, said the Service was reliant on the Better Care Fund monies of £28.5m each year and the budget had to factor in the increasing needs of existing service users at 5.5% (£10m) per annum. A growth in service user numbers was also expected of 0.5% per annum and an increase in the National Living Wage at 6%, which equated to an annual overall growth in costs of rate of 11.5% for 2020/21. As a result an additional £3m of growth has been included in the 2020/21 budget.  Beyond 2020/21 there would be an increasing gap between resources and expenditure of at least £15m per annum unless a long-term funding solution was provided by central government.

It was noted that £2.5m had been achieved towards a £5m savings target under the Spending Review 4 Programme so far, and work was ongoing to find further savings and the remaining £2.5m was not attached to any particular review.

The Deputy City Mayor informed the meeting that a report on the charging policy would be brought to the next meeting of the Scrutiny Commission. She noted the Enablement Service costs were approximately £1m but believed it offset costs of £1m and if funding was ceased the Department would see an increase in costs elsewhere in the budget in future years. It was noted the Department was currently meeting need but was under immense pressure as demand rose.

The Chair asked if the Council sought assurances from other health and social care providers in the city, for example, Leicester Partnership NHS Trust, that adequate, timely support and budgeting was provided to the increasing needs of vulnerable adults. The Deputy City Mayor affirmed that the range of partners working with the Council functioned together to maximise resources.

The Commission acknowledged the difference between available budget and expenditure and the lack of ability to forward plan, and the growing complexity of needs for people below retirement age with deep concern.

AGREED: 

that:

1.    The Commission note the report;

2.    The Commission raise concerns relating to severe cost pressures on Adult Social Care services for the future.

3.    Comments and recommendation from the Commission on the budget item go to Overview Select Committee to inform Budget Council.

The Director for Adult Social Care and Commissioning submits a report to the Commission to provide an update on progress against the manifesto pledge ‘Tackle Care Home Staff Ratio’s as part of their commitment to improve health & Care’.

The Commission is recommended to note the contents of the report and provide any comments or feedback to the Director for Adult Social Care and Commissioning.

The Director for Adult Social Care and Commissioning submitted a report to the Commission which provided an update on progress against the manifesto pledge ‘Tackle Care Home Staff Ratio’s as part of their commitment to improve Health & Care’. The Commission was recommended to note the contents of the report and provide any comments or feedback to the Director for Adult Social Care and Commissioning.

The Deputy City Mayor introduced the report and legislative framework of The Health and Social Care Act 2008 (Regulated Activities 2014: Regulation 18) around the deployment of staff to deliver care.

Annette Forbes, Group Manager, Contracts and Assurance, presented the report. The Commission was asked to note that the Council had no means of legally enforcing a staff-patient ratio in a care setting, legislation stated only that an organisation was required to deploy enough staff. The report also provided information on the number of measures available to the Council to ensure the needs of social care clients were being met, including  the fee setting process.

The report stated Leicester City Council compared well against the national average with regards to the numbers of nursing and residential homes which were graded by the Care Quality Commission (CQC) as ‘Outstanding’ or ‘Good’ overall. It was noted that whilst the Council could not enforce the numbers of staff deployed, the Department looked at intelligence from stakeholders, undertook checks on homes, and checked with individuals and family members to ensure the needs of individuals were being met.

It was noted when looking at the quality of services, the Contracts and Assurance Service (CaAS) undertook Quality Assurance Framework (QAF) assessments on a regular basis. Assessments usually could include a desk top exercise and observations, an auditing of alarm systems, Health and Safety inspections of homes, audit of fire safety, health and safety of workforce. Information gathered would form recommendations enforceable under contracts. A range of information was also received from stakeholders. Regular meetings were held with the CQC and information shared to get a rounded picture of services. Where a contracted provider was failing to meet its obligations a Multi-Agency Improvement Planning (MAIP) approach through a team would ensure deployment of enough staff to manage peoples’ needs and pressure times at homes, for example, mealtimes.

It was reported that fees had increased from April 2019 following a review of residential and nursing care banded structures, but additional needs allowances had also increased.

The commission was told that managers of care homes were informed on what support was available to them. It was noted that over the previous year, 18 care homes had required improvement following checks, three of which had been in relation to staffing levels.

Members questioned how a care homes performance was measured, and how many concerns had been raised over the past 12 months. Members were informed that a home could only be assessed on what officers could see on any specific day, for example, unanswered alarms ringing for a significant length of time, rushed staff, conversations with  ...  view the full minutes text for item 52.

The Director for Adult Social Care and Safeguarding has provided the following statement:

“The 12-week consultation on the proposed changes to the Adult Social Care Charging Policy, for non-residential services, concluded on 15^th November 2019. We are pleased to note that there was a very good response to this consultation, with over 1000 surveys completed in addition to feedback at public meetings. This has provided extensive information, which officers are currently analysing and considering any equalities implications, so that a fully informed decision can be made.

Whilst we had hoped that a decision would be possible in December 2019, this has not been the case due to the need to ensure all feedback is carefully evaluated. It is anticipated that a decision will be made, on whether to progress the proposal made, during February 2020. As a key decision, this would be published in the usual way, with all supporting material.”

The Commission is recommended to receive the above statement and make any comments as necessary to the Director for Adult Social Care and Safeguarding.

The Deputy City Mayor informed the meeting that the report would be brought to the next scheduled meeting of the Scrutiny Commission following analysis of consultation responses and before an Executive Decision was made. The report would also include an Equality Impact Assessment.

AGREED:

1.    That the report be received at the next scheduled meeting of the Scrutiny Commission.

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.

The Chair provided an update from the ‘Adult Social Care Workforce Planning for the Future’ Task Group. Following a meeting with Unison the union a questionnaire would be forwarded to providers to tie in with recruitment and retention.

Items to be added to the Work Programme:

·         Manifesto Pledges

·         Care Charter - Update

There being no other items of urgent business, the meeting closed at 7.10pm.