Agenda and minutes

To issue a welcome to those present, and to confirm if there are any apologies for absence.

It was noted that apologies for absence were received from Cllr Orton and Cllr O’Neill.

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

The Chair asked members to declare any interests in proceedings for which there were none.

The minutes of the meeting of the Adult Social Care Scrutiny Commission held on 8 July 2024 have been circulated and Members will be asked to confirm them as a correct record.

The Chair highlighted that the minutes from the meeting held on 8 July were included in the agenda pack and asked Members to confirm whether they were an accurate record.  
 
AGREED:
 

·       It was agreed that the minutes for the meeting on 8 July 2024 were a correct record. 

The Chair is invited to make any announcements as they see fit. 

The Chair highlighted that Members may have seen recent news articles about the safety of care for vulnerable city residents, particularly some poor standards in care homes and a care agency and sought assurance about the situation in the city.

The Director of Adult Social Care & Commissioning acknowledged the concerns raised following recent news articles and reassured the commission that this is not a systemic issue and that measures continue to be in place manage quality assurance in the external market and ensure residents receive the best possible care. It was further noted that:

·       There are 95 care homes in the city currently, of which 50 support older people and the remainder supporting individuals with a learning disability or mental health condition. Current data indicates 1 care home is rated outstanding and 60 good. There are 28 care homes that require improvement ,and 1 inadequate, of which 7 have not been reinspected by the CQC for over 2 years, and therefore not able to demonstrate  improvements that may have been made to support an improved rating. A further 5 care homes have not yet been inspected by the CQC and therefore correlates with concerns about the confidence in the CQC to regulate standards.

·       There are around 150 regulated registered providers in the city providing domiciliary care to people in their homes. The Council hold a contract with 32 of those providers and statistics from June indicated 75% inspected by the CQC were good or outstanding. Following the recommendation by the Commission regarding the retendering of the home care contract, a requirement of the forthcoming contract is  that providers have to have a CQC rating of good or above, demonstrating our commitment to high standards and performance.

The Chair noted concerns around the sustainability of the CQC and therefore sought further details to inform the Commission of the local quality and assurance measures, in which it was noted that:

·       The Council have a contract specification with providers which includes standards to be met for residents drawing on support and funded by the Council. The contract will include terms and conditions associated to pay and expectations as well as actions if there is a failure in the contract provision. The contract specification, quality assurance framework and regulation of CQC inspections collectively promote the expected standards. 

·       The Council can undertake announced and unaccounted visits to assess providers. Generally, announced visits will focus on paperwork compliance whereas an unannounced visit will observe the day-to-day practice to get a sense of the culture and atmosphere to ensure the care being provided is inclusive and dignified. Officers will usually ask the manager who the most complex person funded by the Council is within their care and will observe to review against their care plan to ensure the care is being provided as expected. 

·       Providers will be assessed against many standards to determine compliance. Where a provider is deemed to be non-compliant this will be categorised as major if there is an immediate impact to the health  ...  view the full minutes text for item 75.

Any questions, representations and statements of case submitted in accordance with the Council’s procedures will be reported.

It was noted that none had been received.  

Any petitions received in accordance with Council procedures will be reported.

It was noted that none had been received.  

The Director for Adult Social Care & Commission submits a report to update the Commission on the commitment to develop an early action strategy for Adult Social Care, including details of the Leading Better Lives project. Members will be asked to note the report and provide comments.

The Director for Adult Social Care & Commissioning presented the report along with the Co-Chair of the Making it Real Group. It was noted that:

·       The Council’s budget is under significant pressure, and adult social care is the largest spend. As part of reviewing budgets and comparing the department to other comparable cities, it has been acknowledged that spend is higher in the city. Whilst we have good fee rates and many people do not require large packages, there are more people drawing on support in the city that contribute to higher costs.

·       It was understood through peer reviews with authorities with similar demographics that were managing their spend had well-developed preventative offer and joined up community support for residents to access and therefore not seeking support from adult social care until later. The department therefore have undertaken work the Ernst & Young Consultants to identify how the Council could work collaboratively internally and externally on an early prevention offer.

·       An opportunity arose to work with Social Care futures, a national movement partnering with local authorities to identify and tackle issues impacting social care. Their ethos on co-production aligned with the commitment in Leicester and therefore agreed to work together to develop the Leading Better Lives project.

·       The department have pledged to work in co-production to ensure projects, processes and procedures have been considered by those with lived experience and the Making it Real Group was therefore established and work alongside officers.

·       When embarking on the project, it was evident that individuals felt it was important to not focus on ‘prevention’ but talk more about allowing individuals to lead a better life and have choices to continue to live in their community. Assumptions were not to be made throughout the project and there was a commitment with trained facilitators that residents were provided the opportunity to share their voice in their own words and it would be listened to when asking what works well in the community, what doesn’t work well and what would people like to see in the future.

·       Information was sought through 14 focus groups, though facilitators would often liaise with various individuals and groups as part of these sessions. 76 survey responses were received and a total of 614 pieces of information was collated through peoples’ voices and stories.

·       The data collected was presented at two workshops in July with attendance from council services, partners from health, the voluntary and community sector and those with lived experience. All information was shared in its original form and attendees were able to theme information to identify four priorities to make a difference for residents and agreed shared responsibility to work together to deliver actions.

·       The project reaffirmed the activities and assets that exist within communities. It provided an opportunity to commit to work collectively to identify ideas and solutions to add further value and create an early action plan to support residents in Leicester.

The Commission commended the positive and collaborative work to identify priority themes to be taken forward.  ...  view the full minutes text for item 78.

The Director for Adult Social Care & Commissions submits a report to provide the Commission with an overview of the anticipated procurement activities to be undertaken by the Social Care and Education (SCE) department during 2024-2025. Members will be asked to note the report and indicate any activities they would like further information on.

The Director for Adult Social Care and Commissioning highlighted that the procurement plan is presented to the Commission annually to set out the pipeline of intended procurement activities. This illustrates where money is intended to be allocated and the types of services sought in the market, providing Members with an opportunity to indicate areas of interest for further discussion or comment.

In response to questions and comments from Members, it was noted that following the introduction of the Social Value Act, evidence of any form of social value is considered as part of the tender assessment when bids are submitted. Bidders are encouraged however to evidence social value to support the sustainability of the voluntary and community sector as well as providing employment opportunities for individuals with learning disabilities or care leavers for example. Officers ensure proposed social value within bids is proportionate to the contract, appropriate for the community and the social value register enables facilitation to ensure benefits are realised.

It was agreed that there is further opportunity as a Corporate Parent for more prescribed value for children which will be explored. 
 
The Chair noted the reliance of short-term contracts within the procurement plan and hoped through preventative work and if there were a different settlement for local authorities that this would come to an end.

It was also requested by the Chair that the Commission be provided with an update on supported living schemes in which the Deputy City Mayor for Social Care, Health and Community Safety highlighted cross divisional working with housing and the opportunity for a joint scrutiny discussion.

AGREED:  

·       The Commission noted the report.

·       A more prescribed offer for children to be considered through procurement.

·       Supported living to be added to the work programme and consideration of joint discussion with the housing scrutiny commission.

Members of the Commission will be asked to consider the work programme and make suggestions for additional items as it considers necessary.

The Chair reminded Members that should there be any items they wish to be considered for the work programme then to share these with her and the senior governance officer.

It was further noted that Members have been invited at attend the Public Health & Health Integration Scrutiny Commission on 10 September 2024 to jointly discuss winter planning.

There being no further business, the meeting closed at 18.36.