Agenda and minutes
Health & Adult Social Care Overview and Scrutiny Committee
Monday, 20th November, 2017 10.00 am
Contact: Amanda Holyoak Committee Officer
Apologies for Absence
Apologies were received from Councillor Paul Wynn.
Declarations of Interest
Councillor Madge Shineton reported that she was a member of Health Concern.
To confirm the minutes of the meeting held on 25 September 2017, attached marked: 3
The minutes of the meeting held on 25 September 2017 were confirmed as a correct record.
Public Question Time
To receive any public questions or petitions from the public, notice of which has been given in accordance with procedure rule 14. The deadline for notification is 5.00 pm on Wednesday 15 November 2017
There were no questions from Members of the Public.
To receive any questions of which Members of the Council have given notice. Deadline for notification is 5.00 pm on Wednesday 15 November.
Councillor Pam Moseley asked a question regarding the role of Shropshire Council and the increasing demand for services being placed on the voluntary and community sector and diminishing monies available to them. (A copy of the question and response is attached to the signed minutes). Members heard that Shropshire Council Adult Services had commenced work with VCS and local housing providers to review and plan the approach to commissioning preventative services beyond 2018/19. In her supplementary question, Councillor Moseley asked about the cessation of CCG funding and said she had asked for a schedule of what the Council currently provided in existing grants to the sector.
Councillor David Vasmer attended the meeting on behalf of Councillor Roger Evans who had asked a question about the required savings in Adult Social Care and the iBCF grant. (a copy of the question and response is attached to the signed minutes). Councillor Vasmer asked for more detail on how savings would be achieved, expressed concern about potential impact on training, asked when confirmation was expected in relation to iBCF funds and about monitoring of the position. It was reported that further detail was expected regarding the iBCF and whether it could be carried over, guidance was expected from central government in the new year.
To consider the annual safeguarding report and future structural arrangements for both Children’s and Adult’s Boards, report attached marked: 6 (Appendix 1 to follow)
Sarah Hollinshead-Bland, Service Manager for Adult Safeguarding, presented the Annual Report of the Keeping Adults Safe in Shropshire Board April 2016 – March 2017.
She explained that the report had been designed to tell more of a story this year and that the Board had been looking at what constituted the appropriate use of the safeguarding process. Looking forward, the Keeping Adults Safe in Shropshire Board and Shropshire Safeguarding Children’s Board would now be working in a more aligned way by establishing a Safeguarding Boards Business Unit.
In discussion of the report, Members commented that the first section was excellent but that the second section was over-detailed and contained duplication. They heard that this was necessary to conform with Care Act Guidance but that a second version, in more of a magazine style presentation would also be made available.
In discussion around training, the emphasis was moving away from the number of people trained to focusing on the difference it had made. It was confirmed that the CCG and GPs were well engaged.
Members discussed domestic abuse involving older people, particularly in cases where dementia was a factor. The Committee heard that this was a very challenging area of work and that there was never the same solution twice. It was important to establish what the person involved wished to happen and focus on care and support needs. It was confirmed that self funders were not excluded from the safeguarding process.
The Committee thanked the Service Manager for the update and asked for sight of the more accessible report once it was made available.
To consider dashboards regarding Delayed Transfers of Care and wider performance. Report attached marked: 7. A presentation will be also be made at the meeting.
The Head of Adult Social Care, provided a report and presentation to the Committee explaining how the council had taken measures to address Delayed Transfers of Care.
The report and presentation covered:
· Definition of a Delayed Transfer of Care
· The responsibilities of the NHS and Council in relation to discharge
· Targets set to reduce delays
· How performance is monitored
· Hospital discharge and Admission Avoidance Initiatives
· Shropshire Council’s performance to date and future target
Members observed the report and presentation were clear and helpful and asked questions relating to:
What was the main factor behind the improved performance, was this as a direct result of extra funding and brokerage, what would happen if funds ran out.
What was the difference between the BCF and iBCF
If funding was to come to an end, would progress reverse or good work continue.
Whether discussion was taking place with Housing Trusts
Where were the step down units, how long people stayed in them and which organisation funded them
If the Council was feeding into the review on community hospital beds and the need for a bed to be available close to the home of the patient.
In response officers reported that extra funding had made a big difference, and there was now a much better understanding between social care and health around what a delay was and working together was more effective. Daily scrutiny of every delay took place
It was confirmed that the new iBCF was only secure for three years and would reduce year by year, the future beyond that being uncertain. It was also confirmed that the Council was feeding into the Community bed review and it was felt that there was a lot of capacity but that beds were not currently in the right place. Members referred to a project at Bishops Castle which had worked well and felt that community beds could be made available in residential or nursing homes.
Discussion also covered roll out of the two carers in a car scheme and a number of members emphasised that something was needed for the very rural areas. Members were pleased to hear that discussions had been started on a number of ideas, including a nursing home providing outreach work in a local community.
Discussion also covered location of Neurological bed provision in rehabilitation units and the Committee asked that more detail on these be obtained from Shropshire CCG.
The Step Down units were located in Shrewsbury, most having two bedrooms and overnight warden support. It was confirmed that Shropshire Council funded care and support needed in the night time and some rental costs. Occupational Therapists made an assessment of equipment that would be needed in the home.
It was agreed that Delayed discharge be revisited at the March 2018 meeting and that SATH should be asked to report on what they were putting in place to improve situation and increase achievement of their target from 36% to the required 80%. It was also agreed that information from ... view the full minutes text for item 17.
To consider the future work programme of the Committee.
The Statutory Scrutiny Officer reminded members of the work programming session held by members earlier in the year to identify where Overview and Scrutiny could add value and tie into key developments of the Council. He took the Committee through the Strategic Scrutiny Work programme which had been developed following similar sessions with all the Overview and Scrutiny Committee. Some topics were cross cutting and would involve joint work with other Committees. It would be important to identify the right time for scrutiny involvement.
It was agreed that Delayed Transfers of Care should be the focus of attention at the March meeting and that it would be important to clearly define the information required from the CCG and Hospital Trust.
It was agreed that Scrutiny needed a greater input into the STP programme should be considered at an additional meeting in February time.
It was agreed that lack of care workers in rural areas was a significant problem and the Committee wished to identify the input Adult Social Care had had in the local Plan review as soon as possible.
Other potential items for inclusion in the work programme included: Obesity and community pharmacies. Obesity and Joined-up strategies was an area of potential joint work with Communities Overview Committee and Performance Management Scrutiny Committee
Vanessa Barrett, Healthwatch Representative referred to issues Healthwatch had identified regarding lack of compliance with accessible information standards at GP surgeries
Members agreed that joint presentations of Quality Accounts to Healthwatch and Scrutiny was a good idea.
It was agreed that it was important to identify the right time for Scrutiny to consider a topic, not to overfill agendas and to ensure the right people attended meetings. Pre-meetings might be needed on some occasions to plan to get the best out of a meeting.
The Statutory Scrutiny Officer agreed to update the proposed Work Programme to reflect discussions and bring proposals to the next meeting.