Agenda and minutes

To receive any apologies for absence from Councillors.

Apologies were received from Cllrs C Johnson, D Farr and C Matthews.

To receive information on any changes in the membership of the Committee.

Note – When a member of a Committee is unable to attend a meeting of a Committee or Sub-Committee, the relevant Political Group Leader (or their nominated representative) may, by notice to the Monitoring Officer (or their nominated representative) prior to the meeting, appoint a substitute member from within the same Political Group. The contact details on the front of this agenda should be used for notifications.

Cllr B Dion substituted for Cllr C Johnson, Cllr S Anderson substituted for Cllr D Farr and Cllr M Earl substituted for Cllr C Matthews.

Councillors are asked to elect the Chair of the Health and Adult Social Care Overview and Scrutiny Committee for the 2021/22 Municipal Year.

RESOLVED that Cllr J Edwards be elected Chair of the Health and Adult Social Care Overview and Scrutiny Committee for the 2021/2022 Municipal Year.

Voting: Unanimous.

Councillors are asked to elect the Vice-Chair of the Health and Adult Social Care Overview and Scrutiny Committee for the 2021/22 Municipal Year.

RESOLVED that Cllr L-J Evans be elected Vice-Chair of the Health and Adult Social Care Overview and Scrutiny Committee for the 2021/2022 Municipal Year.

Voting: Unanimous.

Councillors are requested to declare any interests on items included in this agenda. Please refer to the workflow on the preceding page for guidance.

Declarations received will be reported at the meeting.

Cllr L-J Evans declared, for transparency, that she was an employee of the University Hospitals Dorset Foundation Trust.

To confirm the minutes of the meeting held on 8 March 2021.

The minutes of the meeting held on 8 March 2021 were approved as a correct and accurate record.

To receive any public questions, statements or petitions submitted in accordance with the Constitution, which is available to view at the following link:

https://democracy.bcpcouncil.gov.uk/ieListMeetings.aspx?CommitteeID=151&Info=1&bcr=1    

The deadline for the submission of a public question is 4 clear working days before the meeting.

The deadline for the submission of a public statement is midday the working day before the meeting.

The deadline for the submission of a petition is 10 working days before the meeting.

There were no public questions, statements or petitions received for this meeting.

To note and comment as required on the action sheet which tracks decisions, actions and outcomes arising from previous Committee meetings.

The Committee noted the Action Sheet.

For the Committee to receive an update from Adult Social Care Services on COVID-19, to enable the Committee to monitor the ongoing pandemic and scrutinise the ongoing response to COVID-19.

The Director of Public Health for Public Health Dorset introduced the progress report on Public Health and Adult Social Care Response to the COVID-19 Pandemic. The main points raised during the Public Health section of the presentation were as follows:

·       Infection rates remain low in the BCP Council area which was not dissimilar to other Councils in the South West of England and was lower than the national average for England.

·       Up to 15 May, there were no people admitted or in hospital with Covid and the regional infection rate was 9.4 per 100k of the population.

·       There was no observed increase in local infections since the opening up of Step 2 of the Government’s roadmap.

·       Observations would be ongoing as to whether the further unlock under Step 3 from the 17 May would lead to local increases in cases.

·       The B1.617.2 variant was designated as a variant causing concern nationally and there were rising cases across many Councils, primarily due to community transmission. This variant was currently not a local issue with the South West seeing only low case numbers. Almost all of the cases were connected to recent travel.

·       The vaccination rollout was progressing extremely well across BCP and Dorset and 82% of 40-49 years having received their first dose, 43% of 30-39 year olds having received their first dose and 277,000 people in total having received both doses.

·       The vaccine progress and the low case rates were not cause for complacency and the Committee heard that there was still a very fine balance between the opening up of the economy, tourism and travel industries and the concern around the spread of new variants.

·       There had been a revised local outbreak management plan published in March and the priorities that were set for continuing to live with Covid-19 were clear.

·       These priorities included a rapid response to outbreaks, the mobilisation of rapid community testing with a focus on the more vulnerable, close working with the Test and Trace system to identify contacts, enhanced surveillance to inform rapid suppression of cases, vaccine coverage assurance and an inequalities plan with funding to work to close the gap in uptake and finally a planning surge for testing of variants of concern.

·       Maintaining the confidence in public adherence toward social distancing and hygiene measures was still a key issue and the cuddle with caution was highlighted as a possible area for concern depending on how it was interpreted by the public.

·       Another key issue was the vigilance for any spread of the B.1.617.2 variant in the BCP population.

·       The continuation of the vaccination offer and its prospective uptake was also a key issue.

·       Further key issues highlighted were the increase in national mobility, the risk of importing infections from higher rate areas, the monitoring of infection rates in the younger population and the deployment of behavioural insights and communications strategy to respond to any signs of increase in cases.

The Director of Adult Social Care Services and the Director of Adult Social  ...  view the full minutes text for item 133.

To receive an update on the Point of First Contact Service Design and the Implementation Plan for Adult Social Care, since the previous update in January 2020.

The Head of Access & Carers Services introduced and presented the item on the Point of First Contact Service area.

The Committee heard that the main aims of the redesign of the ‘Front Door’ service were as follows:

·       To harmonise the legacy service models that were in place prior to Local Government Reorganisation.

·       To provide more experienced practitioner support at the start of the process.

·       To promote an early intervention and prevention approach that will  reduce the number of referrals passing to community teams for long-term support.

·       For there to be a strengths-based approach that is compatible with the Council’s overarching organisational design.

The Committee were informed that the newly harmonised front door model had now been renamed as the ‘Adult Social Care Contact Centre’. This had been the result of listening to consultees’ concerns and assessing how best to utilise the services’ assets in order to best meet the users’ needs. Close work with colleagues in Community Development had helped develop the Together We Can initiative. This was a good example of the ever-increasing joint working between and across departments.

Members heard that Covid had unsurprisingly impacted the transformation programme. Since June 2020 all of the Contact Centre staff had been working remotely which had created certain challenges such as difficulties supporting call handlers dealing with distressed calls. Furthermore, home-working meant that legacy workers were unable to meet and develop as a single harmonised team, sharing their different and varied knowledge and expertise. The staff training programme had also been set back and Outreach Officers had been negatively impacted due to the restrictions over lockdown. The emerging outcomes data from January 2021 showed that 65% of all contacts had been resolved without the need for further assessments or a referral.

The next steps for the programme would include:

·       Embarking on further recruitment of outreach officers for home visits.

·       A new software system to be installed to enhance telephony services.

·       The service offer to be enhanced by the provision of occupational therapy input

·       A more interactive and intuitive online system to facilitate customer self-service where appropriate.

·       Improvements in linkage with carer support centre and overall connectivity in services.

·       To bring staff back together after Covid restrictions are eased and to facilitate cohort working in a single place.

·       Close working with strategic improvement partners to help develop the new Front Door service in line with the Council’s Customer Transformation project.

The Committee asked several questions following the report and answers were provided by the Head of Access & Carers Services.

·       A member asked for the contact number for the service and the Committee were informed that it was 01202 123654.

·       A member asked if the service were setting up any Community Hubs and whether there were any assets like libraries that could be used. The Head of Access & Carer Services explained that discussions on this matter were ongoing and that the aim was to reduce the need for long-distance travel and therefore a library hub was being explored in both Poole and Christchurch.  ...  view the full minutes text for item 134.

To receive an update on the Big Plan 2018-21 – a Health and Social Care Strategy for Adults with Learning Disabilities and an overview of the impact of Covid -19 on people with Learning Disabilities, their families and support services.

The item was introduced and presented by the Head of the Strategic Commissioning for Disabilities and the Committee heard that:

·       The update on the Big Plan 2018-2021 recognises that it has been a challenging 12 months for people with a learning disability as well as their families and the staff who work with them.

·       Progress on the Big Plan has been affected by Covid and many of the service’s staff had been re-focused because of the pandemic.

·       Positive work had taken place around the promotion of health checks and improving their uptake.

·       This Big-Plan was supposed to be completed this year (2021) however the impact of Covid and the release of the Government’s new, long-term plan road map (next 3 years) means that it is appropriate for the current Big-Plan to continue, with focus on the key actions within the plan, whilst aligning with the Government’s road map

·       The key actions of the current plan will take several years to complete and should incorporate everything that has taken place so far alongside the impact of Covid and the Government’s new road map. These key actions include but are not limited to moving away from residential care toward more independent living and to improve employment opportunities for people with a learning disability.

·       This revised timeline will enable 2023 to be a year of co-production on a new Big Plan post 2024.

The Committee asked several questions following the report. Answers were provided by the Head of the Strategic Commissioning for Disabilities. The questions and responses were:

·       A member asked a question on finding work for people with learning disabilities and referred to the Crumbs Project as an example of providing training and employment. The Committee heard that a number of schemes were being explored and that there needs to be a focus on getting people through supported employment officer as this will increase their chances of paid work. Some of these services are described as sheltered work opportunities. Members were informed that people with a learning disability were more likely to find employment when they are trained whilst working the role, as opposed to more isolated training first. The Chestnut and Cherry Tree nurseries were referenced as good examples of this.

·       A member asked a question on Community Employment Schemes and voluntary work. The Committee heard that the Community Employment scheme at Dorset County Council was a good example of this and that there is opportunity out there. Voluntary work was highlighted as a good outlet to learn skills. This matter of training and employment was a national issue and opportunities need to be increased on this.

·       A question was raised on healthchecks and the Committee heard from the Head of the Strategic Commissioning for Disabilities that healthchecks had not reached 100% uptake which is reflective of the national picture, however there is a renewed now that the Covid restrictions are easing. The Primary Care network has faced lots of pressures but there is a dedicated work stream in place, working  ...  view the full minutes text for item 135.

To receive any updates from the relevant Portfolio Holders on key issues or actions that have been taken since the last meeting, as appropriate.

The Portfolio Holder for Adults and the Portfolio Holder for Covid

Resilience, Public Health and Education provided an update on the work

that had taken place since the last meeting of the Health and Adults Social

Care O&S Committee.

The main points of the update from the Portfolio Holder Adults were as follows:

·       Highlighted that it was Carer’s week from the 7-13 June and that the theme for the week was making caring visible and valued.

·       An all member seminar would be held on the 20 July 2021 concerning the Adult Social Care Contact Centre in which members were invited.

·       The Portfolio Holder for had been volunteering in a care home and had received first-hand experience of the training, PPE requirements, skills needed for communicating and the variety of activities on offer. The Portfolio Holder encouraged anyone who was interested to volunteer.

·       Several strategies were being developed, including the Technology and Able Care options appraisal, the Market Position Statement, Care Home Strategy and Extra Care Strategy.

The Committee were given the opportunity to ask questions following the Portfolio Holders’ Updates. Answers were provided by the Portfolio Holder for Adults and the Director of Adult Social Care.

·       A member asked about the waiting times for Home First and the 111 service. The Committee were informed that the Home First programme was supported by social workers, occupational therapists and reablement teams among others and therefore a network of care surrounds the service. Users of the service are also provided with relevant contact numbers for both social care and health matters.

The main points of the update from the Portfolio Holder for Covid

Resilience, Public Health and Education were as follows:

·       The Special Educational Needs (SEN) Strategy is also in development. Members heard that there was an overlap between Children’s and Health and Adult Social Care services due that the support given to young people in becoming adults and how any social care or health needs that the young people require will be continued as they move to adulthood. The Portfolio Holder suggested that this be an area of scrutiny that the Committee request a progress report on in the near future.

No more questions were asked and the Committee noted the Portfolio Holders’ Update.

For Members to receive an update on the development of the BCP and Dorset Joint Health Scrutiny Protocol. A draft of the protocol is attached to this agenda including comments received to date, any further updates will be reported to the Committee.

Members received an update on the development of the BCP and Dorset Joint Health Scrutiny Protocol and comments and questions were invited on the current draft document.

The Corporate Director for Adult Social Care and the Deputy-Head of Democratic Services introduced the item and provided an overview of the Protocol.

Members heard that the main reason for joint health scrutiny between BCP Council and Dorset Council would be on issues affecting all residents across both conurbations, to provide efficiency on considering those issues and preventing officers or partners from duplicating work. Furthermore, where the NHS may propose significant variation in local health services it is good practice for the geographical area as a whole to scrutinise the issue. Additional overlap, also exists in the Clinical Commissioning Group, the Hospital Trusts, Dorset Healthcare Community Trusts and Healthwatch Dorset, among others.

In terms of the joint scrutiny practicalities, Members heard that when an item has been selected for joint scrutiny, it would be agreed that one of the Council’s would lead on the item. The procedure rules of the lead Council would be used and a member from the lead Council would Chair the meeting. Membership would involve 3-5 members of each respective Council depending on levels of interest and scale/significance of issue. Items to be considered under joint scrutiny would be agreed by the Chairs of both Council’s respective scrutiny Committees, in consultation with Committee members and officers. The role of Healthwatch in Joint Scrutiny is acknowledged and would be encouraged in joint scrutiny work. Each constituent Committee should receive a report detailing the outcome of the Joint Scrutiny Committee’s work.

Specific attention was given to point 10 of the Protocol and the delegation of referral powers to the Joint Health Scrutiny Committee (JHSC). The Committee heard that where members hold a valid concern that a proposed variation to local health services is not in best interest of local residents, they have the ability to make a referral to the Secretary of State. This is a very specific power that can be exercised by the Committee. This power can also be delegated to the JHSC. The Joint Health Scrutiny Protocol states that it would only be in exceptional circumstances that a referral from the JHSC to the Secretary of State could be overturned by one of the constituent Councils. it would then require Full Council support to withdraw the delegated power from the JHSC and reconsider the decision made. Advice from NHS partners states, and in the spirit of good scrutiny practice, if Joint Health Scrutiny is held and a decision made, it is important that the outcome is validated.

Members asked several questions, which were answered by the Corporate Director for Adult Social Care and the Deputy-Head of Democratic Services. The questions and answers were as follows:

·       A member asked a question on the quorum of the JHSC. The Committee were informed that the JHSC must have a minimum of 3 appointed members from both Councils. However, there was  ...  view the full minutes text for item 137.

To consider and comment as appropriate on the development of the Committee’s Forward Plan.

The Committee considered the Forward Plan.

Following a question from a member for NHS Dentistry Provision to be put on to the Forward Plan, the Chair updated the Committee that a letter had been received, from the NHS, providing an update on current provision and impact from Covid. The issue of NHS Dentistry Provision would remain on the Forward Plan and arrangements for a formal item to come to Committee would be discussed.

A member requested that an item on the Dorset Integrated Care System be scheduled for scrutiny and that this could be an area for possible joint scrutiny.

Finally, a member suggested that in future months, the Covid update item could be reduced as restrictions and cases lower, in favour of other items being given priority.

RESOLVED that the Committee agreed the Forward Plan.

Voting: Unanmious.