Agenda and minutes

To receive any apologies for absence from Councillors.

Apologies were received from Cllr N Geary.

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.

Notification was received from the nominated representative of the relevant Political Group Leader that Cllr P Hilliard was substituting for Cllr N Geary for this meeting of the Committee.

Councillors are asked to elect the Chairman of the Health and Adult Social Care Overview and Scrutiny Committee for the 2020/21 Municipal Year.

RESOLVED that Cllr K Rampton be elected Chair of the Health and Adult Social Care Overview and Scrutiny Committee for the 2020/21 Municipal Year.

Councillors are asked to elect the Vice-Chairman of the Health and Adult Social Care Overview and Scrutiny Committee for the 2020/21 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 2020/21 Municipal Year.

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.

Councillors made the following declarations of interest:

Cllr P Hilliard declared, for transparency purposes and relating to Item 8, that he is the Council’s appointed Governor representative to the Royal Bournemouth and Christchurch NHS Foundation Trust.

Cllr L-J Evans declared, for transparency, that she is a bank employee of Poole Hospital Trust.

Cllr C Matthews declared, for transparency purposes and relating to Item 8, that he is the Council’s appointed Governor representative to the Dorset Healthcare university NHS Foundation Trust.

Cllr H Allen declared, for transparency, that she is a consultant nurse working employed by the Royal Bournemouth Hospital, and works across Dorset.

To confirm the minutes of the meeting held on 2 March 2020.

The minutes of the meeting held on 2 March 2020 were confirmed as a correct and accurate record.

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

A Councillor suggested that the Big Plan update item, that was scheduled for Committee in September, be heard as the first item of business in order to facilitate external participants joining from the start of the meeting.

Following this suggestion, to which the Committee agreed, the action sheet was noted. There were no further comments.

To receive any public questions, statements or petitions submitted in accordance with the Constitution. Further information on the requirements for submitting these 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 public questions is Monday 20 July 2020

The deadline for the submission of a statement is 12.00 noon, Friday 24 July 2020

The deadline for the submission of a petition was, Friday 10 July 2020.

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

To receive a presentation on the above.

The Committee received a presentation on the University Hospitals Dorset merger update by the Chief Strategy and Transformation Officer of the University Hospitals Dorset NHS Foundation Trust.

The presentation included information on the rationale for the merger, the new organisational structure, the strategic goals, the Shadow Interim Board, the merger related benefits, layouts of hospital sites and the Trust Sustainable Travel Plan.

Members heard that:

•         The merger will award greater resilience to the NHS across Dorset, in order to deal with the variety of challenges it faces, with COVID19 as a single example.

•         The new organisation is built around a one culture, one team ethos that will allow a smooth transition from day one with 9000 staff transferring to the new organisation on 1 October 2020

•         Organisational turnover will stand at £630m, comparable to other hospital organisations of this size.

•         The University Hospitals Dorset’s vision is to positively transform the health and care services along with providing excellent healthcare to patients and the wider community, as well as being a great place to work.

•         The Shadow Interim Boards has a Joint Chair and Chief Executive with all other members being made up of existing boards.

•         The merger related benefits were fundamentally about improving the quality of care under a single structure, with additional non-clinical and financial benefits.

•         University Hospital Status allows stimulus for research and innovation, education and training as well as improvement in recruitment and retention of staff. Furthermore, relationships across Bournemouth University would be built, with a future ambition to create a Dorset Medical School.

•         The outline planning application for the Royal Bournemouth Hospital had been granted and the Poole Hospital site application was currently under officer consideration.

•         Each of the estate plans had been assessed with COVID-proofing in mind, with extremely high levels of infection control and isolation measures in place.

•         The Christchurch Hospital site, following a public consultation, will include a Macmillan Unit new build, with a mix of senior living accommodation on site.

•         Poole Hospital will see a large, new theatre block. Internally a refurbishment will take place.

•         The Trust Sustainable Travel Plan involves many healthy travel options with a view to cutting congestion around the Royal Bournemouth Site, reducing carbon levels and making the hospital more accessible to all.

Following the presentation, members of the Committee were able to ask questions of the Chief Strategy and Transformation Officer of the University Hospitals Dorset NHS Foundation Trust.

A member asked a question on the travel plan. The Committee heard that the travel assessment was part of the planning application that was assessed by planning officers and highways officers. A further question was posed on the provision of travel for staff that had to travel across sites, to which members heard that the aim is to reduce travel, with the help of technology, by improving transport timetabling and planning for both staff and patients. Members were informed that a Shuttle bus between sites would  ...  view the full minutes text for item 74.

Adult Social Care has a statutory responsibility to produce an annual report on complaints received, issues that have been raised and any action that has been taken to improve services. Adult Social Care encourages feedback from a range of sources including complaints, compliments, comments, surveys, consultations and engagement to improve services.

This report provides a summary of feedback and learning for BCP Council Adult Social Care from 1st April 2019 to 31st March 2020.

The Committee were presented with the first Adult Social Care annual report on customer opinion and learning for BCP Council by the Head of Strategic Planning and Quality Assurance.

Members heard that the service area had been working together to deliver appropriate responses to complaints across BCP and that the total number of complaints for BCP Council Adult Social Care was lower than the combined figure from the legacy Councils, at 178. Furthermore, 99% of the complaints received had been acknowledged despite some slight delays in speed of response caused by the COVID19 pandemic. There were 13 complaints considered by the Ombudsman in 2019/2020.

The Committee were informed of the main complaint themes these were: communications and response times, financial assessments and charges/fees, and professional practice. These themes are similar to previous years and generally concern managing the users’ expectations.

Members heard that the service had identified several learning improvement areas and had developed/provided online training to 28 members of staff. Training for teams with ‘hotspots’ of complaints would also be developed in a more bespoke way in order to better respond to users.

The Committee heard that the service had received 275 compliments and messages of thanks in 2019/2020.

Members were told that the NHS Digital ASC users survey had been undertaken, with 631 responses from 700. The survey highlighted some areas for improvement, particularly around information and advice and user satisfaction. Action plans are being put in place to look at how we can improve related services and in turn the

measures, around these two areas.

A question was asked on training, with reference to the 28 members of staff who had been trained. The Committee heard that the service area employed 4000 members of staff, and that training was hoped to be rolled out more widely across the service area, with the possibility of it being made mandatory.

A point was made on social contact rates from the January survey and the Committee heard that the figure was positive when compared nationally. The hope was that as community based support improved over time, the figure would increase and social contact rates would improve. The Committee were informed that very few users identified as receiving no social contact at all.

A Member referred to the ‘ease to find services’ rate and was informed that engagement with individuals who are dissatisfied was to be prioritised in order to learn from users and work with providers to improve this. Furthermore, the Front Door Programme, as it develops, would make information clearer and more appropriate in order to better answer users’ questions in a timelier manner.

RESOLVED that:-

(a) The information contained in the report and appendices be noted.

(b) Any actions or issues relevant for the Committee’s Forward Plan be considered.

This report presents the draft Adult Social Care Strategy for consideration by Councillors prior to the presentation of the Strategy to Cabinet on 2September 2020 for approval.

The report outlines how Adult Social Care has engaged with stakeholders, including people who use services and carers, in order to inform a draft set of strategic priorities for the next 4 years.

It set outs how the priorities align to the Fulfilled Lives objectives in the Corporate Strategy and the Council’s wider transformation programme. The draft strategy also responds to national drivers, legislation and where performance measures and customer feedback indicates that strategic change is required to deliver improvements in outcomes and services.

The report highlights the potential to develop new approaches to service delivery as a result of learning through the COVID 19 pandemic.  The overarching priorities for the Strategy are:

·       Engage with individuals and communities to promote well-being

·       Support people to live safe and independent lives

·       Value and support carers

·       Enable people to live well through quality social care

·       Deliver Services that are modern and accessible

The Committee heard from the Head of Strategic Planning and Quality Assurance that the introductory talks on the Adult Social Care Strategy had begun in Autumn 2019. Initial discussions took place among the senior management team, with a focus on what needed to be delivered to transform the service over the next 4 years.

Members were informed that consultation with key stakeholders, primarily staff, in order to gauge views on how to develop strategy took place over this initial period. Elements of the Corporate Strategy, specifically the ‘Fulfilled Lives’ priorities, the NHS 5-year Forward Plan and the Council’s Housing Strategy were all considered while initial developments were made, as were national drivers. In combination, these different reference points all influenced and formed key parts of the strategy’s priorities and development.

In order to improve, the Committee heard that the areas identified for improvement formed another key part of the development process. These areas included:

•         Increasing the percentage of people with learning difficulties living in settled accommodation.

•         Increasing the percentage of Mental Health clients in paid employment.

•         Increasing the percentage of carers receiving direct payments.

It was also explained that several stakeholder engagement events and an online survey for users were undertaken. Despite the COVID19 pandemic reducing the ability for face to face consultation and events, over 140 responses were received. Key feedback included requests for:

•         A good quality of information and advice to be provided.

•         A good quality of early access services to be offered.

•         Improved support for carers to be provided.

•         Increased training opportunities to be provided.

Communicating the progress of the strategy’s development to key partners was vital throughout the process. Finally, the Committee were informed that following their comments and consideration at Scrutiny, the strategy would be submitted to Cabinet.

A question was asked on what support for independent living and basic skills training were offered. The Head of Strategic Planning and Quality Assurance informed the Committee that the housing options were being assessed and that the aim was to provide a range of housing to suit the needs of the users. Furthermore, it was heard that part of the strategy’s offer is looking at how more comprehensive training can be offered, for example on getting people back into employment.

A member posed a question on the financial risks of viably delivering the component parts and if there was any flexibility in the budget to meet these risks. The Head of Strategic Planning and Quality Assurance informed the Committee that the funding requirements and any competing priorities would be assessed over the four-year period.

With COVID19 isolating many service users, a member asked if virtual socialising options were being investigated, such as Zoom. It was heard that assistive technology was already a part of the strategy, for mobility matters as an example, however the scope would be widened in order to provide people with support and socialising within the home.

The Committee were reassured that one aim of the strategy  ...  view the full minutes text for item 76.

The report sets out for the scrutiny of Committee members the BCP Council Adult Social Care response to the COVID19 pandemic as at mid-July 2020.  It provides details on how Adult Social Care has worked with the local NHS and the Care Sector to ensure that local people who require information, advice, guidance,  assessment, care and safeguarding have continued to be supported  through the period of national lockdown and the subsequent gradual easing of lockdown measures. 

It also outlines the work undertaken with the Adult Social Care sector in order to support all social care providers as they have worked with skill and commitment to provide quality care to service users and carers through the unique and highly complex circumstances of the pandemic.

This work has been conducted in the context of rapidly developing and changing national guidance for the health and care system.

The report also outlines the financial impact of COVID19 for the Adult Social Care sector and the funding provided to the sector by the Council through Grant monies from Government.  It provides information on the financial situation for BCP Council Adult Social Care Directorate in 2020/21.

 The Corporate Director for Adult Social Care updated the Committee on the Council’s response to the COVID pandemic. The main points of the update were:

·       COVID had adversely impacted the service provision.

·       88 people had died from COVID related illness in care homes.

·       A new national plan was created for Adult Social Care in April 2020, along with a national task force and local care home support planning mechanism.

The Service Director for Adult Social Care Services informed the Committee of the changes in services that had occurred during the COVID period. The main points were:

·       Broadly, most Adult Social Care services had continued, however certain adjustments had to be made.

·       Telephone and video conferencing with clients had been utilised where possible.

·       The Coronavirus Act 2020 allowed certain easements to be made to statutory activities; this included the closure of day centres where social distancing could not be observed.

·       The Home First model allowed assessments to be made once patients had left hospital.

·       A much larger number of people enquired to the crisis line on financial and food issues.

·       Safeguarding concerns had increased over the last three months; however, many concerns had not developed into investigations.

Members heard from the Corporate Director for Adult Social Care of the issues that had arisen for the adult social care sector were:

·       Financial pressures

·       Personal Perspective Equipment (PPE)

·       Deep cleaning

·       Staffing, for example absence and sickness.

It was heard that to resolve these issues, BCP Council had given a 10% uplift for commissioned providers’ costs from late March to mid-July and that this funding was being reviewed. Furthermore, the Government had created an Infection Control Fund that was targeted primarily at how the sector utilises staff. A key risk in this area was found to be staff moving areas or working in more than one setting. Further funding from Government was being sought to continue to respond to the pandemic.

The specific issue of PPE was discussed, and the Corporate Director for Adult Social Care explained that Adult Social Care providers had generally reported sufficient levels of PPE. Furthermore, the frequency at which providers asked for assistance from the Council had dropped.

Weekly testing of staff and monthly testing of residents in care homes was being rolled out.

On financial matters, the Committee were informed that additional costs would mean that some of the planned savings in the budget would not be met and that despite Government funding the gap totalled £30 million for the Council as a whole. Certain savings had been identified to combat this, such as legacy savings from Local Government Reorganisation (LGR) budgets, holding vacant posts open and training costs. Finally, the Committee were informed that the Corporate Director for Adult Social Care and the Portfolio Holder for Adult Social Care were regularly presenting the case to Government for additional funding support.

The Portfolio Holder for Adult Social Care gave her condolences to the 88 individuals who had died due to COVID. The Portfolio Holder also gave thanks to  ...  view the full minutes text for item 77.

The Healthwatch Dorset Annual Report will be presented to the Committee.

The Committee were given a presentation on the Healthwatch Dorset Annual Report by the Healthwatch Dorset Manager.

The presentation included information on the main projects that Healthwatch Dorset had undertaken in 2019/2020, such as

·       Diabetes awareness - a project that encouraged young people to speak out and create blogs and videos to express their experiences of living with type 1 diabetes, in order to raise awareness.

·       Raising awareness with real-life stories – in partnership with Bournemouth University, Healthwatch Dorset helped produced a series of films about local people’s experiences of health and social care in order to inform and educate students and the wider public.

·       A & E services at Poole Hospital – Investigations were undertaken to discover what matters most to people who use Poole A&E services to help shape changes to A&E performance standards. The Committee heard that all of Healthwatch Dorset’s recommendations were accepted.

·       Cancer support in West Dorset – reports were submitted on support services for cancer patients, their carers and family to inform a Macmillan project. The Committee heard that the work had unfortunately had been put on hold by COVID but would hopefully continue at the end of the year.

·       NHS Long Term Plan – feedback was received by over 500 people on what they would like to see from services in the future.

The Committee also heard a summary of the overall organisation, engagements and services provided by Healthwatch Dorset over the previous year. Highlights included :

·       120 volunteers helped carry out over 400 hours of voluntary work.

·       Healthwatch Dorset employed 4 members of staff and received £204,800 of local authority funding.

·       Over 1500 people shared their health and social care feedback with Healthwatch Dorset and over 1000 people made contact for information, advice and support.

·       26,874 people engaged with Healthwatch Dorset online and 212,190 people were reached through social media.

·       Healthwatch Dorset published 2 reports and 7 short films about improvements that local people wanted to see in health and social care services and 16 recommendations were made from this.

Members were informed that there were a variety of enquiries made by the 240,000 that were helped with information. These included:

·       Health Care

·       Access to GP Services

·       Mental Health Services

·       Other Primary Care Services

·       Transport

·       Hospital Services

·       Social Care

The Portfolio Holder for Adult Social Care informed the Committee that both BCP Council and Dorset Council congratulated Healthwatch for their work over the 2019/2020 year.

A question was posed on the financial report regarding the £10,000 funding gap to which the Committee heard was an underspend and would be made up over the course of the next year.

RESOLVED that:

(a)      

The Committee note the contents of the Healthwatch Dorset Annual Report.

To receive any updates from the Portfolio Holder on key issues as appropriate.

The Committee received an update from the Portfolio Holder for Adult Social Care of work undertaken by the Council over the COVID pandemic.

Members heard that:

·       Scrutiny of health and adult social care had been formally conducted at the O&S Board over the COVID19 period.

·       Twice-weekly meetings had taken place between the Portfolio Holder and the Director of Public Health Dorset on COVID19 in the area.

·       The Health and Wellbeing Board had approved a Local Outbreak Management Plan.

·       On the 13 and 16 July 2020, Adult Social Care staff engagement sessions were held and attended by 200 members of staff. The sessions deal with the pressures of COVID19, home working and the reset and recovery after the COVID period.

·       On 17 July there was an Adult Lead Members South West Briefing Session which concerned the crisis handling of central government during the COVID19 period.

·       The Portfolio Holder attended the Joint Public Health Board whereby an extension was agreed to the Drug and Alcohol Contract.

·       Work had been undertaken with Tricuro during the COVID19 period.

RESOLVED that:-

(a) the Portfolio Holder update be noted by the Committee.

To consider the development of the Committee’s Forward Plan.

Cllr J Edwards asked a question on the closure of Leybourne Doctor's surgery, to which a full response was provided by the Director of Primary and Community Care, NHS Dorset Clinical Commissioning Group.

RESOLVED that the Forward Plan was agreed and approved by the Committee.