Agenda and draft minutes

Health and Adult Social Care Overview and Scrutiny Committee - Monday, 17th January, 2022 6.00 pm

Venue: Committee Suite, Civic Centre, Poole BH15 2RU. View directions

Media

Items
No. Item

175.

Apologies

To receive any apologies for absence from Councillors.

Minutes:

There were none.

176.

Substitute Members

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.

 

Minutes:

There were none.

177.

Declarations of Interests

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.

Minutes:

The Vice-Chair declared, for transparency, that she was an employee of the

University Hospitals Dorset Foundation Trust.

 

Cllr C Johnson declared, for transparency, that she was an employee of the

University Hospitals Dorset Foundation Trust.

 

Cllr C Matthews declared, for transparency, that he was a governor of the

University Dorset Hospitals Trust.

178.

Confirmation of Minutes pdf icon PDF 234 KB

To confirm the minutes of the meeting held on 29 November 2021.

Minutes:

The Committee raised several points contained within the minutes. Actions were requested, including an update on the Carers Strategy strategic vision and an update on the dementia diagnostic waiting times.

Following this, the minutes of the meeting held on 29 November 2021 were agreed as a correct record.

 

179.

Public Issues

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/documents/s2305/Public%20Items%20-%20Meeting%20Procedure%20Rules.pdf 

 

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.

 

Minutes:

There were none.

180.

Action Sheet pdf icon PDF 197 KB

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

Minutes:

The Committee noted the Action Sheet.

181.

COVID-19 Update

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.

Minutes:

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 presentation were as follows:

 

·       Almost all current cases were Omicron, which took off during the 2nd week of Dec.

·       During the New Year (the first week of 2022) BCP Council had very high rates of infection, with almost 1500 cases per 100,000, which was almost the highest rate since the start of mass testing.

·       Up to date information saw cases falling to 811 per 100,000, with Dorset around 600 per 100,000 and the South West at 812 per 100,000.

·       Hospital admissions were down since the previous week, with 77 people with covid in local hospitals.

·       Policy changes were taking place and from 17 January there would be a change in the required isolation period for those who test positive. People can end self-isolation after day 5 as long as they provide two negative lateral flow tests at 24 hours apart. Day zero would be counted as the day symptoms start. An individual who has tested positive can then start taking lateral flow tests on day 5 of their isolation period. Furthermore, if a person tests positive using a lateral flow test, they no longer need to conduct a PCR test. However, individuals will need to show a positive PCR test result for any payment support required during a of covid isolation period.

·       The Vaccination program was still underway, with 15,000 jabs per day being administered in the Dorset system alone. 83% of the eligible population had already had their booster which was noted as a huge Public Health achievement.

·       The vaccination workforce was being reviewed to ensure that there was constant efficiency in the overall health service. Some vaccination staff were beginning to return to their previous roles.

·       The JCVI decision on second doses for 12-15 year olds and for clinically vulnerable children 5-11 year olds was to be published shortly.

·       Trusted Voices and the Vaccine ambassadors continued to work with communities on encouraging people to come forward and take up the vaccine offer.

·       Current restrictions for Plan B and the Omicron variant were to be reviewed on January 26 with communications to be updated via the Outbreak Board during that week.

·       The rules were changing in order to support people in returning to work safely.

·       The Public Health day response team continued to be very busy to support the adult social care sector in managing incidents and outbreaks. Supporting schools and care settings were top of this priority.

·       The supply of lateral flow tests had improved over the last 2 weeks and the NHS were continuing to provide targeted testing in high visibility locations.

·       Local modelling suggests that current trajectory was following the best-case scenario locally, with a predicted continued fall in cases and hospital admissions.

·       It was currently difficult to tell whether the fall in cases was due to reduced prevalence, fewer people testing, or more asymptomatic  ...  view the full minutes text for item 181.

182.

Impact of the Pandemic (COVID-19) on Adult Social Care pdf icon PDF 381 KB

To receive a summary of the impact of the Covid-19 pandemic and 2021/22 Winter period on the delivery of adult social care, including a summary of the financial impact.

Minutes:

 

The Director of Operations for Adult Social Care (ASC) and the Interim Director of ASC Commissioning introduced the report and presented the item. The main points were as follows:

 

Overview:

·       The service had undergone a unique set of winter pressures.

·       National mandated measures to support the ASC service had been introduced in March 2020.

·       Pressures on emergency departments and acute hospitals had taken place.

·       The Incident management hospital discharge scheme was engaged to support the population through this period and was also introduced in March 2020.

·       There were nationwide workforce shortages in ASC and in the local setting the ASC operational area had around 25 vacancies. Other vacancies existed in Occupational Therapy.

 

NHS System pressures:

·       Acute hospitals continued to see challenges due to their bed occupancy rates, with around 95% of the capacity full, meaning very little scope for further capacity.

·       Community hospitals are also under pressure including mental health facilities.

·       GPs and primary care networks were involved in the nationwide vaccination program.

 

The Care Market:

·       Since August 2021, 76 packages of care were handed back to BCP from 21 providers.

·       There are 150 Care Providers in the BCP area.

·       Staff morale is low and staff are exhausted.

·       Covid infection and staff resignations are fueling staffing crisis.

·       Residential care staff are 95% double vaccinated with 31% having received the booster.

 

Operational Pressures:

·       There was a 40% increase in hospital social work demand.

·       The heightened demand meant that waiting times have gone up.

·       Resources were being diverted to hospital discharge out of necessity.

·       There had been an increase in safeguarding concerns, though not all had resulted in a section 42.

 

Financial Implications:

·       There had been an increase in fees for Care Homes.

·       Patients require 30% more care following discharge. This was not unexpected though as people were leaving hospital at the earliest opportunity and therefore were likely to have greater needs upon discharge.

·       Government funding for the hospital discharge program is set to end on 31 March 2022.

·       Workforce and Infection Grants had been awarded to Care sector over this period.

 

Risks:

·       The shortage of care capacity that is delaying care and support.

·       The pressure to discharge patient.

·       Financial pressures on the ASC budget.

·       Greater emergency use of Care Homes for people being discharged who may otherwise go home if they were in hospital longer. This requires the individual to go into an interim residence before going back to permanent residency.

 

The Director of Operations for Adult Social Care (ASC) and the Interim Director of ASC Commissioning answered questions and comments from the Committee. These were as follows:

 

·       A member asked about staff morale and what had been done to prevent resignations / further staffing vacancies. The Committee heard that there had been two large workforce retention funds which had gone directly to the providers of care for their staff. The service provide regular communications with care providers as well as incentives such as extra money during Christmas, free parking, childcare. A £150 grant was awarded for all care staff over  ...  view the full minutes text for item 182.

183.

Adult Social Care Emergency Duty Service pdf icon PDF 642 KB

To update the Committee on the performance of the Adult Social Care Emergency Duty Service.

Minutes:

The Director of Operations for Adult Social Care, Head of Access and Carers Service and Emergency Duty Service Manager introduced and presented the item. The main points of which were as follow:

·       The current ASC Emergency Duty Service (EDS) model incorporated the Bournemouth and Poole services of 2018 and became the BCP service in 2019.

·       The EDS consists of 5 contact officers who are all very skilled in screenings and risk assessments that come in via telephone calls.

·       Officers can also act as appropriate adults if the individual in question is a vulnerable adult.

·       Within the service, there are a number of mental health practitioners who have been approved by the local authority (social services) to carry out duties under the Mental Health Act (MHA) following suitable training. These could be social workers, Occupational Therapists, nurses, for example, though currently most are social workers.

·       The EDS operates outside normal office hours (5pm – 9am) including weekends, Bank Holidays and Christmas. They are the single point of contact for adults in crisis or for someone concerned about an adult in crisis.

·       The EDS tend to deal with adults in crisis who require statutory assessment, particularly under the MHA. The service will help adults under harm and neglect or those in need of an urgent package of care.

·       The EDS receives high volume of calls, and between Apr-Nov 2021 they had fielded 2767 calls.

·       The highest proportion of work undertaken by the team are cases that require MHA assessments.

·       Since the start of the pandemic the EDS has not stopped seeing people face to face.

·       The financial cost to the ASC is £775,000 a year – almost all of this funding is used on staffing.

·       The service’ legal duties and requirements fall within Care Act and MHA.

·       A small fund of £15,000 would be used throughout the year to pay for an emergency fund, a train ticket, food parcels, training and so on.

·       Members heard that equipment that has been issued by the EDS team to an individual can be returned to the contact centre.

·       There are 3 contact officers on shift over an evening. The first shift runs from 5pm till 11:30pm where there are 2 officers. They will then swap over to another, single officer to do the remaining shift. Qualified mental health professionals are able to be contacted. The Contact officers remain at home but may take calls in office space. Social workers go out alone, however they will usually meet doctors on site, as well as the patients, transport, police and so on. Contact officers are aware of all that is going on and will check on the field officers.

·       The Committee heard that the service work with Bournemouth University to recruit staff and to facilitate training.

·       The rotas are very efficiently run, despite the service facing very challenging work.

·       There is an app that is health organisation oriented that is supported by the EDS. It runs both during the day and out of hours and if an  ...  view the full minutes text for item 183.

184.

Portfolio Holder Update

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

Minutes:

The Portfolio Holder for People provided an update. The main points were as follows:

·       BCP spend more than the English average on care for older people, for a lower percentage of population than average. It has been recognised that care tech use is limited and that there is huge potential to enhance our services and save costs utilising care technology. The Fulfilled Lives in Core Strategy is progressing and the Portfolio Holder wants the offer to be available from the first point of contact. The Offer at present, to residents is very traditional, such as fall alarms and Care Line.

·       Ultimately, the service needs to reach more people and to grow and a business case is being made for better technology and more innovative ways to help and monitor the health of vulnerable people. This business case will be crafted and taken through democratic process.

 

The Portfolio Holder for Tourism and Active Health provided the following points of update:

·       The Dorset ICS formal launch date has been deferred to July. However there have been new recruitments at senior level.

·       This approach will foster closer working within a multi-partner model.

·       The hope is for Local Authorities to be prominent in the partnership.

·       This multi-agency partnership will include the NHS, Primary Care Network CN, Local Authorities, Emergency Services and other specialist organisations.

·       Evaluation has taken place of the work undertaken by Warwick County Council as they are one and a half years ahead of BCP on this matter.

 

 

The Committee noted the updates.

185.

Forward Plan pdf icon PDF 528 KB

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

Minutes:

Members discussed the Forward Plan and raised the topics of the Bournemouth Birthing Centre, Suicide Prevention Plan and NHS Dentistry Provision, which were all noted and would be added to the Forward Plan if they had not been already.

 

The Forward Plan was agreed by the Committee.