Agenda and draft minutes

Health and Adult Social Care Overview and Scrutiny Committee
Monday, 20th January, 2020 6.00 pm

Venue: HMS Phoebe, Town Hall, Bournemouth BH2 6DY. View directions

Contact: Democratic Services  Email: democratic.services@bcpcouncil.gov.uk

Media

Items
No. Item

40.

Apologies

To receive any apologies for absence from Councillors.

Minutes:

There were no apologies received at this meeting.

41.

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 no substitutes for this meeting.

42.

Declarations of Interests

Councillors are required to comply with the requirements of the Localism Act 2011 and the Council's Code of Conduct regarding Disclosable Pecuniary Interests.

Councillors are also required to disclose any other interests where a Councillor is a member of an external body or organisation where that membership involves a position of control or significant influence, including bodies to which the Council has made the appointment in line with the Council's Code of Conduct.

Declarations received will be reported at the meeting.

Minutes:

For transparency, Cllr H Allen declared that she was an NHS employee in the Bournemouth, Christchurch and Poole area, Cllr C Johnson also declared that she was an NHS employee in the Bournemouth, Christchurch and Poole area, Cllr L-J Evans declared that she was an NHS Bank employee and Cllr C Matthews declared that he was a governor of the NHS Dorset Governing Body.

43.

Confirmation of Minutes pdf icon PDF 242 KB

To confirm the minutes of the meeting on 18 November 2019.

Minutes:

The Committee confirmed the minutes of the meeting held on 18 November 2019 as an accurate record.

44.

Action Sheet pdf icon PDF 443 KB

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

Minutes:

The Democratic Services Officer updated the Committee on number 38 of the Action Sheet, concerning joint scrutiny with Dorset Council. Members were reminded of the two areas that had been identified for joint scrutiny, South Western Ambulance Service Trust (SWAST) and the Urgent Integrated Care Service and were informed that contact had been made with the Chair of Dorset Council’s Health Scrutiny Committee. The feedback indicated that a June/July 2020 start-time was optimal for starting the scrutiny process.  In addition, it was acknowledged that the current joint scrutiny protocol would be reviewed.

 

45.

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 public questions is Monday 13 January 2020.

The deadline for the submission of a statement is 12.00 noon, Friday 17 January 2020.

The deadline for the submission of a petition is 12.00 noon, Friday 17 January 2020.

Minutes:

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

The Chair informed the Committee that there would be a change in running order, with the addition of two items under Any Other Business. These items were: Clinical Services Review and Budget 2020/2021 and Mid-Term Financial Plan – Assumed Savings. The Chairman explained that the new running order would be as follows:

 

6)       Clinical Services Review

7)       Adult Social Care: Point of First Contact Service Design

8)       Budget 2020/2021 and Mid-Term Financial Plan – Assumed Savings

9)       Review of Local Safeguarding Adults Boards

10)     Emergency Duty Services

11)     Forward Plan

12)     Future Meeting Dates

46.

Clinical Services Review

Minutes:

The Chair introduced Item 6, the Clinical Services Review (CSR), which concerned the outcome of the Independent Review Panel (IRP) and the Secretary of State’s response.

The Corporate Director for Adult Social Care summarised the IRP’s decision. Members were informed that the Secretary of State had accepted the IRP's judgement and agreed with the recommendation that the Dorset Clinical Commissioning Groups (CCG) proposals should proceed, with further action locally.

A member asked whether a special meeting should be arranged to specifically consider the outcome of the IRP. The Committee were reminded by the Corporate Director for Adult Social Care that the purpose of this update was for members to note the outcome of the IRP and the Democratic Services Officer explained that scrutiny would be best targeted during the implementation and delivery stages. The Committee was further advised future scrutiny could be discussed during development sessions and included when developing the Forward Plan for the new Municipal Year.

Two members of the Committee expressed concerns over the longer-term action of Poole Hospital’s A&E and Maternity services being moved away. Both members felt that this was a regrettable decision.

 

RESOLVED that:- the Committee agreed to note the outcome of the IRP and Secretary of State’s response with a view to consider areas of future scrutiny when developing their Forward Plan for the new Municipal Year.

 

47.

Adult Social Care: Point of First Contact Service Design pdf icon PDF 164 KB

To receive an update on the Point of First Contact Service Design and the Implementation Plan for Adult Social Care.

Additional documents:

Minutes:

The Director for Adult Social Care presented a report, a copy of which has been circulated and appears as Appendix ‘A’ of these minutes in the Minute Book.

The Committee received a presentation that provided an overview of the two, current points of first contact for Bournemouth, Christchurch and Poole (BCP) residents and the proposed, new single model.

 

Members heard that having two different points of contact, with different operating models, created an inconsistency in the service area and was also unhelpful to local residents. A review had been undertaken by KPMG between 2 September 2019 and 8 November 2019, which members heard had identified a proposal to combine both current, first points of contact into a single point for all BCP residents, to be temporarily known as the ‘Front Door’ for adult social care.

 

It was explained that there was a rising demand for adult social care services and the projected population of the BCP area would reach 412,000 by 2024, with 23% being aged 65 and over.

 

The Committee was shown a diagram of the proposed front door service and informed that community empowerment, resilience and early engagement were the foundations of the new model. Through these means, it was hoped that access to up to date information and advice, community-based information ‘hubs’, improved community outreach using ‘Care Navigators’ and digital, supported self-assessments would see adult social care issues either prevented or resolved before coming to the front door service. Members were told that the front door service would involve good levels of staffing, featuring specialists, to provide accurate and helpful advice that would then signpost the user to the relevant service.

 

Although the final structure of the front door service had yet been created, the Committee was shown its distinct parts: Call Handling, Professional Response and Community Response. The Director of Adult Social Care also emphasised the importance of partnership between the different sectors, including Primary Healthcare, Community Healthcare and the voluntary sector.

 

As an indicator of the financial costs involved in adult social care, the Director of Adult Social Care explained that, per annum, the average cost of a placement was £37,000 and £19,000 for a Domiciliary Care Package. It was hoped that there would be £750,000 savings made through the revised service by 2021/2022 and a further £750,000 by 2022/2023. Members were told that these savings would be achieved through a combination of means, these being prevention and early intervention work, the improved digital offer and enhancements made in partnership working with the new GP Primary Care Networks

 

Members’ questions were primarily concerned with the quality of service that future users would receive and how the Council could ensure that the community and voluntary offers would be of good quality. The Director for Adult Social Care explained that the early intervention process would be provided via a blend of different services, both Council based and community and voluntary based. The long-standing partners in the voluntary sector that the Council have, along with the careful work  ...  view the full minutes text for item 47.

48.

Budget 2020/2021 and Medium-Term Financial Plan – Assumed Savings

Minutes:

The Chair introduced item 8, the Budget 2020/2021 and Medium-Term Financial Plan (MTFP) assumed Savings and explained that the full list of assumed savings had been considered by the Overview and Scrutiny Board at their meeting on 13 January and that it was suggested that the Health and Adults Social Care Overview and Scrutiny Committee consider the assumed savings relevant to their scrutiny remit.

The Director of Adult Social Care Commissioning presented the item and provided the Committee with a document, which can be found as Appendix ‘A’ to these minutes in the official Minute Book, outlining the savings that were expected within the Adult Social Care Service area from the 2020/2021 Budget and MTFP.

Members were informed that some of the assumed savings concerned staff structuring which would be subject to a formal consultation with employees and would therefore require a broad level of discussion if the Committee requested further information. The Directors of Adult Social Care Commissioning and the Director of Adult Social Care Services proceeded to explain each item individually, highlighting the key information for the Committee.

Members asked questions on the possible impact that the assumed savings would have on the quality and provision of services within adult social care, such as night care, catering services and the reablement service. The Committee heard that there was no intention to reduce the quality or outcomesof these or any services. There was, instead, the aspiration that technological and efficiency improvements would maintain or improve the quality and outcomes of services within Adult Social Care.

The Portfolio Holder for Health and Adults emphasised that the starting point for all of the budgetary planning was for there to be no reduction in outcomes for people who need services , to which a member of the Committee congratulated the service area for identifying  assumed savings of £5.5 million within 3 years while maintaining the quality of outcomes for the public.

 

RESOLVED that:-  having understood the assumed savings and scrutinised the areas of potential high impact, the Committee agreed to note the item.

 

49.

Review of the Local Safeguarding Adults Boards pdf icon PDF 157 KB

To inform the Committee of the outcomes of an independent review of BCP and Dorset Safeguarding Boards and the plans proposed by the Boards for next steps.

Additional documents:

Minutes:

The Chair introduced item 9, the Review of the Safeguarding Adults Boards (SAB) and asked that the Independent Chair of the Bournemouth Christchurch and Poole Safeguarding Adults Board present the report and respond to any questions from the Committee.

The Independent Chair of the Bournemouth Christchurch and Poole Safeguarding Adults Board provided an overview of the independent report that was commissioned to provide options for future governance of safeguarding, a copy of which has been circulated and appears as Appendix ‘B’ of these minutes in the Minute Book

The Committee was informed that this was the first opportunity to provide an update on the reviews undertaken by BCP Council and Dorset Council. Members were told that the review had been delivered on time with good recommendations in areas for improvement, such as a better ‘line of sight’ on safeguarding frontline practice and the ability to identify work that is duplicated by Dorset SAB and BCP SAB. Furthermore, the review had identified good examples of alternative models of governance, such as the new partnership arrangements in each of the Bristol and Bath Council areas.

Overall the Committee heard that the report concluded that safeguarding was ‘working’, however there is an opportunity to improve it. The Independent Chair of the Bournemouth Christchurch and Poole SAB explained that there were budget pressures present and that a better use of intelligence across partnerships would be of benefit.

He explained that it had been agreed that a wider structural review of governance across Children’s and Adults and Community Safety Partnerships in the BCP and Dorset Council areas would be undertaken over the coming six months.  The two SABs for BCP and Dorset Council areas would continue with an improvement plan based on the recommendations of the SAB review report.

Members discussed specific areas of safeguarding, such as County Lines and Cuckooing. The Committee referred to the models adopted by Bristol and Bath on incorporating other areas, such as community safety when approaching the issue.

 

RESOLVED that:-  the Committee agreed to request a further report following the outcome of the structural review.

 

 

50.

Emergency Duty Services pdf icon PDF 206 KB

To receive an update on the Out of Hours Service following its launch in November 2019.

Minutes:

The Head of Long Term Conditions for Adult Social Care in BCP Council presented a report, a copy of which has been circulated and appears at Appendix ‘C’ to these minutes in the Minute Book which provided an update on the Out of Hours Service following its launch in November 2018.

Members were given an update on the performance of the new service and were informed that following the introduction of the new operation, demand was being met with a high-quality response. The Committee was told that as part of the operational change staff were relocated to better working accommodation. Furthermore, the skilled call handlers worked alongside seven social workers, all trained as Approved Mental Health Practitioners. The Head of Long-Term Conditions explained that in addition to the improved quality of practice, there were several benefits to the redesigned model which included: quality assurance audits, consistency in recording practices, daily management oversight, access to senior management during operating hours, increased staff capacity to respond to adult social care emergencies, phone lines staffed at all times during operating hours, reduction in the length of duty shifts from 16 hours to 12 hours, and the introduction of mobile working and technology, increasing flexible and agile working.

Context was also provided on the type and number of visits that the service conducts. Members were informed that 54% of all visits undertaken by the Emergency Duty Services team were Mental Health Act Assessments. A further 36% accounted for visits involving the dispensation of emergency powers, a process that allows individuals to be taken to a place of safety from a public place.

Members heard that a quality audit was undertaken during August 2019 and that the outcome highlighted the good quality assessments with no issues or concerns identified during the auditing period. The main recommendation that emerged from the audit, to maintain the quality of recording, was embedded in the daily practice of the service.

The Committee was informed that no complaints had been received and that several compliments had been made by Dorset Police, a GP and service users. These related to the effective approach to supporting people in mental health crisis who are in custody as well as supporting the family of people in crisis. Members heard that the service now has the capacity to work more closely with partner agencies, families and carers to better support people in crisis.

Finally, the Head of Long-Term Conditions explained that the significant funding that had been agreed by the former authorities of BCP and the Shadow Authority had ensured the good quality out of hours service. The remodeled service had been of high cost because of the necessity to enhance the management and staffing structures, to meet demand and provide a responsive, high quality service.

Members asked questions on funding and were told that no additional investment was expected following the remodeling operation. The Committee showed interest in the possibility of visiting the service in their new premises, to which the Head of Long-Term  ...  view the full minutes text for item 50.

51.

Forward Plan pdf icon PDF 254 KB

To consider and amend the Committee’s Forward Plan as appropriate.

Minutes:

The Chair introduced item 11, before moving through the list of items for consideration at future meetings and inviting members to comment and suggest amendments as appropriate.

The Corporate Director of Adult Social Care Services gave an update on item number 4 of the Forward, the Adult Social Care - Learning Disabilities and Health Checks, and explained that it would consist of a joint report between Adult Social Care and Health and the People First Forum.

Members agreed to the additional meeting date of 27 April 2020.

The Chair informed the Committee that a training session on the Suicide Prevention Plan was being held on Thursday 6 February 2020 from 14:00-16:00 in the Town Hall and encouraged all members to attend.

The Democratic Services Officer reminded members that a development session would be arranged for the Committee to discuss what their scrutiny priorities would be for the new Municipal Year.

The Chair gave an update on the final list of scrutiny leads for the NHS Dorset Quality Accounts, informing members that works on this would be progressed via the Principal Officer of Planning and Quality Assurance.

Requests were made from two members on items to add to the Forward Plan, these being:

1) an update from the Portfolio Holder on the key points of their work in Health and Adult Social Care.

2) a report on the Council’s approach to healthcare for rough sleepers and homeless people.

 

RESOLVED that:-  the Committee approve the Forward Plan with the above amendments.

 

52.

Future Meeting Dates

Set out below are future meeting dates for the Committee:

 

6pm Monday 2 March 2020

6pm Monday 27 April 2019 *

6pm Monday 1 June 2020

6pm Monday 27 July 2020

 

The Committee may wish to consider venues for future meetings.

 

* Monday 27 April suggested as additional meeting.

Minutes:

The Chair requested that members note the future meeting dates as set out in their agenda packs and sought agreement from the Committee, for all future meetings to be held in the Town Hall, Bournemouth.

 

RESOLVED that:- the following meeting times, dates and location be agreed:

 

6pm Monday 2 March 2020 – Town Hall, Bournemouth.

6pm Monday 27 April 2020 – Town Hall, Bournemouth.

6pm Monday 1 June 2020 – Town Hall, Bournemouth.

6pm Monday 27 July 2020 - Town Hall, Bournemouth.

6pm Monday 28 September 2020 - Town Hall, Bournemouth.

6pm Monday 30 November 2020 - Town Hall, Bournemouth.

6pm Monday 18 January 2021 - Town Hall, Bournemouth.

6pm Monday 8 March 2021 - Town Hall, Bournemouth.