Agenda and minutes

To receive any apologies for absence from Councillors.

Apologies had been received from Cllr Bryan Dion.

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.

There were no substitute Members on this occasion.

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.

Councillor L-J Evans declared a personal interest as a bank employee for University Hospitals Dorset NHS Foundation Trust, Councillor C Johnson declared a personal interest as a Staff Nurse employed by the University Hospitals Dorset NHS Foundation Trust and in relation to Agenda Item 8 Day Opportunities Strategy - Case for Change, Cllr Matthews declared a personal interest as his wife worked for the Alzheimer’s Society running memory cafes.

To confirm the minutes of the Health and Adult Social Care Overview and Scrutiny Committee held on 28 November 2022.

RESOLVED that the Minutes of the Health and Adult Social Care Overview and Scrutiny Committee held on 28 November 2022, having previously been circulated, be confirmed as read and accurate and signed by the Chair.

A Committee Member enquired about children and younger people receiving the Covid vaccine and it was advised it would need to be passed to Children’s Services or Public Health for a response.

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.

The following question had been received relating to Agenda Item 8 – Day Opportunities Strategy – Case for Change from People First Forum – Bournemouth, Christchurch and Poole:

Question – regarding Point 64, Option 3 mixed model of Day Opportunities - Please can we have reassurances re the continuation of services until the details of the proposals have been consulted on?

Answer - Services will continue as they are today, but officers will work with Tricuro to ensure people’s needs continue to be met whilst further work with the project groups, including the co-production group on the next stage of the project in regard to service design and modelling will happen subject to Cabinet approval of the Case for Change report.

Any specific decision about a service change would involve consultation with stakeholders of that service and will include independent advocacy and equality impact assessments.

Question - Regarding point 32, you say there has been a negligible travel implication but how have you looked at the other possible implications for example, what checks have you undertaken to assure us that the needs of people with profound and multiple learning disabilities who are now at Parkstone Connect rather than Wallisdown Plus are being met?  Can you confirm that they are having a good service that includes freedom to roam, regular access to meaningful building-based activities and regular meaningful community-based activities?

Answer - Between August 2022 to November 2022, Tricuro organised an engagement exercise where individuals, carers and family members were asked for their feedback and ideas regarding the services they receive. This has been shared with the project groups and was largely positive about services, with a significant number wanting more community access.

The wider BCP view seeking exercise in October and November 2022 also received a number of comments about services, including Wallisdown Plus. Although there were a lot of positive comments, some concerns were raised about the lack of physical space and access to the community. In addition, during 2022 the Learning Disability team observed areas of good practice but had some recommendations to further develop the support provided.

The next stage of the project will review all of this information in order to co-produce, co-design and re-model services to ensure that people’s needs are met through their service provision.

The Health and Care Act 2022 creates a new duty for the Care Quality Commission to review local authorities’ performance in discharging their adult social care functions under the Care Act 2014.

This report sets out the work that has been undertaken to date and further work that is planned to ensure the Council is best placed to achieve a positive outcome from any review of the Council’s services.

The Interim CQC Preparation Leadpresented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix ‘A’ to these Minutes in the Minute Book.

The Health and Care Act 2022 created a new duty for the Care Quality Commission to review local authorities’ performance in discharging their adult social care functions under the Care Act 2014.

The report set out the work that had been undertaken to date and further work that was planned to ensure the Council was best placed to achieve a positive outcome from any review of the Council’s services.

The Committee discussed the report, in particular the following was noted:

• In response to a query about supervision and training for staff, the Committee was advised that there was a supervision policy in place and that it was constantly being reviewed to ensure it was appropriate.  The Committee was reassured that during this process supervision was being strengthened to ensure it was robust and supportive.
• In response to a query regarding the Making It Real Framework detailed in the report, the Committee was advised that it was a national framework intended to act as a voice from people who used adult social care and the CQC would be using that to inform their own framework development to ensure their assessments captured the views of the users of adult social care.
• In response to a query regarding when an inspection would be likely to take place, it was advised that the CQC would be testing the inspection framework from April to September and were seeking five volunteer authorities during that timescale whilst gathering national and local data to assist with the inspections and that an inspection would not be anticipated until after those findings were published
• In response to a query regarding adult social care staffing and whether that would be taken into account when an inspection takes place, the Committee was advised that the CQC would be aware of the national challenges facing adult social care including difficulties in the recruitment of occupational therapists and social workers
• The Committee was reassured of the agenda item being considered later regarding the BCP Council Adult Social Care Market Sustainability Plan which detailed priorities including providing support to the local care sector with recruitment, skills development, and fees.
• In response to a query about any areas of concern, the Committee was reassured that the service had put themselves forward for a safeguarding review which was currently underway and a local government peer review scheduled for June, so Officers were busy planning and preparing for those and that this had given the service an opportunity to reflect and consider areas where it wanted to drive improvement.  The Committee was advised of its role within this journey and that it should consider it as part of its Forward Plan.
• In response to a query regarding the case management system called Mosaic, the Committee was advised of the positives and considerations of being  ...  view the full minutes text for item 59.

To provide Councillors with an update on the position on the national introduction of Liberty Protection Safeguards (LPS) what this means and how it will impact the Council.

The Head of Statutory Servicespresented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'B' to these Minutes in the Minute Book.

The purpose of the briefing report was to provide the Committee with an update on the position on the national introduction of Liberty Protection Safeguards (LPS), what that meant and how it would impact the Council.

The Committee discussed the report and comments were made, including:

• In response to a query, the Committee was advised that the broadening of scope meant the service needed to consider how it worked with people who lacked capacity to make decisions about their own care, however by reducing the assessments to one process would ensure the user would have one contact and a smoother journey to getting the care they required.
• The Committee discussed the safety and concerns regarding the LPS and were reassured of the reasons for it and the quality assurance processes that would be in place.
• In response to a concern regarding the additional burden this process would have on social workers and funding, the Committee was advised that concerns had been shared with Government.  However, it was inferred that other professionals could undertake assessments.
• In response to a concern regarding incorporating 16 and 17 year olds, the Committee was advised of the transitional pathways for preparing for adulthood and how the service worked with Children’s Social Care and Health ensuring specialist training of the Mental Capacity Act was provided to enable them to be more involved in the LPS process in the future.

RESOLVED that Members note the report.

The Day Opportunities Project has developed a ‘Case for Change’, working in co-production with people with lived experience, their families and carers, members of the public and a range of wider stakeholders.  Evidence to support the Case for Change has been gathered through a strategic needs assessment, a review of best practice and innovation, and a public view seeking exercise.  This has led to the formulation of 6 key priorities to underpin the future strategy, including 25 proposals for implementation over a period of the next 5 years 2023-2028.

The Commissioning Manager – Day Opportunities and Interim Head of Strategic Commissioning – Disabilities presented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'C’ to these Minutes in the Minute Book.

The Day Opportunities Project had developed a ‘Case for Change’, working in co-production with people with lived experience, their families and carers, members of the public and a range of wider stakeholders.

Evidence to support the Case for Change had been gathered through a strategic needs assessment, a review of best practice and innovation, and a public view seeking exercise.  This had led to the formulation of six key priorities to underpin the future strategy, including 25 proposals for implementation over a period of the next five years 2023-2028.

This was an ambitious and comprehensive plan, aspiring to ensure there was a blended approach to the future provision of day opportunities across BCP conurbation that promotes community presence, access to a wider range of services, personalisation, choice and safety for people who require day opportunities.

In acknowledging the aspirations of the proposed strategic design priorities, this would require further co-production engagement to realign services to meet current and future need within the available budget and release funding for the realisation of the key priorities.

The Committee discussed the report and comments were made, including:

• In response to a query regarding the needs and desires for the differing age groups, the Committee was advised that there was a mix of provision, including charities, church organisations and micro providers who offered provision for day opportunities and although not formal day care, they played an important part in engagement and socialisation.
• In response to a query regarding funding and savings, the Committee was advised that modernisation and changing the way of working would lead to efficiencies and provide a wider variety of choice.
• In response to a query regarding the temporary closure of day service buildings due to Covid, the Committee was advised that no decisions had been made about any permanent closures and this review would help set out the principles for moving forward which would include building based fully accessible services as well as community based offers.
• The Vice Chair thanked the Committee and Officer for the discussions and reassurances and in response the Committee was advised that the aim was to broaden the day service opportunities to offer a wider variety.

RESOLVED that the Committee note the report and findings from the review of day opportunities and supports the following recommendations to Cabinet:

a)    The strategic priorities for day opportunities set out in point 61 of this report, which underpin the future strategy and its implementation.

b)    The mixed model of day opportunities includes community-based activities for people within their local area and hubs that will ensure a safe space for people who require a building-based service as well as broadening the day opportunities offer. 

c)    Officers to work with stakeholders to re-design and then re-commission services  ...  view the full minutes text for item 61.

This report provides information to members of the Committee on the position of Tricuro in respect of the management and shareholder arrangements.

The Director of Commissioning for People presented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'D' to these Minutes in the Minute Book and introduced the Executive Director of Operations, Tricuro and Interim Director of Corporate Services, Tricuro, who provided the Committee with PowerPoint presentation which detailed:

–  Quality Assurance / CQC Framework

–  Safeguarding

–  Organisational Development 

–  Recruitment and Retention 

–  Workforce 

–  Reablement / Therapy led service 

–  Digital Developments and Innovation 

–  Partnerships

The report also provided information to members of the Committee on the position of Tricuro in respect of the management and shareholder arrangements.

The Committee discussed the report and comments were made, including:

• The Chair congratulated them on the staffing levels and the Committee was advised that once trained, the staff felt fully supported which meant they generally wanted to stay and progress within the business
• In response to a query regarding Coastal Lodge, it was confirmed it was in Bournemouth and that it was a place where users could begin their reablement which allowed an individual tailored process utilising a flexible and dynamic workforce
• It was noted that there was a similar provision in Poole which was not managed by Tricuro and the facilities which could be accessed in Christchurch were also detailed ensuring there was no inequalities for any residents across BCP.
• In response to a query about Tricuro’s responsibilities, the Committee was advised that once someone was reabled and returned home, the support that was provided was detailed, including follow up calls and signposting to any required services.  In response to a query it was noted that this information was not currently available online and that would be considered further.
• In response to a query from the Vice Chair about how the cost-of-living crisis was impacting the sector, the Committee was advised that it was impacting on staff and services however an uplift of 8% in wages for staff in November had helped mitigate the impact.

RESOLVED that the Committee note the report.

Since the last update to Members and in line with government requirements, working with an independent organisation, officers have completed and returned the Fair Cost of Care exercises for both 65+ care homes and 18+ domiciliary care provision to government.

The results of both exercises identified that the Council framework rates for 18+ domiciliary care were below the median average and benchmark rates from the exercise, but that the Council was already paying above average rates when spot purchasing residential care placements. 

Consequently, the funding from government to support a move towards a Fair Cost of Care has been targeted towards supporting people at home, rather than increasing residential care fees.

In addition, a draft Market Sustainability Plan has been produced, which was submitted in October 2022 as required. The plan includes work planned or underway across Adult Social Care Commissioning to help reduce the reliance on long term care, as well as action underway to support the local care sector with recruitment, skills development, and fees.

Provider engagement workshops are planned for 21 and 22 February after which a final version of the plan will be produced for publication by 27 March in accordance with government requirements.

The Interim Director ASC – Commissioning presented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix ‘E’ to these Minutes in the Minute Book.

Since the last update to Members and in line with government requirements, working with an independent organisation, officers had completed and returned the Fair Cost of Care exercises for both 65+ care homes and 18+ domiciliary care provision to government.

The results of both exercises identified that the Council framework rates for 18+ domiciliary care were below the median average and benchmark rates from the exercise, but that the Council was already paying above average rates when spot-purchasing residential care placements.

Consequently, the funding from government to support a move towards a Fair Cost of Care had been targeted towards supporting people at home, rather than increasing residential care fees.

In addition, a draft Market Sustainability Plan had been produced, which was submitted in October 2022. The plan included work planned or underway across Adult Social Care to help reduce the reliance on long term care, as well as action underway to support the local care sector with recruitment, skills development, and fees.

Provider engagement workshops were planned for 21 and 22 February 2023 after which a final version of the plan would be produced for publication by 27 March 2023 in accordance with government requirements.

The Committee discussed the report and comments were made, including:

• In response to a query regarding overseas recruitment, the Committee was advised of the support and work which had increased workforce within local providers and the struggles around affordability of housing and the work being done in that area.

RESOLVED that Members note the draft Market Sustainability Plan, ahead of final amendments and publication, and the findings in the wider report.

To receive a verbal update from the relevant Portfolio Holders.

The Portfolio Holder for People and Homes advised of the work she had been doing which included:

• A visit to the AECC University College where they were shown around the campus and detailed the potential for partnership working for reablement and physio needs.
• An update on damp and mould and the measures being taken to address these issues following the tragic death in the news recently.  These included setting up a strategic compliance group and officer working group to help support residents across all BCP to ensure every opportunity was taken to identify any issues which required attention.

The Portfolio Holder for Communities, Health and Leisure advised of a recent presentation which had been provided to the BCP Health and Wellbeing Board from the Strategic Lead for Greenspace and Conservation regarding the Strategic Greenspace Priorities and advised she would share the presentation with the Committee and Planners for its consideration.  ACTION.

To consider the Committee’s Forward Plan.

The Chair advised there was a basic forward plan in place however it would be for the next Committee and Officers to populate it.

The Chair advised the Committee of the Joint Health Briefing with Dorset to receive an update from the South Western Ambulance Service Foundation Trust which had recently taken place, what was discussed and highlighted how beneficial it was.

The Committee was advised that Dorset wished to hold another Joint Scrutiny Meeting regarding the Integrated Care Board.

The Chair thanked all Committee Members and Officers for their work over the last four years.

The Vice Chair concluded with an ‘Ode to the Health and Adult Social Care Overview and Scrutiny Committee’ which poetically detailed the work and achievements of the Committee since the start of BCP Council in 2019.

To note the date of the next meeting as 5 June 2023.

The date of the next meeting was noted.