Agenda and minutes

A webcast of the meeting can be viewed at [insert link].

The minutes of the meeting held on 5 June 2018 were taken as read, confirmed and signed.

The Chief Executive reported that no questions had been received under Standing Order 35.

The Chief Executive reported that no questions had been received under Standing Order 7(3) and 7(5).

There were no urgent items for consideration.

The Chairman invited members who wished to do so to declare any interest in respect of items on the agenda for the meeting.

No declarations were made.

There were no declarations of the party whip.

The Chairman sought and obtained the consent of the Committee to vary the order of business from that set out on the agenda.

The Committee considered a joint report of the Directors of Adults and Communities, Children and Family Services and Public Health on the outcome of public consultation on the draft joint Leicester, Leicestershire and Rutland (LLR) Carer’s Strategy 2018-21, which set out strategic priorities relating to unpaid carers of all ages.  A copy of the report, marked ‘Agenda Item 9’, is filed with these minutes.

The Chairman welcomed the Spokesmen of the Children and Families Overview and Scrutiny Committee to the meeting for this item.

Arising from the discussion, the following comments were raised:

i)             Some concern was expressed that the number of responses received during the consultation appeared to be low.  Members were advised that significant engagement had taken place with carer groups and the care sector on the proposed content of the Strategy before the commencement of the consultation period.  It was noted with elected members that local networks could be used in future consultations.

ii)            Although this was a joint Strategy, there was a risk of fragmented implementation due to the fact that there would be six sets of governance arrangements.  Despite the organisations having a similar strategic intent, each had a different implementation plan, with actions that were relevant to the individual localities.  The Committee noted that there were a number of positive actions within the County Council’s implementation plan.

iii)           With regard to measuring outcomes, members were advised that a bi-annual survey of carers currently took place which followed a standard methodology and asked a range of questions to ascertain the overall level of satisfaction.  Current feedback from the survey was not particularly positive, and this mirrored the national picture.  It was hoped that improvements in the carer offer would be reflected in a more positive survey response.

iv)           One of the key themes emerging from the consultation was that carers generally agreed that the way in which services were provided for the cared-for created a level of carer strain.  The key issue identified that a lack of signposting caused further stress, and as a result additional dedicated staff were employed in the customer services centre to provide a more helpful and responsive service.

v)            There appeared to be a varying level of support for carers from GPs.  In response to a query around how this could be improved, it was acknowledged that engagement had not always been successful.  However, carers had stated in the consultation that they wanted to receive information and advice through primary care providers and the aspiration was to have this as a place to get information, not just via a consultation with a GP, but as a navigation point.

vi)           The priority in relation to supporting young carers was welcomed, in particular addressing the specific needs of young carers in terms of respite.  As a result of the feedback received, it would be necessary to undertake further work around the offer for young carers, and this would be reflected in the final Strategy which would be presented to the Cabinet at its meeting on 16 October.

vii)         A further issue in relation to young carers was the need to balance their caring responsibilities and their education needs.  In addressing the overall impact on young carers, key was ensuring that the service user they were caring for was receiving the appropriate support in their own right.  The Council had commissioned Barnardo’s to provide a support service for young carers.  The importance of the corporate parenting responsibility of everyone was stressed, along with ensuring that young people were being looked after appropriately.  The views of the Committee on young carers would be forwarded  ...  view the full minutes text for item 25.

A copy of the report to be submitted to the Cabinet at its meeting on 14 September 2018 is attached.  The Committee is invited to comment on the proposals.  The views of the Committee will be reported to the Cabinet.

The Committee considered a report of the Director of  Adults and Communities and Director of Corporate Resources, which was due to be presented to the Cabinet on 14 September 2018, on ‘The Lives we Want to Lead’ – the Local Government Association Green Paper for adult social care and wellbeing.  The Government had stated its intention to publish a Green Paper on adult social care, but the publication of this had been delayed a number of times.  It was anticipated that this would now be published in the autumn, alongside a ten year plan for the NHS.  A copy of the report, marked ‘Agenda Item 8’, is filed with these minutes.

The Lead Member for Adults and Communities stated his support for the main principles within the Green Paper.  He made particular reference to the individual stories within the Green Paper of people who had required adult social care services but were not aware that this was not part of the NHS and hence not a free service.

The current draft response to the LGA Green Paper from Leicestershire County Council was proposing free personal care as being the most equitable and transparent solution but noted that a ‘cap and floor’ mechanism would provide people with protection of assets.  However, this would also require a bureaucratic and resource intensive process, and would mean that a large  number of people who currently funded their own care would have to create an account with the local authority and the local authority would have to assess everyone.

Members welcomed the LGA Green Paper and the report, which outlined the County Council’s perspective and initial assessment.  The Committee was of the view that the issue of funding social care had been avoided for too long and that, given the pressures facing the sector, the LGA needed to lobby hard for Government action to address the funding issue.

In respect of the response to the LGA Green Paper, the Committee asked the Director of Adults and Communities and the Lead Member to have regard to the following when formulating a Council response:

i)             Making personal care free would lead to greater simplicity and help with the integration of health and social care, although it was recognised that this may be too expensive.  As such, the ‘cap and floor’ appeared to be a sensible way forward.

ii)            It was agreed that the responsibility for social care services should not be transferred to the NHS.  The local authority, with elected members representing their constituents, was better placed to understand local needs and be more effective at commissioning primary and social care.  The NHS should focus on its strengths, that being providing acute care.

iii)           The challenges facing social care could not, as the LGA paper made clear, be addressed by narrowly focussing on social care.  The interdependence of housing, public health and other services provided by local authorities needed to be addressed.  In this regard, planned reductions in public health funding were unhelpful.

iv)           The important role of the carer’s workforce needed to be recognised, both in terms of remuneration as well as improved career prospects and training.  Failure to do so would lead to a greater turnover of staff and threaten the sustainability of the care sector.

The Committee recognised that all of the above required bold decisions on funding and that there needed to a be national funding formula for social care.

RESOLVED:

That the Cabinet be advised of the comments made by the Committee.

The Committee considered a report of the Director of Adults and Communities providing an update on the outcome of the consultation on the draft Leicester, Leicestershire and Rutland (LLR) Living Well with Dementia Strategy 2019-22 and presenting the associated draft delivery plan.  A copy of the report, marked ‘Agenda Item 10’, is filed with these minutes.  The comments of the Committee would be forwarded to the Cabinet, where the final Strategy and delivery plan would be presented on 16 October 2018.

Concern was raised over training and development for the social care workforce.  It was recognised that having the appropriate number of staff with the right level of capabilities was key, but that this would become more challenging with an ageing population and a greater number of people with dementia.  Within LLR, the Social Care Development Group provided free or subsidised training primarily to independent sector providers, although the type of training had to be prioritised.  The University of Bournemouth had been commissioned to provide dementia training, which consisted of an introductory dementia awareness course and more intensive training targeted at managers around improving dementia support delivery.  This contract was coming to an end shortly, and consideration was currently being given to what would be commissioned in its place.

Engagement was taking place with the sector to seek their views on what had been offered and what could be offered in the future.  It was felt that dementia and mental health training around older people would be a priority as feedback suggested that this was a challenging area.  Specialist dementia care was an area of concern and improving standards was a priority.

The Committee agreed that workforce development was important, and that every effort should be made to retain as much funding as possible to provide this.

RESOLVED:

(a)  That the report be noted;

(b)  That the comments now made be submitted to the Cabinet for consideration at its meeting on 16 October 2018.

The Committee considered a report of the Director of Adults and Communities providing an update on the short-to-medium term actions for developing the home care market and of future joint commissioning priorities for home care.  A copy of the report, marked ‘Agenda Item 11’ is filed with these minutes.

Arising from the discussion, the following comments were made:

i)             The Committee was pleased to see that some stabilisation had now taken place, and agreed that it was essential to ensure that previous mistakes with providers were not repeated.  The County Council wanted to work with providers who had a strong local presence and had the ability to provide stability and attractiveness to staff.  Where problems had arisen previously, it had been largely due to the fact that providers had been unable to recruit and retain staff.  In order for this to occur, it would be necessary to improve the conditions of employment for staff, and although there had been improvements, the service needed to remain an attractive means of employment.

ii)            In response to a query around measuring service user outcomes, it was important that these were defined by service users.  Communication with carers was seen as essential in order to provide useful feedback as to what they required from the service.

iii)           The Cabinet had decided not to sign up to a joint Sustainability and Transformation Programme (STP) with Health and agreed that this should be an NHS document with the County Council as a consultee.  The CCGs had recently published a refreshed paper on Better Care Together and the policy statement had now been published on the CCGs website with an updated statement around the STP.  Work continued on some of the work streams in the original STP development, in particular the reconfiguration of hospital beds and integrating health and social care services at the point of delivery.  The County Council was also working with Leicestershire Partnership Trust (LPT) to develop an integrated reablement and intensive support service, which would bring together the HART reablement service and the Intensive Community Support service within LPT and it was hoped that this would be operational by October.

RESOVLED:

(a)  That the report be noted;

(b)  That a further update be presented to a future meeting of the Committee.

The Committee considered a report of the Independent Chair of the Leicestershire and Rutland Safeguarding Adult Board (LRSAB) presenting the draft Annual Report of the Board for 2017/18.  A copy of the report, marked ‘Agenda Item 12’, is filed with these minutes.  Any comments or proposed amendments would be addressed in the final report before it was presented to the LRSAB at its meeting on 25 October 2018.

In response to questions the Committee was advised:

i)             The final multi-agency discussion and analysis in relation to the Strategy Meeting audit had not taken place by the end of the year.  However, this had now been completed and actions arising from the audit were being implemented.

ii)            The inaccuracies in the financial information within the Annual Report would be reviewed and put right.

RESOLVED:

That the report be noted.

The Committee considered a report of the Director of Adults and Communities providing a summary of the complaints and compliments for adult social care services commissioned or provided by the Adults and Communities Department in 2017-18.  A copy of the report, marked ‘Agenda Item 13’, is filed with these minutes.

In introducing the report, the Lead Member for Adults and Communities stated that although this was a largely positive report, it highlighted that the department was not complacent about responding to complaints.  However, it was welcoming that the department was learning from the complaints received, and this would continue.

RESOLVED:

That the report be noted.

The Committee considered a joint report of the Chief Executive and the Director of Adults and Communities presenting an update of the Adults and Communities Department’s performance for the period April to June 2018.  A copy of the report, marked ‘Agenda Item 14’ is filed with these minutes.

Arising from the discussion, the following comments were raised:

i)             In response to a query around encouraging e-book loans for people in areas where mobile libraries no longer visited, it was stated that this was not currently the intention of the service.  However, it would be useful to consider whether there was a direct correlation between the increase in e-book loans and the locations of where mobile libraries had previously visited.

ii)            It was agreed that libraries were multi-action spaces used for a variety of means, for example, using the internet and social interaction, as well as loaning a book.  It was felt important for libraries to promote and advertise what resources were available in the building.  Consideration was currently being given to expanding the commercial options within the Council, and this could include making libraries more commercial through the sale of appropriate merchandise.  Further work would take place around this.

RESOLVED:

That the report be noted.

Future meetings of the Adults and Communities Overview and Scrutiny Committee will be held at 2.00pm on the following dates:-

6 November 2018 (commencing at 11.00am)

21 January 2019

11 March 2019

10 June 2019

2 September 2019

11 November 2019

It was noted that the next meeting of the Committee would be held on 6 November 2018 at 11.00 am.

Future meetings of the Adults and Communities Overview and Scrutiny Committee will be held at 2.00pm on the following dates:

21 January 2019

11 March 2019

10 June 2019

2 September 2019

11 November 2019.