Agenda and minutes

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RESOLVED:

That the appointment of Mr. T. Richardson CC as the Chairman of the Adults and Communities Overview and Scrutiny Committee for the period ending with the Annual Meeting of the County Council in 2020 be noted.

Mr. T. Richardson CC – in the Chair

RESOLVED:

That Mr. W. Liquorish CC be elected Deputy Chairman of the Adults and Communities Overview and Scrutiny Committee for the period ending with the Annual Meeting of the County Council in 2020.

The minutes of the meeting held on 11 March 2019 were taken as read, confirmed and signed.

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

The Chairman reported that questions had been received from Dr. T. Eynon CC under Standing Order 7(3) and 7(5).  As the questions related to item for discussion elsewhere on the agenda (Minute 11 refers), he proposed to deal with the questions under this item.

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 Committee considered a report of the Director of Adults and Communities which provided an update on the progress of developing the Adult Social Care Target Operating Model (TOM).  It was noted that the programme was currently on track with the programme plan and original objectives.  A copy of the report marked ‘Agenda Item 10’ is filed with these minutes.

The Committee’s attention was drawn to the key activities which had taken place during the design phase, as detailed in the report, in particular the testing of initial ideas and the preliminary results.  It was the intention that these would be signed off in the coming months to be implemented across the county.  Each service was being tested in a locality and would ultimately be rolled out to each area of Leicestershire.

Arising from the discussion, the following comments were made:

i)             The principles had been trialled and implemented in a number of other local authorities throughout the country.  Within Leicestershire, improvements had already begun to be realised.  One of the areas being looked at was the Customer Service Centre (CSC), in terms of how it operated and how to improve the time it took for work to be passed through the CSC to a locality.  When the work had commenced, it had been taking eight days for the initial work in the CSC to take place and it was now taking two days. 

ii)            In terms of localities in the reablement offer, this had begun to be tested in Hinckley.  It had been found that the productivity of the reablement service could be improved by changing some of the decision making, by reviewing cases on a daily rather than weekly basis.  This would enable greater capacity in the service, such that it had already been possible to take on all the work of the independent sector in the Hinckley area and bring it back in-house to the HART service.  It was anticipated that this would also take place in the Wigston area.

iii)           It was essential that there was service user involvement in the development of the TOM.  However, as it was only currently at the design phase, it was important to get the views of people using the service without giving them false expectations.  A process was used with staff to dip test their views and this was now beginning to be rolled out to service users.  It was easier to check satisfaction levels in areas such as the reablement service due to its short term nature, but when working with people with learning difficulties, it was a more difficult process due to it being more long term.  Significant improvements had been made with the matching process and the department had consulted with groups such as the Learning Disability Partnership Board.

iv)           The report highlighted that should the programme not deliver a recurrent annualised benefit greater than 1.5 times the one-off fee, the strategic development partner’s fee would be reduced until the ratio was satisfied.  It was hoped that this would not have a detrimental impact on the level of service and the work completed.  As part of the overall governance of the programme, the Benefit Monitoring Board met on a monthly basis to consider what had been achieved and to measure individual service user outcomes and the overall benefit to the service area.  Assurance was given that no invoices were signed off by the department until it was satisfied that the target improvements had been achieved.  In relation to the 1.5 times benefit, this related to the fee being contingent upon the delivery of the financial benefits.  ...  view the full minutes text for item 10.

The Committee considered a report of the Director of Adults and Communities which provided a summary of the progress made to prepare for the redevelopment of short breaks services and residential services in North West Leicestershire, including the relocation of existing residents and tenants and the design principles and re-build programme.  A copy of the report marked ‘Agenda Item 11’ is filed with these minutes.

Under Standing Order 7(3) and 7(5), questions had been received from Dr. T. Eynon CC, which the Chairman had agreed would be dealt with as part of this item.  A copy of the questions and the response provided by the Director of Adults and Communities was tabled at the meeting and is attached to these minutes (marked ‘A’).  The Chairman invited Dr Eynon to ask a supplementary question.

Dr Eynon commented that the location of the current Coalville Resource Centre meant that it was often seen as separate to other local community facilities.  She asked whether work would take place with the third sector and other community resources in Coalville so that there wasn’t a gap in provision and its closure was not a surprise to the community.  Dr Eynon also queried how, if in due course the Coalville Resource Centre was declared surplus to requirements, the County Council would look to reinvest any capital that was realised?

In response, the Director of Adults and Communities stated that a similar model was operating elsewhere and worked well.  It was advantageous to users for multiple services to operate from one site, as this enabled them to access more than one service at the same time.  The Smith Crescent /Hamilton Court development would provide a higher level of supported living on one site and it was anticipated that there would be more community based activities available on site. 

The decision relating to the existing Coalville Resource Centre would be made by the County Council’s Property Services.  If it was deemed surplus to requirements and a capital receipt was realised, it was anticipated that this would be used to offset the £3.7m cost of building the new development at Smith Crescent.  Other services were also due to be developed in North West Leicestershire around a dementia support service and possible extra care; as a result the capital investment in this area was expected to be substantial.

RESOLVED:

That the Cabinet be advised that this Committee welcomes and supports the proposals.

The Committee considered a report of the Director of Adults and Communities which provided an update on developments to create sustainable and personalised health and social care services across Leicestershire.  A copy of the report marked ‘Agenda Item 12’ is filed with these minutes.

Arising from the discussion, the following comment was made:

i)             In response to a query around the funding gap, it was stated that commissioning activity and the projections were based on demands and pressures.  The projections for Leicestershire had been published in the Joint Strategic Needs Assessment, which had been updated earlier in the year.  Based upon Local Government Association analysis, Leicestershire would require approximately £90m to meet the shortfall in social care funding.  The link to this document would be circulated to members of the Committee.

RESOLVED:

That the report be noted.

The Committee considered a report of the Director of Adults and Communities which gave an update on the detailed needs analysis that had been undertaken to inform the Social Care Accommodation Development Plan and Investment Prospectus and provided information on the ways in which the Council intended to meet the identified gaps in provision.  A copy of the report marked ‘Agenda Item 13’ is filed with these minutes.

In response to a question concerning the option of the Council developing a housing company or becoming a Registered Social Landlord, the Committee was advised that these, and other options, were being explored and a report would be made to the Cabinet in due course.  The work being undertaken on options affected a number of other departments and services provided by the Council, and as such would be a matter for the Scrutiny Commission.

The Cabinet was due to receive a report at its meeting on 25 June 2019 which would provide the first iteration of the Investment Prospectus, the implementation process, resource requirements and financial implications.

RESOLVED:

That the Cabinet be advised that this Committee welcomes and supports the proposals.

The Committee considered a report of the Director of Adults and Communities which provided an update on the proposed changes to the way in which the Council agreed prices for residential care and residential nursing care, focusing specifically on the second stage of the consultation.  A copy of the report marked ‘Agenda Item 14’ is filed with these minutes.

In response to a query, it was stated that approximately 20% of service users paid a ‘top up’; it was not yet known how many of these would see a reduction in this, but it was anticipated that many would.

The Committee welcomed the increase in the Council’s fees to support the people who required a service and wished to place on record its thanks to officers for the work undertaken in this area.

RESOLVED:

That the Cabinet be advised that this Committee welcomes and supports the proposals.

The Committee considered a report of the Director of Adults and Communities which provided an overview of how social care needs were met within the county, the way people received services and the estimated levels of need locations.  A copy of the report marked ‘Agenda Item 15’ is filed with these minutes.

Arising from the discussion, the following comments were made:

i)             Over 70% of people had packages of care arranged within two weeks and over 90% within four weeks.  The highest number of requests waiting had been in Harborough and Melton Mowbray, and it was felt that these were difficult areas for sourcing care due to the rural nature of the areas and high levels of employment.  It was acknowledged that there were hot spots throughout the county where it was difficult to commission domiciliary care, and despite providers offering a higher salary, there were still difficulties in recruiting staff.  If the framework of providers could not provide a service, other providers would be sought and people were offered a direct payment if they could find a service outside of the normal framework.  Within Melton, local people were seeking to establish a village enterprise to provide such services.  This would be supported by the County Council and if successful, it would be rolled out to the Harborough area.

ii)            It was noted that the department was experiencing pressures of demand, and there were regular senior management meetings with health to address these pressures.  Discussions were ongoing around Continuing Healthcare to agree a protocol and an escalation and dispute process was part of this.  The department was also supporting a community health services review to develop a revised footprint around therapy services.

iii)           A report on the community services redesign programme, by the CCGs and Leicestershire Partnership Trust, was in the process of being enacted.  A report on this had previously been presented to the Health Overview and Scrutiny Committee, and the lack of capacity in district nursing provision had been acknowledged by the CCGs.  The intention was to redesign the current services so that the Integrated Community Services was reviewed to identify which services needed to be in the Home First element (largely therapy services) and separate these from district nursing services.  These would be based around Integrated Locality Teams and would work to keep people at home.  The County Council was supporting the development of integrated care, and it was anticipated that this would release some capacity.

iv)           The national shortage of qualified mental health staff was reflected in Leicestershire, and action had been undertaken to address this through recruitment with the proposed addition of a market premia.  In response to a query around meeting demand, it was stated that the AMHP Service (which assessed people under the Mental Health Act to be sectioned and admitted to hospital) was meeting statutory requirements around assessments.  There was currently no evidence to suggest that the service was not also meeting its other requirements.  A number of agency staff were currently employed and this was helping with meeting the demand, although it was hoped that a number of vacant posts would be filled.

RESOLVED:

That the report be noted.

The Committee considered a joint report of the Chief Executive and Director of Adults and Communities presenting an update of the Adults and Communities Department’s performance for the year 2018/19.  A copy of the report marked ‘Agenda Item 16’ is filed with these minutes.

A member queried whether it would be possible to record where people were from when visiting heritage sites.  There were areas throughout the county where no heritage sites existed and it would therefore be useful to know whether people travelled to other areas to visit a site.  This had previously been undertaken at a district level, and it was suggested that this research could be undertaken by students at one of the universities within Leicestershire.  The Director responded to say that this suggestion would be considered.

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:

2 September 2019

11 November 2019

20 January 2020

9 March 2020

8 June 2020

7 September 2020

2 November 2020.

RESOLVED:

It was noted that the next meeting of the Committee would be held on 2 September 2019 at 2.00pm.

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

11 November 2019

20 January 2020

9 March 2020

8 June 2020

7 September 2020

2 November 2020.