Agenda and minutes

A webcast of the meeting can be viewed on the Council’s YouTube streaming pages.

RESOLVED:

That Mr. T. J. Richardson CC be appointed Chairman for the period ending with the date of the Annual Meeting of the County Council in 2024.

Mr T. J. Richardson CC in the Chair

RESOLVED:

That Mr. N. Chapman CC be elected Deputy Chairman for the period ending with the date of the Annual Meeting of the County Council in 2024.

The minutes of the meeting held on 6 March 2023 were taken as read, confirmed and signed.

The Chief Executive reported that no questions had been received under Standing Order 34.

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.

Ms. Betty Newton CC declared a Non-Registrable Interest in agenda item 10, Leicester, Leicestershire and Rutland Joint Living Well Dementia Strategy 2024-28, as family members worked in a health environment 

Whilst not declared under this item, later in the meeting during consideration of agenda item 11, Update on the Implementation of the Leicester, Leicestershire and Rutland Carers’ Strategy, Mrs Betty Newton CC declared a Non-Registrable Interest in this item as she had previously worked at a University as part of a young carers research group.   Mr. B. Boulter CC also declared a Non-Registrable Interest in this item as his stepdaughter worked in a home for people with learning difficulties.

Mr. T. Richardson CC declared an interest in agenda item 10, Leicester, Leicestershire and Rutland Joint Living Well Dementia Strategy 2024-28, and agenda item 11, Update on the Implementation of the Leicester, Leicestershire and Rutland Carers’ Strategy, following Government guidance issued under  paragraph 2(9) of Schedule 5A to the Local Democracy, Economic Development and Construction Act 2009, which strongly recommended that the Chairman, given their pre-eminent role on the scrutiny committee, not preside over scrutiny of their relatives. Mr. Richardson, as Chairman, had been asked to make the Committee aware that his wife, Mrs. L. Richardson CC, was Cabinet portfolio holder for Health. Mr. Richardson asked Members of the Committee present at the meeting if they were comfortable with him to continue to chair the meeting, bearing in mind the meeting was looking at strategies and not questioning the Member directly. Members confirmed Mr. Richardson could continue to chair the meeting.

There were no declarations of the party whip.

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

The Committee considered a joint report of the Directors of Adults and Communities and Public Health, which invited comments on the draft Leicester, Leicestershire and Rutland (LLR) Joint Living Well Dementia Strategy 2024-28, subject to Cabinet’s approval on 23 June 2023 for the Strategy to be subject to a formal consultation exercise. The report also updated the Committee on the progress of work under the current Strategy (2019-22). A copy of the report marked ‘Agenda Item 10’ is filed with these minutes.

Arising from discussion and questions, the following points arose:

i.          Members welcomed the new Strategy which it was agreed was a good and well thought out document.

ii.          A Member commented that whilst it was noted the Strategy needed to set out the high level aims for improving dementia services across LLR, many residents would be most interested in the detail regarding improvements for the future delivery of services.  For example, how and when would services be expanded across the County and what targets would be applied.  Members were pleased to hear that the County Council and other stakeholders would each produce an action plan which would include detail on specific targets and timescales, the bare minimum of which for the County would be to meet the national target on diagnosis rates.  Work on these plans would begin during the consultation period and so more detail would be provided in the next report to both Scrutiny and Cabinet in September.

iii.          The Committee was assured of ICB colleagues’ commitment to working to ensure that dementia services would be more accessible for people in rural areas. Under the previous Strategy diagnosis clinics had been focused in the City area which now had significantly higher diagnosis rates than the County.  The County Council would therefore be seeking to ensure this was redressed under the new Strategy.  There would be challenge and support from partners and other organisations, such as the County Council to the ICB, to ensure delivery arrangements were put in place in a timely fashion and to specifically address the imbalance of diagnosis rates across LLR.

iv.          The Service would continue to strive to support people to remain independent, using a range of tools, for example, working with informal carers, working with community groups, as well as formal adult social care services in the way contracts were managed and supported.   Members were pleased to hear that promoting independence for those living with dementia would be a key aim supported by the new Strategy, as it was across all adult social care services.

v.          A Member raised concerns that individuals who were illiterate could find it difficult to articulate their needs and might be unable to access advice and information.  The Director assured Members that this would be taken into account during delivery of the revised Strategy, for example, by providing assistance through diagnosis and planning arrangements.

vi.          Members welcomed plans for the Council and its partners to use a range of different activities to engage with carers, family members and those experiencing dementia themselves as part of the consultation, noting that the online consultation would be just one option available.  Members were pleased to hear that recognition had been given to the importance of going out and speaking directly to people as an online approach was not suitable for all.  It was suggested that as part of the consultation process the Cabinet should consider including a section to seek feedback on the experiences of carers and patients, of how they had found the process of getting a diagnosis of dementia.  Members agreed that this could provide some  ...  view the full minutes text for item 10.

The Committee considered a joint report of the Director of Adults and Communities, Children and Family Services and Public Health, the purpose of which was to provide an overview of progress in implementing the Leicester, Leicestershire and Rutland Carers’ Strategy 2022-2025 and the associated action plan in Leicestershire. The report further set out details of the Carers’ Week programme (5-11 June 2023), and outlined key areas being developed to support carers in Leicestershire with the Council’s partners.

Prior to the presentation of the report, the Director informed the meeting of an event that had been held at County Hall that morning to mark the start of Carer’s Week, with over 50 people attending with a range of partners presenting information and advice on a range of topics, including mental health and mindfulness. Good feedback had been received from attendees and partners.

At this point in the meeting Ms Betty Newton CC declared a Non-Registrable Interest in this item as she had previously worked at a university as part of a young carers research group and noted that young carers had been captured by the Strategy.   Mr. B. Boulter CC also declared a Non-Registrable Interest during consideration of this item as his stepdaughter worked in a home for people with learning difficulties.

Arising from discussion and questions, the following points arose:

i.          Between May 2022 and March 2023, the County Council through Voluntary Action South Leicestershire (VASL) had identified 1,000 new carers (around five to six a day).  The Young Carers Services had also reached out to around 73 new carers to provide support, working with schools and colleges.

ii.          It was intended for the action plan to be focussed on Leicestershire to make it more contained. A multi-agency Leicestershire strategy group had been set up, with its first meeting arranged for 30^th June, with partners specific to Leicestershire, who would drive the Strategy and action plan forward.

iii.          Members were pleased to hear that the Strategy and related action plan would be all encompassing and include areas such as parent carer actions around special schools, and post-16 care.

iv.          Members highlighted that young carers were often the hidden face of community care, and that very often families were ashamed that they had young carers looking after them so didn’t speak out.  Also, being a young carer very often meant they missed out on education and a life outside of home as they undertook their caring role. Members noted that the Young Carers service was specifically aimed to support young carers with the issues identified by Members and feedback from the young carers group would continue to inform this Strategy and related action plan.

v.          A Member commented on the small number of people (138) who had claimed the Hospital Discharge Grant for Carers, with just under £40,000 (8%) of the total £2million Adult Social Care Winter Discharge Fund having been used in this way.  The Member suggested that statistics for the area showed that approximately 2,000 to 2,500 patients had been discharged from hospital during that time and therefore questioned how well the grant funding had been advertised on hospital wards.

vi.          Members noted the that the Hospital Discharge Grant for Carers had been just one of a number of schemes funded by the Winter Discharge Grant.  This had been a new and innovative scheme introduced by the Council to assist carers.  Members noted that communication of the scheme had been limited as the Government had only announced the funding on 16 December 2022 but required this be spent by 31 March 2023.  Information had reached the Royal Infirmary  ...  view the full minutes text for item 11.

The Committee considered a joint report of the Chief Executive and the Director of Adults and Communities, the purpose of which was to present an update on the Adults and Communities Department’s performance for the year 2022/23. A copy of the report marked ‘Agenda Item 12’ is filed with these minutes.

Arising from discussion the following points were made:

       i.          A Member shared his recent experience of a family members stay in hospital and raised concerns about the lack of discussion with hospital staff prior to discharge regarding their reablement needs.  He suggested that a critical factor that had not been but should have been considered early on was the level of capacity and ability of the person prior to their stay in hospital.  The Member suggested that this would provide a baseline to assess a person against to help determine what support was needed to help an individual’s return to that level of independence wherever possible.  The Member further suggested that hospital staff should be preparing patients days before their return home as part of their care in hospital to reduce the amount of support, if any, the patient would subsequently require. The Member commented that it was only after his family member had been discharged from hospital that these discussions had been held with the Homecare Assessment and Reablement Team (HART) by which time their condition had already deteriorated resulting in more home care support being required.  It was suggested that holding these discussions and providing early support would help avoid the need for long term dependence on costly local authority adult social care services in a number of cases.  The Committee thanked the Member for sharing their personal experience which provided an important way of identifying issues within the system that needed to be improved.

      ii.          The Director commented that it was the view of the Council that if part of medical treatment included a period of recovery, that should be part of the whole NHS treatment pathway, and should not be seen as separate, as recovery was as important as the treatment itself.  However, the Director said that the sheer number of people waiting for hospital treatment placed intense pressure on the NHS to free beds.  This had been particularly so since the Covid-19 pandemic when a number of operations had been cancelled.  To achieve the most effective long-term outcome for patients, they needed to be helped more whilst in hospital.  However, this was not the most efficient approach for the NHS as this would mean beds could not be released as quickly as needed for the large number of patients waiting for treatment.  

    iii.          Members were assured that the treatment pathway across the whole system of Health and Social Care was being looked at and improvements were being made. The Council was working collaboratively with the NHS, which was now funding the expansion of the Authority’s reablement service considerably.  At present the service did not have capacity to assess all patients before they left hospital. Approximately 20% of people currently left hospital and went straight to home care without reablement support.  The added funding from the NHS would help to address this and ensure everyone got a reablement assessment before leaving hospital in future.   Avoiding a person’s dependency on long-term home care was primarily in the patients best interest, as well as avoiding more costly home care services.

    iv.          Members noted that the Department was developing a pilot aimed at getting support workers into the hospitals to work more effectively with the patient particularly regarding their reablement needs, before they are discharged.  Members acknowledged that  ...  view the full minutes text for item 12.

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

The Committee considered a joint report of the Chief Executive and the Director of Adults and Communities, the purpose of which was to provide the Committee with information relating to the publication by the Department of Health and Social Care (DHSC) ‘Care Data Matters: a roadmap for better data for adult social care’ in February 2023. A copy of the report marked ‘Agenda Item 14’ is filed with these minutes.

Arising from discussion and questions, Members noted the following points:

Mr. Hadji left the meeting at this point at 3.32pm.

       i.          It was clarified that the Authority would not have access to NHS health data, but that the NHS would have access to the Council’s data.  Members were assured that in working with the NHS information would be anonymised, but there would be much better cohesion between Health and Local Authority analytics.

      ii.          Members noted that reports would continue to be brought to the Committee over the following year, with a couple of new metrics, such as the CQC ratings and safeguarding data, but changes in reporting would be seen over the next couple of years.

RESOLVED:

That the report on the information relating to the publication by the Department of Health and Social Care (DHSC) ‘Care Data Matters: a roadmap for better data for adult social care’ in February 2023 be noted.

The Committee considered a report of the Director of Adults and Communities, the purpose of which was to provide and update on the performance of the Council’s Adult Learning Service (LALS) and to seek the views of the Committee on the proposed Accountability Statement mandated by the Department for Education (DfE) from 2023, appended to the report. A copy of the report marked ‘Agenda Item 13’ is filed with these minutes.

Arising from discussion and questions, Members noted the following points:

       i.          With the decline in maths and English skills in schools, it was suggested that the future need for the service would likely increase. Members noted that the Multiply Programme was an example of the support being provided to adults regarding numeracy skills, and that the service was seeing an increase in people, particularly males, affected by the pandemic and leaving school with low results and who were now joining the programme.

      ii.          The Adult Learning Service was facing the challenge and trying to engage with people to encourage them to join English and numeracy programmes, however this was challenging.

    iii.          It was recognised that early intervention and working with schools was critical to breaking the cycle.

RESOLVED:

That the report on the performance of the Council’s Adult Learning Service (LALS) and the proposed Accountability Statement be noted.

The Committee considered a report of the Director of Adults and Communities, the purpose of which was to provide information to the Committee retrospectively on the proposed expenditure of the Market Sustainability and Improvement Fund (MSIF). The MSIF grant determination letter was published on 4 April 2023 and required all authorities to submit a return to the DHSC by 24 May 2023. A copy of the report marked ‘Agenda Item 15’ is filed with these minutes.

Arising from discussion and questions, Members noted the following points:

       i.          A Member commented that the funding had been allocated for two years, with no guarantees that this would continue and questioned how this might affect the service in the longer term.  The Director advised that the expectation would be for equivalent funding to be made available by central government through other means such as the Adult Social Care grant or the Better Care Fund instead. [KR1] 

      ii.          The capacity plan to be submitted at the end of June would provide information on the current market projections and gaps across adult social care, and what might be needed moving forward.

    iii.          The Chairman commented that the Council had done a lot of work around the cost of care and was in a better position that most other councils across the country as a result, despite its low funded position and whilst the Authority had a lot to be proud of, the funding position going forward would need to be monitored.

RESOLVED:

That the report provided to the Committee retrospectively on the proposed expenditure of the Market Sustainability and Improvement Fund (MSIF) be noted.

Future meetings of the Committee are scheduled to take place on the following dates, all at 2.00pm:

Monday 4 September 2023

Monday 6 November 2023

Monday 22 January 2024

Monday 4 March 2024

Monday 3 June 2024

Monday 2 September 2024

Monday 4 November 2024

The dates of future meetings of the Committee scheduled to take place on the following dates, all at 2.00pm, were noted:

Monday 4 September 2023

Monday 6 November 2023

Monday 22 January 2024

Monday 4 March 2024

Monday 3 June 2024

Monday 2 September 2024

Monday 4 November 2024