Agenda and minutes

An apology for absence had been received from Councillor Mrs H N J Powell.

It was noted that the Chief Executive, having received notice under Regulation 13 of the Local Government (Committees and Political Groups) Regulations 1990, had appointed Councillor Ms Tiggs Keywood-Wainwright as a replacement member of the Committee in place of Councillor Mrs H N J Powell, for this meeting only.

No declarations of Councillors' interests were received at this stage of the proceedings.

RESOLVED

That the minutes of the Adults Scrutiny Committee meeting held on 24 February 2016 be confirmed and signed by the Chairman as a correct record.

(To receive a report which provides the Committee with a position statement on the progress and themes coming out of the Care Quality Commission (CQC) inspections of Adult Social Care Services in Lincolnshire)

Consideration was given to a report, which provided the Committee with a position statement on the progress and themes coming out of the Care Quality Commission's (CQC) inspections of Adult Social Care services in Lincolnshire.

It was highlighted in the report that the Committee was to bear in mind that the CQC was not subject to Local Authority Scrutiny, and that the relationship was an informal one based on an understanding, trust and joint aspiration to improve services by sharing insight and complementing each other's roles.  The Committee noted further that the CQC was neither a commissioner, nor a provider of services.

It was reported that the role of the CQC was to monitor, inspect and regulate all health and social care services in England to ensure that they met fundamental standards of quality and safety within the framework of the Health and Social Care Act 2008.

Deanna Westwood, CQC Inspection Manager, Lincolnshire, provided the Committee with a short presentation, which focussed on the Adult Social Care Re-inspections in East Midlands.  The presentation highlighted the number of ratings which had improved, stayed the same or deteriorated following re-inspection.  Slide two identified that for the 21 re-inspections 5% had deteriorated, 67% had neither improved nor declined; and 29% had improved.  Clarification was given to the Committee that slide two related to re-inspections and that this only applied to the 21 re-inspections in Lincolnshire.

Slide three provided overall ratings with regard to residential nursing homes.  The Committee noted that the ratings in the East Midlands were broadly comparable with England, in that there were some apparent differences at local authority level.  It was reported that overall, Lincolnshire was in line with the average East Midlands level and across England.  For nursing home ratings for the 57 inspections carried out, Lincolnshire had 47% that required improvement; and 53% that were rated as being good.  In relation to residential homes, of the 108 rated, 1 had been found to be inadequate, 28% required improvement; 70% had been rated as good; and 1% had been found to be outstanding.

Some discussion ensued as to what equated a rating of inadequate.  The Committee was advised that at the centre of all the work carried out by CQC inspections was the effect on the person, and whether the person was in a safe environment.  It was noted that when inspectors made an assessment, they used their professional judgement, in conjunction with objective measures and collected evidence, to assess the services they were inspecting against key questions.  The key questions included safety; effectiveness; caring; responsiveness to needs; and leadership qualities.  The Committee was advised further that information relating to how the CQC conducted their inspections was available on the CQC website.

The Committee was given examples of what could potentially make a rating of either outstanding, or inadequate.  It was highlighted that the CQC did not have the powers to bring in new management into an establishment, however, if the risks were found to be significant,  ...  view the full minutes text for item 62.

(To receive a report which captures information on this winter to date from an acute hospital Adult Care perspective)

The Committee gave consideration to a report from Lynne Bucknell, County Manager, Special Projects & Hospital Services, which provided information relating to the winter to date from an acute hospital Adult Care perspective.  It was reported that hospital teams continued to be robust in their work with health colleagues ensuring that the person and their carer were always at the centre of their plans for discharge.

The report presented focussed on the resilience of hospital teams supporting United Lincolnshire Hospitals NHS Trust (ULHT) and Peterborough and Stamford Hospitals NHS Foundation Trust.  The Committee was advised that Adult Care had worked with health colleagues to ensure that there was a robust winter plan in place for the whole system.  Appended to the report at Appendix A was a copy of the Lincolnshire System Resilience Group System Wide Plan 2015/16).  Appendix B provided the Committee with a copy of the Lincolnshire County Council Winter Plan for 2015/16; and Appendix C provided a copy of the Transitional Care Pathway.  

It was highlighted to the Committee that in mid-October 2015 the Emergency Care Improvement Programme (ECIP) had been launched.  It was noted that ULHT was one of the 28 most challenged systems across England being supported by the ECIP Team.  ECIP was a clinically led programme designed to offer intensive practical help and support to urgent and emergency care systems to deliver improvements in quality, safety and patient flow.  It was noted further that ECIP support had remained in place until 31 March 2016.  As part of the ECIP approach to facilitating improvements in Lincolnshire the team had visited specific ULHT sites where they focussed on issues within the acute strategy and finance, staffing, medical leadership, IT systems supporting flow, management, discharge issues and social care and associated community services.

The report highlighted that ECIP had stated "There is a good presence in each of the units, hospital discharge staff seem to be well supported by social care colleagues".  It was also noted that social care staff were well embedded as part of the multi-disciplinary teams.

One thing that ECIP had organised was a "perfect week" to analyse flow within the acute sector, one had been held in February 2016, and a further one had been held at Easter 2016.

Page 16 of the report provided information relating to the Adult Care Hospital Teams.  The Committee was advised that Lincoln County Hospital had 14 staff, Pilgrim had 13 staff, Grantham had 7 and Peterborough had 9 staff in the dedicated teams supporting Lincolnshire residents to safely return home following their hospital stay.  It was highlighted that discharges from other hospitals including Queen Elizabeth Hospital, Kings Lynn, Scunthorpe General Hospital and Diana Princess of Wales Hospital, Grimsby were also supported by the local teams.

It was highlighted that during a nine month period from April 2015 to December 2015, an average of 53 referrals a week had been received across ULHT and Peterborough hospitals teams.  The Pilgrim Hospital, Boston had the  ...  view the full minutes text for item 63.

(To receive a report which provides the Committee with an opportunity to consider its work programme for the forthcoming year)

Consideration was given to a report by Simon Evans, Health Scrutiny Officer, which enabled the Committee to consider its work programme for its forthcoming meetings.

The Committee was asked to consider a request from the Health Scrutiny Committee regarding looking into the issue of delayed transfers of care, and then reporting its findings back to the Health Scrutiny Committee.  The Chairman agreed that this would be considered at the next planned agenda setting meeting.

The Executive Support Councillor for Adults provided the Committee with a brief update on the minutes of the Lincolnshire Safeguarding Scrutiny Sub-Group Meeting from its meeting on 6 January 2016, which would be included in the Committee's next agenda.

RESOLVED

1.    That the work programme as detailed in Appendix A to the report presented be noted.

2.    That the request from the Health Scrutiny Committee concerning delayed transfers of care be considered further at the next pre-agenda meeting.