Agenda and minutes

Apologies for absence were received from Councillor H N J Powell and Councillor C R Oxby (Executive Support Councillor for Adult Care and Health Services).

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 Mrs M J Overton MBE 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 Adult Scrutiny Committee meeting held on 6 April 2016 be confirmed and signed by the Chairman as a correct record.

The Chairman made the following announcements:-

i)          Budget Outturn 2015/16

Work was underway on the closing down of the accounts for 2015/16 which was the first year of using the Agresso system and every effort was being made to complete the various processes required to close the accounts.  This item had originally been scheduled at this meeting of the Committee, and it would now be considered on 29 June 2016.

ii)         Better Care Fund

A report was considered at the full meeting of the County Council on 20 May 2016 in regard to a decision taken on 26 April 2016 under the "Rule 17 Urgency Procedure" which finalised the submission of the Better Care Fund (BCF).  Further updates on the progress of the BCF would be submitted to the Committee.

iii)       Visits to Day Centres

The Committee had requested that visits to day centres be arranged and consideration was being given to two visits during late June or July 2016.  It was proposed that the first visit be held at the Warwick Road Centre (Louth), Virginia House (Louth) and The Wong (Horncastle).  The second visit would be to Scott House (Boston) and Ancaster Day Centre (Lincoln).  The maximum number permitted to visit was four and dates would be offered to members on a first-come-first-served basis.  The Committee were encouraged to attend even if the centres were not in their own divisions.

(To receive a report and presentation from Matt Jackson, Regional Director, East and South East England Allied Health Care, which will provide the Committee with an update on the Lincolnshire Assessment and Reablement Service)

Consideration was given to a report and presentation from the Regional Director of Allied Health (East and South East England) which provided the Committee with an update on the Lincolnshire Assessment and Reablement Service.  During the first six months delivery of the contract, by Allied Health Care, the service had seen a 60% improvement on capacity, delivering over 1900 face to face reablement contact hours per week. 

The Assistant Director (Frail, Elderly and Long Term Conditions) advised the Committee that a short report had been circulated with the agenda pack on the current position within the Lincolnshire Assessment and Reablement Service and introduced Matt Jackson, Regional Director of Allied Health Care (East and South East England).

Mr Jackson gave a presentation to the Committee which provided some background information on Allied Health Care and also the four main components of the service provided within Lincolnshire.

Allied Health Care was the largest provider of social care in the UK and operated from 100 branches providing care and support to over 30,000 people on a daily basis.  A team of 13,500 staff were employed throughout the UK, 139 of which were Lincolnshire based.

The four main components of the service provided by Allied Health Care were provided below:-

·       Capacity/Workforce Planning, Pathway Management and Optimising Acute and Community Demand;

·       A safe, effective and personalised service:  Virtual Care Rounds;

·       Outcomes focused care reablement supporting "whole person" (and family) care; and

·       Quality reporting to support service development.

During discussion, the following points were noted:-

·       Clarification was provided that the cost of the contract was approximately £4 million and that all work, including the increased capacity, was undertaken within that budget, £2 million of which was allocated from the Better Care Fund (BCF);

·       Although Allied Health Care was the only provider of this contract, it was confirmed that where people could benefit from care provided by Lincolnshire Partnership NHS Foundation Trust (LPFT) or Lincolnshire Community Health Services (LCHS), one care plan would be developed;

·       The position of community facilitators had been included within the tender for the contract and was included within the allocated budget.  There were currently 16 community facilitators who came from a range of backgrounds, including domiciliary care.  It was explained that the aim of reablement workers was to give people the opportunity to regain their independence which did not necessarily suggest that care workers were automatically appropriate for these roles;

·       Although there were acute facilitators located in Lincoln and Boston, Grantham was also included once each week.  The volume of the flow had been prioritised and work was ongoing with the community hospitals;

·       In bidding for the contract, Allied Health Care thought that they had been proactive, retrospective and reactive, taking the view that holding a consultation with staff in the period leading up to Christmas could have destabilised the care provided.  It was thought that learning more about the service and ascertaining areas of higher demand would ensure that workforce planning could be better targeted;

·       The Committee was encouraged to provide  ...  view the full minutes text for item 5.

(To receive a joint report from Emma Scarth, County Manager, Performance and Development and Jane Mason, County Manager Carer, which will advise the Committee of the processes and context of personal budgets)

Consideration was given to a joint report of the County Manager (Performance and Development) and the County Manager (Carers) which advised the Committee of the processes and context of personal budgets.

Emma Scarth, County Manager (Performance and Development) gave an overview of the report and introduced Mrs Mel Smeeton (Carer), Jane Mason (County Manager (Carers)) and Kimleigh Wolters (Service Manager, Penderels Trust) who were in attendance from the different areas working to support access to Personal Budgets.

Mrs Smeeton gave a PowerPoint presentation, entitled "Coproduction Matters", which included the following:-

·       Pat's Journey – Mrs Smeeton's mother was diagnosed with vascular dementia in 2011; the family were determined to keep mum at home, providing part-time care initially (September 2014) and full-time, live-in care from May 2015;

·       What's important to us – wanting to keep mum at the heart of the family; care package to meet changing need; familiar surroundings, people and continuity of care; no hospital admission and regular GP checks; and planning for the future;

·       Mel's Journey – Mrs Smeeton joined local peer network and attended Integrated Personal Commissioning conference in January; member of Strategic Coproduction Group (April 2016); link between local peer support, LG, CDGs and Board, strengthening the voice of people with lived experience; and coproduction was integral in shaping future decisions;

·       Why Coproduction? – to act as a "conduit" transmitting information to ensure cohesion between all groups; ensure choice was not limited by lack of knowledge; and standardising the language nationally;

·       Summary – evolving care needs; quality of life and the benefits; opportunity to influence; and empowerment through knowledge and a common language.

It was explained that Penderels Trust provided the following support:-

·       Personal assistant recruitment;

·       Guidance on all aspects of being a good employer including legal obligations and responsibilities;

·       Assistance with choosing and using a care agency;

·       Help with money management and keeping accurate records;

·       Managing 'managed accounts'; and

·       Assistance in arranging day services.

The Chairman invited Mr Iggy Patel, a service user who managed his own personal budget, to address the Committee.  The main points made by Mr Patel included:-

·       Mr Patel managed own personal budget and employed five carers, which increased to seven during the summer months;

·       Mr Patel indicated that services were available regarding direct payments but these services not available for a a service user who managed his own direct payment;

·       Five years of experience as a direct payment user and Mr Patel had undergone four assessments during that time.  Each time he had been referred to the Penderels Trust despite choosing to manage the direct payment himself;

·       Mr Patel advised the Committee that the process of employing staff using a direct payment was not difficult and stated that there were no processes in place or manual available to provide a clear explanation to support individuals who chose to manage their own personal budget;

·       Mr Patel stated that a manual had been devised by Lincolnshire Independent Living and presented to Adult Social Care but this had not been utilised.

The Chairman  ...  view the full minutes text for item 6.

(To receive a demonstration from Jasmine Sodhi, Performance and Equalities Manager, which will advise the Committee on how to access the new Performance Infographics on the Lincolnshire Research Observatory website; and 

To receive a report from Emma Scarth, County Manager, Performance and Quality Development, which will provide the Committee with an update on the Adult Care – Quarter 4 and Full Year Performance Information)

Consideration was given to a report from Glen Garrod, Executive Director Adult Social Services, which provided an update on the Adult Care – Quarter 4 and Full Year Performance Information.

Emma Scarth, County Manager – Performance and Development, introduced the report and suggested that a more formal report may be presented in the future on customer satisfaction levels of service users.

During discussion, the following points were noted:-

·       A table listing the strategies to include a brief statement and how many service users for each area was suggested.  However, it was explained that not all areas had a written strategy and that a flow diagram was available for customers in those instances;

·       It was considered that the satisfaction survey had resulted in a good outcome as the figure of 80% included only "extremely satisfied" and "very satisfied" answers.  The Committee was advised that if the option of "quite satisfied" had also been included in the overall satisfaction result then this would have taken the figure to 95%.  This indicator was nationally prescribed and there was no ability to change the questions.  It was agreed that a detailed report on the survey be presented to the Committee to enable a broader picture to be discussed;

·       Delayed Transfers of Care (DTOC) figures were higher than during the same quarter last year which had been an exceptional situation across both health and social care.  It was expected that this would improve during Quarter 1;

RESOLVED

          That the report and comments be noted.

(To receive a report from Catherine Wilman, Democratic Services Officer, which enables the Committee to have an overview of the activities of the Lincolnshire Safeguarding Boards Scrutiny Sub-Group.  Minutes from the 6 January 2016, and draft minutes from 6 April 2016 are attached)

Consideration was given to a report from Catherine Wilman, Democratic Services Officer which gave the Committee an overview of the activities of the Lincolnshire Safeguarding Boards Scrutiny Sub-Group and, in particular, the Sub-Group's consideration of adult safeguarding matters.

RESOLVED

          That the draft minutes of the meetings of the Lincolnshire Safeguarding Boards Scrutiny Sub-Group held on 6 January 2016 and 6 April 2016 be noted.

(To receive a report from Simon Evans, Health Scrutiny Officer, 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 forthcoming meetings.

The Committee was advised that the Health Scrutiny Committee for Lincolnshire had reiterated its request that the Adults Scrutiny Committee give detailed consideration to Delayed Transfers of Care (DTOC).  Although the Committee was advised that the progress with Delayed Transfers of Care would be included as part of the quarterly performance report, the Committee's preference was that this item should be considered as a single detailed item.

It was agreed that an item would be added to the work programme on Delayed Transfers of Care and the Chairman agreed to discuss this further with the Director of Adult Social Care on how this would be considered by the Committee.

RESOLVED

1.    That the Work Programme, as detailed in Appendix A to the report, be noted; and

2.    That following the request made by the Health Scrutiny Committee for Lincolnshire an item on Delayed Transfers of Care be added to the Committee's work programme, which would be considered in addition to the reporting of performance in the quarterly reports.