Agenda and minutes

Venue: Committee Room One, County Offices, Newland, Lincoln LN1 1YL

Contact: Rachel Wilson  Democratic Services Officer

Items
No. Item

9.

Apologies for Absence/Replacement Members

Minutes:

Apologies for absence were received from Councillors Mrs J E Killey, Mrs M J Overton MBE and C L Strange.

 

The Chief Executive reported that having received notice under Regulation 13 of the Local Government (Committees and Political Groups) Regulations 1990, she had appointed Councillor R B Parker as a replacement member of the Committee in place of Councillor Mrs J E Killey for this meeting only.

 

10.

Declarations of Members' Interests

Minutes:

Councillor M A Whittington wished it be noted that his mother was in a residential care home part funded by Lincolnshire County Council.

 

Councillor C E Reid wished it to be noted that in relation to agenda item 5 – Extra Care Housing, that he was a City of Lincoln Councillor and was a member of the Housing Forum.

 

Councillor Mrs C J Lawton also wished it to be noted in relation to agenda item 5 – Extra Care Housing, that housing came under her portfolio as an Executive Cuncillor on South Holland District Council.

11.

Minutes of the meeting held on 22 May 2019 pdf icon PDF 186 KB

Minutes:

RESOLVED

 

            That the minutes of the meeting held on 2 May 2019 be signed by the Chairman as a correct record.

12.

Announcements by the Executive Councillor, Chairman and Lead Officers

Minutes:

It was reported that the authority had received a 'Highly Commended' at the Municipal Journal Awards in the Category of Digital Transformation for the work which had been undertaken to create a Digital Roadmap for Social Care.  This included the implementation of Connect to Support in partnership with the NHS, as a one stop shop for information and advice, the sharing of access to Mosaic across partner organisations, roll out of 4G laptops to all frontline staff and improving the digital maturity of the Council's care providers through access to NHS mail.  The Chairman requested that the Committee's best wishes be passed on to all those involved.

13.

Extra Care Housing pdf icon PDF 128 KB

(To receive a report by Kevin Kendall, Assistant Director County Property, which sets out the business case for the provision of Council funding for an Extra Care Housing development at De Wint Court.  Members are invited to consider and comment on the report prior to consideration by the Executive on 9 July 2019)

Additional documents:

Minutes:

Consideration was given to a report which set out the business case for the provision of Council funding for an Extra Care Housing (ECH) Development at De Wint Court, Lincoln.

 

The report recommended that £2.8m of the £11.886m Adult Care Capital grant was used to enable the De Wint Extra Care Housing scheme to commence development in October 2019.  The proposed De Wint ECH scheme in the City of Lincoln was a partnership between the City of Lincoln Council (CoLC) and the County Council to provide Extra Care Housing for the anticipated demand in the City.  The development would provide a total of 70 units of accommodation for a minimum 30 year period enabling choice for residents and revenue savings by providing an alternative to expensive residential care.  The total cost of the development would be £12m, with the CoLC contributing £6m, Homes England £3.2m and the County Council £2.8m that provides Adult Care with nomination rights on 35 units for 30 years using a process of first right of refusal with no void risk.

 

Members were provided with the opportunity to ask questions to the officers present in relation to the information contained within the report and some of the points raised during discussion included the following:

·         It was highlighted that there were four other probable schemes, but each would have its own business model, and would have different levels of contribution from the Council.  The four schemes under development were for locations in Louth, Horncastle, Spalding and Nettleham.

·         The scheme in Lincoln was not primarily about saving money, but instead about promoting independence and increasing resilience.  However, after 15 years, the council would recover its funding.

·         De Wint Court would be primarily focused on older people and would work across three levels of dependency:- high, medium and low.  The authority would be more interested in nominations for people with high or moderate levels of need who were close to entering residential care.

·         The quality of life for people in extra care housing developments was found to be better than for those living home alone or in residential care.

·         It was queried whether there were any plans to sell any of the units and members were advised that there were two business models for extra care housing - those developers who would sell properties on a complex and then residents would pay a service charge; and those developments where units were available to rent.  It was agreed that those schemes that the Council should invest in would be for those Lincolnshire residents who could not afford to buy their own home.  All the schemes would be on a tenancy basis as it was believed this was the best model for those that the Council was seeking to target.

·         In terms of financial implications, it was queried whether the authority would face increasing costs.  Members were advised that most extra care housing was developed by housing associations.  However, two years ago the Government had set a  ...  view the full minutes text for item 13.

14.

Short Breaks Provision in Lincolnshire pdf icon PDF 118 KB

(To receive a report by Carl Miller, Commercial and Procurement Manager – People Services, which invites the Committee to consider a report on the re-procurement of the Short Breaks and Emergency Placements Service for people with learning disabilities, which is due to be considered by the Executive Councillor for Adult Care, Health and Children's Services between 4 – 5 July 2019)

Additional documents:

Minutes:

A report was received which invited the Committee to consider the re-procurement of the Short-Breaks and Emergency Placements Service for people with Learning Disabilities which was due to be considered by the Executive Councillor for Adult Care, Health and Children's Services between 4 and 5 July 2019.

 

Members were guided through the report and were provided with the opportunity to ask questions to the officers present in relation to the information contained within the report and some of the points raised during discussion included the following:

·         One member commented that they knew what a vital role Cedar House in Spalding played for people who stayed there and for their families.

·         Members were advised that there had been a good level of interest from providers, and it was thought that there would be more providers who would come forward once the contract went out to tender.

·         One member commented that they were fully supportive of this provision continuing, and were reassured by the staffing ratio's proposed.  Gratitude for the work that the officers did was expressed and it was commented that the Council should be proud that they offered this service.

·         In terms of 'Alternatives Considered' it was queried what consideration had been given to examine whether there were benefits to bringing the service in-house.  Members were advised that contracted services were performing well, and so there had been a focus on a continuation of these contracted services.  It was highlighted that one of the responsibilities of the executive director had been to make £40m in savings, and these savings had in part been made by outsourcing.  It was unlikely that the authority would be able to run these services at the same cost as the providers.  If there was any scheme which would be better value to be run in-house, it would be brought to members.

·         Members were advised that there were currently no regulated care services provided in-house.  It was highlighted that for the Council to provide regulated services, there would be a need to review the skills base of the directorate.

·         It was commented that this model did provide the authority with flexibility, and the authority was commissioning services for its own assets.

·         It was suggested that there should be a comparison on costs for providing the service in house.

·         Queries were raised regarding the presentation of the finance information, as members could not determine whether it was value for money.

·         It was clarified that the contract cost of £4,609,925 was the total cost of the contract over 5 years, based on the combined spend for 2018-19 for Cedar House and Swallow Lodge of £921,985.  It was hoped to manage the 1:1 costs by specifying the staffing.  A request was made for a financial schedule for this proposal to be made available, and this be included in future reports to the Committee.

·         It was queried what evidence the providers had given the authority that they had incurred additional expenditure, and members were informed that this would be based  ...  view the full minutes text for item 14.

15.

Section 117 Joint Policy pdf icon PDF 122 KB

(To receive a report by Heston Hassett, Section 117 Specialist Project Manager, which invites the Committee to consider a report on the creation of the Section 117 Joint Policy for Lincolnshire County Council, Lincolnshire Clinical Commissioning Groups and Lincolnshire Partnership Foundation Trust, which is due to be considered by the Executive Councillor for Adult Care, Health and Children's Services between 22 July – 2 August 2019)

Additional documents:

Minutes:

The Committee received a report which invited members to consider the creation of the Section 117 Joint Policy for Lincolnshire County Council (LCC), Lincolnshire Clinical Commissioning Groups (CCGs) and Lincolnshire Partnership Foundation Trust (LPFT), which was due to be considered by the Executive Councillor for Adult Care, Health and Children's Services between 22 July and 2 August 2019.

 

This was a new multi-agency policy replacing the existing arrangements in the three individual organisations.  The policy had been ratified for use by the LPFT's Executive Board and was due to be approved by the CCG's appropriate governance processes in July 2019.  The policy required a decision from the Executive Councillor for its use across LCC for multi-agency working.

 

Members were advised that Section 117 of the Mental Health Act (MHA) 1983 (as amended by the MHA 2007) provided a responsibility on Local Authorities and Clinical Commissioning Groups to provide/commission After-Care Services.  It was noted that LCC, in partnership with the Lincolnshire CCG's had been reviewing their approach to the funding of s.117 cases following negotiation in relation to the s.75 Agreement for Learning Disability Services.  As a result, LCC, Lincolnshire CCG's and Lincolnshire Partnership NHS Foundation Trust had been set an inter-agency requirement to review their s.117 policy provisions.

 

Members were provided with an opportunity to ask questions to the officers present in relation to the information contained within the report and some of the points raised during discussion included the following:

·         It was commented that it was very important that people were supported after leaving hospital treatment.  It was encouraging that this was now more of a collaborative approach.

·         It was queried whether there would be performance monitoring, and members were advised that reviews would take place at 3 months and 12 months.

·         It was highlighted that the report stated that there would be assessments every six or twelve months, and it was queried how long it would take to implement any actions that emerged from the review.  This referred back to the Mental Health Act code of practice and was a way of ensuring that the health care professionals were being proactive.  It was noted that quality audits of case files would take place where it would be looked at how the individual practitioner operated.  It was important that practice was of the highest standard.  Care plans for S.117 were very specific.

·         It was confirmed that this policy had been agreed by all partners, but it still needed to go through the governance procedures.  It was also noted it would be considered by the Children and Young People Scrutiny Committee.  The policy would be considered by the CCGs' executive meeting during the coming week.

·         Work was taking place to create an accessible version which could be accessed by members of the public.

·         One of the alternatives considered was to develop a single agency policy, however this would not have addressed how the relevant bodies, particularly the CCG's and Council worked together to discharge their joint responsibility under s.117 MHS  ...  view the full minutes text for item 15.

16.

Adult Care and Community Wellbeing Performance Report - Quarter 4 2018/19 pdf icon PDF 46 KB

(To receive a report by Katy Thomas, County Manager - Performance & Intelligence (Adult Care and Community Wellbeing), which presents the performance against Council Business Plan targets for the Directorate as at the end of Quarter 4 2018/19)

Additional documents:

Minutes:

Consideration was given to a report which presented the performance against Council Business Plan targets for the Directorate as at the end of Quarter 4 2018/19.  A summary of performance against target for the year was provided in Appendix A of the report and a full analysis of each indicator over the year was provided in Appendix B of the report.

 

Members were guided through the report and those indicators which had not been achieved but were amber were highlighted to the Committee.  It was noted that no indicators were showing as red.  Members were provided with the opportunity to ask questions to the officers present and some of the points raised during discussion included the following:

·         Measure 34 – Chlamydia diagnoses per 100,000 15 – 24 year old – the target population was the 18-25 age range, with the University of Lincoln being a hot spot.  Young people increasingly did not want to go their GP's, and the testing kits available through the post were producing the best results.

·         Measure 63 - % of clients in receipt of long term support who receive a direct payment – it was agreed that this was a high target.  However, current performance suggested that Lincolnshire was in the upper quartile. 

·         There were regular reports on delayed transfers of care, and a national change of definition was due which would mean that there would be an increase in the figures by 5 – 10%.  It was expected that this would affect all councils equally.

·         It was queried whether the University of Lincoln supported students who had received a positive chlamydia diagnosis, for example by offering counselling.  Members were advised that both Bishop Grosseteste University and the University of Lincoln were quite well engaged with this.

·         Measure 31 - % of alcohol users that left drug treatment successfully who do not re-present to treatment within six months – it was queried what performance was like across the county, and members were advised that it was very variable as the service was dealing with people's ability to change their own behaviour.

·         It was reported, as an example, that Doncaster Council had invested heavily in mental health, drugs and alcohol services with a very dedicated and well-resourced service which supported a relatively small number of people.  Individuals would be receiving this service for 4-10 years.  It was noted that this was easier to deliver this service as a unitary council in an urban area.

·         Measure 130 - % of Adult Safeguarding Concerns that lead to a safeguarding enquiry – it was reported that on 27 June 2019 the Overview and Scrutiny Management Board had recorded its concern that this new Council Business Plan measure had replaced the previous indicator 'enquiries where the source of risk is a service provider' and had recommended that both measures should be included in the Council Business Plan and also agreed that these measures should be considered by the Adults and Community Wellbeing Scrutiny Committee, whose advice would be reported to  ...  view the full minutes text for item 16.

17.

Adult Care & Community Wellbeing 2018/19 Final Budget Outturn pdf icon PDF 521 KB

(To receive a report by Emma Farley, Strategic Finance Manager, which sets out the 2018/19 final budget outturn for Adult Care and Community Wellbeing)

Minutes:

Consideration was given to a report which set out the 2018/19 final budget outturn for Adult Care and Community Wellbeing (AC&CW).  The Adult Care outturn was £212.963m, an under-spend of £2.019m (0.94%) against a budget of £214.982m.

 

Officers were congratulated on producing a balanced budget, and it was highlighted that there were many more complex cases than in the past, particularly in relation to discharges.

 

Members were provided with an opportunity to ask questions to the officers present in relation to the information contained within the report and some of the points raised during discussion included the following:

·         In relation to Deprivation of Liberty Safeguards (DoLS), a new model for authorising deprivations of liberty in care was expected going forward as Parliament had passed legislation to replace the current Deprivation of Liberty Safeguards.  It was expected to come into force in October 2020 and would be known as the Liberty Protection Safeguards (LPS).  It was noted that Lincolnshire was one of the few councils who no longer had a backlog of cases, but there would be no additional funding from Government for the changes.

·         It was commented that Government funding for Adult Social Care had dropped since 2010, and it was queried how the directorate would spend extra money if it was available.  Members were advised that a report by the House of Lords Economic Affairs Select Committee had just been published entitled "Social Care Funding: Time to End a National Scandal" which set out the premise that Adult Social Care was substantially under-funded.  If the authority did receive additional funding it would be for the Council to decide how to spend it, however recommendations from the Executive Director would fall into three broad groupings – (1) prevention, in particular those that had a low level of need; (2) increase of the pay rates for care workers, as there were 20,000 care workers in Lincolnshire and they did not always get recognition for the difficult job they did; and (3) increasing the amount of time that staff had to do their jobs, as time was a very expensive commodity in health and social care.

·         It needed to be recognised that Lincolnshire had a relatively stable service, and it did a lot of joint working with the health service, district council and a lot of what the authority did would not be possible without these partnerships.

·         It was confirmed that there was a training provision for carers.  The authority spent around £2.4m on block contracts with Carers First, who were commissioned to support the authorities with different activities.  There was an estimated 80,000 carers in Lincolnshire (including family and friends) and the authority was engaged with about 10,000 of them.  The authority had invested in employment support for carers, as evidence suggested that if carers were supported in work they would be able to continue with their caring responsibilities.

·         In terms of benchmarking, Lincolnshire's overall expenditure was in the lowest quartile for the region.  The commissioning model worked  ...  view the full minutes text for item 17.

18.

Adults and Community Wellbeing Scrutiny Committee Work Programme pdf icon PDF 511 KB

(To receive a report by Simon Evans, Health Scrutiny Officer, which invites the Committee to consider its work programme for the forthcoming year)

Minutes:

The Committee received a report which provided the opportunity to consider the work programme for the coming year and the following was noted:

·         It was proposed to move the reports on Rural and Coastal Communities in Lincolnshire and Integrated Lifestyle Support Service to the 9 October 2019 meeting.

·         It was noted that Councillor C E H Marfleet was unable to attend the next meeting on 4 September 2019, therefore Councillor Mrs E J Sneath would be chairing the meeting.

·         It was highlighted that there was a need to ensure that there was someone from this Committee available to attend meetings of the Overview and Scrutiny Management Board.

 

RESOLVED

 

            That the work programme, subject to the above amendment, be noted.

 

 
 
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