Agenda and minutes

Apologies for absence were received from Councillor A M Key, S R Parkin and T V Young.

There were no declarations of interest.

RESOLVED:

          That the minutes of the meeting held on 7 September 2022 be        approved as a correct record and signed by the Chairman.

RESOLVED:

          That the minutes of the meeting held on 28 September 2022 be a     approved as a correct record and signed by the Chairman.

There were no announcements made by the Chairman, Executive Councillor or Lead Officers.

(To receive a report by Cat Eglinton, Inspection Manager – Care Quality Commission, which provides the Committee with an update on local and national Care Quality Commission (CQC) operations and strategic direction)

Consideration was given to a report by the Inspection Manager – Care Quality Commission, (CQC), which provided the Committee with an update on local and national Care Quality Commission (CQC) operations and strategic direction, including the current inspection and regulation methodology; an update on inspections in Lincolnshire and an update on the state of care report, which was due to be published on 21 October 2022.

The Committee was advised of the future direction of the Care Quality Commission with the introduction of a new strategy which aimed to ensure health and care services provide people with safe, effective, compassionate, high-quality care and to encourage those services to improve.

Consideration was given to the report and during the discussion the following points were noted:

·       The importance of sharing examples of best practice was emphasised. Where possible, the CQC would proactively share information about outstanding services, and it was hoped that this would continue on a regional and national level as the organisation moved to a more dynamic model.

·       Historically, intelligence held about individual services had been held by individual inspectors.  The introduction of more advanced data intelligence service which incorporated data sources to effectively highlight areas of risk had been significant in improving intelligence and highlighting areas of concern. Individual inspectors used their judgment and professional expertise to monitor the risks highlighted by the data sources.

·       Like many other care organisations, the CQC had also faced challenges in recruitment and were continuing to recruit to temporary posts prior to a proposed change in structure as part of the introduction of the new strategy.  A large number of bank inspectors provided additional capacity to fulfil regulatory duties.

·       Clarification was provided that all care organisations that provided both accommodation and personal care were required to be registered with the CQC.

·       Assurance was provided that once recruitment had been undertaken within the CQC, there would be sufficient resource within teams to implement the changes proposed in the new strategy.

·       The Inspection Manager agreed to provide information on any additional investment into CQC to take on new powers of inspecting local authority adult care functions and integrated care boards. A response would be circulated to the Committee/further detail.

·       The severe impact on homes which did not have a registered manager was highlighted. Registered care homes had a legal responsibility to the Commission to register a manager to the home and enforcement action could be taken against services who failed to do so. Members were reassured that CQC had identified the most at-risk services within Lincolnshire that did not have a registered manager and continued to monitor those services to manage risk within those services.

·       It was expected that registered managers would have completed their level 5 management qualification. Further details on how the qualification was obtained and would be provided to the Committee.

·       Registering as a manager with the CQC was a thorough process to ensure candidates were appropriate.

·       All adult social care inspections were unannounced. Inspections of auxiliary services received 12 to 24  ...  view the full minutes text for item 37.

(To receive a report by Pam Clipson, Head of Finance – Adult Social Care and Wellbeing, which invites the Committee to consider the budget for the Adult Care and Community Wellbeing directorate)

Consideration was given to a report by the Head of Finance – Adult Social Care and Wellbeing which invited the Committee to consider the budget for the Adult Care and Community Wellbeing directorate. The report highlighted the key drivers and risks within the budget which included interim bed usage, community safety equipment, the value of the better care fund and the Homes for Ukraine scheme.

The Committee noted that the Adult Care and Community Wellbeing directorate was forecasting financial balance within 2022-23 which would include the drawdown of non-recurrent reserves. The Medium-Term Financial Plan was forecasting increased pressures of approx. £11m per year from 2023-24 which was driven by the forecast increase in national living wage and growth in demand across working age adult services.

Consideration was given to the report and during the discussion the following points were noted:

·     Officers highlighted the use of reserves as an important element of budget management.

·     Decisions on the budgets for local authorities by the Chancellor of the Exchequer would be material for the wider council and health care services given the current pressures and limitation on resources that look to worsen.

·     The Adult Care and Community Wellbeing directorate were working to establish several options to meet budgetary pressures. Announcements by the Government would give a clearer picture of future budgetary pressures and expectations.

·     Some suggestions from the Committee to address budgetary pressures within the directorate included raising the threshold for care to only give support in the most serious cases; asking relatives to help with care and reconsidering the affordability of large capital expenditure.

·     It was clarified that the care act required support to be offered to those in a substantial or critical need.

·     The Committee welcomed the continued investment in preventative services within adult care.

·     The importance of providing wellbeing services was highlighted.

·     The benefits of utilising community support were emphasised. Community services were seen as essential in stimulating communities to come together collectively such as in the winter warm room initiative that had been implemented in Uphill Lincoln.

·     It was hoped that the directorate could decrease the level of debt due to be paid to the Council to around £6-7m per year.

·     Integrated working between the Council and Integrated Care Board sought identify options for transitional beds using pooled budgets.

·     A rise in the use of interim beds had created a budget pressure. The reablement service was getting people out of hospital on time however ward closures at Lincoln County Hospital would generate further pressures.

·     District Councils had begun to work together with the voluntary sector to identify possible programmes of support to communities facing cost pressures.

RESOLVED:

        That the report be noted.

Consideration was given to a report by the Health Scrutiny Officer which invited the Committee to consider its work programme, as set out on pages 30 – 31 of the agenda pack.

The following items had been identified for inclusion on the work programme:

• Acute care flow through hospitals
• Better Care Fund

Following a proposal from the Health Scrutiny Officer Councillors Mrs N F Clarke, K E Lee and Mrs M J Overton MBE volunteered to participate in a joint working group on Obesity alongside members of the Children and Young People Scrutiny Committee.

The Chairman advised that he had attended the Executive on the 4^th October 2022 to present the Committee’s comments on the Extension of the Substance Misuse Treatment Services Contract;  the Extension of the Lincolnshire Integrated Sexual Health Services Contract and Market Sustainability, Fair Cost of Care. Further to comments raised by the Board, the Chairman also raised concerns around accessibility for sexual health services, in particular the potential for a loss of confidentiality in needing to travel out of local areas to access services.

The Chairman requested that the Committee be briefed on the Specialist Adults Accommodation at Grange Farm and the Langrick Road, Boston – Extra Care Housing and Working Aged Adults accommodation reports prior to the considering the final pre-decision reports on in February 2023.

RESOLVED:

          That the report be noted.