Agenda and minutes

Apologies for absence were received from T A Carter and R J Kendrick.

It was reported that, under Regulation 13 of the Local Government (Committee and Political Groups) Regulations 1990, Councillor N Sear be appointed as a substitute for Councillor R J Kendrick for this meeting only.

None were declared.

RESOLVED:

           That the minutes of the meeting held on 5 April 2023 be approved as a       correct record and signed by the Chairman.

The Executive Director for Adult Care and Community Wellbeing advised that from 1 April 2023 the CQC had a new duty to assess local authorities. As part of a pilot scheme, Lincolnshire County Council would be the first Council to be visited by the CQC assurance team as part of a pilot phase in July 2023 and would be given an indicative rating. Formal assessments would begin in October.

The Chairman credited the Executive Director for Adult Care and Community Wellbeing and the directorate for volunteering for the pilot scheme which was reassuring and showed confidence in its work.

(To receive a report by Afsaneh Sabouri, Assistant Director of Adult Frailty and Long Term Conditions and Alina Hackney, Head of Commercial Services, which invites the Committee to consider a report on the Procurement of Active Recovery Beds 2023-24 which is due for a decision by the Executive on the 6 June 2023. The views of the Committee will be reported to the Executive as part of its consideration of this item)

Consideration was given to a report by the Assistant Director – Adult Frailty and Long Term Conditions, which invited the Committee to consider a report on the procurement of active recovery beds for 2023/24, which is due for a decision by the Executive on 6 June 2023, as set out at appendix A to the report.

The Committee supported the recommendations to the Executive and during the discussion the following points were recorded:

• The Committee welcomed the scheme and emphasised the benefits of the scheme within the care sector.
• The Committee was reassured that an average occupancy rate of 80% for active recovery beds was a good level of usage.  There was an aim for a slightly higher level of occupancy, whilst at the same time providing the health and care system with the capacity to manage any surges in demand across the whole county.  Furthermore, there was flexibility to increase the number of beds during periods of higher demand.
• The Committee emphasised year-round pressures for the Health Service, not just during winter months.
• The Committee highlighted the benefits of active recovery beds, which could be presented in simple terms as a comparison between the daily cost to the health and care system of an acute hospital bed, at around £465 per night, and the daily cost of an active recovery bed, at approximately £150 per night. 
• Some concerns were raised around the purchasing of block beds and it leading to the Council paying for beds that they did not need. Assurance was provided that the cost pressures had been mitigated by the agreed price per bed and the funding for active recovery beds continued to be from a ring-fenced government grant, dedicated to supporting hospital discharge, which had been successfully applied for its intended use. Unlike some other integrated care systems, where much lower levels of the grant had been used. 
• The Committee stressed the importance of the government committing to permanent funding, so that the service could continue as part of the core offer. 

RESOLVED

1.      That the recommendations to the Executive, as set out in the report, be supported;

2.      That a summary of the comments made be passed on to the Executive as part of its consideration of this item.

(To receive a report by Theo Jarratt, Head of Quality and Information – Adult Care and Community Wellbeing, which provides an update on how digital initiatives are supporting services in Adult Care and Community Wellbeing)

Consideration was given to a presentation by the Director for Public Health and the Head of Quality and Information – Adult Care and Community Wellbeing, which provided an update on how digital initiatives were supporting services in Adult Care and Community Wellbeing, as set out at within the report 

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

• Assurance was provided that the providers of digital care record systems were required to use one of nine nationally approved digitalised systems to ensure that data systems were compatible with each other. 
• The Committee highlighted the cost benefits of moving towards a digital programme which would provide more money for frontline services.
• Officers emphasised that the digital initiatives were part of a pilot scheme and would give further indication to the direction of future digital initiatives.
• The services had successfully recruited to two permanent posts to progress the care and wellbeing digital agenda, and the adverts for the temporary roles would be published imminently.
• The Committee emphasised a need to ensure continued to support to those with little access to technology, some of which would be supported by relatives to access services online.
• It was hoped that the proposed digital initiatives would lead to better outcomes for people receiving Adult Social Care. It was emphasised that the initiatives developed were seen as a pilot to allow the service to better understand and develop the digital programme in order to better support families and develop resilience within communities.
• The Committee requested that an update on the progress of the scheme be reported to the Committee in the summer of 2023 or sooner, if common themes emerged prior to that.
• Assurance was provided that audit systems were in place to help fraud prevention and to ensure that people were spending in line with their need for care. It was highlighted that the move to direct payments and people commissioning their own care had led to people spending less for their care.

RESOLVED:

              That the report be noted.

(To receive a presentation by Glen Garrod, Executive Director – Adult Care and Community Wellbeing, which invites the Committee to consider the information presented on the Next Steps to Put People at the Heart of Care – A Plan for Adult Social Care System Reform 2023 to and 2024 to 2025)

Consideration was given to a presentation by the Executive Director – Adult Community Wellbeing, which provided an overview of the Next Steps to Put People at the Heart of Care – A Plan for Adult Social Care System Reform 2023 to 2024 and 2024 to 2025.

Consideration was given to the update and during the discussion the following points were recorded:

• It was thought that reference to better support for unpaid carers within the paper referred to increased respite breaks and improvements in information and advice provided to carers to increasingly build resilience. It was estimated that around 1 in 8 people employed by the Council were unpaid carers and there was an economic argument for supporting carers, including improvements in workforce supply.
• To date there were two confirmed funding source which formed part of the Better Care Fund for 2023/24 – the Disabled Facilities Grant and the Market Sustainability Funding.
• Proposed innovation improvement projects for Lincolnshire County Council included delegation of tasks from health workers to social care workers; new approaches to the use of digital technology and housing and investment in international recruitment, all of which were already in development and allocated within the current budget.
• The Committee recognised the importance of highlighting career opportunities and career pathways. 
• Members emphasised the value of international workers within the health and social care profession.
• The Committee raised concerns over the financial burden of adult social care reforms, if introduced.

RESOLVED:

              That the report be noted.

(To receive a presentation from Glen Garrod, Executive Director – Adult Care and Community Wellbeing, which provides an overview of The Hewitt Review – An Independent Review of Integrated Care Systems)

Consideration was given to a presentation by the Executive Director – Adult Community Wellbeing, which provided an overview of the Hewitt Review – An Independent Review of Integrated Care Systems.

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

• In relation to the recommendation that NHS England and the Department and Health and Social Care should convene a national partnership group to develop together a new framework for GP Primary Care contracts, Members noted that an increasing number of GP’s were salaried, a number remained partners of practices on a profit share basis. The potential for the ability of local systems to influence the behaviour of GP’s was highlighted, and the potential benefits of population health management due to a better understanding of community need and targeting behaviour accordingly.
• It was clarified that reference to budgetary cuts to the Running Cost Allowance for 2025-26 was likely to be in reference to proposals that NHS Integrated Care Boards were expected to make savings against NHS continuing healthcare budgets, despite the fact that demand for NHS continuing healthcare was growing as a result of population and medical changes.

RESOLVED:

              That the report be noted.

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

Consideration was given to a report by the Health Scrutiny Officer for Lincolnshire, which invited the Committee to consider its work programme.

An report detailing the outcomes of the Care Quality Commission Assurance Pilot would be added to the work programme for the meeting scheduled for 6 September 2023. 

The Committee emphasised the importance of reducing the number of reports considered at each meeting to ensure that each item was given adequate consideration.

RESOLVED:

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

In accordance with Section 100 (A)(4) of the Local Government Act 1972, the following agenda item has not been circulated to the press and public on the grounds that it is considered to contain exempt information as defined in paragraph 3 of Part 1 of Schedule 12 A of the Local Government Act 1972, as amended. The press and public may be excluded from the meeting for the consideration of this item of business.

RESOLVED:

That In accordance with Section 100 (A)(4) of the Local Government Act 1972, the press and public be excluded from the meeting for the consideration of this item of business as it was considered to contain exempt information as defined in paragraph 3 of Part 1 of Schedule 12 A of the Local Government Act 1972, as amended.

(To receive an exempt report by Dave Pennington - Head of Development (Corporate Property), which invites the Committee to consider a report on the Refurbishment of Ancaster Day Centre which is due for decision by the Leader of the Council (Executive Councillor – Resources, Communications and Commissioning), between 5 – 9 June 2023. The views of the Committee will be reported to the Leader of the Council as part of his consideration of this item)

Consideration was given to an exempt report which invited the Committee to consider a report on the Refurbishment of Ancaster Day Centre.

RESOLVED:

              That the recommendations, as set out in the exempt report, be         supported.