Agenda and minutes

Apologies for absence were received by Councillor R J Kendrick and Councillor M A Whittington. 

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 M A Whittington and Councillor P A Skinner be appointed as a substitute for R J Kendrick  for this meeting only.

None were declared.

RESOLVED:

              That the minutes of the meeting held on 24 May 2023 be approved          as a correct record and signed by the Chairman.

The Chairman had recently visited three local Adult Day Care Centres in Boston, Sleaford and Stamford and commended the staff involved and their dedication which was evident through the happiness of the service users.

The Chairman observed that if Day Centres, had their own  minibuses, it would enable the service users to attend for full day sessions and asked if there was a means of undertaking simple repairs to the facilities at low cost. The Executive Support Councillor Adult Care and Community wellbeing thanked the Chairman for his feedback and would pass it on.

The Vice-Chairman had also attended the Boston Day Centre and commended and the enthusiasm of the staff, the inspiring manager, and the amazing projects undertaken by the service users.

(To receive a report by Richard Proctor, Independent Chair, Lincolnshire Safeguarding Adults Board, Linda MacDonnell, Head of Safeguarding, Adult Care and Community Wellbeing which invites the Committee to consider the prevention strategy of Lincolnshire Safeguarding Adults Board)

Consideration was given to a report by the Independent Chair – Lincolnshire Safeguarding Adults Board and the Head of Safeguarding – Adult Care and Community Wellbeing which invited the Committee to consider the prevention strategy of Lincolnshire Safeguarding Adults Board (LSAB), as set out in the report.

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

• The six safeguarding principles were at the core of all work by the LSAB and were widely known and promoted with partners and were taken from the Care Act 2014.
• Anyone at immediate risk of a safeguarding concern would be directed to call 999 for an urgent response.
• The Committee raised concerns over the large number of Serious Clinical Incidents relating to pressure ulcers, which had been ongoing for many years. Assurance was provided that all providers should undertake training on how to prevent pressure sores and incidents were measured through performance monitoring. Health and Social Care partners universally recognised the risk of pressure sores and were engaging in preventative action. The LSAB acknowledged the concerns raised and would ensure that they liaised with the Lincolnshire Safeguarding Children Board, who were undertaking the same preventative measures for pressure sores.
• The routes into safeguarding were well known by local organisations and assurance was provided that LSAB would continue to communicate with local banks to raise awareness of possible financial safeguarding incidents and how to report them.
• Concerns were raised that approximately 37% of all adult safeguarding enquiries related to residential care, nursing care or hospital settings.  However, many of these enquiries did not lead to a s.42 enquiry. 
• In relation to the key prevention focus for Continuous Improvement in the Quality and Safety of Residential, Nursing and Hospital Care and the aim to encourage safer recruitment initiatives across the Integrated Care System workforce leads, it was recognised that the LSAB could only encourage safer recruitment initiatives, as recruitment was not directly the LSAB’s responsibility, but was the responsibility of each  partner.
• The Committee were assured that making safeguarding personal was a core value of the Board and a key influence in all decisions.
• The Committee emphasised the difficulties of providing support to victims of abuse who were not willing to accept support.
• It was suggested that difficulties accessing GP services were a barrier to addressing some safeguarding concerns.
• Although the importance of making safeguarding person was important, it was suggested that this should not be at the expense of looking at the wider situation.
• The prevalence of suicide risk, particularly by males under 40 was highlighted as an issue for consideration in future. The Chairman felt it was important to ensure that suicide risk was considered when implementing safeguarding procedures.

RESOLVED:

That the report be noted.

(To receive a report by Carl Miller, Commercial and Procurement Manager, which invites the Committee to consider the proposals for the re-procurement of the substance misuse treatment service which is due to be made by the Executive on 4 July 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 Consultant in Public Health, and the Commercial and Procurement Manager, which invited the Committee to consider the proposals to the Executive on the Substance Misuse Services Re-Commissioning, as set out in the report to the Executive at Appendix A.

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

• The Committee were advised that the number of dependent alcohol users in Lincolnshire is estimated at 7,000 and the number of crack cocaine and opiate users was at 4,000. It was felt that these estimates were likely an understatement of the level of need and that the service was only be able to ‘scratch the surface’ in terms of tackling needs. However, the existing constraints on expenditure were acknowledged.

·       Assurance was provided that the figure of £60,000 of public health grant for the substance misuse family support service did not represent the expected level of expenditure on this service. 

·       The committee were concerned that signposting to services was not clear within communities and emphasised a need for professionals and communities needing to be aware of the services offered and signposting to be clear. This included digital routes into the service and the facility of self-referral. Challenges surrounding the stigma of accessing support were acknowledged and assurance was provided that the new service would focus on a visible and accessible branding and marketing strategy.  Clear and simple pathways (including self-referral) into the service would be key.

·       It was estimated that £1 of expenditure on treatment services equated to £4 of savings from reduced demand on other services. The Government is developing ways to capture the range of benefits from investment in substance misuse services as part of the national strategy, which when available Lincolnshire would follow.  Irrespective of these figures, the Committee concluded that service represented a direct investment in the wellbeing of people and communities.

·       The Committee welcomed the development and implementation of the key performance indicators, as outlined in paragraph 9.5 of the report which was hoped would provide a high level overview of the service. 

·       The Committee were advised that there was a residential rehabilitation unit operated in Scarborough which worked well and provided good results. The Committee suggested that a rehabilitation service within Lincolnshire would be beneficial.

·       Despite challenges with recruitment across the sector, the service had been successful in obtaining supplemental grant funding for specialist staffing posts and had been successful recruiting to a number of those posts. The focus was now on building the expertise and training of those staff over the coming months. There were clear expectations on staffing set out within the terms of the contract.

·       The service provided to individuals wasdependent on their circumstances and always needs led.

·       The Committee acknowledged that the needs of the population for North and North East Lincolnshire were different to that of Lincolnshire County Council, and it had therefore been decided to reprocure contracts separately.

·       It was agreed that a broader approach  ...  view the full minutes text for item 17.

(To consider a report by Pam Clipson, Head of Finance, Adult Care and Community Wellbeing, which invites the Committee to consider the budget outturn for the Adult Care and Community Wellbeing Directorate for 2022/23)

Consideration was given to a report by the Head of Finance, Adult Care and Community Wellbeing, which invited the Committee to consider the Adult Care and Community Wellbeing Financial Position 2022-23, as set out in the report.

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

• The Committee welcomed the 298 additional care workers employed under the better care fund. In response to a question raised, Officers agreed to liaise with care providers on the possibility of recruiting college students to home care roles.
• The Committee welcomed the report and commended officers for their good financial management, however, the Committee were concerned that there was a level of unmet need within communities which was not being addressed. A need for more preventative measures and support to reinvigorate community resources lost through covid was emphasised. 
• Members were assured that the work of the directorate was not purely financially driven and support would be made available to those in need, in line with statutory requirements.
• Councillor K E Lee wished it to be recorded that she supported the comments made in relation to unmet need and highlighted the lack of free support due to the impact of staffing reductions in the Citizens’ Advice service and lack of health care appointments and provision.
• Overall, the finances for the service were roughly that of other localities, although there was a slightly higher number of people in residential care. The Council continued to invest in extra care housing to manage this.
• In relation to the Public Health and Community Wellbeing underspend of £1.418m it was suggested that closer working with District Councils to support with health checks in order to utilise the funds could be beneficial.

RESOLVED:

              That the report be noted.

(To receive a report by Caroline Jackson, Head of Corporate Performance, which invites the Committee to consider the Quarter 4 performance data for the Adult Care and Community Wellbeing Directorate for 2022-23)

Consideration was given to a report by the Head of Corporate Performance, which invited the Committee to consider the Service Level Performance Reporting Against the Success Framework for Quarter 4 of 2022-23, as detailed in the report.

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

• PI 60 – Permanent admissions to residential and nursing care homes aged 65+ - Despite a reduction in admissions, many residential care places had been at a higher cost than previously anticipated due to an increase in more complex cases. 
• PI 116 – Concluded safeguarding enquiries where the desired outcomes were achieved – a change in the wording to include the addition of ‘of those who were asked their outcomes’. This would ensure that the data presenting was not misleading.
• PI 123 – People that report that services help them have control over their daily life – the national average was 76%. The 80% target was set as being an achievable target above the national average.
• PI 31 – Percentage of alcohol users that left specialist treatment successfully – in relation to the low target, it was explained that given the challenges expected and the fact that the complexity of clients were increasing and the support provided to lower level needs, the target was the minimum that would be expected. The importance of showing performance in numbers and percentages was acknowledged and reassurance was provided that both numbers and percentages would be monitored. 

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, which invited the Committee to consider its work programme.

The Committee was advised that there were no changes to the work programme set out in the report.

RESOLVED:

              That the work programme be noted.