Agenda and minutes

Apologies were received from Councillors Mrs N F Clarke, Mrs M Overton MBE and S R Parkin.

No interests were declared at this point in proceedings.

RESOLVED

1.That the minutes from the previous meeting held on 28 June 2023 be approved as a correct record and signed by the Chairman.

The Chairman informed the Committee that Tony Atkinson, the former Chairman of the Boston Carers Group had passed away. He praised his work in his community, most notably supporting the activities of Day Centres.

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

(To receive a report by Justin Hackney, Assistant Director of Specialist Services, which provides an update on the current position of key areas of work being undertaken with the Lincolnshire Safeguarding Adults Board (LSAB).

Consideration was given to a report from the Independent Chair – Lincolnshire Safeguarding Adult Board and the Head of Safeguarding – Adult Care and Community Wellbeing which provided an update on the current position of key areas of work being undertaken with the Lincolnshire Safeguarding Adults Board (LSAB)

Members received the report and during the discussion the following points were noted:

·   It was reported that ‘neglect and acts of omission’ contributed towards 29% abuse cases; members were informed that this was a broad category and data was analysed to identify themes and patterns of abuse to enable the LSAB to respond accordingly.

·   All ACCW staff received training on the influence of coercive control and the Adult Safeguarding team ensured potential abuse victims were alone when conducting interviews, including via telephone, where necessary.

·   Assurance was provided that practitioners were displaying ‘professional curiosity’ when enquiring about cancelled medical appointments. There was multi-agency ‘Did not attend or was not supported to attend’ guidance in place.

·   As part of ‘Priority 4: Making Safeguarding Personal’, LSAB coordinated meetings with Lincolnshire Police and the East Midlands Ambulance Service to offer guidance on when a Safeguarding Concern should be raised in accordance with Section 42 of the Care Act 2014. The Head of Safeguarding clarified to Members that this collaboration fell under the remit of Priority 4 as it empowered LSAB partners to initiate conversations and responses to safeguarding situations in the correct manner.

·   Alleged perpetrators of abuse were contacted by the Adult Safeguarding team and given the right to respond to the allegations when a safeguarding concern was raised, unless this increased risk.

·   The Significant Incident Review Group was independently chaired and received all Significant Incident Notifications from the LSAB and these would include feedback and recommendations from the coroner if relevant. It was assured the Safeguarding Team and the Coroner’s Office maintained a strong working relationship.

·   Safeguarding processes had become more person-centred and less process-led since the implementation of the Care Act 2014.

·   The steady increase in safeguarding referrals nationally was a positive indication that there was a greater understanding an awareness of safeguarding and that people understood how to raise concerns.

·   A key challenge was working with adults who had capacity and chose to make what may be considered as unwise decisions and remain in situations that placed them at risk. It was noted that it was important for these individuals to retain choice and control and ensure they know how they can access support.

RESOVLED

That the report be noted.

(To receive a report by Justin Hackney, Assistant Director of Specialist Services, which provides an update on the progress in delivering the ambitions outlines in the In-House Day Services plan ‘Living Life to the Full’)

Consideration was given to a report from the Service Manager – Day Services, Innovation & Development, which provided the Committee with an update on the progress in delivering the ambitions outlines in the In-House Day Services plan ‘Living Life to the Full’.

The Service Manager guided the Committee through the report and summarised the strategic direction and priority actions for the development of the service up to 31 March 2024. During consideration of the report, the following points were highlighted:

·       Members were invited to annual event organised by Day Services alongside partners in Skegness on 18-22^nd September 2023. It was noted that Wednesday 20^th September was the most appropriate day for Members to attend.

·       Direct payments were considered empowering for individuals in receipt of them, and it was questioned whether there was a specific job role responsible for signposting to various provisions available to them. The Service Manager agreed direct payments were empowering in collaboration with Day Care services and provision, and ensured individuals in receipt of direct payments were invited into the Service to share potential opportunities with them.

·       Members considered whether there were disused buildings previously used for Day Centres, and whether these could be used for alternative purposes.

·       The Executive Councillor for Adult Care and Public Health was working to ensure a community-based offer was available; these services were popular among those without a disability and provided a positive environment for staff and users alike.

·       Day Services was working with Health colleagues to introduce no smoking sites to promote good health outcomes for users in January. Changes to the location of smoking shelters to render them less accessible had already reduced onsite smoking.

·       Some Members had visited Day Centres and praised the work undertaken there.

·       Day Services were working with Transport Services Group (TSG) to improve capacity. A pilot was successful and opened future opportunities for travel provision to be extended for Day Service users. Additionally, the service was supporting those who could be empowered to eventually travel independently to reduce pressure on the service.

·       The Service was publicising positive case studies and regularly utilising social media, as well as a County News article to showcase positive changes.

·       The attendance figures within the report reflected Service users from Monday to Friday and a significant number of users attended multiple times per week.

·       The drop-in offer responded to the individual needs of service users and not all required to spend a full day at a centre. Drop-in attendance had decreased which indicated the expansion of the service and developing partnership arrangements who hosted other events through District Councils.

·       The Day Service in Grantham had relocated after the pandemic and was unsuccessful in acquiring another site which had left users and staff disappointed. The Service Manager assured that work was underway to identify a suitable site and offered to discuss progress with the local Member.

·       Members questioned whether the payment and financial assessment processes could be streamlined to benefit users; the Service Manager clarified that any change  ...  view the full minutes text for item 26.

(To receive a report by Caroline Jackson, Head of Corporate Performance, which summarises the service level performance for quarter 1 of 2023/24 for the Adult Care and Community Wellbeing directorate)

Consideration was given to a report by the Head of Corporate Performance which summarised the service level performance for quarter 1 of 2023/24 for the Adult Care and Community Wellbeing Directorate, as detailed in the report.

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

·       It was requested that Performance Reports included both figures and percentages moving forward.

PI 60 Permanent admissions to a residential and nursing care home aged 65+

·       The Assistant Director - Adult Frailty and Long-Term Condition assured spare capacity was utilised and that LCC did not incur a cost from vacant beds.

PI 59 Carers supported in the last 12 months

·       This measure did not achieve its target although it was assured this data applied to the previous contract, and the Data Team were working closely with the service to ensure data was up-to-date and accurate.

·       The Service were currently working closely with the Carer Service to introduce new support services and to ensure data referred to the correct cohort.

PI 111 People supported to successfully quit smoking.

·       A 12 week delay in data for this measure was noted to accommodate the completion of service interventions.

·       Support was initiated with a phone call where the appropriate professional to offer support was identified. Resultantly, users were offered one to one bespoke treatment, or group support depending on their preferences.

·       Members welcomed the holistic approach to smoking and alcohol support as those suffering with addiction often had other issues such as poor mental health; it was noted that patients typically had a dedicated psychiatric nurse.

·       The Committee highlighted the potential danger of electronic cigarettes and vapes when supporting people quitting cigarettes. The Assistant Director – Adult Frailty and Long-Term Condition also informed that some people relied on e-cigarettes to eventually become tobacco free.

·       Members and officers expressed concern regarding single use vapes due to their accessibility, especially to young people.

·       There was a referral route to smoking services via inpatient mental health support; this reflected that depression and anxiety sometimes led to smoking and there was a need to tackle the initial issues that lead to dependency.

PI 121 Carers who have received a review of their needs.

·       It was noted that there were 814 carers on the review list last financial year, of which 604 had successfully completed a review in the past 12 months.

·       Reviews could take varying amounts of time depending on the individual and their needs.

·       Regarding payments to both patients and carers, it was noted that Lincolnshire County Council exceeded audit expectations and payments were closely monitored.

·       It was suggested the target for this measure be changed to make it more achievable.

PI 33 Percentage of people aged 40 to 74 offered and received an NHS health check.

·       The Head of Corporate Performance agreed to circulate information regarding the number of adults who experienced health issues following an NHS health check which resulted in the illness not being identified.

·       Information regarding adults who regularly visited their GP  ...  view the full minutes text for item 27.

(To receive a report by Andrea Kingdom, Head of Service – Hospital Social Work Teams, Prison and Brokerage and Afsaneh Sabouri, Assistant Director – Adult Frailty and Long Term Conditions, which provides an update on the Acute Hospitals – Admission to Discharge Care Pathway)

Consideration was given to a report from the Head of Service – Hospital Social Work Teams, Prison and Brokerage, and the Assistant Director – Adult Frailty and Long Term Conditions, which provided an update on the Acute Hospitals – Admission to Discharge Care Pathway.

The Committee was guided through the report, and during the discussion the following points were highlighted:

·   The Executive Councillor for Adult Care and Public Health praised the Hospital Discharge Reablement Service, which was leading nationally.

·   The Head of Service agreed to a Committee site visit to a Care Transfer Hub.

·   Members were informed that discharge planning began as soon as the patient was physically able, and it was unlikely that the process could be streamlined any further.

·   In collaboration with EMAS, a group had been established to monitor delays of patients waiting for transport home following discharge.

·   Initially, 80 active recovery beds (ARBs) were available before the pre-procurement process; there were now 40 ARBs available, and 60 expected as of 1 January 2024.

·        Members were informed that virtual wards involved an assessment to determine whether patient needs could be supported at home. It was assured that patients were contacted by video call and a home visit occurred if there were any concerns for their wellbeing. Access to ARBs was dependent on the preference of the individual or input from the family. It was assured that the geographical placement of Care Homes across Lincolnshire enabled patients to recover as close as possible to their home. Alternatively, the benefits of ARBs were explained thoroughly, meaning that often patients and families were willing to travel if needed.

·       Members congratulated the Service.

RESOLVED

1.That the progress made by the County Council in supporting hospital discharge be noted.

2.That the Committee supports the plans for the winter 2023/24.

(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 from the Health Scrutiny Officer, which invited the Committee to consider it’s work programme.

The Committee was informed that there would be an item scheduled for the meeting due to be held on 18 October 2023 to consider potential subject matters for a Scrutiny Review.

RESOLVED

        That the Committee’s forward work programme, as set out in the report, be noted.