Agenda and minutes

Apologies for absence were received from Councillors T Carter, N Clarke and M Clarke.

None were declared.

RESOLVED:

        That the minutes of the meeting held on  6 September 2023 approved as     a     correct record and signed by the Chairman.

The Executive Director – Adult Care and Community Wellbeing announced that that the Care Quality Commission had finished undertaking the pilot assessments of Adult Social Care Services in Local Authorities, which had included an assessment of Lincolnshire County Council. A national moderation panel would meet at the end of October to consider the report of the five pilot assessments undertaken prior to proceeding with formal assessments early in 2024. The final report on the pilot assessment of Lincolnshire County Council was being finalised and it was hoped that it could be brought for consideration by the Committee at its meeting on 27 November 2023.

(To receive a presentation by Nina Eastwood, Inspection Manager – Care Quality Commission and Michele Hurst, Inspection Manager Care Quality Commission, which invites the Committee to consider an update by the Care Quality Commission (CQC))

Consideration was given to a presentation by the Operations Manager - Care Quality Commission, which provided an update on the inspection and monitoring of adult social care providers in Lincolnshire.

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

• In comparison with Nottinghamshire, it was thought that Lincolnshire had a slightly higher number of services rated as inadequate, and a similar amount of services rated as requires improvement, although specific data was not made available at the time of the meeting.
• Most homes classified as being without a Registered Manager were likely to be in the recruitment process or have a manager in place who was in the registration process, which could take 8 to 12 weeks. It was a requirement that any homes without a registered manager for more than 28 days must notify the CQC.
• There were no specific qualifications needed to become a Registered Manager, although individuals may have an NVQ 5 or equivalent qualification, but it was not essential. Assurance was provided that the registration process was thorough, and interviews explored whether applicants had the relevant qualifications, knowledge, and experience to undertake the role.
• Some concerns were raised by the Committee over the lack of requirement for qualifications, although some members acknowledged the value of experience when recruiting to such positions. Members supported the idea of supporting staff with qualifications on the job to further skills and opportunities. It was noted that the Social Care Reform White Paper had expressed an intention to strengthen the regulations and qualifications for registered managers, which had been welcomed by the sector.
• The Head of Commercial Services – People Services assured the Committee that although CQC carried out inspections of services, Lincolnshire County Council had oversight on an ongoing basis and improvement plans would be implemented for any services deemed inadequate or requiring improvement.
• Similarly, the absence of a registered manager within a service would trigger the risk matrix and initiate further oversight from LCC.
• The Committee was reassured that CQC inspections would include conversations with staff members to identify any key issues within the services.
• Members highlighted impact of delays in discharge from healthcare services to care services could have on an individual’s health and quality of life. Members were reassured that in Lincolnshire, discharge from healthcare services was working well.
• Where a service had been deemed inadequate by CQC or identified as having significant risk from assessments made by LCC, the Council would take a leading role on intervening in the service, whilst working closely with CQC and other partners to make improvements where possible. In some cases, it was clear that the right decision was to decommission the service and find alternative arrangements for residents.
• A report on Contract Management within Adult Care and Community Wellbeing would be reported to the committee at its next meeting and would provide an insight into the intervention, management and the compliance of homes, from the perspective of the local authority.
• Judgements inadequate  ...  view the full minutes text for item 34.

(To receive a report by Simon Evans, Health Scrutiny Officer, which invites the Board to consider whether it wishes to identify a topic that would benefit from an in-depth scrutiny review by Scrutiny Panel A)

Consideration was given to a report by the Scrutiny Officer, which invited the Committee to consider potential topics for review by Scrutiny Panel A.

Upon considering the report, the Committee agreed to await the publication of the CQC pilot assessment of Adult Social Care Services in Lincolnshire which was hoped to be published in November, before putting forward a topic for discussion as there was potential that it would identify areas of work.

RESOLVED:

          That potential topics for a scrutiny review by Scrutiny Panel A be    reconsidered following the publication of the CQC Pilot Assessment     of Lincolnshire County Council’s Adult Care Services.

(To receive a report by Pam Clipson, Head of Finance – Adult Care and Community Wellbeing, which invites the Committee to consider the Adult Care and Community Wellbeing Budget Monitoring for 2023-24)

Consideration was given to the Head of Finance – Adult Care and Community Wellbeing, which invited the Committee to consider the Adult Care and Community Wellbeing Budget monitoring update for 2023-24, as set out in the report.

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

• A £700,000 underspend was welcomed, although Members acknowledged that the level of underspend was insignificant in comparison to the daily spend within the Directorate and highlighted the impact of seasonal variations on the budget, in particular winter pressures.
• The Executive Director – Adult Care and Community Wellbeing highlighted the increasing trend by the Government to issue in year grants which was likely to continue. 
• The forecasted increased cost pressures of £13.5m for 2024/25 were highlighted. Members acknowledged the difficulty in managing expectations to achieve a balanced budget for 2024/25.
• The Executive Councillor for Adult Care and Public Health thanked the Head of Finance – Adult Care and Community Wellbeing for her work to keep budgets balanced and regulated, which was echoed by the Committee. Longer term aims for the Directorate included sustaining the workforce, supporting mental health provision and how to support providers to sustain workforces.
• Members were pleased that the capital funding programme was confirmed and commended staff for their outstanding work in helping vulnerable people.
• The Council continued to invest in day services, with a number of developments ongoing. The positive impact of the investments in these services was overwhelming.

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 a report by the Scrutiny Officer, which invited the Board to consider its planned work programme.

The Committee noted the following additions to the work programme:

• A report on Contract Management within Adult Care and Community Wellbeing Workforce development, recruitment and retention within the Adult Social Care sector.
• Analysis of the CQC’s pilot assessment of Adult Social Care in Lincolnshire.

RESOLVED:

          That the report and additions to the work programme be noted.