Agenda and minutes

An apology for absence was received from Councillor T V Young.

It was reported that, under Regulation 13 of the Local Government (Committee and Political Groups) Regulations 1990 that Councillor M D Boles had been appointed as the replacement member for Councillor T V Young, for this meeting only.

An apology for absence was also received from Councillor W Bowkett, Executive Councillor for Adult Care and Public Health.

No declarations of members’ interests were received at this point in the proceedings.

RESOLVED

That the minutes of the Adults and Community Wellbeing Scrutiny Committee meeting held on 17 January 2024 be approved and signed by the Chairman as a correct record.

The Chairman advised the Committee that due to commitments of some of the presenters at other meetings, there would be a change in the order of the agenda.  Item 8 Integrated Lifestyle Service Contract Extension would now be the first main item of business, followed by the remaining items of business in the order listed in the agenda.

The Committee noted that Glen Garrod was due to retire during the month of April.

The Executive Support Councillor for Adult Care and Public Health extended her thanks to the Adult Care team for all their hard work over the weekend, helping to maintain services during the junior doctor’s strike.

This was echoed by the Executive Director of Adult Care and Community Wellbeing, he extended his thanks to NHS staff and adult social care staff who were working very hard in difficult circumstances to make sure that people were receiving a good service. 

(To receive a report by Andy Fox, Consultant in Public Health, which invites the Committee to consider the proposals for an extension for the Integrated Lifestyle Support Service, prior to consideration by the Executive on 5 March 2024. The views of the Committee will be passed on to the Executive as part of its consideration of the report)

Consideration was given to a report from Andy Fox, Consultant in Public Health, which invited the Committee to consider and comment on proposals for an extension to the Integrated Lifestyle Support Service as detailed in the Executive report at Appendix A, prior to consideration by the Executive at its meeting on 5 March 2024.

The Consultant in Public Health highlighted that Integrated Lifestyle Support was a key component of Lincolnshire’s developing Integrated Care System, to prevent ill-health, address inequalities, and reduce demand on health and care services.

It was highlighted that the Executive report sought authorization for an exception to the Council’s Contract Regulations for a 12-month extension to the Integrated Lifestyle Service contract plus three elements of additional delivery with the current provider until 30 June 2025.   It was noted that extending the contract would enable a robust commissioning process to take place, which would consider whether additional elements (Child & Family Weight Management, Falls Prevention, Employee Wellbeing) should be included in any future model.

During consideration of this item, the Committee raised the following comments, which were not directly relevant to the proposal before the Executive on 5 March 2024, but were in relation to the development of the future contract that would be effective from 1 July 2025:

·       The Committee welcomed the inclusion of a pilot Child and Family Weight Management Service into the contract which started in July 2022, and would strongly support the development of this element continuing in the future contract, as supporting children to be healthy benefited the parents and the wider family also;

·       The Committee extended support to the retention of the self-referral route in the future contract, along with GP referrals.  It was felt that this should be linked to promotion on the website, and potentially be referring to the Wellbeing Service brand; and the importance of harnessing and developing the motivation of individuals accessing the services.  The Committee also saw the benefit of the contract review considering the treatment pathways in detail, and in future recognises the importance of rationalisation and flexibility.  This might be pilot services being included by contract variations, for example, NHS weight loss treatments; 

·       Existing service provision was offered in 19 locations, which the Committee supported.  A similar geographical distribution would be the Committee’s preference for the new contract.  Allied to this, was the importance of all activities offered by individuals and local organisations being held in local venues, for example village and community halls, as a means of supporting increased exercise and activity throughout the county.  It was noted that these recreational activities in turn provided social benefits and employment opportunities, and the Committee suggested that start-up funding should be explored;  

·       The Committee was mindful that extra funding could be very useful in supporting the development of services, justified by an evidence base which demonstrated that public health interventions were almost always cost saving.  It was noted that it was possible that there could be requirement for extra funding to be directed to public health activity,  ...  view the full minutes text for item 59.

(To receive a report by Anne-Marie Scott, Assistant Director – Prevention and Early Intervention, which provides an introduction to the Lincolnshire Carers Service which was re-commissioned in October 2022)

Consideration was given to a report from the Anne-Marie Scott, Assistant Director – Prevention and Early Intervention, which provided the Committee with an introduction to the Lincolnshire Carers Service which had been re-commissioned in October 2022.  It was noted that the service provided a single point of access for unpaid carers to seek advice, support and guidance through a universal offer and receive further support where eligible.  Details relating to the extent and range of service available were detailed within the report presented.

It was highlighted that the Lincolnshire Carers Service supported the Council’s legal obligations under the Care Act 2014, to promote the wellbeing of unpaid carers and to prevent, reduce and delay the onset of need.

It was noted further that in its first year, the service had demonstrated positive outcomes and received excellent customer feedback.

It was highlighted that data from the annual Survey of Adult Carers in England had indicated that in Lincolnshire, most of the carers who had responded were retired, spending 100 hours a week in their caring role. As such, it was felt that those accessing the Lincolnshire Carers service were carers who were spending a large proportion of their time caring and may require more support to balance their caring role with their own wellbeing.

In conclusion, the Committee noted that by intervening early and providing access to information, advice, practical and emotional help and financial support, carers could have a life of their own while effectively maintaining their caring responsibilities.

During consideration of this item, the following comments were noted:

·       Some concern was expressed that the number of carers supported in the last 12 months had still not been met, despite all the good work highlighted in the report.  The Committee was advised that the measure in question shown in the performance report to be considered later on in the agenda was not just a measure of the Lincolnshire Carers Service, it was a measure for the broader services that were offered to carers, including children’s as well.  It was reported that the performance indicator would be reviewed for the next financial year to ensure that the definition and target was appropriate, and some benchmarking would be undertaken to see how performance compared to other authorities;

·       That the service needed to be promoted better.  It was reported that the service was primarily promoted through the Council’s website, the Connect to Support website, County News and by adult social care colleagues.  The Committee noted that a carer’s hub had recently opened at Pilgrim Hospital, Boston, which focused on those coming to hospital to support somebody, so that there was somewhere they could go for help and advice.  It was suggested that a reference card detailing the range of services available to a carer would be useful for elected members to have and be able to pass on to those in their communities who came to them for guidance;.

·       It was highlighted that nationally it could take up to two years for an  ...  view the full minutes text for item 60.

(To receive a report by Alina Hackney, Head of Commercial Services and Pam Clipson, Head of Finance – Adult Care and Community Wellbeing, which invites the Committee to consider the proposals for the rates paid to providers of residential care and community supporting living, prior to consideration by the Executive on 5 March 2024. The views of the Committee will be passed on to the Executive as part of its consideration of the report)

Consideration was given to a report from Alina Hackney, Head of Commercial Services and Pam Clipson, Head of Finance – Adult Care and Community Wellbeing, which invited the Committee to comment on the Usual Costs for residential care and residential nursing care, prior to consideration by the Executive at its 5 March 2024 meeting.  A copy of the Executive report was attached at Appendix A to the report from the Committee to consider.

It was reported that on 1 March 2023, the Executive had approved the setting of Usual Costs (Also referred to as Expected Costs) for residential accommodation for a one-year period to 31 March 2024.

Table 1 in paragraph 2.6 of the report provided details of the proposed rates for 2024/25 compared to 2023/24 for Older People, Mental Health and Physical Disabilities; Table 2 provided details of the current and proposed rates for Learning Disabilities; and Table 3 provided the current and proposed rates for residential 1:1 for the Committee to consider. It was noted that the 2024-25 rates further built on the 2023-24 rates established following a market assessment carried out in 2021, uplifted to reflect the increase in the national living wage and forecast inflationary increase.

In conclusion, the Committee was advised that the proposed Usual Costs represented an appropriate rate to enable the continued viability of the residential care market in Lincolnshire and the continued provision of choice of good quality care for the residents of Lincolnshire.

Note: Councillor T A Carter declared a non-pecuniary interest as a Trustee at a residential home receiving payment.

During consideration of this item, the Committee made the following comments:

·       The Committee extended their strong support to the seven recommendations to the Executive;

·       Congratulations were extended to the Team involved in the detailed work on the calculation of the proposed rates;

·       The Committee believed that the overall proposals represented a fair price for the services;

·       The Committee welcomed the hardship process, as a mechanism to support residential care homes in financial difficulty; and

·       The Committee looked forward to the in-depth review of the existing framework and requested a further item on its agenda later in the year, as part of the procurement arrangements on how the new framework was developing.

(Note: Councillor M D Boles left the meeting at 12:17pm)

The Chairman on behalf of the Committee extended his thanks to the presenters.

RESOLVED 

1.      That support be extended to the seven recommendations to the Executive as detailed on page 3 to 4 of the report pack.

2.      That the comments detailed above be passed on to the Executive.

(To receive a report by Caroline Jackson, Head of Corporate Performance, which invites the Committee to consider the Service Level Performance against the Corporate Performance Framework for Quarter 3 of 2023-24 which relates to the Adult Care and Community Wellbeing directorate)

The Committee considered a report from Caroline Jackson, Head of Corporate Performance, which invited consideration of the Service Level Performance against the Corporate Performance Framework 2023-24 for Quarter 3 which related to the Adult Care and Community Wellbeing directorate, details of which were provided on pages 21 to 42   of the report pack.

The Committee noted that the overall picture for the performance indicators for Quarter 3 was that 94% of the measures had either exceeded or were achieving their target.

(Note Councillor T A Carter left the meeting at 12.55pm)

During consideration of the item, the following points were noted:

·       Some concern was expressed regarding the Carers Supported in the last 12 months target not being reached, and to the target being reviewed.  Reassurance was provided that there would be a clear rationale for any change, which would include service delivery and benchmarking and that any changes made to this indicator would be brought to the Committee’s attention;

·       The Committee noted that Lincolnshire was a low spender per head of population, and that the performance measures highlighted that Lincolnshire provided a quality service at an economical rate, and this had been echoed by the Care Quality Commission inspection in the previous year;

·       Clarification was provided that with regard to PI 65 People in receipt of long-term support who have been reviewed.  It was reported that people were entitled to an annual review each year, and that it was anticipated that all the reviews would be completed by the end of the year.  Confirmation was also provided that this was an accumulative measure;

·       PI 158 For Adults discharged from hospital, the percentage who remain at home 91 days after discharge.  Praise was extended to the partnership working with NHS colleagues;

·       PI 173 Proportion of adults with a learning disability who live in their own home or with their family.  The Committee noted that if the adult in this measure passed away, help would be provided to the family through the care and support offer.  Officers agreed to investigate this further; and

·       PI 122 requests for support for new clients aged 65 plus, where the outcome was no support or support of a lower level.  The Committee was advised that this measure was a standard measure across the country.  It was noted that a large majority of people who contacted adult social care for support, were happy with the advice and guidance they received at that time to deal with the issues they had.  It was noted further that the service during the next twelve months would monitor how many people come back to service, so this measure also acted as a quality check.

The Chairman extended his thanks on behalf of the Committee to the presenter. 

RESOLVED

That the performance of Adult Care and Community Wellbeing be recognised for its performance during Quarter 3 with 17 of the 18 indicators meeting or exceeding their target.

(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 Simon Evans, Health Scrutiny Officer, which invited the Committee to consider and comment on the contents of its work programme.

The Health Scrutiny Officer briefed the Committee on the items for consideration at the 24 April 2024 meeting.

During consideration of this item, reference was made to the Residential Care Contract being considered at the October 2024 meeting.

RESOLVED

That the work programme presented on pages 43 to 46 of the report pack be noted, subject to the inclusion of the suggestions put forward by the Committee above.