Agenda and minutes

Venue: Committee Room Three, County Offices, Newland, Lincoln Lincs LN1 1YL. View directions

Contact: Catherine Wilman  Democratic Services Officer

No. Item


Apologies for Absence/Replacement Members


Apologies were received from Councillor C E H Marfleet.


Declarations of Members' Interests


Councillor Mrs E J Sneath in the Chair.


No declarations were made.


Minutes of the meeting of the Adults and Community Wellbeing Scrutiny Committee held on 6 September 2017 pdf icon PDF 217 KB




That the minutes of the meeting held on 6 September 2017 be approved and signed by the Chairman as a correct record.


Announcements by the Chairman, Executive Councillor for Adult Care, Health and Children's Services and Executive Director of Adult Care and Community Wellbeing


The Executive Director of Adult Care and Community Wellbeing reported that the Council had been successful in recruiting a Director of Public Health, Professor Derek Ward, who would commence his role on 29 January 2018. 


Thanks were expressed to Tony McGinty who had stepped up as Interim Director of Public Health.


The Council's Communications Officer informed the Committee that there would shortly be media coverage on the BBC of a serious case review undertaken by Lincolnshire Safeguarding Adults Board of a series of individual cases of financial exploitation of vulnerable adults in a Lincolnshire town.  It had been the first thematic review of its type in the country.




Health and Wellbeing Board's Housing, Health and Care Delivery Group Update pdf icon PDF 389 KB

(A report by Lisa Loy, Housing for Independence Manager, which provides an update on the Housing, Health and Care Delivery Group (HHCDG) and the wider Housing for Independence (HfI) work)


A report was considered that provided an update on the Housing, Health and Care Delivery Group (HHCDG) and the wider Housing for Independence (HfI) work.


The vision for HfI was evolving with the principal aim of integrating housing, health and care whilst supporting a vision for joined up services focussed on the individual. The aim of HfI was to help residents remain at home for longer, and therefore, reduce the need for hospital and care admission to avoid unnecessary costs.  Work streams included the Joint Strategic Needs Assessment (JSNA) and the modernisation of Disabled Facilities Grants (DFG's).


There was a discussion about people hoarding possessions and extraneous items in their homes.  It was thought that there was no single organisation that had a mechanism for resolving hoarding issues.  It was suggested the county hold a hoarding summit of relevant agencies to try and come up with a strategy.  At which point, it was reported that North Kesteven District Council had recently approved a hoarding policy.


It was felt a reliance on social housing exclusively was not the solution and there was a need to rely more on private landlords.


It was reported that £5 million had been put into DFGs in 2017/18. However, there was a history of service users saying they'd been underfunded.  Few authorities in Lincolnshire would say that there was sufficient demand and spending the money on more DFG's was not felt to be the solution.


It was reported that the DFG allotted to District Councils in recent years had risen from £2.26 million in 2013/14 to £5.8 million in 207/18.  It was noted that this funding needed to be allocated through the Better Care Fund in counties with two tier authorities.




That the progress made to date by the Health and Wellbeing Board's Housing, Health and Care Delivery Group be noted.





Care Quality Commission Update pdf icon PDF 262 KB

(To consider a report from Greg Rielly, Inspection Manager, Adult Social Care Directorate, Care Quality Commission – the national regulator of health and social care services.  The report provides an overview for the Committee on the Care Quality Commission's activities in relation to adult social care services in Lincolnshire, where the Commission is the regulator)


The Committee considered a report from the Care Quality Commission (CQC), which provided a position statement on the progress and themes coming out of the CQC's inspections of Adult Social Care services in Lincolnshire.


It had been highlighted in the report that the CQC was not subject to local authority scrutiny and the relationship was an informal one based on an understanding, trust and joint aspiration to improve services.


Greg Rielly, the CQC's Inspection Manager for Lincolnshire reported that since the last attendance at Adults Scrutiny Committee, the CQC's inspection methodology had changed and become more intrusive, including the inspection of hospital providers.


The ratings given to establishments after inspection were Inadequate, Requires Improvement, Good and Outstanding.  In Lincolnshire 78% of establishments were rated as Good, with 21% as Requires Improvement and Inadequate and Outstanding at 1% each.


The CQC had recently put a new structure in place for regulatory breaches, so that if a provider was rated as Requires Improvement three times in a row, they would be struck off.


Of the individual criteria that had to be met during an inspection, Safe and Well Led seemed to be the hardest to meet.  Also, on 1 November, a new criterion How Caring? would be introduced.


There was discussion regarding the workforce of each provider and the CQC's requirement for each to have a Registered Manager.  There were currently 23 locations in Lincolnshire without a Registered Manager and failure to register a manager within 12 weeks could result in criminal enforcement and potentially a fine of £4,000 minimum.


Members sought clarification on the process to register a manager and it was explained that the process could take up to six weeks, following which there was every possibility that the registration could be refused on various grounds.  In addition to this, managers sometimes left the provider, whilst registration was in progress.


It was felt by some Councillors that failing to register or retain a manager was a vicious circle for providers.  Special measures and penalties for not having one in place did not come with extra funding or support to help secure and retain one.


There was a question regarding the 82% of adult social care services originally rated as inadequate, which improved their rating following a re-inspection.  Officers explained that the County Council undertook an interim site visit in between the CQC inspections, where they had a contract.  If a provider was causing considerable concern, the Council would visit on a monthly basis.  Low risk providers, performing well, qualified for an annual visit.  There had also been additional inspections focussing on a particular issue, if the need arose.  The CQC and the County Council continually communicated to share knowledge.


Officers reported that in Lincolnshire, most providers were small to medium enterprises, for which keeping on top of inspections from CQC, LCC and the NHS was not an easy job.  Melanie Weatherley, the Chair of the Lincolnshire Care Association (LinCA) could offer support and help to  ...  view the full minutes text for item 29.


2017/18 Adult Care and Community Wellbeing Quarter 2 - Themed Performance Report: Carers Service pdf icon PDF 168 KB

(To receive a report by Theo Jarratt, Interim County Manager for Performance, Quality and Information, which provides the Quarter 2 position statement and narrative on performance measures relating to Carers Services in Lincolnshire)



Additional documents:


The Committee considered a report which provided a Quarter 2 position statement and narrative on performance measures relating to Carers' Services in Lincolnshire.  Case Studies of carers' stories were attached to the report and Members commented that they found these very helpful in humanising the service offered by the Council.


A presentation was received from the Lincolnshire Carers' Service which incorporated Lincolnshire County Council, Serco and Carers First.  The presentation covered the following points:


·         Lincolnshire carers' survey;

·         Survey of adult carers in England 2016/17;

·         The carers' journey;

·         What's included in the offer to carers;

·         Carers First outcomes;

·         Carers Direct Payments: numbers of awards;

·         Carers Direct Payments: average spend;

·         Figures for young carers, compared to adult carers;

·         Carers First collaboration with ULHT;

·         Quality assurance;

·         Going forward – 2017-2019.


The following comments made during the presentation were noted:


·         There were 1174 young carers registered in the county aged between 5 and 19 years.  They were often identified when the person they cared for received an assessment.  There was a team within Children's Services which oversaw the care of young carers and schools were also kept informed.  There were other areas of support through faith groups and clubs;

·         The cared for were always welcome to attend carer activity and support groups with their carers. However, carers often wanted to go to groups on their own as respite.  If the person cared for did not want to be left alone, the carer's personal budget could be used to pay for someone to attend them;

·         The Workplace Pension for carers was currently being researched.  Most Job Centres had a trained member of staff to help carers to get jobs as well as help with education needs for young carers;

·         There would always be unidentified carers, because many people did not recognise themselves as being in such a role, but simply as caring for their loved one.  This was where literature and information in public places, such as GPs' surgeries was helpful.




That the report, presentation and comments made be noted.





Adult Care and Community Wellbeing Local Account 2016-17 pdf icon PDF 93 KB

Additional documents:


Consideration was given to a report which provided a draft summary and full version of the Adult Care and Community Wellbeing Local Account 2016-17, which was a sector led improvement programme.  The document included the Public Health sector.


The intention was to upload the summary report to the Adult Care's web pages on the County Council's website once its content and format had been agreed.


Members congratulated the authors on a very readable and approachable summary document.  They felt the visual design of the summary was very good.


It was noted however, that some of the pages looked a little empty and would benefit from extra information as follows:


·         Lincolnshire Carers Service – inclusion of case studies;

·         Mental Health Services – inclusion of short term statistics as well as long term which were already included;

·         Abbreviations needed explaining;

·         The Managed Care Network was deserving of a mention.




1.    That the Adult Care and Community Wellbeing Local Account 2016/17 summary document and full version be noted;


2.    That the comments made and suggested amendments be noted.




Lincolnshire Safeguarding Boards Scrutiny Sub Group Update pdf icon PDF 139 KB

(To receive a report by Catherine Wilman, Democratic Services Officer, which provides the Committee with an update on the activity of the Lincolnshire Safeguarding Boards Scrutiny Sub Group)

Additional documents:


The Committee considered an update from the Lincolnshire Safeguarding Boards Scrutiny Sub Group which included minutes from its meeting on 26 September 2017.


It was noted that the next meeting of the Sub Group would be on 15 January 2018, the minutes from which would be included on the agenda for this Committee at its February meeting.




That the update and minutes be noted.


Adults and Community Wellbeing Scrutiny Committee Work Programme pdf icon PDF 200 KB

(A report by Simon Evans, Health Scrutiny Officer,in connection with the Committee's work programme, which is reviewed at each meeting.  Members of the Committee are encouraged to highlight items that could be included for consideration)


A report was considered with provided the Committee with an opportunity to review its programme of work for the coming months.


It was noted that the following topics would be considered for a forthcoming meeting:


·         Managed Care Network;

·         Substance Misuse;

·         Meet and greet with new Director of Public Health.




That the work programme be noted with the inclusion of the noted additions.



Original Text: