Agenda and minutes

Venue: Committee Room One, County Offices, Newland, Lincoln LN1 1YL

Contact: Rachel Wilson  Democratic Services Officer

No. Item


Apologies for Absence/Replacement Members


Apologies for absence were received from Councillor Mrs J E Killey and Councillor Mrs P A Bradwell OBE (Executive Councillor for Adult Care, Health and Children's Services).


Declaration of Members Interest


Councillor MA Whitington wished it to be noted that his mother was in a residential care home in Grantham and was funded by LCC.


Minutes of the meeting held on 10 April 2019 pdf icon PDF 209 KB




            That the minutes of the meeting held on 10 April 2019 be signed by the Chairman as a correct record.


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

·         In relation to rural and coastal communities in Lincolnshire, and neighbourhood teams using community assets, it was planned to bring a report to this Committee in September 2019.

·         The KPMG report had not yet been published, and the Assistant Director, Adult Frailty & Long Term Conditions would make enquiries regarding the publication date and notify the Chairman. Once the report was available it would be circulated to the Committee.

·         It had been very interesting to hear the views of the representatives from Libertas and this was something which needed to be followed up.

·         It was noted that the Councillor Development Group had recently arranged a session on Dementia awareness, and it was commented that it was excellent, and 18 members had attended, and it was suggested that it may be beneficial to run the session again.

·         It was highlighted that an Autism Awareness session was being held on 26 June 2019 and members were encouraged to attend.

·         It was queried whether it would be possible to run the dementia session for parish councils in order to make them aware of all the facilities.  This would be looked into by officers and it was thought that the team would be prepared to visit the parish councils.  It was queried whether the communications team could help get the message out to parish councils.  The positive comments in relation to the session would also be passed back to staff.

·         In relation to pre-decision scrutiny items, it was suggested that it would be helpful for the Committee for the outcome of the decision after going to the Executive to be included in the minutes.

·         Further to the briefing on Autism that the Committee received at the previous meeting, members commented that they would like to have more awareness of the number of people.


Announcements by the Executive Councillor and Lead Officers


There were no announcements.


Winter Funding Update Report pdf icon PDF 1 MB

(To receive a report by Tracy Perrett, County Manager – Hospitals and Special Projects, which provides a summary to members on Winter Funding for Adult Social Care Services to alleviate winter pressures on the NHS)


Consideration was given to a report which provided a summary to Members on Winter Funding for Adult Social Care Services, supporting an aim to alleviate winter pressures on the NHS.  It was reported that in October 2018 the Secretary of State for Health and Social Care had announced £240m of additional funding for council's in England to spend on Adult Social Care Services, and this had been divided between the local authority, with Lincolnshire County Council receiving £3,367,950.


The key areas that Lincolnshire County Council focused on fell broadly into the categories of supporting hospital discharge with a focus on flow through the hospitals, and admissions avoidance.  Members were guided through the various schemes which were set out in the report and provided with the opportunity to ask questions to the officers present and some of the points raised during discussion included the following:

·         Lincolnshire as a system had improved its performance, whilst many other areas had not improved.  For example, in Lincolnshire Delayed Transfers of Care (DTOC) had reduced from 3.5% to 2.6%.

·         In relation to the housing link worker, it was noted that they would be based at Lincoln County Hospital as that was where the greatest demand would be, but they would cover all the other hospitals as well.

·         It was acknowledged that extending the delivery of equipment from five to seven days a week had not been as successful as hoped and a number of barriers had been identified.  However, it was queried whether this was a level of service which was required as in many cases equipment needs could be planned in advance.  It was more an issue of culture and how colleagues could be supported with discharge planning.  It was suggested that this should be a process which should be started as soon as an individual enters hospital.

·         It was noted that Lincolnshire County Council staff were 'ward aligned', which meant they should be informed when a patient was admitted.

·         Members praised the work which had been done so far. 

·         Concerns were raised regarding cross border working, as in the north of the county people were more likely to be taken to an out of county hospital (Grimsby, Hull or Scunthorpe).  Members were advised that work was underway to look in more detail at cross border working, and that the location of GP practices played a role in this, as the County Council and NHS boundaries did not directly match up.  There was a possibility that the proposed primary care networks might assist in this.  If services were devolved to place and locality and there were place based budgets, this may start to resolve some of the issues.

·         It was highlighted that some of the work being carried out by the Local Enterprise Partnership (LEP) should help with improving cross border working.

·         It was commented that the advance announcement of funding had been positive, and that as a result planning and performance had been improved.

·         There was a need for continuity on wards  ...  view the full minutes text for item 5.


Government Green Paper and Future Funding

(To receive an update from Glen Garrod, Executive Director of Adult Care and Community Wellbeing, who will provide the Committee with information on the latest position regarding the Government Green Paper and the future funding of Adult Social Care)


The Committee received an update from Glen Garrod, Executive Director Adult Care and Community Wellbeing, in relation to the latest position regarding the Government Green Paper and the future funding of Adult Social Care.


It was reported that although the situation was fluid, it was increasingly less likely that a green paper would be published on care and support for older people in the foreseeable future.  The original intention had been that the green paper would inform the comprehensive spending review, which in turn would determine the future spending for Adult Social Care.  However, the upcoming spending review may only be for one year, to cover the period 2020/21.


The other challenge was that any significant changes would require primary legislation, but now there was not enough time to take legislation through the parliamentary process. 


It was highlighted that for 20 years there had been various discussions on how adult care should be funded and there was now a pressing need to address this issue.  There were a number of elements which would have been within the green paper, such as support for carers.  The Carer's Action Plan had been published in 2018, but there was limited funding to support it.


Members were reminded that the Better Care Fund was due to end on 31 March 2020, if it was not carried forward in some form.  It was highlighted that there may be a number of announcements in the next 6 - 12 months, but these may not necessarily present a long term solution.  For some councils, there was severe pressure on their adult social care budgets, but this was not the case for Lincolnshire.


(NOTE: Councillor Mrs M J Overton MBE joined the meeting at 11.00am)


Members were encouraged to watch two BBC Panorama programmes which were due to be aired on 29 May 2019 and 5 June 2019 which would be entirely focused on adult social care.  These programmes followed a number of different families based in Somerset.  Somerset County Council had experienced particular difficulties the previous year in relation to adult social care.


In terms of the green paper on Prevention is Better than Cure, it was reported there was still a lot of interest from the Government to publish this.  It was thought it would cover the areas of digital, some areas of public health as well as housing.  It was noted that there was a lot of talk about housing in the context of adult social care, however there would be a need for three government departments to work together and see this as a joint enterprise.


Members were provided with the opportunity to ask questions to the officers present in relation to the information contained within the update, and some of the points raised during discussion included the following:

·         Members were advised that the NHS had carried out an exercise to reduce the number of non-medical items provided for free on prescription, some of which were dietary.  It was noted that this may  ...  view the full minutes text for item 6.


The Commercial Team Annual Report 2018/19

(To consider a report on the Commercial Team Annual Report 2018/19, which will provide information to the Committee on the activities of the Team supporting the delivery of services in Adult Care and Community Wellbeing)

Additional documents:


Consideration was given to a report which presented the Annual Report (April 2018 – March 2019) of the Commercial Team, which supported the delivery of the Council's objectives for Adult Care and Community Wellbeing.


Members were guided through the report and were provided with the opportunity to ask questions to the officers present in relation to the information contained within the report and some of the points raised during discussion included the following:

·         It was queried whether there was an emergency plan in place in the event of four or five residential homes closing.  Members were advised that there was a process for such circumstances, and the Commercial Team had a significant role in that.  The Team had a co-ordinating role across health and social care, and continued to work with a range of colleagues across multiple agencies.  Work had been undertaken with a number of providers where closure had been prevented.  The role of the Commercial Team was about supporting the market and was not just about compliance.

·         It was queried how reliant the care sector in Lincolnshire was on EU staff, and it was noted that there would be an impact without the EU staff, as there would also be across the whole country.  The authority would continue to work with providers and there were contingency plans in place, and some of these risks could be mitigated.

·         It was noted that the number of beds available at Louth Hospital had reduced by half, however, members were advised that the NHS had liaised with Lincolnshire County Council on this in terms of measuring the impact and market in this area.  The aim as a service was to have more joint working arrangements in place with the NHS.  It was believed that the NHS and the local authority could work together more often in commissioning services.

·         In terms of the Care Quality Commission (CQC) reports, it was queried what was the difference between a rating of "requires improvement" and "good".  It was confirmed that the authority would work with a provider to help them maintain a "good" rating, as well as assisting to move up from a "requires improvement".  In the case of a rating of "requires improvement" this could be due to a wide range of factors such as the provider failing to deliver all aspects of their improvement plans, or being late notifying the CQC of changes, or at the other end of the spectrum there could be concerns about care.  The Commercial Team would also carry out unannounced visits, if a provider was low risk, they would receive at least one visit per year.  The frequency of visits would vary depending on the risk assessment of the provider, and if they were high risk there could be staff visiting the establishment every day.  For those providers requiring improvement, there was a lot of intensive support available.

·         It was noted that there had been a 20% increase in visits in one year by the Commercial Team,  ...  view the full minutes text for item 7.


Adults and Community Wellbeing Scrutiny Committee Work Programme pdf icon PDF 469 KB

(To receive a report from Simon Evans, Health Scrutiny Officer, which provides the Committee with an opportunity to consider its work programme for the coming year)


Consideration was given to a report which provided the Committee with the opportunity to comment on its work programme for the coming year.


It was reported that there were now eight items listed for the agenda for the meeting on 3 July 2019, and it was suggested that three of them were taken off and deferred to a future meeting.  The three items it was suggested that should be moved to the September meeting were as follows:

·         Rural and Coastal Communities in Lincolnshire

·         Annual Report of the Director of Public Health

·         Homes for Independence Strategy




            That the work programme, including the above amendments, be agreed.



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