Agenda and minutes

Apologies for absence were received from Councillors B Adams and Mrs J E Killey.

The Chief Executive reported that having received notice under Regulation 13 of the Local Government (Committees and Political Groups) Regulations 1990, Councillor S P Roe had been appointed as a replacement member of the Committee in place of Councillor B Adams for this meeting only.

An apology for absence was also received from Councillor Mrs Patricia Bradwell OBE, Executive Councillor for Adult Care, Health and Children's Services.

There were no declarations of interest made at this point in the meeting.

RESOLVED

That the minutes of the Adults and Community Wellbeing Scrutiny Committee meeting held on 13 January 2021 be agreed and signed by the Chairman as a correct record.

The Chairman extended his thanks to everyone involved in the successful vaccination programme in Lincolnshire.

(To receive a report by Gareth Maddison, Service Development Manager, and Claire McNally, Project Manager, which invites the Committee to consider the Market Position Statement 2020 – 2023)

The Chairman welcomed to the meeting Gareth Maddison, Service Development Manager and Clair McNally, Project Manager, Service Development, to present their report which invited the Committee to consider and comment on the draft Adult Care and Community Wellbeing Market Position Statement (MPS) 2020-2023, prior to its final publication.

The Committee noted that market development was a statutory requirement for all local authorities following the implementation of the Care Act 2014.  Key to this was the development of an MPS, which should include the local authority's direction of travel, policy intent, key information and statistics on needs and demands and trends.  Detailed at Appendix A to the report was a copy of the final draft Adult Care and Community Wellbeing Market Position Statement 2020- 2023 for the Committee to consider.

In conclusion, the Committee was advised that an MPS was seen as good practice within the sector and that the document would aid in developing a care and support market in Lincolnshire which delivered a wide-range of sustainable high quality services.

During discussion, the Committee raised the following comments:

·       Overall, the Committee agreed that the MPS was a good document, easy to read and well presented.  A suggestion was made for statistical information to be presented earlier in the document, to highlight pressure and needs better;

·       That further consideration needed to be given to encourage innovative thinking, as had been done throughout the Covid-19 pandemic;

·       The need to encourage more young people into caring roles.  The Committee was advised that a key element of the Government White Paper related to workforce for social care and the need for a workforce strategy to help with recruitment and retention of staff within the care sector.  There was a recognition that to attract young people into such roles, a career structure was needed to be put in place;

·       Skills for Care estimates for staff turnover rates in Lincolnshire – The Committee noted that the Lincolnshire rate of 32.2% was similar to the regional estimate of 34.2%, and to the England rate of 31.9%.  Further details of how Lincolnshire was planning to develop and build workforce capacity were provided on page 26 of the report;

·       One member highlighted the very important role carers provided and the work carried out by LinCA (the Lincolnshire Care Association).  The Committee noted that Lincoln College had started a course in care work, in conjunction with LinCA for young people interested in choosing care as a career.  It was noted further that this was one of  a few courses in the country;

·       The impact of Brexit on the caring profession.  The Committee noted that Lincolnshire had not seen much impact of Brexit, which might be as a result of the Covid-19 pandemic, as 2020 had not been a normal year within the sector; 

·       Whether expectations of the Direct Support Service had been met.  Page 30 of the report provided details of the current contracting arrangements and service provision;

·       Demographics - The Committee noted that the trend for an  ...  view the full minutes text for item 47.

(To receive a report by Caroline Jackson, Head of Corporate Performance, which summarises the Adult Care and Community Wellbeing Service Level Performance for Quarter 3)

The Chairman invited Caroline Jackson, Head of Corporate Performance to present to the Committee the Tier 2 Service Level performance measures for Adult Care and Community Wellbeing.

The Committee noted that 10 measures had achieved their target; 2 measures had exceeded their target; and 4 measures had not been successful in meeting their target. 

Those not achieving target were:

·       Percentage of alcohol users that left specialist treatment;

·       People supported to successfully quit smoking;

·       Adults aged 18-64 living independently; and

·       Adult Safeguarding concerns that lead to a Safeguarding enquiry.

During discussion, the Committee raised that in relation to percentage of alcohol users that left specialist treatment, that it might be useful to identify age ranges, so that a more targeted approach could be taken.  It was agreed that as evidence suggested that alcohol consumption had increased during the pandemic, this was an area that needed further investigation.  Reassurance was given that as services started to recover following the pandemic, such matters would be addressed in the Joint Strategic Needs Assessment.

RESOLVED

That the performance of the measures above or below target for Adult Care and Community Wellbeing for Quarter 3 be noted.

(To receive a report from Kakoli Choudhury, Consultant in Public Health, which highlights some of the mental wellbeing activities undertaken during 2020/21 and progress towards the implementation of the Suicide Prevention Action Plan)

The Chairman invited Shabana Edinboro, Acting Programme Manager, Public Health Division, to present the report to the Committee, which highlighted some of the mental wellbeing activities being undertaken during 2020/21; and the progress being made towards the implementation of the Suicide Prevention Action Plan.

The Committee noted some of the activities that had being undertaken with regard to Mental Wellbeing, which included the Lincolnshire County Council Employee Health and Wellbeing Strategy, which had been launched in May 2019; the provision of dedicated Health and Wellbeing information on George; the provision of lunchtime wellbeing sessions; One You Lincolnshire; resilience training modules; Mental Health First Aid and confidential counselling support.

It was reported that evidence had shown the negative impact of social isolation and loneliness had on people's health and wellbeing, both physical and mentally.  The Committee noted that the Public Health Division were currently providing services and resources which supported the social connection network, which included: the Joint Strategic Asset Assessment; rural and coastal communities' health inequalities; social prescribing; and the Communities of the Future Project.    

The Committee was advised that with the help of the council's Communication Team, the Public Health Division had developed a '12 Positive Steps to Better Mental Wellbeing' social media campaign, which had been shown during December 2020 and January 2021.  It was highlighted that a virtual mental health webinar had also been arranged in October 2020, to highlight the importance of mental wellbeing.

It was highlighted to the Committee the impact Covid-19 had been having; details of the three main groups affected; and the impact of long Covid-19 were shown on pages 103 and 104 of the report.

The Committee was advised that the Suicide Prevention Strategy 2020-2023 and the Action Plan for 2020-2021 had been published in October 2020.  It was noted that the strategy and the action plan had been produced in collaboration with the Suicide Prevention Steering Group (SPSG), which was a system-wide, multi-agency partnership consisting of statutory and non-statutory organisations who were interested in or involved in reducing suicides in Lincolnshire.  A copy of the action plan was provided at Appendix A to the report for the Committee to consider.

Overall, it was noted that progress on the action plan had been good, despite the pandemic.  The Committee noted further that the majority of actions were on target.  Two actions shown in 'Red' on the action plan 1.2 – Identify/develop clear pathways of support for both individuals and professionals and 4.2 – Develop Real Time Surveillance  were behind target, mainly as a result of the re-deployment of staff into the Covid-19 response; and that their delivery dates would need to be adjusted. It was also highlighted that it was planned to contract 4.2 out for a short period of time. The Committee was advised that the one action 4.1 – Explore alternative data sources to gather intelligence to aid prevention of suicidal behaviours shown as being 'Yellow' was behind target as a result of the current time commitment of Intelligence Teams  ...  view the full minutes text for item 49.

(To receive a report from Semantha Neal, Assistant Director of Prevention and Early Intervention, and Phillip Garner, Programme Manager, Health Improvement, which invites the Committee to consider the performance of the provider in its first year of service)

The Chairman invited the following presenters to the meeting for this item:

·      Derek Ward, Director of Public Health;

·      Rachel West, Contract Manager;

·      Dan Rogers, Head of Service, Thrive Tribe; and

·      Andy Emerson, Head of Service Delivery, Thrive Tribe

The report shown on pages 127 to 144 of the agenda pack provided the Committee with an update on the Integrated Lifestyle Service (One You Lincolnshire).

In a presentation from the Thrive Tribe representatives, the Committee were reminded of the timeline from when One You Lincolnshire had launched in Lincolnshire.

It was reported that despite the impact of Covid-19 restrictions on the mobilisation of the contract, in year one the levels of referrals had been encouraging, with over 8,000 Lincolnshire residents having accessed   integrated lifestyle services.  It was highlighted that half of the referrals had been from primary care (49%); and that the majority of secondary care referrals (29%) had come from midwives into the smoking in pregnancy service; and that there had been 22% of self-referrals for smoking.  Information was provided regarding the referral pathways, it was noted that the majority of clients using the service were using it to stop smoking. 

The Committee noted that during Covid-19, essential services had continued to be delivered.  It was highlighted that as a result of the closure of leisure centres and gyms, the 'Other Room' had been created as an in-house platform to deliver structured sessions for all abilities; these included chair-based activity, yoga and "The Sweat Room" for more advanced users.  It was highlighted further that this had proven to be a valuable tool with over 800 people accessing the service to date.

It was highlighted that the pandemic had disrupted the use of sub-contractors with most of the work moving to the One You Lincolnshire Core Team, who had quickly adapted to a digital and virtual approach to delivering services.  It was highlighted further that the anticipated number of referrals from the NHS had not materialised, as many of the initially eligible clients groups had been shielding.  However, extending the self-referral pathway during Quarter 2 2020-2021 had been successful in opening up lifestyle support, when professional referral routes had been restricted.  Details of the referral distribution for Quarter 2 were shown in Figure 9 on page 143 of the report.

It was reported that there had been challenges, but One You Lincolnshire had shown great adaptability to continue service delivery during the pandemic and that the same approach would enable them to react and innovate further in response to challenges ahead, which were likely to arise during the remainder of the contract year and beyond.  Future developments to maximise service impact were highlighted as evaluating existing targets; introducing physical activity during pregnancy; developing of the community support fund to maximise opportunities for those in areas of deprivation; and exploring opportunities to increase support for the healthy ageing 60 plus population.

During discussion, the Committee raised the following comments:

·       That there needed to be more focus on the over 60 age group  ...  view the full minutes text for item 50.

(To receive a report from Semantha Neal, Assistant Director of Prevention and Early Intervention, and Sean Johnson, Public Health Programme Manager, which invites the Committee to consider a decision report which recommends that Lincolnshire County Council adopt the Lincolnshire Homes for Independence Blueprint prior to a decision being made by the Executive Councillor for Adult Care, Health and Children's Services between 26 February and 3 March 2021.  Councillor Mrs Wendy Bowkett, Chair of the Housing, Health and Delivery Group will be also in attendance for this item)

The Chairman welcomed to the meeting Councillor Wendy Bowkett, Chair of the Housing, Health and Care Delivery Group and Semantha Neal, Assistant Director of Prevention and Early Intervention, and invited them to present the report, which invited the Committee to consider a proposed decision that Lincolnshire County Council should adopt the Lincolnshire Homes for Independence blueprint.  The decision was due to be made by the Executive Councillor for Adult Care, Health and Children's Services between 26 February and 5 March 2021, and that the views of the Committee would be reported to the Executive Councillor as part of their consideration of this item.

The Chair of the Housing, Health and Care Delivery Group introduced the report and extended her thanks to everyone involved in the process in moving the Lincolnshire Homes for Independence blueprint forward.

Attached at Appendix 1 to the report was a copy of the Executive Councillor report for the Committee's consideration.

The Committee was advised it was considered appropriate that Lincolnshire County Council should formally adopt the blueprint to demonstrate its commitment to collaborative working and joint ownership of the vision for the provision of a greater range of housing options for those who need additional support, and better integrated services to promote and sustain independent living in Lincolnshire.

It was highlighted that implementation of the Delivery Plan would be overseen by the Housing, Health and Care Delivery Group, and that progress would be reported annually to the Lincolnshire Health and Wellbeing Board.  A copy of the delivery plan was detailed at Appendix C to the Executive Councillor report presented.  Page 154 of the report highlighted that the Lincolnshire Health and Wellbeing Board had 'signed-off' the blueprint at its meeting on 1 December 2020.

The Committee welcomed the development of the blueprint, which as a living document would form the basis of collaboration between the County Council and district councils further developing homes for independence in Lincolnshire.  The blueprint represented a significant example of partnership working and the Committee looked forward to its adoption by the district councils and strongly recommended endorsement by the Executive of the County Council.

Reference was made to developing strong relationships between local planning authorities and the developers of housing, although viability of a particular development was often cited as a reason for less affordable housing.  The Committee also referred to the post-pandemic opportunities, for example through programmes such as One Public Estate, to retro-fit existing housing, as well as new-build.  

RESOLVED

1.    That support be given to the recommendation to the Executive Councillor for Adult Care, Health and Children's Services as detailed on page 148.

2.    That the comments raised by the Committee as detailed above be passed to the Executive Councillor for Adult Care, Health and Children's Services in relation to this item.

(To receive a report by Simon Evans, Health Scrutiny Officer, which invites the Committee to consider its work programme for the coming year and ensure that scrutiny activity is focused where it can be of greatest benefit)

The Chairman invited Simon Evans, Health Scrutiny Officer, to present the item to the Committee.

The Committee gave consideration to their work programme as detailed on page 195 of the report pack.  The Committee was advised that the Item on Personal Health Budget/Direct Payments for the 14 April 2021 meeting was to be deferred to a future meeting.

The Committee agreed that the 14 April 2021 meeting would remain in the meeting diary, to consider the remaining item of business scheduled and that an informal meeting was suggested at the rising of the formal Committee meeting, to allow the Committee to discuss its achievements, and to identify any items that needed to be taken forward for further consideration.

RESOLVED

1.    That the work programme as presented be received.

2.    That the decision made by the Executive on 2 February 2021 on Extra Care Housing Scheme and Community Supported Living Units for Working Aged Adults at The Hoplands Sleaford with North

Kesteven District Council be noted.

3.    That an informal meeting of the Committee be arranged at the rising of the formal meeting scheduled for 14 April 2021.