Agenda and minutes

Venue: Council Chamber, County Offices, Newland, Lincoln LN1 1YL. View directions

Contact: Emily Wilcox  Democratic Services Officer

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Items
No. Item

57.

Apologies for Absence/Replacement Members

Minutes:

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

58.

Declarations of Members' Interests

Minutes:

There were no declarations of interest.

59.

Minutes of the meeting held on 12 January 2022 pdf icon PDF 575 KB

Minutes:

RESOLVED:

              That the minutes of the meeting held on 12 January 2022 be               approved as a correct record and signed by the Chairman.

60.

Announcements by the Chairman, Executive Councillor and Lead Officers

Minutes:

Members were reminded that a training session on Community Strategy and Voluntary Sector Funding was scheduled 6 April 2022, following the meeting of the Committee.

 

The Chairman congratulated the Director for Public Health on his appointment to the post of Director of Public Health for Greater Lincolnshire on a temporary basis, which had become effective from 21 February 2022.

61.

Service Level Performance against the Corporate Performance Framework – Quarter 3 pdf icon PDF 437 KB

(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)

Additional documents:

Minutes:

Consideration was given to a report by the Head of Corporate Performance, which invited the Committee to consider the Service Level Performance against the Corporate Performance Framework – Quarter 3, in relation to the  Adult Care and Community Wellbeing Service.

 

The Committee was advised that out of 18 measures which could be reported in quarter 3, 12 either achieved or exceeded their target and 6 measures had not achieved the targets set.

 

 

The measures which had met or exceeded their target were highlighted. 

 

Further detail was also provided for the reasons that 6 measures had not achieved their target:

·       People in receipt of long term support: Teams which undertook reviews had seen significant pressure due to Covid and therefore prioritisation of work had seen unplanned review and reviews of new packages of care a priority over stable packages of care.

·       Carers being supported: There was an upward trend in carers being supported since quarter 2 but the target had not been met

·       Carers who have received a review of their needs

·       Adult Safeguarding concerns that led to a safeguarding enquiry: The Council continued to work with partners to improve the adult safeguarding concerns that led to a safeguarding enquiry. Outcomes of a recent audit confirmed decision making was sound in relation to whether to progress to an enquiry.

·       The percentage of alcohol users that left specialist treatment successfully: There was a move within the service to fully open and to increase face to face appointments. The presentations to the service continued to be more complex with clients having multiple issues which required more intense residential services and was impacting on discharge rates as treatment were taking longer and were less likely to be successful straight away. The service had seen a 10% increase in successful discharges this reporting year against a 34% increase in new clients.

·       People supported to successfully quit smoking: this target had been impacted by Covid with no GP subcontractors delivering smoking cessation in this quarter. One You Lincolnshire continued to support this shortfall with good quality service provision which was having an impact.

 

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

 

Adult Safeguarding concerns that lead to a Safeguarding enquiry

 

  • Members questioned why audits had concluded that the progress to enquiries were adequate but the measure continued to not reach the target.
  • Officers confirmed that they were working with partners to ensure that safeguarding concerns were reported appropriately.
  • There was a significant variance between benchmarking data for other Local Authorities and as a result Officers would review the target.
  • Pressures felt by Covid-19 had generated a higher levels of referrals, many of which had been inappropriately reported. 
  • The Committee emphasised the importance of ensuring that changes to the reporting of concerns did not result in legitimate concerns being missed.
  • Reassurance was provided that the Council’s safeguarding team undertook regular audits to ensure that the triage had made the correct decision on whether to refer safeguarding matters.
  • Preventative safeguarding work  ...  view the full minutes text for item 61.

62.

Section 75 Agreement for Learning Disability Between Lincolnshire County Council and Lincolnshire Clinical Commissioning Group pdf icon PDF 383 KB

(To receive a report by Justin Hackney, Assistant Director, Specialist Services and Safeguarding, which invites the Committee to consider a report on the Section 75 Agreement for Learning Disability which is due to be considered by the Executive on 1 March 2022. The views of the Committee will be reported to the Executive as part of its consideration of this item)

Additional documents:

Minutes:

Consideration was given to a report by the Assistant Director - Specialist Services and Safeguarding which invited the Committee to consider a

report on the Section 75 Agreement for Learning Disability which was due

to be considered by the Executive on 1 March 2022.

 

The Committee was advised that a Section 75 Agreement was a legal agreement between local authorities and NHS bodies which allowed one party to delegate delivery of specified functions to the other party if those arrangements would lead to improved outcomes.

 

The Learning Disability Section 75 was a commissioning agreement that created a pooled budget and appointed a lead commissioner and also provided for an integrated assessment and care management function for Adult Social Care and Continuing Health Care.

 

The report proposed that Lincolnshire County Council (LCC) be the lead commissioner and the host for the pooled budget and the associated integrated arrangements. The existing Learning Disability Section 75 agreement formally ended on 31 March 2022 and there was no provision to extend the existing agreement past this date.  It was therefore proposed that a new agreement be developed and agreed for 1 April 2022 for an initial period of 5 years, with the option to extend for a further two years subject to agreement by both parties.

 

As part of the report, the Committee received a presentation, which included the following details in relation to report:

 

  • Details of the commissioning of the agreement
  • The expenditure and forecasted budget for 2022-23
  • The individual benefits of the agreement, which included a more joined up experience of care for adults with a learning disability; an identified key worker; a single care and support plan; an integrated approach to quality assurance of care; strong assessment and review performance and promoting and supporting integrated working
  • Other benefits of the agreement
  • Details of the agreement between Lincolnshire County Council (LCC) as the lead commissioner and Lincolnshire Clinical Commissioning Group

 

The Committee supported the recommendations to the Executive and during the discussion the following points were noted:

 

·       The section 75 agreement provided good value for money and was a showcase for close partnership working with the local NHS.  This was likely to develop further as part of the Integrated Care System arrangements, where it was important that local authorities should act as equal partners with the local NHS, rather than adult care being subsumed into the NHS. 

·       The Committee welcomed the partnership working and the benefits of the service were emphasised

·       It was hoped that a disputed case would be resolved amicably between partners,  however there was an escalation process and a resolution clause in place should it need to be used.

·       The section 75 agreement had the benefit getting the most from the expertise in both the County Council and the NHS.

·       The section 75 agreement’s resilience was demonstrated by its maturity, reflecting refinements and developments over the previous decade, which put both partners in a strong position with any future legislative changes.

·       Innovation should continue be enabled in the future  ...  view the full minutes text for item 62.

63.

Carers Support Service Re-procurement pdf icon PDF 833 KB

(To receive a report by Carl Miller, Commercial & Procurement Manager, which invites the Committee to consider a report on the Carers Support Service Re-procurement, which is due to be considered by the Executive Councillor for Adult Care and Public Health between 28 February and 4 March 2022. The views of the Committee will be reported to the Executive Councillor as part of their consideration of this item)

Additional documents:

Minutes:

Consideration was given to a report by the Carl Miller, Commercial & Procurement Manager, which invited the Committee to consider a report on the Carers Support Service Re-procurement, which was due to be considered by the Executive Councillor for Adult Care and Public Health between 28 February and 4 March 2022

 

The Carers' Support Service supported adult carers over the age of 18, young carers transitioning from early help arrangements, parent carers, former carers, and families of substance misusers. The current contract was due to expire on 30 September 2022.

 

A review of the service had been commissioned, which had highlighted strong service performance and no concerns with the quality and impact of the provider's service delivery. It also highlighted the need to resolve the presentation of the perceived two provider model, with a strong, single, unified service identity moving forward.

 

It was therefore proposed to re-commission the service in largely the same format, with the intention that the service would continue to assist the Council in meeting its legal duties to carers, providing services for face-to-face carer assessment, eligibility determination, the planning and provision of support, authorisation of personal budgets and review.

 

The working assumption was that the new service will be commissioned within the current available budget. A pooled budget with multiple income sources of £1,708,868 was potentially available from existing Public Health budgets to fund the new service.

 

It was proposed that the contract be awarded for five years, with the option to extend for a further two years following that.

 

The Committee supported the recommendations to the Executive and during the discussion the following points were noted:

 

·       There would be an opportunity within the contract to work closely in partnership with the provider to introduce further refinements as the contract progressed

·       When the contract for general support services, which was currently provided by Serco and included the customer service centre element of the carers’ service, was developed, it was suggested that other options were considered such as whether the customer service centre element could be provided in-house, or form a separate contract or become part of a unified service with the carers’ support service element.  

·       A single unified service approach was strongly supported, whilst at the same time recognising the local element to service provision.

·       The importance of timely assessments, both at initial contact and as a review, was stressed. 

·       The provision of funding for the refurbishment of Mosaic was supported.

·       Assurance was provided that the budget for the carers service was sufficient.

·       A breakdown of the support provided was agreed to be circulated to the Committee.

·       The importance of engaging with volunteer groups was emphasised.

·       The Committee requested that a progress report on the service, no earlier than April 2023, as this would enable the new provider to settle into the service. 

 

 

RESOLVED:

 

  1. That the recommendations to the Executive be supported;

 

  1. That a summary of the comments made by the Committee be reported to the Executive as part of its consideration of this item.

 

64.

Residential Care and Residential with Nursing Care Usual Costs pdf icon PDF 489 KB

(To receive a report by Alina Hackney, Head of Procurement – People, which invites the Committee to consider a report on Residential Care and Residential with Nursing Care Usual Costs, which is due to be considered by the Executive on 1 March 2022. The views of the Committee will be reported to the Executive as part of its consideration of this item)

Additional documents:

Minutes:

Consideration was given to a report by the Head of Procurement – People, which invited the Committee to consider a report on Residential Care and Residential with Nursing Care Usual Costs, which was due to be considered by the Executive on 1 March 2022.

 

The Committee received a presentation, which highlighted the following in relation to the report:

 

  • An overview of the Learning Disability Service, which had an annual total spend of approximately £125m per year, being one of the council’s highest spend and risk areas
  • Details of the programme of review for the service
  • Details of the findings from Independent review
  • Details of cost modelling and market engagement
  • The outcome of the review of the service

 

The ultimate aim of the programme was to establish a new set of contracts for residential services that were both affordable to the Council, and met the Council's legal duties, along with the necessary changes and improvements that would allow for successful operation of services over the next contract duration.

 

It was recommended that a Usual Cost be be set for the next 12 months taking into account the likely effect of changes to providers' costs, both National living Wage and forecast inflation to address non-pay costs. Given the volatility of market cost of care following the pandemic and in lieu of full details of the anticipated social care reforms, to help ensure the level of risk to the residential market was reduced and provide assurance about future income from the largest single purchaser of such care in Lincolnshire (the Council), a three-year contract with an annual rate review for years two and three was recommended to avoid Usual Costs losing pace going forward

 

The Committee supported the recommendations to the Executive and during the discussion the following points were noted:

 

·       Setting the fee rates for one year from 1 April 2022 was supported, on the basis of the present climate of uncertainty and the need to let the market settle.

·       Providers were able to charge above rates that had been set, which would require a third party top up.

·       The exploration of block purchasing (paragraph 6.3.1) was supported, and it was understood the use of block purchasing was more likely to focus on providers of specialised services, as this would be means of securing places for Lincolnshire residents in a local setting.

·       There was concern that with the rate of inflation (4%) used in the calculation of the revised rates may not be adequate, but it was understood that the care sector would approach the Council if a higher inflation rate were to persist.

·       It was confirmed that a number of the care providers also provided day care services.  The Council were looking at how they could further support local providers with establishing day care services.

·       The hardship fund (recommendation 6) of £1 million was supported by the Committee as a means of supporting increased utility and insurance costs from providers and was also supported by the Chair of the Lincolnshire Care  ...  view the full minutes text for item 64.

65.

Adults and Community Wellbeing Scrutiny Committee Work Programme pdf icon PDF 673 KB

(To receive a report by Simon Evans, Health Scrutiny Officer, which invites the Committee to consider its work programme)

Minutes:

Consideration was given to a report by the Health Scrutiny Officer, which invited the Committee to consider the Committee’s future work programme, as set out on pages 98 – 101 of the agenda pack.

 

Following on from discussions during the meeting, the Committee welcomed the following items to be added to the work programme

 

  • Progress on the social care reform white paper, People at the Heart of Care
  • Alcohol and smoking services
  • Invitation to the new provider of the Carers Service to be invited to a meeting of the Committee no earlier than April 2023
  • Volunteer recruitment
  • A possible item to further analyse the performance indicate relating to the number of Adult Safeguarding concerns that lead to a safeguarding enquiry

 

RESOLVED:

 

              That the Work Programme be agreed, subject to the amendments   proposed.

 

 

 

 
 
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