Agenda and minutes

Apologies for absence were received from Councillors T A Carter and N F Clarke.

There were no declarations of interest.

RESOLVED:

              That the minutes of the meeting held on Wednesday 25 May 2022 be             approved as a correct record and signed by the Chairman.

The Chairman advised the Committee that there was nothing specific to announce at this point other than a series of initiatives from the government were expected to impact on the Committee’s work programme from September onwards.  

The Executive Support Councillor for Adult Care and Public Health was pleased to announce that the Quad Restaurant within County Offices would be reopening on 11 July 2022 and would be run as an opportunity for those with learning disabilities to gain catering, service and customer skills. 

(To receive a report by Justin Hackney, Assistant Director – Specialist Services and Safeguarding, which provides an update on the work of the Lincolnshire Safeguarding Adults Board)

Consideration was given to a report by the Assistant Director – Adult Care and Community Wellbeing and the Chairman of the Lincolnshire Safeguarding Adults Board (LSAB), which provided the Committee in the current position of key areas of work being undertaken within the LSAB.

The Assistant Director – Adult Care and Community Wellbeing was pleased to announce that Richard Proctor had now been formally appointed as the Chairman of the LSAB on a permanent basis.

The LSAB had carried out a detailed analysis of the Annual Safeguarding Adult Return which had informed the priorities to be incorporated in the updated LSAB strategic plan. The new three-year strategic plan was currently in draft form and was due to be published in July 2022. Details were provided on the four priorities of the plan which were: prevention and early intervention; learning and shaping future practice; safeguarding effectiveness and making safeguarding personal. 

A recent review of the LSAB’s making safeguarding personal (MSP) approach to safeguarding practice had progressed and an action plan had been developed which could be found at Appendix A to the report.

11:07 – Councillor M J Overton entered the meeting.

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

• The plan showed clear direction and was prioritising key issues that had not been a key focus in previous years.
• The Committee expressed concerns that pressure sores remained a safeguarding risk after many years of suggestions and initiatives aimed at reducing their occurrence.  It was clarified that pressure sores had been identified as the highest rate of concern for serious clinical incidents within the NHS. A focus on pressure sores had been included within the strategy to encourage the partnership to prioritise reducing the prevalence of pressure sores and investigate how the partners could work collectively to make improvements.
• It was acknowledged that domestic abuse was an underreported crime. The LSAB would continue to communicate with the public to encourage reporting of domestic abuse. The re-procurement of domestic abuse support service in the County would see the expansion of capabilities for the Council and its partners to tackle domestic abuse.
• Concerns were raised that safeguarding was not fully embedded across all Lincolnshire Councils. Assurance was provided that the Lincolnshire Making Safeguarding Personal workstream board were working on wider preventative work such as ensuring all Council workers coming into contact with the public had received safeguarding training.  There was an opportunity to work with wider partners to embed safeguarding into all Council employees.
• It was acknowledged that the cost-of-living crisis could lead to safeguarding risks across the County. Preliminary work had been carried out which investigated the wider impact of economic changes. Further details would be provided within the report on the Integration White Paper for Health and Social Care report at the next meeting.
• The focus on preventative work was commended.
• Partnership working and adopting a common approach to the prevention and early intervention of safeguarding risks in Lincolnshire had been successful. The importance  ...  view the full minutes text for item 13.

(To receive a report by Pam Clipson, Head of Finance, Adult Care and Community Wellbeing, which invites the Committee to consider Adult Care and Community Wellbeing’s financial performance in 2021-22)

Consideration was given to a report by the Head of Finance – Adult Care and Community Wellbeing, which invited the Committee to consider a report on the Adult Care and Community Wellbeing Financial Position for 2021-22.

A summary of the financial outturn for each service was provided.  Overall, the adult care and community wellbeing directorate had an underspend of £2.382m for 2021-21. 

It was proposed that a revenue to capital transfer of £0.5m be used in 2022/23 to invest in in day service buildings to increase access and use of the buildings by the wider local community. £0.2m would also be allocated to continue working with health colleagues to further integrate across the discharge to assess pathway.

2021-22 had continued to see the Coronavirus pandemic impact across services and Adult Care and Community Wellbeing had received significant grant funding to enable continued support to adult social care providers and to continue to prioritise and redeploy its workforce as Lincolnshire recovered from the pandemic. The directorate carried forward £4.558m of specified grant funding into 2022-23, relating specifically to the contain outbreak management funding and the clinically extremely vulnerable funding.

The Committee noted that the medium-term financial plan beyond 1 April 2023 would need to be revised during the summer as the social care reforms consultation was due to be published.

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

• The Committee were encouraged by the underspend. It was clarified that the underspend from 2020-21 had been carried forward and spent on the completion of the De-Wint Court housing development in Lincoln. Despite a significant increase in public health costs during the pandemic, the receipt of additional Covid-19 grants in 2021-22 had supported these costs and contributed to the underspend.
• No further Covid-19 grants were anticipated for 2022-23, but approximately £4m of ring-fenced grants had been allocated to support services which continued to see impacts of Covid-19.
• Officers were working on their proposal for the Market Sustainability and Fair Cost of Care Fund which would be considered by the Committee in September prior to consideration by the Council.
• The Committee acknowledged the forthcoming pressures as a result of the Adult Care reforms.
• The Council were pursuing a new business model for the charging of Fair Cost of Care Fund rates and to this end digital technology should mitigate the requirement for additional staff.
• The level of agency spend within the Adult Care and Community Wellbeing Directorate was low and most agency spend within the adult care sector was made by providers, which had seen a further increase throughout the pandemic. Two Covid-19 grants had been received for workforce recruitment and retention, of which 98% had been passported to the provider workforce to support with the cost of agency spend throughout the pandemic.
• Within the directorate, agency staff were only used in hard to recruit areas, such as on the East Coast.
• Agency spend was mitigated through an apprenticeship scheme in partnership of the University  ...  view the full minutes text for item 14.

(To receive a report by Caroline Jackson, Head of Corporate Performance, which provides the Committee with an update on service level performance for Adult Care and Community Wellbeing for 2021-22 Quarter)

Consideration was given to a report by the Corporate Performance Manager which provided an update on service level performance for Adult Care and Community Wellbeing.

Out of a total of 20 measures reported in quarter 4, six measures had exceeded the target nine measures have achieved the target and five measures did not achieve their target.

Despite the challenges over the recent years, evidence suggested that Lincolnshire continued to perform well in comparison to similar large rural shire counties. By using a range of national outcome and finance measures, the comparisons showed that Lincolnshire Adult Care was a low spend, high outcome authority.

An overview of performance for quarter 4 was provided. Despite challenges faced as a result of Covid-19, good evidence of effective service delivery resilience, and adaptability of all involved in care could be evidenced, although it was acknowledged that there was room for improvements in certain areas.

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

• The Committee acknowledged that the target for the percentage of alcohol users that left specialist treatment successfully was aspirational as there would always be a proportion of people would continue to drink alcohol. It was confirmed that the figures for this target were cumulative throughout the year. It was also noted that many people receiving support for alcohol had received a ‘dual diagnosis’ where mental health was challenging.
• With regard to smoking cessation, a request was made for more information on the age profiling of smokers, as there was a suggestion that the prevalence among young people was increasing.
• A number of investments and changes had been made to the alcohol cessation programme which would hope to see benefits as they progressed. More detail would be provided at a future meeting.
• A number of procurements had been re-tendered for a short period of six to 12 months in order to align contract times with North Lincolnshire and North East Lincolnshire to support initiatives across the Greater Lincolnshire.
• It was noted that there was a backlog of reviews within both the NHS and social care. The Council worked hard on a preventative approach to meet peoples needs to reduce the need for long term support and would continue to work to improve the number of people in receipt of the long term support who had received a review.
• The importance of ensuring that all carers received a review of their needs was emphasised. Officers acknowledged the contribution made by carers and assurance was provided that the Council were in regular communication with carers to make improvements to the quality of their lives.
• Officers would consider whether a specific target was needed within the corporate plan to monitor gambling addiction, although for overview and scrutiny purposes, this would fall under the remit of the Public Protection and Communities Scrutiny Committee.
• Improvements had been made to manage first contacts within the customer service centre. 
• Demographics suggested that there were around 80,000 informal carers within Lincolnshire, many of whom  ...  view the full minutes text for item 15.

(To receive a report by Simon Evans, Health Scrutiny Officer, which invites the Committee to review its proposed work programme and note the forward plan)

Consideration was given to the Health Scrutiny Officer which invited the Committee to consider its work programme, as set out on pages 69-72 of the agenda pack.

The Committee welcomed the addition of an item on Fair Rates in September 2022 and an item on the Domestic Abuse Strategy, potentially at the October or November meeting.

It was requested that the Director for Public Health provide an update on the new public health arrangements for Greater Lincolnshire at the next meeting of the Committee. 

RESOLVED:

              That the work programme be agreed.