Agenda and minutes

Apologies for absence were received from Councillor S Parkin.

The Committee also noted apologies from Glen Garrod, Executive Director – Adult Care and Community Wellbeing.

None were declared at this point in the meeting.

All declarations will be recorded under the relevant minute item

It was agreed that the second bullet point for minute 54 be amended to read ‘The Director of Public Health considered the options available to restrict the density of fast-food outlets in some communities, including through planning regulation and local saturation zones for alcohol and fast food outlets’.

RESOLVED:

        That the minutes be approved, subject to the above amendment.

There were no announcements by the Chairman, Executive Councillor or Lead Officers.

(To receive a report from David Boath, Corporate Performance Manager, which summarises the Service Level Performance against the Success Framework 2022-23 for Quarter 3)

Consideration was given to a report by the Head of Corporate Performance, which summarised the Service Level Performance against the Corporate Performance Framework for Quarter 3 of 2022-23, as detailed in the report.

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

Measure PI 59 - Carers supported in the last 12 months:

·     Members were assured that carers known to the authority were well supported and this was monitored by the carer’s delivery partnership. Details of the support offer would be circulated.

Measure PI 122 – Requests for support for new clients – where the outcome was no support or support of a lower level

·     Alternative support for new clients who did not meet the criteria for a full assessment included providing additional information or signposting to community support.

Measure PI 65 – People in receipt of long-term support who have been reviewed

·     Reviews took place annually, however changes to care packages would also instigate a review. As standard, reviews took place face-to face, however in some circumstances virtual reviews could be scheduled, subject to a risk assessment.

Measure PI 60 – Permanent admissions to residential and nursing care homes aged 65+

·     Targets were reviewed annually by each service area and were signed off by the Executive Director - Adult Care and Community Wellbeing. Targets were benchmarked against national and local data.

Measure PI 31 – Percentage of alcohol users that left specialist treatment successfully

·     The Committee were assured that this measure was being reviewed by various partners as part of work on the prevention and treatment of alcohol use, prior to the recommissioning of the alcohol treatment service.  

PI 33 – People aged 40 to 74 offered and received an NHS health check

·     The Committee noted the benefits of health checks and were pleased that this measure had reached the target. Members welcomed work between the NHS Lincolnshire Integrated Care Board (ICB) and GP’s to review the arrangements for health checks which hoped to provide a more regular pattern of contact.

·     It was suggested that thought be given to the introduction of an indicator which would measure the response to social care needs for adults living at home. However, it was acknowledged that this was monitored through a number of other measures, for example timely and adequate assessments and ensuring suitable support or equipment.

PI 60 – Permanent admissions to residential and nursing care homes aged 65+:

·     Investing into services such as extra care housing and the reablement services would have led to lower levels of permanent admissions to residential and nursing homes for long term care, and would focus on a community offer, which was shown within the budget.

·     The number of people entering long term residential care had begun to increase following a drop in admissions as a result of the Covid-19 pandemic.

PI 111 – People Supported to successfully quit smoking:

·     Public Health were working closely with the ICB to avoid duplication when offering support for services, for example on  ...  view the full minutes text for item 62.

(To receive a report by Pam Clipson, Head of Finance – Adult Care and Community Wellbeing and Alina Hackney, Head of Commercial Services, which invites the Committee to consider a report on Community Supported Living, Residential Care and Residential with Nursing Care Usual Costs prior to its consideration by the Executive on 7 March 2023. The views of the Committee will be reported to the Executive as part of its consideration of this item)

Councillor T A Carter declared a non-pecuniary interest as a trustee of Holbeach and East Elloe Hospital Nursing Home.

Consideration was given to a presentation by the Head of Finance – Adult Care and Community Wellbeing and the Head of Commercial Services, which outlined the key points from the report to the Executive on Community Supported Living, Residential Care and Residential with Nursing Care Usual Costs, including rate construct, risk, the market sustainability and improvement fund, the hardship fund and referred Members to the proposed recommendations.

The Board supported the recommendations to the Executive and during the discussion the following points were highlighted:

·       Assurance was provided that the Council had consulted with the whole market place on the rate construct. Responses received had been mixed but had identified potential challenges for larger organisations, which the Committee expressed concerns about. The Committee was reassured that targeted support would be provided to those considered homes high risk.  An example of support could be the hardship fund, where providers could receive funds for assistance with increased energy and insurance costs. 

·       Lincolnshire County Council had been the only local authority operating a hardship fund during 2022-23 and had also been advising other local authorities on how to operate one. There was potential for the hardship fund to be extended into 2023/24.  The Committee requested details of the application of the hardship fund as part of its regular budget monitoring updates.

·       Non-staffing costs related to a variety of costs, for example costs of taking part in activities and for personal protective equipment.

·       The Committee accepted the rationale used to calculate the proposed levels of fees to be paid to providers for these services.

·       Inspections of homes were undertaken by the Care Quality Commission (CQC) however the Council engaged with relatives and residents as part of an annual review of commissioning arrangements.

·       Historically, star rated/incentive schemes to improve standards had not been successful and the Committee acknowledged a preference to target support where it was most needed whilst aspiring for everybody to be operating at a high standard.

·       The Council had advised CQC of the risks of allowing further care homes to open in Lincolnshire, given the difficulties many homes were already facing.

·       The Committee welcomed the use of block contracts, as a means of supporting and providing stability to the residential care and community supported living market. 

·       The Committee expressed a preference to see the programme of developing intermediate care accelerated, in partnership with the NHS.  An example of this had been the establishment of sixty ‘active recovery beds’, which were already seeing high numbers of people returning to their home to live independently, as opposed to long term residential care.  Funding for active recovery beds was being sought from the NHS, so that this initiative could continue beyond 31 March 2023. 

·       A need to consider to how settings such as community supported living might be promoted to the public as alternatives to residential care was highlighted.  This and other parts of the transformation programme  ...  view the full minutes text for item 63.

(To receive a report by Lucy Gavens, Consultant in Public Health, which invites the Committee to consider a report on Substance Misuse Grant Monies, prior to its consideration by the Executive on 7 March 2023. The views of the Committee will be reported to the Executive as part of its consideration of this item)

Consideration was given to a report by the Consultant in Public Health, which invited the Committee to consider a report on Substance Misuse Grant Monies, which was due to be considered by the Executive on 7 March 2023.

The Committee supported the recommendations to the Executive, and in considering the item the following points were highlighted:

·       The Committee recognised that the four grants available are focused on services for the treatment of alcohol and drug misuse.  These services supported a wider drug and alcohol strategy, which included an emphasis on prevention. The Committee supports this emphasis, as the use of drugs can have a severe impact on individuals, families and their communities, and successful prevention ultimately reduces the need for treatment services.    This strategy had been developed by the Lincolnshire Drug and Alcohol Partnership, which included representation from the Police, the Probation Service, the NHS and district councils.  The Committee requested to see all the services provided by these organisations, which would support the strategy, maintained.  

·       Plans were in place to sustain the model beyond twelve months, should grant funding not be extended. 

·       The salary Data Analysist post was set at the same rate as other data analysists within the Adult Care and Community Wellbeing directorate.

·       The Committee would like to see outcome measures and benchmarking applied to the use of the additional funding.  For example, increased funding from the Government during 2022-23 had led to the case load of each substance misuse support worker reducing from 70 to 55 clients, which would be expected to lead to improved outcomes.  The emphasis on assertive outreach workers was also expected to improve outcomes.

·       The Committee recognised that it was usually the Government or national third sector organisations, which take the lead on campaigns highlighting the risk of drugs and alcohol misuse and suggested that consideration might be given to a local campaign, as had taken place previously, to complement the national campaigns. 

·       Collaboration with partners was key to addressing challenges with rough sleepers and support for alcohol and drug addiction. Plans were in place in what’s evaluating what was working well to inform the next steps for recommissioning.

·       Some Members were concerned about the impact the reduction to the number of PCSO’s would have on community-based support to those with substance misuse issues.

·       Grant funding had been allocated primarily to increase staffing levels with the aim to improve quality and outcomes.

·       The Committee emphasised the value of outreach support workers.

·       The Committee requested that a report be programmed for a future meeting to monitor the success of the programme.

RESOLVED:

1.     That the recommendations to the Executive, as set out in the report, be supported;

2.     That a summary of the comments made be passed on o the Executive as part of its consideration of this item.

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

Consideration was given to a report by the Health Scrutiny Officer, which invited the Committee to consider its work programme.

The Committee noted that a report on the Introduction to the Lincolnshire Carers Services would be postponed until later in the year.

RESOLVED:

        That the work programme be agreed.