Adult Social Care and Health Select Committee Minutes

Date:
Tuesday, 9th July, 2019
Time:
4.00pm
Place:
Jim Cooke Suite, Stockton Central Library, Stockton on Tees TS18 1TU
 
Please note: all Minutes are subject to approval at the next Meeting

Attendance Details

Present:
Cllr Evaline Cunningham(Chairman), Cllr Clare Gamble(Vice-Chair), Cllr Jacqueline Bright, Cllr Kevin Faulks, Cllr Andrew Stephenson (Sub for Cllr Lynn Hall), Cllr Mohammed Javed, Cllr Tina Large, Cllr Paul Weston, Cllr Bill Woodhead (MBE)
Officers:
Emma Champley, Rob Papworth, Kerry Anderson, Darren Boyd, Angela Connor, Peter Mennear, Judy Trainer, Marianne Sleeman (DCE)
In Attendance:
Jean Golightly, Jo Gamble, Dr Neil O'Brien, Paula Swindale, Paul Wittingham (HaST CCG)
Apologies for absence:
Cllr Lynn Hall
Item Description Decision
Public
ASH
7/19
EVACUATION PROCEDURE
 
ASH
8/19
DECLARATIONS OF INTEREST
 
ASH
9/19
CLINICAL COMMISSIONING GROUP - MERGER PROPOSALS

AGREED:

That the information be noted and a response to the CCGs be developed.

ASH
10/19
SCRUTINY REVIEW OF CARE HOMES FOR OLDER PEOPLE
AGREED:

That the information be noted and draft scope and project plan be approved.
ASH
11/19
QUARTERLY CARE QUALITY COMMISSION INSPECTION UPDATE
AGREED:

The updates be noted and information requested be circulated.
ASH
12/19
REGIONAL HEALTH SCRUTINY UPDATE
AGREED:

The information be noted.
ASH
13/19
SELECT COMMITTEE WORK PROGRAMME
AGREED:

That the Work Programme 2019 - 2020 be noted.
ASH
14/19
CHAIRS UPDATE
 
4pm - 6pm

Preamble

ItemPreamble
ASH
7/19
The Chair welcomed everyone to the meeting and the evacuation procedure was noted.
ASH
8/19
There were no interests declared.
ASH
9/19
Members were presented with an overview of the Merger Proposals by the Clinical Commissioning Group. The key issues in discussion with the Committee were as follows:

• The preferred merger would be 2 CCG’s with a shared management structure i.e. one covering Tees Valley and one covering County Durham.

• The merger would aim to make a 20% saving on running costs ensuring stronger and clearer consistency which would reduce the management budget to approximately 17 million pounds.

• The money saved would be equally weighted between the two CCGs taking into account the footprint of each area.

• The merger would create minimum redundancies, currently the 5 CCG’s were managing vacancies to avoid this.

• The management structure would remain the same within the merger i.e. 1 Accountable Officer and 2 Chief Officers; with a view to making systems work more efficiently.

• The merger proposes to create a more robust organisation which could still deliver locality based GP-led commissioning but with a reduced administrative burden. The majority of support functions would continue to be ‘bought in’ from North East Commissioning Support, and the CCGs would in future be continue the approach to collaboratively commission services.

Members had no objection to the preferred option.
ASH
10/19
Members received introductory presentations to provide context for the Scrutiny Review of Care Homes for Older People.
The main issues discussed were as follows :
Care Home Market in Stockton
• There were 31 regulated care homes in Stockton for older peoples and although there had been some improvement in quality of provision, Stockton remained one of the poorer performers within the North East

• There was an 82% occupancy within Stockton and this had an impact on quality and demand was reducing due to supported living

• The ‘Well Led Programme’ had been well received and indications were that it was delivering positive results

Quality Assurance and Compliance

• The Local Authority has a dedicated quality and performance team working in partnership with providers and delivered a risk based quality improvement programme
• The Local Authority were also utilising the Provider Assessment and Market Management Solutions (PAMMS) which was on online assessment tool mirroring CQC Inspection themes
• Feedback was encouraged from patients, family, managers and staff and assessments were carried out annually. The frequency of monitoring and interventions varied according to the quality threshold level and if there were major concerns, interventions could be weekly
• 11 care homes had published PAMMS assessments to date (8 good, 3 Requires Improvement); those rated less than good had an action plan and were supported by a quality assurance and compliance officer
Role of the Social Worker
• Social workers complete assessments under the Care Act, complete reviews with care homes and respond to any safeguarding risks
• Safeguarding policies/ procedures and training was also provided to all care homes
• A Serious Concerns Protocol was implemented when required
HaST CCG
• The CCG commissioned a range of universal services, including:
o Hospital Services
o GP/ Primary Care
o Community nursing e.g. District Nurses
o Therapy Support
o Support for residents with specific long term conditions
o Nutrition and Dietetics
o Community Matrons
o Single Point of Access
o Mental Health and Dementia Services
o Equipment Services

• Additional CCG Investment free to Care Homes included:
o Care Home Training and Education Programme
o Proactive Intensive Community Liaison Service
o Falls prevention
o Red Bag Scheme
o Capacity Tracker
o Touchscreen technology
o Medicines optimisation
o Provision of mutual aid to sustain the market
o Primary Care Networks - Enhanced Health in Care Homes
o Engagement

• All Care Homes had signed up to the Red Bag Scheme; this facilitated information sharing when a resident transferred to hospital
• Members were given assurances about the integrated approach to Safeguarding within the Care Homes
ASH
11/19
Consideration was given to the summary of inspection reports published ion Quarter 4 2018-19.

The main issues discussed were as follows:

• Members were informed the Local Authority do not have any influence on the rating system used by the CQC.
• Members requested details of how dental services were rated.
• It was suggested consideration be given to the format of future reports potentially including an overall summary the position in the Borough.
ASH
12/19
Consideration was given to the Regional Health Scrutiny Updated offered by the Scrutiny Officer.
ASH
13/19
Consideration was given to the Adult Social Care and Health Select Committee Work Programme 2019 - 2020.
ASH
14/19
The Chair informed the Committee of a meeting with the representatives of the CCG and queries regarding to changes to ordering of repeat prescriptions would be raised there, with responses provided to the Committee. Any questions should be sent to the Scrutiny Officer.

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