Adult Social Care and Health Select Committee Minutes

Tuesday, 20th July, 2021
4.00 p.m.
Jim Cooke Conference Suite, Stockton Central Library, Stockton, TS18 1LD
Please note: all Minutes are subject to approval at the next Meeting

Attendance Details

Cllr Evaline Cunningham (Chair), Cllr Jacky Bright, Cllr Luke Frost, Cllr Lynn Hall, Cllr Mohammed Javed, Cllr Steve Matthews, Cllr Norma Stephenson OBE
(sub for Cllr Clare Gamble), Cllr Paul Weston
Ann Workman, Emma Champley, Gavin Swankie, Peter Otter (A&H); Gary Woods (MD)
In Attendance:
Apologies for absence:
Cllr Clare Gamble, Cllr Ray Godwin
Item Description Decision
AGREED that the minutes of the meeting on the 22nd June 2021 be approved as a correct record and signed by the Chair.
AGREED that the Progress Update be noted and the assessment for progress be confirmed.
AGREED that the draft scope and project plan of the Day Opportunities for Adults review be approved.
AGREED that the Adult Social Care and Health Select Committee Work Programme for 2021-2022 be noted.


There were no interests declared.
Consideration was given to the minutes from the Committee meeting held on the 22nd June 2021.
Consideration was given to the assessment of progress on the implementation of the recommendations from the Scrutiny Review of Hospital Discharge (Phase 1 - discharge to care homes during the COVID-19 pandemic). This was the second progress update following the Committee’s agreement of the Action Plan in December 2020, and key developments in relation to the outstanding action were noted as follows:

Recommendation 2 (North Tees and Hartlepool NHS Foundation Trust provide a prompt response to the communication issues raised by care homes through the survey undertaken as part of this review): Several elements of progress were highlighted regarding care home communication, integration of care home representatives in weekly multidisciplinary team (MDT) forums, the provision of a single link and contact number for families and carers around discharge, and the Clinical Triage Service. Evidence of the impact of these measures was outlined and it was noted that the Trust had not received any formal complaints from Stockton-on-Tees care homes about communication since the last progress update in April 2021.

The Committee commended the Trust on the pace of progress evidenced and was pleased to hear developments around the recruitment of Multidisciplinary Forum Facilitators to link-in with care home managers - it was agreed that it would be helpful if these were named roles.

Feedback on the latest Provider Forum (organised by the Council) which took place on the 16th July 2021 was requested - Officers confirmed that last week’s event was again well received, with good attendance from care home providers. Members were reminded that these Forums had been held throughout the pandemic, had included Department of Health and Social Care (DHSC) input as well as a range of exceptional speakers (who had given their time despite the pressures around their own day jobs), and had played an important role in supporting the local uptake of COVID-19 vaccinations.

A query was raised around complex cases (including end-of-llfe) and potential discharge delays as a result of multidisciplinary forum arrangements. Further information in relation to this issue would be provided after the meeting.

Since all the Trust’s actions in relation to recommendation 2 were deemed to remain ‘on-track’, the Committee looked forward to a further update at a future meeting
Scrutiny Review of Day Opportunities for Adults

Prior to the consideration of the scope and project plan for the Committee’s next in-depth scrutiny review regarding Day Opportunities for Adults, a background briefing was provided by the Council’s Transformation Manager (Day Opportunities) in relation to the following key aspects involving this scrutiny topic:

• Purpose of day opportunities
• Day opportunity providers
• People using day opportunities
• Costs and income
• Impact of the COVID-19 pandemic

The Committee was informed that day opportunities for adults in Stockton-on-Tees was currently provided in three ways; Council-run day services, Council-commissioned day services from the independent or voluntary sector, and support purchased directly by individuals from the independent and voluntary sector using a direct payment (it was acknowledged that further work was required to identify the amount spent on accessing day opportunities through direct payments). Access to such services was initiated via an individual’s Social Worker following an assessment of their needs, and it was confirmed that the Borough’s residents were able to access those providers listed who were outside Stockton-on-Tees.

A key driver around this scrutiny topic was the impact of COVID-19 on access to, and delivery of, existing services. In line with Government guidance, access to day centres had been limited during the pandemic, with some buildings closed for periods of time and attendance only offered to those individuals who had no alternative arrangements and who would be at risk if the provision was withdrawn. However, weekly contact had been maintained with individuals unable to attend day services due to COVID-related restrictions.

Reflecting on the content of the background briefing, Members felt that an important part of the forthcoming review would be to clearly demonstrate the communications with service-users and their families / carers since the emergence of COVID-19, and to establish a timeline for when previously relied-upon provision could be resumed (in whatever form that could / should be in light of the continuation / lifting of ongoing restrictions). Obtaining detailed information regarding community day options was also vital.

The Committee noted the different age-ranges that were potentially affected by this review, and it was suggested that elderly and vulnerable people may, understandably, be more reluctant to re-engage with services due to ongoing worries around COVID-19 infections. At the younger end of the spectrum, concerns were expressed around potential gaps in service provision for those people leaving education and transitioning into adult services.

In related matters, a recent email regarding the temporary pause of respite admissions to Bankfields Court, Normanby (Tees Adult Learning Disability Services) due to COVID-19 staffing issues was highlighted - this would be circulated to the Committee after this meeting.

Consideration was then given to the draft scope and project plan for the Scrutiny Review of Day Opportunities for Adults. The main aims of the review would be to consider and identify options for the remodelling of Day Opportunities Services, primarily to move away from traditional building-based ‘service-driven’ provision to a ‘needs-led’ community-focused service which clearly articulates the role of the Council, independent / VCSE assets, stakeholders and volunteering in delivering this model. Critical in any future planning would be the need to ascertain the views of service-users and their families / carers, particularly in light of the considerable impact that the pandemic-related changes to day services will have had on informal carers.

A number of contributors had been identified including the Council’s Adults and Health and Children’s Services directorates, external providers of day opportunities, the Tees Valley Clinical Commissioning Group, Catalyst (including volunteers), and service-users / families / carers. Depending on developments around the ongoing pandemic, it was hoped that some site visits could also be undertaken.
Consideration was given to the Committee’s current Work Programme. The next meeting was scheduled for the 14th September 2021 and would include consideration of the Healthwatch Stockton-on-Tees Annual Report 2020-2021, the draft Action Plan in relation to the recommendations within the Hospital Discharge (Phase 2 - discharge to an individual’s own home) final report, and the first evidence-gathering for the Day Opportunities for Adults review.

Further to previous concerns raised around the Care Quality Commission (CQC) during COVID-19 (most recently at the last Committee meeting in June 2021), CQC representatives had since been invited to address the Committee on a range of issues including visibility within care homes, focused inspections on infection prevention and control, and their future regulatory approach. It was confirmed that a CQC representative would be in attendance at the next Committee meeting in September 2021 to provide a response to these issues, and that this would coincide with the presentation of the next CQC quarterly update report (Q1 2021-2022).
The Chair informed Members that the final report of the Committee’s Hospital Discharge (Phase 2 - discharge to an individual’s own home) review was presented to Cabinet last week (15th July 2021). All recommendations were subsequently endorsed, and the Chair was asked to pass on the Cabinet’s appreciation for the work undertaken on this important topic.

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