Adult Services and Health Select Committee Minutes

Monday, 14th September, 2015
Jim Cooke Conference Suite, Stockton Central Library, Stockton on Tees, TS18 1TU
Please note: all Minutes are subject to approval at the next Meeting

Attendance Details

Cllr Mohammed Javed (Chair); Cllr Carol Clark (Vice Cllr Sonia Bailey), Cllr Michael Clark, Cllr Evaline Cunningham, Cllr Kevin Faulks, Cllr Lynn Hall, Cllr Stefan Houghton, Cllr Mick Moore and Cllr Tracey Stott.
J Humphreys, S McEneany, L Hanley (CESC); P Kelly (PH); P J Mennear, P K Bell (LD).
In Attendance:
Councillor Jim Beall (Cabinet Member for Adult Services and Health).
Apologies for absence:
Cllr Sonia Bailey and Deborah Miller.
Item Description Decision
The evacuation procedure was noted.
There were no interests declared.
AGREED that the performance information be received and the outstanding information be provided.
AGREED that the Overview of Public Health Services be received.
AGREED that:-

1. The report be noted.

2. The proposals for site visits and inspection outcomes be approved.
There was no Chair's Update.
4.00 p.m. - 6.00 pm


Consideration was given to a report that provided an overview of performance in the delivery of Adult Social Care Services during 2014-15.

Attached to the report was an overview of key achievements during 2014-15, a summary of key challenges for the year ahead, and reference to some of the emerging issues which were likely to impact on future delivery and performance of services.

Also attached to the report was further detail regarding the performance indicators that underpin some of the key achievements.

A copy of the 2014-15 Local Account which would be presented for approval to Cabinet at its meeting on 10th September was also attached to the report.

Jane Humphreys (Corporate Director of CESC), Liz Hanley (Adult Services Lead) and Sean McEneany (Head of Adult Operations) were in attendance at the meeting and presented an overview of performance.

Members were then given the opportunity to ask questions and make comment on the overview of performance and these could be summarised as follows:-

- When will the rest of the thematic summaries quarter 4 data be available?

The Corporate Director of CESC responded as follows:-

- Further information will be provided with regard to thematic summaries quarter 4 data.

- Members queried progress made in relation to Autism Services.

It was noted that Adult Services were now reviewing Out of Borough placements but did not want to destabilise placements that were currently effective at meeting needs.

The Cabinet Member for Adult Services and Health reported that there was a political steer for more autism provision in the Borough. The use of Ware Street for day services was seen as a good start.

- Members noted that the respite provision is good in the Borough but is there support for parent carers?

- With regard to parent carers support there was a transition issue and education provision needed to be looked at.

- Members queried the impact of the National Living Wage announcement. It was noted that home care providers in particular were lobbying for an increase to reflect the Living Wage. There could be a substantial impact on resources.

The Cabinet Member noted that it was an aspiration to secure alternative methods of delivery for home care services, potentially involving the voluntary community and social enterprise sector.

With regard to the Local Account, Members queried the results of the surveys and ‘scores for proportion of people who use services who feel safe’. The Corporate Director of CESC reported that the 2013-14 National Performance Indicators from the Social Care Survey were based on perceptions and the figures could change each time the survey was completed. Also, because the survey was anonymous the results could not be analysed any further.

Other surveys undertaken by the Council suggested higher feelings of personal safety, such as those undertaken on behalf of the Safer Stockton Partnership.

Alternative provisional figures for the following year suggested an improved percentage score for that indicator. The 2014 LGA peer review of Safeguarding had produced positive outcomes.

Members requested feedback on the trends in provision of low level support.

The Chair felt that there was some great work being done.
The Director of Public Health gave Members an Overview of Public Health Services.

There were 5 mandated Public Health functions that the Council was required to deliver under the Health and Social Care Act 2012. These were:-

1. Community Sexual Health Services
2. Health checks
3. The National Child Measurement Programme for Children in Reception and Yr6
4. Ensuring arrangements are in place to protect the public
5. Providing Public Health support for the local CCG

The mandated functions were only a small part of the activity of the Public Health Department. The DPH report for 2014/15 was focused on health inequalities in the Borough and that was where much of the department’s work was aligned. Areas of particularly high activity for the team therefore included:-

• Drug and alcohol treatment services
• Tobacco control
• Oral health in children
• Diet and obesity
• Sexual Health
• Mental health including self-harm and suicide
• Warm homes
• Risk taking behaviours

The Director of Public Health took Members through the latest health profile published in 2015.

The Director of Public Health reported that he could give Members a ward by ward break down at the forthcoming development sessions.

It was noted that immunisation rates were currently very high for Stockton, but screening uptake needed further work.

The average life expectancy was getting closer to the England average, but the gap between lowest and highest in the Borough was the largest in England. Over the previous five years there had been a two year increase in the gap which was a significant change.

The lower level was relatively stable, whereas the high end of expectancy was improving. The figures for the bottom ten per cent were particularly low compared to the remainder.

Progress against preventable heart disease had been good across the Tees area, as compared to the England average. Cancer mortality needed further work.

With regard to diet and obesity in children the Director of Public Health reported that there was a family based programme to support the child in a family environment and that the issue must be tackled in the home.

It was reported that obesity in reception year was reducing slightly, however in year 6 the data was stable with one in five children classed as obese.

The Committee raised the importance of good housing, and it was confirmed that the Council would support any action to tackle rogue landlords.

Statistics on the uptake of the Meningitis B vaccine were not yet available, Meningitis C uptake was c.95%.
Members were requested to consider an update on how the Committee monitors the quality and performance of health and care services, and consider further improvements.

As part of the ongoing approach to strengthen oversight of the quality and performance of children’s, adult and health services, an increasing range of information had been provided to the Adult Services and Health, and Children and Young People, Select Committee.

This included considering a range of key reports at Committee (for example the performance reports, and Quality Accounts), circulation of inspection result information, and training programmes.

This was due to the recognised need to respond to the specific recommendations of the Francis Inquiry and other national developments including Winterbourne View.

Subsequent national issues had reinforced the need for strong oversight of these issues by scrutiny members, particularly the Rotherham child abuse case. Sunderland Council’s Ofsted Children’s inspection found that elected Members scrutiny of such services was not rigorous enough to have an impact on outcomes.

The full range of activity for Adult Services and Health Committee was attached to the report.

In order to assist the Committee with the skills and background knowledge to fulfil this role, Members were provided with Questioning and Challenge training in July. All materials and further information were available on request. Members were also reminded that individual support was available on requested from the Scrutiny Team at any time.

To further enhance this approach it was proposed to increase the number of site visits and enable a formal reporting through to Committee regarding inspection reports.

It was recognised that Members benefitted greatly from being able to visit services in person. These help inform in-depth scrutiny reviews, and enable Members to acquire greater knowledge about the service areas within their remit.

To date, site visits had been undertaken to inform specific reviews or look into ad hoc issues such as visiting new NHS services. These would continue to be identified when appropriate.

In addition it was proposed to introduce a rolling programme of site visits to enable Members to experience the Council’s adult care services, across all client groups. This would include visits to commissioned services wherever possible.

There was not an expectation that all Members would be able to attend every visit. It was suggested that two Members would attend with a relevant officer from CESC and /or scrutiny officer. These visits would not be formal inspections, or replace any of the scheduled monitoring by commissioners. However, a proforma would be provided for Members to record any issue (positive or negative) that they identify. It was proposed that feedback from the visits would be presented at the next Select Committee meeting.

Should the Committee support the proposal, a schedule of visits would be arranged. Members would then be asked to sign up to visits they wish to undertake.

As Members were aware the Care Quality Commission was the national inspectorate for health and adult care services. Inspection reports were regularly published for regulated services. Services were rated as being Outstanding, Good, Requires Improvement or Inadequate.

The Scrutiny Team received a list of recently published CQC inspection reports from across the North of England. A high level summary of any report relevant to the Borough was circulated to all Members by email as soon as practicable (i.e. either the service is located in the Borough or as in the case of major NHS organisations it provides services to local residents).

In order to provide for formal reporting of inspection outcomes through to Committee, whilst retaining a manageable workload, it was proposed that Members should receive a quarterly inspections update. This would round-up inspection results published since the previous update and outline any actions taken.

Members can, of course, continue to raise any specific queries regarding any inspection report published at any time.

Ahead of the publication of reports that show an Inadequate rating, the CQC should send an advance copy of the Press Notice to the Council two to three days prior to its release and publication of the report. It was proposed that any such notices be circulated to the Committee so that Members were aware of the imminent publication of the report and any subsequent press coverage (the full report would not be available at that time).

These proposals related to CQC Inspection reports. The Committee would also be provided with Stockton Healthwatch Enter and View Reports when published. Whilst not a formal inspection, these would add valuable intelligence to the Committee’s work.

Council concerns in relation to the timeliness of information received from CQC had been taken up following the review of Home Care and a response from CQC was attached to the report.

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