Stockton-on-Tees Borough Council

Big plans, bright future

Adult Services and Health Select Committee Minutes

Date:
Tuesday, 13th October, 2015
Time:
16.00
Place:
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

Present:
Cllr Mohammed Javed(Chairman), Cllr Michael Clark(Vice-Chairman), Cllr Sonia Bailey, Cllr Evaline Cunningham, Cllr Kevin Faulks, Cllr Lynn Hall, Cllr Paul Rowling(Vice Cllr Tracey Stott), Cllr Sylvia Walmsley(Vice Cllr Mick Moore).
Officers:
Liz Hanley, Phillip Williams(Adult Services), Ruby Poppleton(Public Health), Peter Mennear and Kirsty Wannop(LDS).
In Attendance:
Dr Paul Williams(NHS Hartlepool and Stockton-on-Tees CCG), Joanne Heaney (NHS Hartlepool and Stockton-on-Tees CCG), Jenny Long(Primary Care Commissioning, NHS England ), Phillip Williams,
Apologies for absence:
Cllr Stefan Houghton, Cllr Mick Moore, Cllr Tracey Stott, Deborah Miller
Item Description Decision
Public
ASH
33/15
EVACUATION PROCEDURE
 
ASH
34/15
DECLARATIONS OF INTEREST
 
ASH
35/15
MINUTES FOR SIGNATURE - 28TH JULY 2015
 
ASH
36/15
DRAFT MINUTES - 8TH SEPTEMBER 2015
AGREED that the minutes be approved.
ASH
37/15
QUALITY STANDARDS FRAMEWORK (QSF) UPDATE
AGREED that the information be noted and updates on the QSF process be added to the Committee's work programme.
ASH
38/15
SCRUTINY REVIEW OF ACCESS TO SERVICES FOR PEOPLE WITH LEARNING DISABILITIES
AGREED that the information be noted.
ASH
39/15
MINUTES OF THE HEALTH AND WELLBEING BOARD
 
ASH
40/15
WORK PROGRAMME 2015-16
 
ASH
41/15
CHAIR'S UPDATE
 
4.00pm/5.30pm

Preamble

ItemPreamble
ASH
33/15
The evacuation procedure was noted.
ASH
34/15
There were no interests declared.
ASH
35/15
The minutes of the meeting held on 28th July 2015 were signed by the Chair as a correct record.
ASH
36/15
Consideration was given to the minutes of the meeting held on 8th September 2015.
ASH
37/15
The Committee considered a report that provided an update on the development and utilisation of Stockton on Tees Borough Council's Quality Standards Framework (QSF).

The aim of the QSF was to develop a process for consistently assessing and evaluating the quality, effectiveness and overall performance of the providers we contract with.

The QSF was originally established to evaluate Older People's residential care (Care Homes and Care Homes with Nursing) and Home Care services and this had now been running for 3 years (including the pilot year).

The QSF provided an in depth evaluation of the regulated services that the council commissions and included reviews of the following areas:

• Leadership & Management
• Staff Competence
• Safeguarding
• Service user finances
• Complaints
• Care Planning
• Service User experience of their Care & Support
• Medication management
• Quality of the environment

Provider feedback on the QSF had generally been positive:

• It was seen as a robust process
• It provided greater transparency and consistency in evaluating services
• It was instrumental in raising quality
• It improved communication & joint working between Stockton on Tees Borough Council & providers

The QSF was an evolving process, that:

• Was regularly reviewed
• Built on best practice where appropriate
• Works with providers in refining the approach to ensure it continued to deliver a fair and balanced assessment of services
• Ensured the process was as efficient as possible
• Was harmonised with other agencies where possible, reasonable and appropriate.

Members were also provided with details of the QSF Framework, Process and the programme going forward including future reporting timescales. It was noted that the QSF had now been expanded to include all regulated services including Metal Health & Learning Disability services.

Members highlighted that 20% of providers had opted out, what were we doing to make these providers participate? It was stated we could not make providers take part but, when the contracts were re-commissioned this would be included within the contract to participate and provide the information.

This did not stop Adult Services from responding to concerns about those providers that do not participate, on a reactive basis.

Members queried whether the QSF could be used as a lever to improve level of healthcheck update in learning disability services. It was noted that this issue would be raised with operational services using their links with the health service.
ASH
38/15
The Committee considered information on the Annual Healthcheck for People with Learning disabilities. Members were shown a short DVD that was produced to help encourage those with learning difficulties to have their Annual Healthcheck and give people more of an understanding how appointments should be approached.

It was highlighted that 6 out of 10 people with learning disabilities were not receiving their annual healthcheck and Stockton were simply not doing enough. It was hoped that the review would help to create recommendations to improve this statistic dramatically.

Representatives of the Clinical Commissioning Group recognised the extent of the issue locally. NHS England noted that the service was optional and that Practices could not be forced to provide it although all Practices locally had done so. Patients should receive a health check and health action plan. Practices were paid according to the number of checks undertaken but there was no performance monitoring incentive or sanction in place.

People with learning disabilities had on average a life expectancy fifteen years lower than the remainder of population. This was often due to issues that could be prevented including lack of immunisation, screening, diabetes prevention, and blood pressure monitoring.

It was noted that the CCG commissioned health facilitators from the Tees, Esk and Wear Valleys Trust and these were being included as part of the Community Learning Disability Team. There had been some improvement on the previous year's figures and it was believed the facilitators had had some role in that. Recent engagement events with GPs had taken place and changes had been suggested to procedures.

Members were then given the opportunity to ask questions and make comment and these could be summarised as follows:-
- Can GP's not utilise the Health Facilitators to undertake the simple checks like height, weight and blood pressure to make it easier for those with learning disabilities? GP's weren't always aware of the health facilitators though work was being done to circulate this information.

- Surrounding authorities were performing better than Stockton so why aren't we following the same procedures as them to ensure the checks are being carried out?

This was down to needing to improve clinical leadership and how much priority was given to the issue compared to others. Practices were not all undertaking effective reasonable adjustments. It was possible that some Practices had tried methods that had proven ineffective and this had not been followed up.

It was also noted that practices generally were not looking at their performance figures in comparison to others locally. It was hoped that the proposed overarching body that was going to look after all 25 Practices in Stockton would encourage practises to perform better by ensuring they had this information.

Members identified this gap in the monitoring framework. Members supported Practices being ‘named' regarding their performance.

Members noted that guidance suggested each Practice should have a named clinical lead on this issue and it was noted that the use of these was not known in Stockton.

Consideration could be given to commissioning the service in a different way although this would mean a less holistic approach.

It was queried why England were not highlighting the difference in take up between areas. It was noted that resources was an issue, and that they would in any case look to the CCG for assistance.

The Committee gave officers their full support going forward to help improve numbers and confirmed it would be examining the issue further as part of the review. The Chair noted that vulnerable groups should not receive a poorer service.
ASH
39/15
The minutes of the Health and Wellbeing Board be noted.
ASH
40/15
The Committee noted its work programme.
ASH
41/15
The Chair had nothing to update.

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