|Councillor McCoy declared a personal interest in item 7 'Stockton Fuel Poverty Partnership...' as she was a member of the Stockton and District Advice and Information Service.|
Cllr Beall declared a personal interest in item 5 'Stockton Local Safeguarding Children Board' as his wife was the Safeguarding Board's Business Manager.
|The minutes of the meeting held on 29 July 2015 were confirmed as a correct record and were signed by the Chairman.|
|The minutes of the following meetings were considered and noted:|
Children and Young People's Partnership held on 17th June and 21st July.
Children and Young People's Health and Wellbeing Joint Commissioning Group - 1st July 2015.
Adults' Health and Wellbeing Joint Commissioning Group - 17th August 2015.
|The Board received a presentation from Colin Morris, Independent Chair of Stockton's Local Safeguarding Children Board. The presentation dealt with the Safeguarding Board's:|
- Governance and Membership
- Annual Report 2014/2015
- Stockton on Tees Locality Working
- Serious Case Reviews and Learning
- Priority Areas for 2015/2017
Members asked a number of questions relating to the work of the Safeguarding Board.
Members raised the issue of neglect and noted that drugs, alcohol, mental health and domestic violence were very often factors. The Safeguarding Board was consulted when services were commissioned in these areas.
It was noted that the Safeguarding Board had a sub group that looked at outcomes from Serious Case Reviews, nationally, and scrutinised Ofsted reports to pick out learning opportunities to get the best outcomes for children in the borough.
|Members received a report relating to the Better Care Fund quarterly performance submission.|
It was explained that the Q1 return had been required by NHS England on, or before, 28 August. As this date did not fit with scheduled meetings of the Board, and in line with a previously agreed procedure, the Chair of the Board had signed it off. The return was submitted to this meeting for noting and comment.
The Board considered the return and requested that a progress report on the implementation of the Better Care Fund Plan be submitted to the December meeting of the Board.
|Members received a report that presented the work of the Fuel Poverty Partnership. The report also presented the Board with the Council's Affordable Warmth Strategy and Action Plan and the revised Warm Homes Healthy People intervention.|
It was noted that the Warm Homes Healthy People programme supported some of the most vulnerable members of the community, whose physical and mental health could be made worse by the cold.
The Board endorsed the strategy and all the work being undertaken, particularly as it was long term and targeted.
Members were informed that the programme was extensively promoted e.g. in GPs surgeries and pharmacies. It was agreed that every opportunity for promotion should be taken and Board members suggestions included, snippets of information in elected members' newsletters, the use of library services, BCF Multi Disciplinary Team.
Members of the public, who applied to the programme, but were not eligible, were signposted to other schemes e.g British Gas and GoWarm.
|Members received the Children and Young People's Plan which had been developed by the Children and Young People's Partnership in order to give clear strategic direction to the Council and partner agencies in their work to develop provision and improve outcomes for children and young people in Stockton on Tees,|
The plan set out key priorities over the 2015 - 18 period, how these had been identified, and how progress towards improved outcomes would be monitored. It was explained that the Plan would be presented to Council for approval.
Members noted that links with schools were extremely good and it was agreed that references to the role of schools, as key partners, would be strengthened within the plan.
|Members considered a report that provided the Board with an update relating to work currently being undertaken by NHS Hartlepool and Stockton on Tees Clinical Commissioning Group (CCG), in collaboration with the Council.|
The Board noted that the numbers of nursing care beds were driven by things such as the providers' business models, fees and cost of care. There had been a concerning decline in beds and this had impacted negatively on patients and their length of stay in acute services.
Dissatisfaction with fees paid, had been cited as one of the reason why providers may, in the longer term, choose to withdraw nursing beds.
Homes had difficulty attracting and retaining good quality, experienced nursing staff. Even where they had been able to do this the nursing staff were often working in isolation and their continual professional development needed to be considered to ensure a long term sustainable workforce.
The CCG, the Council and Hartlepool Borough Council had met to urgently review current commissioner concerns in relation to the provision of nursing residential care and agree a commissioning model for nursing and residential care homes that would ensure a sustainable system that responded to patient need across the whole care home sector.
Members noted that a North Tees Care Home Commissioning Group had been established to review and agree a system wide commissioning vision, to improve both health and social care outcomes for the people of Hartlepool and Stockton-on-Tees residing in care homes and to ensure sustainability of the future nursing bed provision across the care home sector.
Additionally, 1:1 meetings had taken place with current care home providers to understand, in greater detail, the current pressures, constraints and barriers experienced by providers. Twenty one out of twenty eight providers invited from across Hartlepool and Stockton-on-Tees care home sector attended the meetings. Meetings held were positive and providers engaged in conversation and a number of themes were identified. These themes would be reviewed by the North of Tees Care Home Commissioning Group and incorporated into the development and delivery of the new model of care.
The Board noted that given concerns providers had raised about financial difficulties the CCG was in the process of remodelling potential new core payment rates for funded nursing care and fully funded continuing healthcare. A financial feasibility options paper had been agreed by the CCG Governing Body. The CCG would engage with the market and, subject to the outcome, it was expected a new core fee rate would come into force.
It was explained that to reduce the overlap and address the perceived burden of 'inspection' visits by care home providers, the North of Tees Care Home Commissioning Group had agreed to work in collaboration to streamline and align both the LA's Quality Standard Framework and the CCG's Clinical Quality Assurance Tool (CQA) audits. Although the practicalities of implementation still had to be agreed, between the Local Authorities and the CCG, it was envisaged that the CQA tool would be offered to nursing residential care home providers from April 2016.
Discussion by the Board included:
- monitoring care through enhanced engagement with families.
- attracting nurses from the whole community and overcoming cultural obstacles.
- members noted the problems associated with the supply and recruitment of suitable qualified nursing staff and requested that Health Education North East be asked to attend a future meeting of the Board, to discuss the issues.
- Development of Trusts to run Nursing Homes.
|The Board received a report that provided a performance update regarding key indicators from the performance monitoring framework for the Joint Health and Wellbeing Strategy delivery plan, at August 2015. |
Members scrutinised the data and asked a number of questions.
There was particular discussion about a reduction in people accessing the stop smoking service. It was explained that this was an issue nationally and Stockton's reduction had been less than the North East average. It was believed that the downturn was linked to the impact of electronic cigarettes and other alternatives to the use of the service. The Council continued to use data to effectively target vulnerable populations and promote the services available.
Members noted that the Council's Adult Services and Health Committee would be looking at the low take up of NHS health checks by people with Learning Disabilities.
|Consideration was given to the Five-year Children and Young People's Mental Health and Wellbeing Plan, for Hartlepool and Stockton-on-Tees, in line with the national ambition and principles set out in "Future in Mind - Promoting, protecting and improving our children and young people's mental health and wellbeing". |
It was explained that a requirement of Future in Mind was for areas to develop a local plan focused on improving access to help and support when needed and improve how children and young people's mental health services are organised, commissioned and provided.
In response, the Hartlepool and Stockton-on-Tees Children and Young People's Mental Health and Wellbeing Transformation Plan 2015-20 had been developed; building on the foundations of the previous Tees wide CAMHS transformation work.
The transformation plan provided a framework to improve the emotional wellbeing and mental health of all children and young people across Hartlepool and Stockton-on-Tees. Members noted that the aim of the plan was to make it easier for children, young people, parents and carers to access help and support when needed and to improve mental health services for children and young people.
The plan sets out a shared vision, high level objectives, and an action plan which takes into consideration specific areas of focus for local authority areas.
It was explained that funding streams were available to address some of the priorities in the Plan, though it was unclear whether this would be additional.
Members noted that successful implementation of the plan would result in:
An improvement in the emotional well-being and mental health of all children and young people.
Multi-agency approaches to working in partnership, promoting the mental health of all children and young people, providing early intervention and also meeting the needs of children and young people with established or complex problems.
All children, young people and their families would have access to mental health care based upon the best available evidence and provided by staff with an appropriate range of skills and competencies.
There was concern about the ability to deliver the plan as there was no guarantee of future investment, given local government cuts and required efficiencies at the CCG.
|The Board considered a report that provided an overview of the proposed changes to the Council's Gambling Policy.|
Members were informed that the Council was required, by the Gambling Act 2005, to publish a statement of the principles that it proposes to apply when exercising its functions under the Act, in the form of a Gambling Policy. This policy statement must be published every three years. The Council's current policy statement took effect on 3rd January 2013 and was now due for review. Consultation on the current proposals commenced in July 2015.
Members were given the opportunity to provide any comments at the meeting, or subsequently to Margaret Waggott, Head of Democratic Services, Trading Standards and Licensing.
|Consideration was given to a report that provided the Council's draft revised Statement of Licensing Policy, which was currently under review. |
The Board noted the limitation in that health and wellbeing was not an objective that could be considered in granting or renewing licences.
|The Chair informed the Board that CQC would be undertaking a thematic review with regard to older people, in the Stockton on Tees area, who had suffered strokes, or a fractured femur. The review would include exploring how effectively health and social care providers and commissioners were coordinating care. Fieldwork would begin in October.|
|Members considered the Forward Plan and agreed that:|
- the meeting scheduled for 23 December 2015 would be moved to 17th December 2015.
- a report on the implementation of the Better Care fund would be provided to the December meeting.