Agenda and minutes

To receive any apologies for absence.

Apologies for absence were received from Mr P Turner, Mr S Collins and Mr D Gawne.

To report and note changes to the membership of the Board.

It was noted that the following changes had been made to the Board membership:-

Ms D Garton had replaced Mr R Bingham as a member of the Board.

Members are invited to disclose any disclosable pecuniary interest they have in any item on the agenda which comprises

1          Details of any employment, office, trade, profession or vocation carried on for profit or gain.

2          Details of any payment or provision of any other financial benefit (other than from the authority) made or provided within the relevant period in respect of any expenses incurred by you in carrying out duties as a member, or towards your election expenses.  (This includes any payment or financial benefit from a trade union within the meaning of the Trade Union and Labour Relations (Consolidation) Act 1992.

3          Details of any contract which is made between you (or a body in which you have a beneficial interest) and the authority

(a)     Under which goods or services are to be provided or works are to be executed; and

            (b)     Which has not been fully discharged.

4          Details of any beneficial interest in land which is within the area of the authority.

5          Details of any licence (alone or jointly with others) to occupy land in the area of the authority for a month or longer. 

6          Details of any tenancy where (to your knowledge)

            (a)     The landlord is the authority; and

            (b)     The tenant is a body in which you have a beneficial interest.

7          Details of any beneficial interest in securities of a body where

(a)     That body (to your knowledge) has a place of business or land in the area of the authority; and

(b)     Either –

         (i)        The total nominal value of the securities exceeds £25,000 or one hundredth of the total issued share capital of that body; or

         (ii)       If that share capital of that body is of more than one class, the total nominal value of the shares of any one class in which the relevant person has a beneficial interest exceeds one hundredth of the total issued share capital of that class.

In addition, you must also disclose other non-pecuniary interests set out in the Code of Conduct where these have not already been registered.

Note

A “disclosable pecuniary interest” is an interest of a councillor or their partner (which means spouse or civil partner, a person with whom they are living as husband or wife, or a person with whom they are living as if they are civil partners).

There were no declarations of interest made at the meeting.

To consider whether the press and public should be excluded from the meeting during consideration of any item on the agenda.

RESOLVED, that the press and public not be excluded from the meeting during consideration of any item on the agenda.

To confirm as a correct record the minutes of the meeting of the Scrutiny Advisory Board – Adults held on 25 January 2022 (copy enclosed).

RESOLVED,that the minutes of the meeting held on 25 January 2022 be agreed as an accurate record and signed by the Chair.

To receive a presentation by Acting Director of Adults Social Services (copy enclosed).

The Acting Director of Adults Social Services gave a presentation on the Adult Social Care Strategic Position & Workforce which included the following areas:-

·      Health & Social Care System

·      Current Situation

·      System Coordination

·      Adult Social Care Operations

·      Residential Care

·      Day Services Cumbria Care

·      Day Services Independent Providers

·      Commissioning Update

·      Financial Support to Providers

·      Workforce – Proud to Care Cumbria

·      Adult Social Care Winter Plan

·      Managing Demand Update

·      Workforce Update

·      Market Sustainability Update

·      Promoting Independence

A member noted that some people had been placed in residential care pending support at home and queried if that figure was large and had it increased.

The Acting Director of Adults Social Services remarked that the figure was in peaks and troughs and she would circulate the numbers after the meeting.

A member queried if there were any links with schools and colleges for care as a career.

The Commissioning Manager commented that there were links via social media and links with individual schools.

A discussion took place regarding providers and the current situation and what plans were in place going forward.  Was the term providers to include the voluntary sector.

The Acting Director of Adults Social Services remarked that meetings had taken place regarding cost of living issues to support the Social Care Workforce and it was an increasingly difficult situation.  If there was a simple answer it would have been done. A market supplement had been provided.  We ae asking what else can be done and how can services be grown that will enable people to live independently.  Consideration is given to Social Work recruitment and a local approach rather than a Cumbria wide approach.  Providers also did include the voluntary sector and it is an area that Cumbria County Council continue to explore.

A member noted the terminology No Right to Reside and commented that it was a very unfortunate piece of terminology.

The Acting Director of Adults Social Services commented that she would love not to use that terminology however it is in national guidance.  However she was very confident that no-one in Cumbria Care would use it in front of any patient.

A member remarked about the Support Living Framework and queried if the Scrutiny Advisory Board – Adults had seen the report.

The Strategic Policy and Scrutiny Advisor would send the Cabinet report out to members.

A member commented on the Residential Care Framework and Day Opportunities and asked for some clarification.

The Commissioning Manager responded that new providers would join at any point in the contract.

A member queried if families were involved in discharge meetings.

The Acting Director of Adults Social Services commented that national guidance on discharge meetings would become legislation in the summer.  It was less likely that social workers would be involved.  There were requirements within the NHS for the family to be involved where there were complicating factors.  The number of complaints about the procedure had been minimal through the pandemic.  The Senior Manager – Health and Social Care Short Term Interventions commented that social  ...  view the full minutes text for item 16.

To receive a presentation by Acting Director of Adults Social Services (copy enclosed).

The Senior Manager – Health and Social Care Short Term Interventions gave a presentation on Discharge to Assess which included the following areas:-

·      What is discharge to assess

·      How do you know what support someone needs

·      What are hospital discharge pathways

·      North Cumbria Position

·      South Cumbria Position

·      Where we need to get to

·      Adult Social Care Pressures Plan

A member noted the 4 Pathways and queried if NWAS were involved in the discharges and if the discharges were possible 24 hours per day.

The Senior Manager – Health and Social Care Short Term Interventions noted that the NHS had a contract for hospital transport, however NWAS does provide some transport.  She remarked that no-one was discharged after 7pm.  It was important to do what was best for both the individual and the setting.  She confirmed that any transfer into inter-residential setting was done before 7pm but that a return to home could be different.  Discharges were done through the day because there was staffing available then.

The Assistant Director – Provider Services commented that the hospital tried to have patients back for lunch.  This gave time for any issues to be resolved.  Any transfers after 7pm would be due to family choice.  The no discharge after 7pm is embedded in the principles of Discharge to Assess.

It was noted that the use of enhanced Assistive Technology to support discharge was on the future work programme for the June meeting.

A member remarked that if people are assessed at home rather than in hospital was it possible that equipment was not available and if the person had to go back to hospital and go through triage that would cost in the region of £5-6,000.

The Senior Manager – Health and Social Care Short Term Interventions assured members that there are equipment stores readily available throughout the county and any specialist equipment would be ordered prior to the return home.

A member commented that due to the geographical nature of Cumbria how is rurality and travel time factored in.

The Assistant Director – Provider Services noted that the travel time is factored in and that rurality is considered because people would be tired after long journeys.

A member remarked about the assessment at home and who performed the assessments and how it was ensured they had the appropriate skills.

The Assistant Director – Provider Services commented that Reablement and Assessment Officers completed the assessments with help from an Occupational Therapist if it was complex.  She confirmed that the Reablement and Assessment Officers were thoroughly trained and the process was detailed.

A member remarked about complaints and who acted on the complaints.

The Senior Manager – Health and Social Care Short Term Interventions replied that Cumbria County Council did see some complaints and some went direct to the NHS.  Meetings had taken place with the NHS to discuss issues from both perspectives.  The Acting Director of Adults Social Services remarked that there was a formal complaints policy.  If the complaint was purely NHS  ...  view the full minutes text for item 17.

To consider a report by Acting Director of Adults Social Services (copy enclosed).

The Senior Manager – Safeguarding presented a report providing an update and analysis of adult safeguarding activity in the third quarter of 2021/22, briefing members on progress against key areas of performance relating to ‘Making Safeguarding Personal’, providing a benchmark against other local authorities and describing actions planned to strengthen and consolidate improvements in adult safeguarding in Cumbria through the Safeguarding Adults Board.

During the question and answer session that followed, a member raised the under reporting and queried if this was a national situation or unique to Cumbria.

The Senior Manager – Safeguarding noted that it was a very similar picture throughout the country.

A member noted the age group most at risk were 85+ was there any research or explanation into that.

The Senior Manager – Safeguarding noted that as people age they are more exposed to levels of risk and that people see you as more at risk because of age.  However, the high numbers are evidence that people are concerned to report abuse for it to be dealt with.

A member asked for reassurance that the Safeguarding Hub worked through Covid and with staff shortages.

The Senior Manager – Safeguarding explained the process that any concerns are directed through SPA Officers and are then directed towards Safeguarding if required.

The Chair commented that the cases for Sexual Abuse and Self-Neglect had gone up and was that connected to poverty.

The Senior Manager – Safeguarding remarked that Self Neglect had been under reported as people had not been seen due to lockdowns.  To receive high levels means that the issue is now being flagged up.  The numbers are incremental and allowed people to notify what was happening.

The Chair sought assurance that the calls were answered at weekend if people had concerns.

The Senior Manager – Safeguarding noted that a caller would receive the same response over the weekend as for any other service. 

The Chair then thanked the Senior Manager – Safeguarding for his presentation.

RESOLVED,that

(1)  the report be noted;

To consider a report by Acting Director of Adults Social Services (copy enclosed).

Members received a briefing paper that informed of new or updated items of significance to the Adult Scrutiny Advisory Board. Members were informed that the Scrutiny Performance Working Group had identified no specific items for consideration by the Board.

The Strategic Policy & Scrutiny Adviser informed the members that Scrutiny Management Board on the 1 March 2022 had agreed the scope, for a joint Health and Adults Task and Finish Group focused on the implications of the Health and Care Bill reforms on the integration of Health and Care across the systems in both North and South Cumbria. This Task and Finish Group would build on the work of the previous Health and Adults Joint Advisory Group.  The Strategic Policy & Scrutiny Adviser remarked that volunteers were needed to join the Task & Finish Group and would any volunteers communicate with the Democratic Services Officer.

Members received the Board’s work programme and were encouraged to submit potential items for consideration.  A member remarked that with the upcoming Local Government Reorganisation they were concerned .

It was agreed that an agenda planning meeting would be set up with the Chair, Vice Chair and Acting Director of Adults Social Services that all points would be captured with the Shadow Authorities.

The Chair then thanked the Strategic Policy & Scrutiny Adviser for his report.

RESOLVED,that

(1)  the report be noted;

(2)  consideration by given at the next agenda planning meeting for the inclusion of the discussed items outlined above to be placed on the Board’s agenda.

To note that the next meeting of the Scrutiny Advisory Board – Adults is scheduled for 24 June 2022.

It was noted that the next meeting of the Board will be held on 24 June 2022 at 10.00 am.