Agenda and draft minutes

Scrutiny Advisory Board - Adults
Thursday, 28th June, 2018 10.00 am

Venue: Conference Room,Cumbria House, Botchergate, Carlisle CA1 1RD

Contact: Stewart Consterdine  Email: stewart.consterdine@cumbria.gov.uk

Items
No. Item

93.

APOLOGIES FOR ABSENCE

To receive any apologies for absence.

Minutes:

Apologies for absence were received from Mr C Cotton, Mr W Clark and Mr J Mallinson who was substituted by Mr A Wonnacott.

 

94.

MEMBERSHIP

To report and note changes to the membership of the Board

Minutes:

There were no changes in membership.

 

95.

DISCLOSURES OF INTEREST

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).

Minutes:

Mrs C Bowditch declared a personal interest in item 7 as she is a carer and her son is in receipt of benefits from Cumbria County Council.

 

96.

EXCLUSION OF PRESS AND PUBLIC

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

Minutes:

RESOLVED that the press and public should not be excluded from the meeting.

 

97.

MINUTES pdf icon PDF 74 KB

To confirm as a correct record the minutes of the meeting of the Scrutiny Advisory Board – Adults held on   19 March 2018   (copy enclosed).

Minutes:

It was noted that Mrs C Bowditch was not included in the list of attendees although she did attend the meeting.

 

RESOLVED,    that the minutes of the meeting held on 19 March 2018 be confirmed as a correct record and signed by the Chair.

 

98.

Adult Social Care Charging Policy pdf icon PDF 185 KB

To receive a report including an early analysis of the consultation response, how they will be actioned and what the next steps will be.

 

Minutes:

The report was presented by Paul Latimer, Senior Manager Adults.

 

The purpose of the report was to update Scrutiny Advisory Board – Adults, on the results from the consultation on current proposal to review fees and charges across Health Care and Community Services Directorate in relation to the following proposals;

 

Proposal 1 - Arrangement fee to full paying non-residential service users

Proposal 2 – changes to how much a person pays for non-residential services

Proposal 3 – changes to the administration fee for deferred payments.

 

The desired outcomes from the proposals would:-:    

 

·         Increase income generation by the Council  (in line with legislation) to support the continued delivery of services to vulnerable people

 

·         Maximise fees and charging opportunities (within legislative requirements.)

 

·         Achieve a sustainable platform for charging against services and provisions within the Health, Care and Communities directorate.

 

·         Determine a clear policy and approach for to fees and charges for statutory and non-statutory services for the future.

 

·         This will require formal consultation on changes to the County Council’s Charging Policy.

 

The report detailed the results following 3 month consultation ending on 9 June 2018.

 

Due to the low return rate the results did not provide statistical confidence to draw any general conclusions or recommendations regarding the proposals. However, based on the returns more responders agreed that people should contribute towards their care and support services if they could afford it, however, more than half of the responders disagreed with all three proposals to increase fees or introduce new fees.

                                                                                      

Next Steps

 

  • Published notice on the Councils consultation webpage stating the outcome of the consultation and reaffirming the decision taken by Council in respect of fees and charges. Week ending 15 June 2018.
  • Customers directly affected by these changes would be written to confirming their new contribution and the date these changes would be implemented on.
  • Target implementation date 1 August.

 

There followed a discussion from which various questions were raised.

 

Firstly a question was asked concerning what service was provided for the £4.50 per week fee.

 

The Senior Manager Adults confirmed that this fee was for the administration for the services that would meet the client’s needs.

 

A question was also asked regarding on what basis the charge was calculated and if the charging policies at other authorities had been looked at..

 

The Senior Manager Adults explained that the County Council Finance had looked at the whole of the activity the Administrators would undertake and this was the amount calculated to cover costs. He also confirmed that he would share with members the benchmarking research that had been carried out in respect of  other authorities charging policies.

 

Concern was raised on the low number of replies to the consultation and also that the decision had already been made regarding the fees before the consultation started.

 

The Strategic Policy & Scrutiny Adviser informed members that he would provide them with the date when the full proposals were agreed by Full Council.

 

A further question was asked if any assessment was made with the  ...  view the full minutes text for item 98.

99.

Social Work Practice - New ways of working - Strength Based Approach pdf icon PDF 107 KB

To receive a report on how the Council is proactively working to prevent, reduce and delay the need for formal care provision. By acting as an organisation that proactively recognises and embraces talents, strengths and assets. Role for Scrutiny to assist in the developing and testing of new ideas that will identify the model of Social Work Practice in the future.

 

Additional documents:

Minutes:

The report was presented by Catherine Whalley, Assistant Director (Deputy Director Adult Services), People.

 

The purpose of the report was to explain the work being undertaken in adult services to develop strength based practice and to support the emergence of a culture that promotes and supports independence.

The paper had been requested by Scrutiny to support better understanding of the work to develop strength based practice.

In August 2017, analysis of Personal Budgets revealed significant numbers of recipients had accrued surplus money in their Direct Payment accounts.  This was taken as an indicator that personal budget allocations may be greater than actual level of need. 

 

In response the Promoting and Supporting Independence project group was established and had been leading a programme of work that includes:

 

·         Undertaking Promoting Independence Reviews to ensure that the personal budget allocated is appropriate to level of need

·         Recouping surplus money from accounts

 

This work had led to significant recovery of monies back to the council, and had evidenced that there were opportunities to support our workforce and the citizens of Cumbria to achieve more independent outcomes/lives, with reduced levels of formal care and support.

 

A dedicated Strength Based Practice work stream had been established (May 2018), tasked with developing tools and testing new ways of working and formulating implementation plans for roll out.

 

The Assistant Director (Deputy Director Adult Services), People explained that it was really important that we recognise and celebrate the strengths and assets we have. There was a wealth of experience, skills and knowledge within Cumbria County Council, and it this, coupled with the passion that existed in our workforce that will drive our ambitions to become a strength based organisation.

 

In March, the first Adult Social Care Managers Forum was held. The focus was upon budget pressures and ambitions to drive a culture that recognises strengths and opportunities for independence. Really positive feedback was received from the managers who attended and valued the opportunity for engagement.

 

The Assistant Director (Deputy Director Adult Services), People explained that the presentation had been updated and that she would share this with members.

 

The members requested to have the opportunity to be able to consider the deliverables and outcomes of the plans and be included in the plans development.

 

The Assistant Director (Deputy Director Adult Services), People confirmed that she would consider when she would be able to give members the opportunity to consider these matters.

 

A discussion took place from which a number of questions arose.

 

There was a question asked concerning the amount of balances on these accounts, the number of people who had accrued surplus money on their account and the amount of money that had been recouped. Also who was managing them at the time?

 

The Assistant Director (Deputy Director Adult Services), People explained that she could not comment on how the system was managed previously but it does not seem to have been managed effectively in the past. She would provide members with the figures they have requested. The  ...  view the full minutes text for item 99.

100.

Deprivation of Liberty Standards. pdf icon PDF 561 KB

To receive a report providing an analysis of DoLS activity since bringing the service back in house to the Council in October 2017. To describe the actions taken and planned to deal with the volume of applications.

 

Minutes:

The report was presented by Nick Waterfield, County Manager Social Care North

 

The report was brought to the Board to provide brief background to the Deprivation of Liberty Safeguards (DoLS) for adult’s service and the current situation and backlog of DoLS applications.

 

It was also to demonstrate and quantify current volume of work in relation to DoLS in Cumbria whilst providing an update and analysis of DoLS activity since bringing the service back in house to the Council in October 2017.

 

The report also explained the actions taken and planned to strengthen or consolidate improvements in the service and to consider future options.

 

Deprivation of Liberty Safeguards (DoLS) were introduced into the Mental Capacity Act 2005 by the Mental Health Act 2007. DoLS provided a framework for approving the deprivation of liberty for people who lack the mental capacity to consent to necessary treatment in a hospital or care home. Local authorities, including Cumbria, have the responsibility for DoLS in their area and act as the ‘Supervisory Body’ for DoLS. Hospitals and care homes act as ‘Managing Authorities’ for DoLS who make applications for residents without capacity to the supervisory body for assessment. The DoLS process involved assessments by a specially trained Best Interest Assessor (BIA), and by a specially trained doctor, referred to as the Mental Health Assessor. The application for DoLS was then authorised by the Supervisory Body if appropriate.

 

There have been recent changes affecting DoLS. A Supreme Court judgment in 2014 significantly widened the definition of deprivation of liberty, meaning more people were subsequently considered to have their liberty deprived. There was a ten-fold increase in the number of deprivation of liberty applications following the judgment.

 

The national average rate for DoLS applications was 492 applications received per 100,000 adults. The number of applications received in Cumbria had been lagging behind the national average. During the reporting year 2015-16, Cumbria reported 1005 applications received. During the reporting year 2016-17, only 492 applications were recorded as received for all of Cumbria. The current backlog of assessments in Cumbria is 1,394.

 

The decision was taken last year to bring the service back in house to achieve greater control over the delivery of the service, the responsibility of which ultimately lied with us as the local authority and supervisory body. The service was officially brought back in house in October 2017.

 

During a discussion on the various figures within the report it was noted that there seemed to be a disparity in the figures for Eden in the Number of Referrals figures and also the Out of County section required explanation.

 

The County Manager Social Care North explained that due to the number of care homes being less in Eden than in the other areas, the number of referrals would be lower. Also the Out of County referrals are mostly in the South of the County near to the Lancashire Border as there are a number of were clients are in a home or in hospital in Lancashire.

 

A  ...  view the full minutes text for item 100.

101.

Safeguarding Adults at risk from abuse and neglect pdf icon PDF 1 MB

To receive the quarterly report on Safeguarding, incorporating information on Domestic Homicide reviews.

 

Minutes:

The report was presented aby Adrienne Halliwell, Senior Manager Safeguarding,

 

The report provided members with an update and analysis of adult safeguarding activity for the 12 months of 2017/18. It also briefed members on progress against the key areas of performance relating to Making Safeguarding Personal.

 

The report also described the actions planned to strengthen and consolidate improvements in Adult Safeguarding in Cumbria.

 

There were 1336 Individuals associated with the total 1613 Episodes of Safeguarding Concerns /Enquiries which were raised in the quarters of 2017/18. This evidenced that some people had more than one episode in the period.

 

Previous reports, whilst correctly reporting the total number of individuals supported in the full period, unfortunately understated the number of people referred again for further episodes in subsequent quarters. For example if one individual had episode/s started in each quarter, they should be counted four times. The total number of individuals supported in the 17/18 period was 1336. This was an average of 378 individuals per quarter in the 17/18 period. Comparison with 16/17 average shows that this was a 23% increase on the number of individuals entering the service per quarter. 

 

In addition the average number of Episodes raised in 17/18 is 403 per quarter which was a 22% increase on the 16/17 average of 329 per quarter.

 

In 17/18 1613 concerns were raised showing 33% by Social Care Staff, 18% by Health sources, 11% Police and 5% from Family/ Neighbour/Friends. This was a distinct pattern shift from 16/17 for Social Care 15%, Health 23%   whilst Police was similar at 9%.

 

Over the reporting period the removal of the risk to the individual has been improving from 36% at Qtr. 1 17/18 of the cases to an improved position of 43% at Qtr. 4 17/18.

 

The data was indicative of a well performing service. Cumbria compared well against Quarter 3 17/18 benchmarking with the North West partners being one of the top 3 out of 21 Local Authorities whose risk removal rate was greater than 40%.

 

Following a discussion a member enquired how many of the enquiries end up in prosecution.

 

The Senior Manager Safeguarding, informed members that these figures were not to hand but she would provide these figures over the last 12 months in Cumbria.

 

A further question was asked on how the board be made more aware of any high profile cases that are being dealt with.

 

Senior Manager Safeguarding, advised that these cases were not historically reported correctly. She agreed that raising the profile of these cases would certainly help and would have these included in future reports.

 

AGREED actions were:

 

·         Figures on number of enquiries which have progressed through to prosecution in Cumbria over the last 12 months to be provided for Members – Senior Manager Safeguarding.

 

The report was NOTED and the members thanked the officers for this report.

 

102.

Adult Scrutiny Advisory Board Briefing pdf icon PDF 51 KB

To consider items not covered elsewhere in the Board agenda, report from Performance Working Group and to agree the work programme.

 

Additional documents:

Minutes:

The briefing was presented by David Stephens, Strategic Policy & Scrutiny Adviser

 

The briefing paper informed members of new or updated items of significance to the Adult Scrutiny Advisory Board.

 

The Scrutiny Performance Working Group met on the 10th May and received an update on the performance of the reablement service; the group was shown regional and national comparison data which showed that Cumbria’s performance is relatively stable.

 

The Joint Advisory Group held a development session with members on the 4th May, independently facilitated by Stephen Singleton from the Cumbria Learning and Improvement Collaborative.

 

Members were invited to consider the updated scrutiny work programme as it stands at June 2018.  They were referred to Appendix 1 attached to the report.

 

Following a discussion it was thought that an update on the Green Paper on “Social Care” and “Transforming Care” would be helpful.

 

It has already been agreed that the Update on the delivery of Strength Based Approach to Social Care will be brought to the January meeting of the Board.

 

AGREED actions were:

 

·         Update work programme, include ‘Green Paper on Social Care’ and ‘Transforming Care’ to October Board. – Strategic Policy & Scrutiny Adviser.

 

The report was NOTED and the members thanked the officers for this report.

 

103.

DATE OF NEXT MEETING

The next meeting of the Scrutiny Advisory Board – Adults is scheduled for 10 October 2018 at 10.00 am in Committee Room 1, County Hall, Kendal.

 

Minutes:

The next meeting of the Scrutiny Advisory Board – Adults is scheduled for 10 October 2018 at 10.00 am in Committee Room 1, County Hall, Kendal.