Venue: Conference Room, Cumbria House, Botchergate, Carlisle CA1 1RD
Contact: Shamim Lindsay Email: email@example.com
APOLOGIES FOR ABSENCE
To receive any apologies for absence.
Apologies were received from Mr J Mallinson and Mr B Wearing attended in his place.
To report and note changes to the membership of the Board
There were no changes in membership to report on this occassion.
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.
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 disclosures of interest made on this occasion.
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.
RESOLVED that, the press and public not be excluded from the meeting during consideration of any items of business on the agenda.
To confirm as a correct record the minutes of the meeting of the Scrutiny Advisory Board – Adults held on 10 October 2018.
RESOLVED that, the minutes of the previous meeting 10 October 2018 be confirmed as a correct record and signed by the Chair.
To receive a report detailing Delayed Transfers of Care figures.
Members had before them a report that described the statutory requirements relating to delayed transfers of care as determined by The Care Act 2014. The report provided members with a detailed explanation of what constitutes a Delayed Transfer of Care (DTOC). The report also provided details of the current DTOC position in Cumbria and described the partnership arrangements in place to improve the DTOC position in Cumbria.
The Senior Manager - Safeguarding and Care Governance explained that the data she had presented to members was retrospective and so she tabled more recent figures from November 2018 which showed that performance was improving but still were not meeting the Better Care Fund targets. It was AGREED that, the figures showing performance in November 2018 be circulated by email to all members (ACTION: AH)
Members asked for clarification on the timescale for assessment and it was explained that there was a 48 hour deadline after receiving notification and that this could vary depending on the reason for submission. Members asked whether the service would be penalised for not meeting the Better Care Fund target. The Senior Manager explained that fining is not mandatory meaning so it was unlikely the service would be charged for the delays, however future agreements with the Better Care Fund could be affected. It was AGREED that, a briefing be provided on the timescales for the next round of the Better Care Fund transfer of funds and what if any implications the DTOC figures will have on this. (ACTION: AH)
Members highlighted the work which had previously been done by community hospitals to improve outcomes in this area and sought assurances that work was being carried out system wide to improve the rate of delays. There was further discussion took place about the South West of the county, and it was AGREED that, an explanation of the high ‘Average Delays per day per 100,000’ in South Cumbria for November 2018 be provided to the Board. (ACTION: AH)
It was RESOLVED that,
1) figures showing performance in November 2018 be circulated by email to all members,
2) an update be brought before the Board on recruitment to the rapid response service in the west of the County,
3) An explanation of the high ‘Average Delays per day per 100,000’ in South Cumbria for November 2018 be provided to the Board,
4) A briefing be provided on the timescales for the next round of the Better Care Fund transfer of funds and what if any implications the DTOC figures will have on this.
The Chair thanked the Senior Manager – Safe Guarding and Care Governance for her informative presentation.
To receive a presentation on the purpose, priorities and plans of the Learning Disability and Autism Board
Members received an update on the work of the Learning Disability and Autism Partnership Board.
The presentation covered the following topics:-
· Core Principles
· Learning Disability
· Partnership Boards
· Partnership Boards in Cumbria
· A Bit of a Quiz
· National Priorities
· What do People and their Families Want?
· Moving Forward – Citizenship
· Next Steps
Members asked for clarification on what would come under the remit of the Learning Disability and Autism Partnership Board. It was clarified that the Board began as a way of bringing together stakeholders who wished to improve the lives of people with learning disabilities and autism. It was explained that the Board did not currently feed directly into any registered board or committee.
The quality of annual health checks was cited as an area where more needed to be done. The Commissioning Manager - Children’s, Young People & Adults explained how, with partners, the Board had carried out an audit and was to begin a review of the quality aspect of the annual health check so that people with autism had more access to them.
Members discussed the Healthwatch Learning Difficulties report and AGREED this would be circulated the Scrutiny Advisory Board – Adults. (ACTION D:S)
It was highlighted to officers that engagement with the Autism Champions across the County would be beneficial and officers confirmed that this process had begun and requests to members had been sent. Members AGREED that the Learning Difficulties & Autism Partnership Board would make contact with each of the Health and Well Being Forums to increase awareness of the work of the Board and that they provide the action plan responding to the Healthwatch report for the Board to scrutinise. (ACTION M:H)
Members asked officers if they knew the number of people with autism living in Cumbria. The Commissioning Manager responded that the only estimate available is based on the national average of 1.1% of the population which would suggest that 5,000 people in Cumbria live with autism.
A discussion took place about the National Autism Strategy and background was provided about the action plan that was in development for the county to assure that there was provision for people living with autism. It was AGREED that the Scrutiny Task & Finish Report on Autism to be circulated to the Partnership Board for information. (ACTION D:S)
It was RESOLVED that
1) The Healthwatch Learning Difficulties report to be circulated to the board.
2) Scrutiny Task & Finish Report on Autism to be circulated to the Partnership Board for information.
3) Learning Difficulties & Autism Partnership Board to make contact with each of the Health and Well Being Forums to increase awareness of the work of the Board.
4) Provide the action plan responding to the Healthwatch report to the Scrutiny Adults Board to scrutinise.
The presentation was NOTED.
The chair thanked members of the Learning Disability and Autism Board for their informative presentation.
PROMOTING INDEPENDENCE PROGRAMME
To receive details of how the programme will realise planned savings within 2018–19 budget, incorporating an update on the delivery of the ‘Strength Based Approach to Social Care’ (copy to follow).
Members received a presentation on the Strength Based Practice and Promoting Independence Programme from the Assistant Director - Strategic Commissioning. The presentation provided an update to members which covered the following points :-
· Principles – CCC Core Principles – Key Principles of Strength Based Working
· What is Strength Based Practice?
· What does this mean?
· Approaches to Managing Demand
· Promoting Independence Programme
· Historic Legacy Demand
· Achievements to date – New Demand
· Achievements to date – Legacy Demand
· Case Study
· New Steps – New Demand
· New Steps – Legacy Demand
Members requested that the Assistant Director clarify how the programme would be effective if there was less focus on eligibility criteria by which to assess need. She answered that the programme was not about abandoning criteria but instead about creating an environment whereby practitioners were not overly limited by it.
Members commented about the difficulties that arose from not getting the slides in advance of the meeting. It was AGREED that presentation slides be circulated to the members of the Board (ACTION D:H).
Questions were raised regarding the effect of these changes on the relationship with care providers. The Assistant Director – Strategic Commissioning explained how reaction from providers had been mixed as some would see their income affected. Despite this, members were told that providers do want to discuss alternative provision.
Discussion then took place around what a reasonable offer of support to people should look like. The officer explains how this would mean reviewing historical demand to find care packages that no longer fitted the need and applying the new evidence based approach to find a sustainable way to improve the service. It was AGREED that a further update on the implementation of the programme be brought before the June meeting of the Scrutiny Advisory Board – Adults (ACTION J:A, C:W).
It was explained to members that the focus of the programme was to assure a quality relationship between practitioner and person using the service to the point where they produce the support plan together providing an interactional rather than transactional service. Following on from this, members asked whether feedback was gathered and how it was followed up. The Assistant Director explained how feedback could be provided as part of the assessment, but also through the customer feedback tool which was developed and sent to customers to provide a review of the service. It was AGREED that a copy of the Customer Feedback Form be circulated to members (ACTION K:B).
It was RESOLVED that,
1) Presentation slides be circulated to the members of the Board.
2) A copy of the Customer Feedback Form to be provided to the members of the Board.
3) A further update be provided on the implementation of the programme be brought to the June meeting of the Adults Scrutiny Board.
The presentation was NOTED.
To receive the latest figures and analysis of Safeguarding alerts and investigations, details of actions undertaken and improvements planned (copy to follow).
The Senior Manager, Safeguarding and Care Governance – People provided an update and analysis of adult safeguarding activity for Quarter 2 2018/19 whilst also briefing members on progress against the key areas of performance relating to Making Safeguarding Personal.
It was reported that there were 434 Individuals associated with the total 523 Episodes of Safeguarding Concerns /Enquiries which were raised in the quarter 2 of 2018/19. The Senior Manager explains that some people will have had more than one episode in the period.
In comparison with quarter 2 2017/18 this showed an increase of 46 individuals and increase of 115 episodes.
Members raised concerns over the 20% increase in referrals made. The Senior Manager explained that Cumbria historically had been low in the volume of referrals. The 20% rise had now brought the county in line with the national average and this likely reflected better referral practice rather than an increase in abuse or neglect.
Members asked the Senior Manager if there was a record kept of all safeguarding referrals that resulted in court cases. It was explained that a record of criminal investigations was kept and could be collated on request
After a discussion about the disparity between districts with regards to the rates of referrals it was AGREED that future updates would provide further benchmarking information including comparisons with the same quarter in previous years and comparisons with other local authorities (ACTION A:H).
Members RESOLVED that,
1) Future reports include comparisons with the same quarter in previous years on volume of concerns.
2) Future reports include bench marking information with other comparator authorities.
The report was NOTED.
To consider items not covered elsewhere in the Board agenda, report from Performance Working Group and to agree the work programme (copy enclosed).
Members received a briefing paper which provided updated items of significance to the Scrutiny Advisory Board - Adults.
The Scrutiny Performance Working Group met on Thursday 9th October where Members received a briefing on how in-house social care and commissioning are working to ensure compliance with issued Assistive Technology. It was AGREED that a report be brought to the next Scrutiny Advisory Board meeting to update on progress in the take up of assistive technology incorporating an analysis of any barriers access to 4G represents (ACTION J:B).
The Joint Advisory Group with the Adults Scrutiny Board met on the 26th October to scrutinise the implementation of Integrated Care Communities in North Cumbria and Morecambe Bay Health Care Systems. The meeting took place in the new Eden ICC Co-ordination Hub in Penrith and Members had the opportunity to tour the Hub and talk to staff.
Members were informed that the next meeting of the Joint Advisory Group will take place on the 28th February and will be focusing on Population Health Management Models being developed in the North and South Systems
Members discussed theHealthwatch Learning Disability report and the Government’s consultation on the Social Care Green Paper which is due to be brought to the Board for the April meeting.
It was RESOLVED that,
1) A report be brought to the next Scrutiny Advisory Board meeting to update on progress in the take up of assistive technology incorporating an analysis of any barriers access to 4G represents.
2) A report be brought to the next Board meeting on the implementation of the changes to Adult Social Care Charging policy which took place in 2018 incorporating an analysis of the impact on service users, levels of complaints received etc.
3) A report to the June Board meeting on the Action Plan being produced through the LD & Autism Board responding to the Healthwatch report.
4) A report to the June Board meeting on the implementation of the Promoting Independence Programme.
DATE OF NEXT MEETING
The next meeting of the Scrutiny Advisory Board – Adults is scheduled for Monday 1 April 2019 at 10.00am in Committee Room 1 County Hall, Kendal.
The next meeting of the Scrutiny Advisory Board – Adults will be held in Committee Room 1, County Offices, Kendal on the 1 April 2019 at 10am.