Venue: Council Chamber - Time Square, Market Street, Bracknell, RG12 1JD. View directions
Contact: Kirstine Berry
To approve as a correct record the minutes of the meeting of the Adult Social Care, Health and Housing Overview and Scrutiny Panel meeting held on 11 September 2018.
To review the Actions Log arising from the Minutes, to include an update on the Task & Finish Groups’ progress and to provide an update on any issues arising since the last meeting.
RESOLVED that the Minutes of the Adult Social Care, Health and Housing Overview and Scrutiny Panel held on 11 September 2018 be approved as a correct record, and signed by the Chairman.
Arising from the Actions Log, Action 14 (from the 24 July meeting) Item 20 Healthwatch, Bracknell Forest Annual Report 2017-2018, Members confirmed that they had raised awareness amongst residents about the need to opt in to Healthwatch if they wished to continue receiving updates.
Referring to Matters Arising Since the Last Meeting, the sixth Bulletin supplied by the East Berkshire CCG about “The Big Conversation”, Members asked what impact the “Feeling Unwell?” communications piece which signposts people to the correct service, had been.
Janette Fullwood, Head of Children, Young People’s and Families: East Berkshire Clinical Commissioning Group (CCG) advised that the impact of the signposting communications piece was currently unknown.
Melanie O’Rourke, Assistant Director: Adult Social Care Operations advised that anecdotal evidence showed there had been lighter winter pressures on the NHS over Christmas. Cold weather and snow would usually drive up hospital admissions but the weather had not been severe and admissions numbers had not been high. Hospitals were accepting admissions within normal expected ranges and some even at lower levels and the current situation was looking positive.
ACTION: Janette Fullwood, Head of Children, Young People’s and Families: East Berkshire Clinical Commissioning Group (CCG) confirmed she would look at the specific impact of the communications piece and advise the Panel.
Declarations of Interest and Party Whip
Members are asked to declare any disclosable pecuniary or affected interests and the nature of that interest, including the existence and nature of the party whip, in respect of any matter to be considered at this meeting.
Any Member with a Disclosable Pecuniary Interest in a matter should withdraw from the meeting when the matter is under consideration and should notify the Democratic Services Officer in attendance that they are withdrawing as they have such an interest. If the Disclosable Pecuniary Interest is not entered on the register of Members interests the Monitoring Officer must be notified of the interest within 28 days.
Any Member with an Affected Interest in a matter must disclose the interest to the meeting. There is no requirement to withdraw from the meeting when the interest is only an affected interest, but the Monitoring Officer should be notified of the interest, if not previously notified of it, within 28 days of the meeting.
There were no declarations of interest relating to any items on the agenda, nor any indication that Members would be participating under the party whip.
Urgent Items of Business
Any other items which, pursuant to Section 100B(4)(b) of the Local Government Act 1972, the Chairman decides are urgent.
There were no urgent items of business.
To receive submissions from members of the public which have been submitted in advance in accordance with the Council’s Public Participation Scheme for Overview and Scrutiny.
No submissions had been made by members of the public under the Council’s Public Participation Scheme for Overview and Scrutiny.
Introduction from Nikki Edwards, Executive Director: People
Introduction from Nikki Edwards, Executive Director: People. An opportunity to update the Panel and share her vision on her role as Executive Director for People’s Directorate and to introduce the leadership team.
Nikki Edwards, Executive Director: People gave an introduction, shared her vision on her role as Executive Director for People’s Directorate and introduced the leadership team.
The People Directorate structure was outlined:
· Nikki Edwards Executive Director: People
· Tony Dwyer, currently the Locality Manager for Mental Health Services in Bracknell but his post will become Interim Assistant Director for Mental Health and Out of Hours Services.
· Melanie O’Rourke, Assistant Director: Adult Social Care Operations. Manages learning disabilities, mental health, older people, long term conditions, and integrated services.
· Hannah Doherty, currently Interim Joint Assistant Director Early Help and Communities but from March 2019 will be Head of Learning Disabilities and Autistic Spectrum Disorder.
Other members of the directorate working in children’s and adult’s services were unable to be at the Panel meeting as they were working on a time bound Joint Targeted Area Inspection (JTAI). Those colleagues were:
· Rachel Morgan, Assistant Director: Education and Learning
· Thom Wilson Joint Assistant Director: Commissioning
· Sonia Johnson Assistant Director: Children’s Social Care Operations.
Nikki Edwards, Executive Director: People outlined the process of how the Directorate had come together and explained:
· The People directorate brought together Adult and Children’s services.
· The implementation date was 01 September 2018.
· The new team had looked at synergies where the two services worked together.
· They had held on to social care specialists, with Tony Dwyer, Locality Manager looking at emergency mental health services and out of hours.
· Gill Vickers, Executive Director: Delivery retained some services in the Delivery Directorate such as the emergency duty service, Forest Care and the Heathlands development.
There were 2 vision statements, that had to be blended and a draft vision for the new Directorate was now produced.
It was explained that people were at the heart of their services and there was a total commitment to the residents of the Borough.
The new vision matched the Council’s plan and priorities.
Nikki Edwards, Executive Director: People described the draft vision statement was in two parts. The first part explained to service users why they were there, to:
· Protect you from harm if you need us
Help you to get support so that you can be physically and
Work with you and your community to help you to be
Nikki Edwards, Executive Director People, explained that her team:
· Prided themselves in good, strong and effective services and wanted outstanding service across the whole People Directorate by focussing on quality.
· Wanted to integrate services with partners and work closely with those partners to make services seamless.
· Would enhance and continue daily working with partners.
· Wanted to provide information and choice and focus on what is important.
The second part of the vision explained how they would do it by:
· Focusing on quality practice
· Integrating services with partners
· Providing information & choice
· Focusing on what is most important
The draft vision had been stated, shared and was being worked to,
The next steps for the development of the Directorate were outlined.
· Of note, the JTAI inspection was ... view the full minutes text for item 38.
Janette Fullwood, Head of Children, Young People’s and Families: East Berkshire Clinical Commissioning Group (East Berks CCG) to provide an update on the refreshed multi-stakeholder LTP for children and young people’s mental health and wellbeing and the new governance arrangements for the delivery of the plan and new outcomes.
Janette Fullwood, Head of Children, Young People’s and Families: East Berkshire Clinical Commissioning Group (East Berks CCG) provided an update on the refreshed multi-stakeholder Local Transformation Plan (LTP) for children and young people’s mental health and wellbeing and the new governance arrangements for the delivery of the plan and new outcomes.
Janette Fullwood, Head of Children, Young People’s and Families: East Berkshire Clinical Commissioning Group (East Berks CCG) Introduced herself to the Panel and explained that:
· Mental health for children and young people was a significant and growing issue.
· 1 in 8 children had a diagnosable mental health condition whereas previously it had been 1 in 10.
· Locally the Child and Adolescent Mental Health Services (CAMHS) were seeing more complex cases and raised numbers of cases.
· There was some good news nationally following the Green Paper and the Government had committed to invest in new mental health teams locally.
· Since last February 2018 when she had started her role, the system was now working in an integrated way, with budgets and resources working together.
Background was provided to the LTP. It was explained that:
· The LTP was not new and had originally been part of a document called “Future in Mind” produced in 2015 which had set out how, as a system, local services could would work together to deal with mental health and emotional wellbeing.
· East Berkshire’s first LTP had 9 strategic priorities. This plan had now been refreshed in a multi agency way.
· The new LTP was 80 pages long.
ACTION: Janette Fullwood Head of Children, Young People’s and Families: East Berkshire Clinical Commissioning Group (East Berks CCG) to provide the link to the full LTP to the Panel
· The refreshed LTP had been signed by all directors of children’s services.
· The CCG lead the plan but the whole system now worked together.
There were some highlights of the new approach:
· Additional services, including online support and community counselling across the patch had been commissioned (KOOTH).
· Psychological Perspectives in Education and Primary Care (Ppep Care) training had been delivered to professionals including GPs and teachers, upskilling the workforce.
· An eating disorder and rapid response service for those presenting in crisis was now in place.
· The increase in tier 4 admissions, for those who were most unwell and needed inpatient admission, had slowed and the average length of stay was reduced.
The current challenges with the LTP were described:
· There was a fragmented offer for children and young people who didn’t always know where to go for help resulting in extra pressures for specialist CAMHS.
· Approximately 50% of the referrals were inappropriate referrals, because of fragmented services.
· More work needed to be done with parents and carers to develop their participation. Co-production with these groups was necessary. The Special Educational Needs Service (SEN) was much more advanced in this area.
· The previous plan had looked at what needed to be commissioned not at how the system was working.
· This year there was is just over £1m ... view the full minutes text for item 39.
To consider and comment on the key themes and priorities for Adult Social Care, Health and Housing as outlined in the Council’s Draft Budget Proposals for 2019/20.
Panel members are asked to give advance notice to the Chairman of any questions relating to the Draft Budget Consultation in advance of the meeting.
The Panel considered and commented on the key themes and priorities for Adult Social Care, Health and Housing as outlined in the Council’s Draft Budget Proposals for 2019/20.
Panel members were asked to give advance notice to the Chairman of any questions relating to the Draft Budget Consultation in advance of the meeting.
Julian McGowan, Business Partner: Finance, introduced the draft Budget proposals that related to Adult Social Care, Health and Housing.
He advised the Panel that:
· The report summarised the proposed 2019/20 budget and provided details on savings, pressures and fees & charges relevant to the Adult Social Care, Health and Housing Overview and Scrutiny Panel (ASCH&H O&S Panel).
· The overall budget had been set at £79m which resulted in a gap of £2.5m from known funding sources.
· Members would be able to close this gap by
o Raising Council Tax
o Using general reserves
o Requesting further savings to those already detailed in the paper are identified. The annexes detailed the commitment budget and identified pressures and savings.
· The commitment budget included a target of £616k efficiencies from Adult Social Care transformation.
· Pressures had been estimated at £850k for Adult Social Care, offset by savings across Adult Social Care and Housing of £567k.
· The Capital budget for Adult Social Care contained just one project, the redevelopment of the Heathlands site into a new care home.
· The total value of this scheme was £10m, funded £7m by the Council and £3m from the CCG.
Within Adult Social Care related savings, Members asked what the Mental Health Community Network budget was to provide and why it hadn’t been used.
In response to the Member questions, Julian McGowan, Business Partner: Finance advised that:
· The money was used for Community Connectors and recovery services. There was unspent money because the service had been delivered in a smaller envelope than had been anticipated.
Within Adult Social Care related savings, clarity was sought to explain the statement “Additional income from increased activity in the deputyship team”
In response to the Member question, Melanie O’Rourke, Assistant Director Adult Social Care Operations advised that:
· The Ministry of Justice had made some changes to guidance on charges that could be made and an increase in income had resulted from those charges. For example, charges could now be applied for completion of court reports, travel into individual’s homes and applied to people who own their own homes.
Health and Wellbeing Board Alliance Update
Executive Member for Adult Services, Health and Housing to update the Panel on the Integrated Care System (ICS) Health and Wellbeing Board Alliance.
Councillor Dale Birch, Executive Member for Adult Services, Health and Housing updated the Panel on the Integrated Care System (ICS) Health and Wellbeing Board Alliance.
He advised the Panel that:
· When the Sustainability and Transformation Plan (STP) was established, the way they were established excluded elected Members from being involved.
· The STP, now Integrated Care System (ICS) were approached to get proper elected Member representation on the Frimley ICS.
· The Health and Wellbeing Board Alliance was established and made up of Members who were all either chairmen of Health and Wellbeing Boards (HWB) boards or vice chairs or lead Members, in all the local authorities that made up the Frimley ICS footprint.
· The Terms of Reference were to ensure that elected Members across the ICS footprint had a voice in the development in the large and complex plan for the future of all resident’s health, care and wellbeing.
· The Health and Wellbeing Board Alliance had been chaired by Sir Andrew Morris, who had recently moved on in the system to NHS Improvement and the new lead is for the HWB Alliance was Fiona Edwards, Chief Executive of Surrey and Borders Partnership NHS Foundation Trust, who had 18 years in NHS senior management and was experienced in areas of mental health and learning disabilities. Fiona Edwards was very keen on the use of new technology, timeliness and cleanliness of data within the system.
· The HWB Alliance Board had met 8 times,
· They had reviewed the in year current ICS plan and were now working on 5 and 10 year forward view plans, looking at communications and engagement with residents.
· Nationally, the Frimley ICS was one of the most integrated and advanced in the country and were seen as an exemplar in the process. Colleagues in the Frimley ICS were held in high regard nationally, for their work on connected care and prevention.
· The HWB Alliance Board had looked at things and had assisted in communications and engagement and marketing the complexities of the system.
· The HWB Alliance Board had agreed the Frimley Health and Care logo which was amended from the initially suggested NHS logo.
· The HWB Alliance Board had also had input into the Creating Healthier Communities Plan and contributed to changes that were made to that plan.
· Local authorities, and local health organisations were working together as Frimley Health and Care system to provide joint healthcare providing you and your family with the right care, at the right time and in the right place.
· The effects of the HWB Alliance Board had been noticeable. One of the key outputs was a glossary. There were 9 or 10 different organisations using specific language, organisation specific terms and using their own governance arrangements. The glossary identifies and collates all of the terminology used across a number of organisations into an understandable reference document.
· The HWB Alliance Board was also looking to bust the myths about what was happening in the health service such as the noise about the STP being Health ... view the full minutes text for item 41.
To consider the latest trends, priorities and pressures in terms of departmental performance as reported in the Quarterly Service Report for the second quarter of 2018/19 (July 2018 to September 2018) relating to Adult Social Care, Health and Housing. A current comment and an overview of the key issues (risk rated red items) relating to the second quarter will be provided.
Panel members are asked to give advance notice to the Governance and Scrutiny Team of any questions relating to the Quarterly Service Report where possible.
The Panel considered the latest trends, priorities and pressures in terms of departmental performance as reported in the Quarterly Service Report for the second quarter of 2018/19 (July 2018 to September 2018) relating to Adult Social Care, Health and Housing. A current comment and an overview of the key issues (risk rated red items) relating to the second quarter was provided.
Nikki Edwards, Executive Director: People introduced the QSR and acknowledged it was out of date as the Panel had not met since 11 September 2018 and the QSR for Q2 2018/19 had not been available on the date of that Panel meeting.
The Panel were advised that the dashboard for QSR monitoring was not ready yet and commentary was provided (by exception) for items risk rated red.
Melanie O’Rourke, Assistant Director: Adult Social Care Operations advised the Panel that:
· She was proud of the achievements to create savings with no direct effect on individuals and no increase in complaints.
· Transformation plans had been refreshed.
· Future prioritisation was on programme priorities in such a way as to keep delivering.
The current figure of 838 household nights in B&B accommodation (quarterly) was questioned by Members.
Hannah Doherty, Interim Joint Assistant Director: Early Help and Communities, explained:
· Tenterden Lodge had been closed for major works and needed to be revamped. Alternative accommodation had needed to be found for those who needed it and this had resulted in higher numbers in B&B accommodation in Q2 but those numbers were now back below the target figure in Q3.
The Executive Member for Adult Social Care further advised that:
· There were a couple of places held and kept available at Tenterden Lodge for homeless people in cold periods so a quick response could be provided.
· A Severe Weather Emergency Protocol (SWEP) update would be provided to Councillors in the next few days.
· Extensive work was being done to avoid homelessness.
· Housing had been asked to indicate the success of our programmes to avoid homelessness in the first place.
Members asked for details of the new Drug, Alcohol and Addiction Therapy (DAAT) programme that had commenced on 6 November 2018.
Melanie O’Rourke, Assistant Director: Adult Social Care Operations advised:
· The new Drug, Alcohol and Addiction Therapy (DAAT) programme had been implemented, and positive feedback had been received.
· The group programme which had been 4 days per week for 8 weeks had changed to 3 days per week for 10 weeks. The content of the programme had been refreshed and the programme met the needs of the people taking part.
· Feedback indicated that the programme was working.
Members asked how much of the additional funding of £240m for winter pressures in social care nationally Bracknell Forest would receive and whether there any conditions attached.
Melanie O’Rourke Assistant Director: Adult Social Care Operations advised that:
£364K has been allocated to Bracknell Forest Council, with the condition that this will address Delayed Transfers of Care making sure across the Integrated ... view the full minutes text for item 42.
Executive Key and Non-Key Decisions
There are currently no items on the Executive Forward Plan relating to Adult Social Care, Health and Housing.
There were no items on the Executive Forward Plan relating to Adult Social Care, Health and Housing.
Date of Next Meeting
The next meeting of the Adult Social Care, Health and Housing Panel has been scheduled for 4 February 2019.
The next meeting of the Adult Social Care, Health and Housing Panel has been scheduled for 4 February 2019.