Agenda and minutes

The Chairman welcomed everyone to the meeting.

The Chair will draw attention to the emergency evacuation procedure as set out under Note 6.

The Democratic Services Officer drew attention to the emergency evacuation procedure.

Apologies for absence were received from Councillors John Whittock and Loraine Brinkhurst.  Councillor Brian Webber was substitute for Councillor Whittock.

The Chairman informed the meeting that Councillor Brinkhurst was not at the meeting because of the death of her father.  The Panel offered its condolence to Councillor Brinkhurst and her family.  

Members who have an interest to declare are asked to:

a)  State the Item Number in which they have the interest

b)  The nature of the interest

c)  Whether the interest is personal, or personal and prejudicial

Any Member who is unsure about the above should seek advice from the Monitoring Officer prior to the meeting in order to expedite matters at the meeting itself.

There were none.

There were none.

At the time of publication no notifications had been received.

There were none.

The Panel will have an opportunity to ask questions to the Cabinet Member and to receive an update on any current issues.

The Chairman invited Councillor Vic Pritchard (Cabinet Member for Adult Social Services and Housing) to update the Panel on current issues within his portfolio (attached as Appendix 1 to these minutes).

The Panel asked the following questions and made the following points:

Councillor Sandry said that there was a perception that Housing Team had poor correspondence with the Planning Team in terms of the New Homes Bonus scheme and asked for assurance that those two teams do talk to each other.

Councillor Pritchard responded that there was a close liaison between those two departments.

Councillor Sandry asked Councillor Pritchard if he had knowledge of how many individuals were in Julian House now, in particular if there was overflow in number of people staying.

Councillor Pritchard responded that Julian House was not populated to its full capacity.

Councillor Jackson asked if the £400 cap on housing benefit would affect Bath and North East Somerset area and how many people would be affected.

Councillor Pritchard responded that he would not be able to give a specific answer to that question.  He added that rents had been assessed on monthly basis.

The Chairman said that he was not sure how changes to new social tenancies including fixed term reviews and increasing social rents to 80% or even 90% of market rents (calculated using housing benefit rates) would work.  He asked if there was any conversation with the Somer Housing on that issue.

Councillor Pritchard responded that no announcement had been made so far and he would provide more information, if available, to the Panel at the next meeting.

The Chairman asked that the Care Quality Commission assessment results be sent to the Panel once they become public document.

Councillor Pritchard agreed with this suggestion.

The Chairman thanked Councillor Pritchard for the update.

The Panel will receive an update from the BANES NHS on current issues.

The Chairman invited Janet Rowse to update the Panel on current issues in NHS BANES (attached as Appendix 2 to these minutes).

The Panel asked the following questions and made the following points:

Councillor Organ shared his positive personal experience on Health Checks in his surgery in Keynsham.  He also said that he was impressed that the hospital beds freed up as people go home more quickly because of effective community services.

Councillor Sandry asked what form of screening would be commissioned by the Council in future and whether the Council would commission sexual health services.

Janet Rowse replied that the DH guidance was not yet published but that it was expected that most screening programs would be commissioned by the Council.  She also said that a number of services currently commissioned by the NHS were expected to be transferred to the Council and one of those services is likely to  be sexual health.

Councillor Sandry asked what would be the option recommended by the NHS presented to the Council and Transfer of Community Services.

Janet Rowse replied that the recommendation was consistent with the presentation to the last HCOP Scrutiny Panel and proposed Social Enterprise as the direction of travel.

The Panel congratulated on the Health and Social Care Award for ‘Clinic on the move’ multi-agency partnership which brought sexual health services into the community, taking services from clinical settings into non-clinical environments.

The Chairman thanked Janet Rowse for the update.

The Panel are asked to consider an update from the BANES Local Involvement Network.

The Chairman invited Diana Hall Hall and Mike Vousden to update the Panel on current issues involving Bath and North East Somerset Local Involvement Network (BANES LINk) as per the report.

Note: A revised update from the BANES LINk is available on the Panel’s agenda website and also at the minute book in Democratic Services.

The Chairman commented that the future of BANES LINk, to act as a Health Watch, should be resolved with the Health White Paper.

Janet Rowse commented that there were ongoing conversations between the Partnership and LINk about their future status.  Janet Rowse also said that she had been asked by the Chief Executive of the Council to consider the future of Health Scrutiny as part of the establishment of the new statutory Partnership Board

Councillor Jackson raised the point about the Ketamine abuse amongst young people and suggested that the Panel should look into this issue.  Diana Hall supported that suggestion.

Janet Rowse suggested that the officer from Drug Services could come at the next meeting and brief the Panel on that issue.

The Panel agreed to discuss ‘Ketamine abuse amongst young people’ at the next meeting.

The Chairman thanked Diana Hall Hall and Mike Vousden for the update.

The draft Adult Social Care & Housing Medium Term Service & Resource Plan (MTSRP) is presented for consideration by the Panel:

1)  To ensure all members of the Panel are aware of the context for Service Action Planning

2)  To enable comment on the strategic choices inherent in the medium term plan together with the links to the Corporate Plan

3)  To enable issues to be highlighted for consideration in January by the committee as part of the service action planning and budget processes

4)  To enable issues to be referred to the relevant Portfolio holder at an early stage in the service planning and budget process.

The Panel is asked to:

1)  Comment on the medium term plan for Adult Social Care & Housing 

2)  Identify any issues requiring further consideration and highlighting as part of the service action plans and budget reports to be considered in January by the Committee

3)  Identify any issues arising from the draft plan it wishes to refer to the relevant portfolio holder for further consideration.

The Chairman invited Janet Rowse to introduce the report.

Janet Rowse gave a presentation (attached as Appendix 3 to these minutes) in which she highlighted the following points:

• Background – Budget Savings Targets
• Adult Social Care and Housing – The Financial Challenge
• Summary Proposals for 2011/12
  • Productivity and Efficiency
  • Service Re-design
  • Changing the offer
• Risks

The Panel asked the following questions and made the following points:

Janet Rowse said that safeguarding would remain a priority for the Council.  Jo Gray added that the Lean Review currently taking place is expected to identify opportunities for greater productivity and this is likely to inform plans for future staff numbers. Within the plans 50% of the proposed staff reductions (10 in total) relate to Lean Reviews. 

Councillor Sandry asked about Community Meals issue and if there were any criteria for people to get them free.

Janet Rowse replied that the service users had been charged at the same level of £3.90 per meal although the actual cost of the provision of a meal was £5.20.  The difference between the annual cost of providing the meals service and income from charging for the service was approximately £125,000.  That difference was met from the adult social care budget through a subsidy.

Councillor Sandry asked for more details/information on reduction in commissioning of services from the third/voluntary sector to be available within the Service Action Plan at the next meeting of the Panel.  The Panel agreed with this request.

Councillor Sandry asked what amount of budget control had been obtained with the vacancy management.  Councillor Sandry said that the Panel was told in past that the vacancy management cost could not be used to cover an increase in social care.

Janet Rowse and Jo Gray replied that this would be monitored.

The Chairman said that the Community Learning Services had been quite positive and powerful service for the community.  He felt that those services should be provided by the Policy and Partnerships.

Jo Gray agreed with the Chairman on the role of the Community Learning Services in the community and that the role of the service should be looked across the whole Council.  However, difficult decisions would need to be made in these times.

The Chairman asked for more details and information on the Community Learning Services to be available within the Service Action Plan at the next meeting of the Panel.  The Panel agreed with this request.

The Chairman also asked for more details and information on Housing Savings to be available within the Service Action Plan at the next meeting of the Panel.  The Panel agreed with this request.

It was RESOLVED that:

1)  The Panel noted the report; and

2)  The Panel identified the following issues requiring further consideration and highlighting as part of the service action plans and budget reports to be considered in January 2011:

a.  Reduction in commissioning of services from the third/voluntary sector

b.  Community Learning Services; and

c.  Housing Savings.

The Local Area Agreement year end performance report 2009/10 highlighted that the target for admissions to residential care for older people had not been met.  The Panel requested further investigation and information to explain performance and expressed an interest in understanding the wider context for this issue.

The Overview & Scrutiny Panel for Healthier Communities & Older People are asked to note the findings of the investigation that has taken place in relation to residential admissions  and to provide a steer in relation to the appropriateness/achievability of the current target in light of the wider contextual issues detailed in the report.

The Chairman informed the meeting that the officer who meant to present this report had not been able to attend the meeting due to ill health.  The Panel would have an opportunity to debate this item in the officer’s absence and the questions from the Panel would be answered at the next meeting if those questions could not be answered by Janet Rowse or Derek Thorne.

Councillor Sandry asked if the stretch targets were set by the government or locally.

Janet Rowse replied that stretch targets were set locally as part of the Local Area Agreement.

Councillor Clarke expressed his concerns on excessive number of older people dying in Bath and North East Somerset during winter months.  He also said that the area was now in the position for being the worst in England for excess winter deaths and that something had to be done to reduce this figure and improve the overall mortality rate for the area.

Janet Rowse replied that there was a big debate on this matter and that some deaths could be prevented, but that it was important to note that life expectancy in B&NES is well above average. The issue is the proportion of people who die in winter since this suggests some deaths may be preventable. Given the advice from public health colleagues that there is an association with poorly heated homes, her view was that these deaths were unlikely to be in residential homes although it was noted that this has not been tested.

The Panel agreed to have a report on ‘Excessive number of older people dying in Bath and North East Somerset during winter months’ for the next meeting.

Janet Rowse also said that although there would be no more Care Quality Commission Annual Performance Assessment, the Council would continue to monitor commissioning of care locally.  The Panel welcomed this information.

It was RESOLVED to note the findings of the investigation that took place in relation to residential admissions and to receive a report on ‘Excessive number of older people dying in Bath and North East Somerset during winter months’ at the meeting in January 2011.

From 1 April 2010, Tiers 3 and 4 Child & Adolescent Mental Health Services (CAMHS) have been delivered by a new provider, Oxfordshire and Buckinghamshire Foundation NHS Trust (OBMH).  Overview & Scrutiny Panel requested information about the new CAMHS Services.  This report provides a brief outline of the new model of service delivery for CAMHS.  Paul Sheffield, Assistant Service Director, OBMH will be attending Overview & Scrutiny Panel to provide further information about the new service.

The Healthier Communities & Older People’s Overview & Scrutiny Panel are asked to note the report.

The Chairman invited Liz Price and Paul Sheffield (Assistant Service Director- CAMHS forOxfordshire and Buckinghamshire Mental Health NHS Foundation Trust) to introduce the report.

Liz Price and Paul Sheffield went through the report.  Paul Sheffield also gave an overview of the referral criteria for the child and adolescent mental services that would be screened through the single point of access in Bath and North East Somerset.  These include Specialist CAMHS Community Service, Outreach Service for Children and Adolescents (OSCA) and CAMHS Learning Disability Service.

Leaflets explaining the work of CAMHS and OSCA in Bath and North East Somerset together with the referral criteria for Bath and North East Somerset CAMHS community services are available on the minute book in Democratic Services.

Councillor Organ said that it was nice to hear that the referral form was made simple.  He asked how many people from Bath and North East Somerset needed patient admission.

Paul Sheffield replied that there were 6 cases from Bath and North East Somerset which needed patient admission and that there were 2 patients at the moment at the inpatient facilities in Swindon.

Councillor Sally Davis (Chair of the Children and Young People Overview and Scrutiny Panel) welcomed the report and information provided by the officers at the meeting.  She asked that the further update should be presented to the Children and Young People Panel.

Councillor Sandry asked if it would be possible for the Panel to have a list of tiers and functions of each tier.  Liz Price said that she would send this information to the Panel.

Councillor Sandry asked about planned tier 2 service.

Liz Price explained that tier 2 service would co-ordinate the emotional help and wellbeing referrals and to provide capacity to avoid tier 3 referrals.

Janet Rowse commented that the funding for this service was in place and the funding on behalf of the NHS and Council had been agreed to enable this to commence as from April 2011.

Councillor Sandry asked if there was a case that patients were not able to be accommodated in Swindon and instead moved to Oxford.

Paul Sheffield said that it was never the case so far although there was no guarantee that it would never happen in future.

Councillor Jackson said that it was very difficult to get mental health support quickly enough for a child.  She asked about the referral process and who was involved in it.

Paul Sheffield replied that the usual practice was to have referrals from GP.  He also said that referrals could also come from youth worker.  Paul Sheffield commented that the service knew that there were a lot of young people who need help and that no child should wait more than 4 weeks to get help.  Anything longer than 4 weeks would be a loss.

Councillor Sandry asked about the transitions of patients from the CAMHS to Avon and Wiltshire Mental Health Partnership (AWP).

Paul Sheffield replied that both services had been  ...  view the full minutes text for item 32.

This sets out the Panels future workplan for Panel members to discuss.

The Panel noted their future workplan with the following additions:

• ‘Ketamine abuse amongst young people’ – for January 2011
• ‘Excessive number of older people dying in Bath and North East Somerset during winter months ’ – January 2011