Agenda and minutes

Gill Stobart, Co-opted Panel Member and Dr Bryn Bird, B&NES Locality Clinical Chair had given their apologies to the Panel.

At this point in the meeting declarations of interest are received from Members in any of the agenda items under consideration at the meeting. Members are asked to indicate:

(a) The agenda item number in which they have an interest to declare.

(b) The nature of their interest.

(c) Whether their interest is a disclosable pecuniary interest or an other interest,  (as defined in Part 2, A and B of the Code of Conduct and Rules for Registration of Interests)

Any Member who needs to clarify any matters relating to the declaration of interests is recommended to seek advice from the Council’s Monitoring Officer or a member of his staff before the meeting to expedite dealing with the item during the meeting.

Councillor Gerry Curran declared an other interest with regard to agenda item 8 (Cabinet Member Update) as he is an employee of HCRG.

Councillor Paul May declared an other interest with regard to agenda item 10 (Adult Social Care - Transformation Plan) as he is a non-executive Sirona board member.

There were none.

The Chairman asked if a link to the B&NES SACRE website was now in place on the B&NES Council website.

The Democratic Services Officer informed the Panel that it was now in place.

The Chairman stated that he had met both Cabinet Members recently regarding HCRG and said that a report was expected for the Panel to discuss at their meeting on 17^th May. He added that should appendices to the report be judged to be commercially sensitive the Panel would need to meet, in part, in an exempt session.

The Chairman said that he was still waiting for the Panel to be informed of the names of the 10 Local Authorities that met on February 15th 2022 as part of the Independent Review of Children’s Social Care.

Councillor Michelle O’Doherty asked again if all councillors could be sent School Appeals guidance / process information to then be in a position to advise families if contacted.

Councillor Ruth Malloy said she was still awaiting a response to her question of how many Mental Health First Aiders there were within HCRG.

The Director of Adult Social Care said she would take these points away and remind colleagues of the requests made.

Councillor Paul May asked if the Children’s Services Ofsted Inspection report would be available for the next Panel meeting.

The Democratic Services Officer replied that it was the current intention to have this report to the Panel for its meeting on 17^th May.

The Panel confirmed the minutes of the previous meeting as a true record and they were duly signed by the Chairman.

The Cabinet Member will update the Panel on any relevant issues. Panel members may ask questions on the update provided.

Councillor Alison Born, Cabinet Member for Adults addressed the Panel, a summary is set out below and a copy of the update will be attached as an online appendix to these minutes.

HCRG

The Council and the CCG continue to work together on the future of the community services contract following the unexpected sale of Virgin Care to Twenty 20 Capital. We met with representatives of Twenty 20 Capital and HCRG on March 29^th to discuss the new owner’s vision for the service and work continues on the revised options appraisal. The options appraisal and recommendations will be discussed by the Panel prior to a decision being made by Cabinet and the CCG ahead of the June deadline.

Update on system pressures and recruitment to Care posts

The local health and care system remains under considerable strain. Shortages in social care capacity continue to have knock on effects on the hospital system and also on ambulance services.

Within the local care home sector 47 residents and 65 staff are currently suffering from Covid.

Good progress is being made on recruitment to the in-house home care service that we are developing in partnership with the RUH. We are hoping to interview the care-coordinator in the next few days so the service should become operational soon. We are also currently seeking new tenders to increase homecare capacity in the area.

As of 6^th April the RUH had 27% of their beds ready for discharge and 72 Covid patients, which required 50 further beds to be closed due to quarantine procedures. 150 staff members were also absent due to Covid.

Staffing Update - Adult Social Care

Two new Assistant Director posts have been created to reflect the current complexity of work in adult social care and the fact that the Community Resource Centre provision has transferred back from Sirona to B&NES Council. Nathalia Lachkou recently moved from Oxfordshire County Council to the AD Commissioning role and we had a very strong field for the AD Operations interviews on Thursday 7^th April.

Debbie Forward is retiring from her senior Commissioning manager role at the end of April, Deborah Wolfson has been appointed as an interim to cover this important work for three months as we interview this week for a permanent replacement.

Future changes within adult Social Care

Build Back Better - Adult Social Care Charging Reforms. This incudes the lifetime cap of £86k on the amount anyone in England will need to spend on their personal care in a residential setting, alongside a more generous means test which is presently an upper capital of £23,250 which will raise to £100,000.

Adult Social Care are preparing for the new CQC inspection framework. It is expected that CQC will share the framework in early summer and the key focus will be on local authorities and integrated care systems with a consistent set of themes, from registration through to ongoing assessment. The CQC assessment framework will go live in 23/24.

The Mental  ...  view the full minutes text for item 102.

The Panel will receive an update from the B&NES, Swindon & Wiltshire Clinical Commissioning Group (BSW CCG) on current issues.

The Chairman introduced the report to the Panel and explained that Dr Bird was unable to attend would therefore respond in writing to any questions. A copy of the update will be attached as an online appendix to these minutes.

The Director of Adult Social Care informed the Panel that Corinne Edwards had stepped down from her role as B&NES Chief Operating Officer, BSW CCG and that interviews to replace her were due to take place in the first week of May.

Kevin Burnett asked the following three questions.

Is the BSW Academy a training centre or if not, what were its functions?

Does the Integrated Care Alliance (ICA) work independently of the Integrated Care Board (ICB) or does it have any of its own functions?

Could some guidance be given with regard to Covid testing and the receiving of booster vaccinations within so many weeks of actually having Covid as testing may now be taking place on a less regular basis.

Councillor Alison Born suggested that the question in relation to Covid be passed to the Director of Public Health to answer.

This reports intention is to update Children’s and Adults Health and Wellbeing, Policy Development Scrutiny Panel on the progress to date on transformation of Adult Social Care.

Councillor Alison Born, Cabinet Member for Adults introduced the report to the Panel. She explained that the intention of the Plan was to bring services in line with best practice across the country.

She said they want to enable our services to make better use of the local voluntary and community services, ensure that we can support people at an earlier stage in their life and to improve access to services.

She added that they were also working on the connections between Children and Adult Services and the transitionary period between the two.

She notified the Panel of the seven workstreams to the Plan:

·  Early Intervention & Community Resilience

·  Optimising the Social Care Front Door

·  Social Care Processes and Interventions

·  Reablement

·  Community Mental Health Services Framework

·  Transitions

·  Redesign Liquid Logic

The Director of Adult Social Care said that work on the Plan began in the Summer of 2021 and elements had already begun to change due to new directives that are being / will be introduced.

She explained that work was ongoing across the service in terms of the Care Bill and Integrated Care System.

She said that the financial reforms will inevitably change their approach further as there will be areas of work that require a particular level of focus. She added that this was in addition to a new assessment framework being introduced by the CQC (Care Quality Commission).

She stated that the biggest area of focus would be on Transitions, in particular young people aged between 14-25, to be able to give them a good journey through this period of their life. She added that this would mean working with the individuals, their families and schools as much as possible.

She said that a robust 3^rd sector provision was in place and that the Council works very closely with them alongside HCRG.

She recommended that the Panel at some point receives a presentation on the new Mental Health Framework provision that is available. She added that workforce was also an issue in this area and the challenge therefore to have the right people in the right place.

She said that there was an intermediate care focus to reablement through the use of physiotherapists and occupational therapists and that the intention is to increase patient flow through this area where possible.

She said that she felt that a good start had been made but it was acknowledged that there was plenty of work still to do.

The Chairman said that he felt that it was not a comfortable position to be in having to find savings of £4m over the next three years alongside the changes that have been outlined.

Councillor Liz Hardman asked how the savings will be achieved, if at all, given that the report highlights rising care costs and social care reforms.

The Director of Adult Social Care replied that a three-year financial strategy had been agreed in November 2021 and that they have worked very hard to make sure that people are not adversely  ...  view the full minutes text for item 104.

This report presents the latest workplan for the Panel. Any suggestions for further items or amendments to the current programme will be logged and scheduled in consultation with the Panel’s Chair and supporting officers.

The Chairman introduced this item to the Panel and explained that following the latest agenda setting meeting with the Vice-Chair items were in place for the next six months.

Kevin Burnett asked if information could be received regarding the Family Hubs funding bid.

The Chairman suggested that this could be supplied through the next Cabinet Member Update.

Councillor Liz Hardman asked if an update could be provided on the Children Missing Education Service.

Councillor Paul May requested that the Ofsted inspection report be added to the workplan.

The Democratic Services Officer replied that the expectation was that the Ofsted report would be presented to the Panel at their meeting on 17^th May 2022.

Kevin Burnett asked if following on from the Covid Impact report in January would policy work on the prevention of poverty and ongoing support be linked to the Food Equity Plan.

Councillor Alison Born commented as well as receiving a Mental Health presentation at a future meeting, Simon Sethi, Director of Operations, RUH has offered to update and address the Panel

Councillor Joanna Wright asked for an update on Social Prescribing as mentioned at the previous meeting.

The Chairman replied that it was worth seeing if this information could be supplied through a Cabinet Member Update.

Councillor Ruth Malloy said that she would like further information on the pressures of the Ambulance / A&E service.

The Director for Adult Social Care replied that this was also a matter that Simon Sethi could address when he attends a Panel meeting.

Councillor Paul May commented that he felt that the meeting had worked really well to have the focus solely on Adult Services.

The Chairman thanked the Panel and officers for their contributions to the meeting.