Agenda and minutes

The Cabinet Member for Children’s Services, Councillor Kevin Guy and Co-opted Panel Member, David Williams had sent 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 Paul May declared an other interest in respect of agenda item 10 as he is a non-executive Sirona board member.

There were none.

Councillor Jess David asked for an amendment to her comments on page 41. She said that it should say that she ‘understood the rationale…’.

Kevin Burnett asked if any further information was yet available from the Secretary of State regarding the funding pressure in the education system.

The Corporate Director replied that he did not think that anything had been received, but that he would check on behalf of the Panel.

Kevin Burnett asked if he could have a response to his question from the previous meeting as to whether B&NES schools were yet involved in Operation Encompass.

The Director of Adult Social Care, Complex and Specialist Commissioning replied that Operation Encompass was not in place in B&NES.

Rob Fortune, Avon & Somerset Police added that the local work force is not aligned currently to enable notifications to be sent into schools before they begin each day.

The Director of Adult Social Care, Complex and Specialist Commissioning assured the Panel though that timely notifications are being sent to schools when incidents occur.

Rob Fortune stated that they are striving towards being able to deliver notifications in line with Operation Encompass.

The Director of Adult Social Care, Complex and Specialist Commissioning said that this remains an agenda topic for the B&NES Community Safety and Safeguarding Partnership.

With these comments and amendment in mind the Panel confirmed the minutes of the previous meeting as a true record and they were duly signed by the Chairman.

The Panel will receive an update from the Clinical Commissioning Group (CCG) on current issues.

Dr Ian Orpen addressed the Panel. A copy of the update can be found on their Minute Book and as an online appendix to these minutes, a summary of the update is set out below.

Working together in B&NES, Swindon and Wiltshire (BSW) – CCG Merger Update

As previously reported, NHS England and Improvement approved in principle our application to merge with Swindon and Wiltshire CCGs on 14 October 2019. This was following support from each CCG Board to merge, stakeholder engagement and communication, and a member practice vote.

The three CCG’s Governing Bodies are currently meeting in common, but from 1 April 2020 there will be single a Governing Body for BSW CCG.

Dr Ruth Grabham took up the position of Medical Director for BSW CCG on 1 March 2020.

Locality Clinical Chairs for B&NES (Dr Bryn Bird – who will take on my role for the Panel) and Swindon (Dr Amanda Webb) will join Dr Grabham on the Governing Body from 1 April, and voting is currently underway for the Wiltshire role. Five Locality GPs have also been appointed to the Governing Body, with Dr Tim Sephton representing B&NES. Corinne Edwards is also a local key lead officer.

We are still in the process of recruiting for the registered nurse role. A fully constituted Board is a condition of merger.  We anticipate all posts will be filled by the end of March.

Release of the Five-Year Plan for BSW

The BSW Partnership will be publishing a draft public-facing version of its Five-Year Plan for BSW this week, which sets out how health and care services across the region will be organised between now and 2024.

The priorities have been drawn up by health and care organisations from across BSW and include feedback gained from an extensive public engagement campaign carried out last summer.

The priorities set out to:

•  Address the problems posed by an increasingly elderly population by helping people to age well, stay well at home and improve how community services can help them

•  Help to improve the quality of life for people with learning disabilities and autism and their families by improving access to services

•  Help to deliver the best mental health support for local people, regardless of personal circumstances, age or individual need

The full version of the plan will be available later in the Spring.

Coronavirus planning across B&NES

Nationally, the NHS and Public Health England (PHE) are well prepared for outbreaks of new infectious diseases. 

Locally, we are working extensively with our partners and providers in B&NES and across Swindon and Wiltshire to ensure the safety of our patients and colleagues while also ensuring services are available to the public as normal.

Testing of suspected coronavirus cases is carried out in line with strict regulations. This means that suspected cases are kept in isolation, away from public areas. Any equipment that comes into contact with suspected cases is thoroughly cleaned as appropriate. Specific guidance has  ...  view the full minutes text for item 50.

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

Councillor Rob Appleyard, Cabinet Member for Adult Services addressed the Panel. A copy of the update can be found on their Minute Book and as an online appendix to these minutes, a summary of the update is set out below.

He wished to give his thanks to Dr Orpen for the work and support he has given the area over many years.

Autism Partnership

The Terms of Reference have been agreed and a number of workstreams are ongoing.

Outbreak of novel Coronavirus – Covid 19

Public Information is being routinely provided by Public Health England. Councillors are also receiving regular updates from our Public Health team.

He thanked everyone involved so far for their hard work.

Suicide Prevention Strategy launch

The proposed Suicide Prevention Strategy for Bath and North East Somerset 2020-2023 was launched with partners including Bath Mind at a suicide prevention stakeholder event on 6 February.

The strategy commits partners across Bath & North East Somerset to:

• Reducing suicide and self-harm
• Ensuring that no resident will think that suicide is their only option
• Tackling the stigma associated with suicide and developing community conversations about suicide
• Building community resilience
• Supporting those who are affected by suicide

Preventative Initiative

A new film that aims to help more women with learning disabilities to access breast screening has been made featuring women who live locally to Bath and North East Somerset. The film is based on real experiences of women with learning disabilities told from their own point of view and hopes to give more information to people with learning disabilities and their families and carers about this important NHS breast screening programme.

The film has been produced by Biggerhouse Film in a partnership with Bath and North East Somerset Council, NHS England & NHS Improvement, the Avon Breast Screening Programme and North Bristol Trust. The women were supported throughout the making of the film by Virgin Care Services, Learning Disability Primary Care Liaison Nurses. It is aimed at women with learning disabilities who are eligible for the NHS breast screening programme aged from 50 to their 71st birthday.

The Chairman said that he was passing on information that he receives about Covid-19 to the local Parish Councils.

The Corporate Director replied that it would be preferable to signpost people to the Public Health England website as that would always have the most up to date advice.  ( https://www.gov.uk/government/organisations/public-health-england )

Councillor Michelle O’Doherty asked if organisations such as Julian House were receiving relevant advice in their role for assisting homeless people.

The Corporate Director replied that they were in receipt of the same information as the Council.

Dr Ian Orpen added that medical support provision is already in place for homeless people.

Councillor O’Doherty asked how a rough sleeper diagnosed with Covid-19 self-isolate.

The Corporate Director replied that further discussion would be required with Julian House as to how they could accommodate people in this scenario.

Councillor Ruth Malloy asked how we can check if public buildings and schools are displaying posters that contain  ...  view the full minutes text for item 51.

The purpose of the report is to give an overview of the Virgin Care contract; Virgin Cares performance against national and local standards and also key performance indicators, and, the governance arrangements in place to ensure these are delivered.

The Director of Adult Social Care, Complex and Specialist Commissioning and the Head of Contracting & Performance introduced this report to the Panel.

The Director of Adult Social Care, Complex and Specialist Commissioning explained that the report was intentionally long and sought to address the queries raised previously by Protect our NHS BANES.

She summarised the following points from the report.

Between January and December 2015, BaNES Clinical Commissioning Group (CCG) and B&NES Council carried out a review of community heath and care services for children, young people and adults.  The review, known as Your Care, Your Way, looked at the wide range of services providing care and support in people’s homes and communities.

The top five priorities identified through the engagement process with our residents were:

1.  A person not a condition

2.  A single plan

3.  Invest in the workforce

4.  Join up the information

5.  Focus on prevention

Over 200 different community services were within the scope of the Your Care, Your Way review which were provided by over 60 different organisations.  The commissioning and contract management of these services were at the time of the review all carried out by the CCG and Council.

Following the identification of the priorities of our local population, a new approach to contracting community services was identified as being required. A detailed assessment was undertaken and legal guidance sought; this resulted in the ‘prime provider model’ being chosen as the best contracting method for delivering the community’s priorities.  Under this model, the CCG and Council would enter into a contract with a single prime provider and this organisation would have responsibility for the delivery and coordination of services, they would also have sub-contracting responsibility for some specialist, third sector provider and small and medium-sized enterprises (SME’s).

In addition to the five priorities (listed above) identified through public consultation the following three areas also formed part of the assessment used during the procurement:

1.  Social value

2.  Value for money and affordability

3.  Delivering transformational change

The Virgin Care contract is a seven-year contract which commenced from 1st April 2017 to 31st March 2024 with the option to extend the contract term by three years (2024/2025, 2025/2026 and 2026/2027). 

The Council have the co-ordinating commissioning role for the contract and currently the contract is made up of a total of 56 community services:

•  36 delivered directly by Virgin Care

•  14 services are sub-contracted

•  6 services are delivered by both Virgin Care and a sub-contractor

Three of the 36 services directly delivered by Virgin Care cannot be sub-contracted at any point whereas the other 33 can be via negotiation in line with contract regulations. The three which must be delivered by Virgin Care (referred to as delegated functions) are:

•  PD1 Adult Social Care Statutory Services

•  PD2 Continuing Healthcare

•  PD3 Children’s Health Statutory Services

The Virgin Care contract is organised through the following contract governance structure:

Contract Quality Performance Meeting (CQPM) – Bi-monthly

Finance and Information Group  ...  view the full minutes text for item 52.

The paper seeks to assure the Panel that relevant policies, procedures and strategies recognise and address exploitation and furthermore sets out examples of the services and programmes commissioned to support children, young people and adults with care and support needs.   

Rob Fortune, Avon & Somerset Police introduced this report to the Panel and summarised some key points from within it.

Child sexual exploitation involves situations, contexts or relationships in which a person under 18 is given something, such as food, accommodation, drugs, alcohol, cigarettes, affection, gifts or money in return for performing sexual activities or having sexual activities performed on them. It can also involve violence, coercion and intimidation, with threats of physical harm or humiliation

Avon and Somerset Constabulary response to Child sexual exploitation is Operation Topaz. Topaz is a perpetrator disruption team enabling the Force to proactively protect the highest risk child sexual exploitation victims by developing opportunities to disrupt suspects. Topaz recognises that disrupting suspects is often the most effective way of safeguarding victims of child sexual exploitation.

The Topaz Victim Contact / Engagement Officer works alongside victims to build relationships and gather information to enable well-informed safeguarding and disruption. The focus is on supporting victims to enable the capture of an evidential account, intelligence gathering and safeguarding; working alongside the Topaz Disruption Officer to disrupt perpetrators and locations.

Across Bristol, B&NES and South Gloucestershire about 150 perpetrators are flagged to Topaz and potentially posing a risk of CSE and about 200 children are flagged as being at risk.

The current figures for children and young people that are at risk of or are being criminally exploited in B&NES is 69 and children and young people at risk of or are being sexually exploited is 57; there is some overlap with these figures as some children will appear in both groups.

As a result of some of the findings from Operation Button it was agreed that Requests for Service pertaining to CSE would be referred to our MASH (Multi- Agency Safeguarding Hub) this enables a more integrated approach and a greater understanding of the risks. 13 young people have been progressed through our MASH processes to ensure that their needs are being adequately met.

B&NES has developed a frontline response for young people who are at risk and victims of CSE. Through the development of the Willow Project CSE victims are offered support dependent on their level of need. The Willow Project is a multi-agency/multi-disciplinary virtual made up of professionals who have been trained to work with young people at risk of or involved in lower level CSE.

The professionals within the team remain employed within their substantive post and then commit half a day per week to working within the Willow Project. The aim of the project is to support, advocate and provide time to potential victims of CSE.

The Modern Slavery Act 2015 define the criminal offence of slavery servitude and forced or compulsory labour (section 1) and the separate criminal offence of human trafficking. This might include labour exploitation, sexual exploitation, criminal exploitation, organ trafficking and forced marriage. Modern Slavery is not the same as illegal immigration or people smuggling. It is characterised by elements of violence, intimidation, deception, coercion, abduction and  ...  view the full minutes text for item 53.

The Children, Adults, Health and Wellbeing Policy Development and Scrutiny Panel have asked for report on the use of unregulated placements within B&NES. 

The Commissioning Manager introduced this report to the Panel and highlighted some key points from within it.

Not all settings in which ‘looked after’ children live are subject to regulation. To understand what constitutes an unregulated setting it is useful to understand what a regulated residential setting is.  The Care Standards Act 2000 defines a regulated residential children’s home as an establishment that provides ‘care and accommodation’ ‘wholly or mainly’ for children.  The only other form of regulated setting in addition to children’s homes are foster placements.

Therefore, an unregulated setting provides accommodation and support but not care.  The law does not set out what care is, but there are some simple rules to apply.  Administering medication, cooking for young people and shopping for them will constitute care.  Whereas assisting young people to learn these skills will constitute support. If a provider crosses the line and provides care on an ongoing basis, the accommodation will become an unregistered children’s home and will be illegal. Unregulated supported ‘living’ accommodation comes in all sort of shapes and sizes and are places where young people (usually 16 and 17-year-olds) can live and receive support as part of transition to full independence.

Parliament has currently determined that some services should sit outside that regulatory framework. As from the 12th February 2020 OFTED are undertaking an open consultation regarding ‘Unregulated provision for children in care and care leavers.

Five years ago the Council was contacted by a service provider in Bristol.

In B&NES we currently have 3 young people placed in unregulated placements, all of whom are between the ages of 16-18 years and have an allocated social worker.  This number can sometimes change daily, depending on the needs of children within the service.  Historical data shows; March 2019 – 6, June 2019 – 8, and December 2019 – 3. 

It is important to note that our aspiration in B&NES is that no child will be placed in an unregulated placement.  However, at times these placements are a necessity due to the young person’s needs and specific circumstances, i.e. risks presented and their wishes and feelings.

It is recognised that some of our most vulnerable and high-risk young people in B&NES are sometimes best supported in this type of provision.  These decisions are not taken lightly, and agreement must always be sought from Head of Service, with Agency Decision Maker sign off.

The Placements, Commissioning and Contracts Team (PCCT) have a preferred provider list for 16+ accommodation and support providers that has been tendered through a dynamic purchasing system, in partnership with three other local authorities.  All providers have been checked in terms of policies, finances and quality, and references have taken.  In all there are 33 providers who have qualified to be on the list. From the list B&NES tend to purchase services from less than four of the providers with whom we have built up a trusting relationship.

Councillor Jess David asked what steps are being taken to attempt  ...  view the full minutes text for item 54.

The Panel will receive a verbal update on this item from the People and Communities Strategic Director.

The Corporate Director (People) addressed the Panel. He stated that primarily his recent workload had been focussed on the Council’s budget and plans surrounding the impact of Covid-19.

He spoke briefly about the Bath Community Academy (BCA) site to say that consultants had been engaged to offer a view of what options could be pursued. He added that a public consultation would take place on this matter in the future.

Councillor Liz Hardman asked if an update was available regarding a local Alzheimer’s Centre that she had raised at a previous meeting.

The Corporate Director (People) replied that he had had some further discussions and would update Councillor Hardman offline from this meeting.

Councillor Paul May commented that he would be keen to see the BCA site used for a wide skill set of people as it was still seen as a valuable site for the community.

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 and asked Panel members for their comments or suggestions for the workplan.

Kevin Burnett recalled they had earlier in the meeting agreed to receive a presentation on the Autism Partnership Group.

Councillor Paul May asked for a further discussion by the Panel on the budget following the debate that had been held by Council.

Councillor Liz Hardman stated that they had agreed to receive a further report relating to Virgin Care in six months’ time.

The Chairman thanked them for their comments.