Agenda and minutes

The Chair welcomed everyone to the meeting.

The Chair will draw attention to the emergency evacuation procedure as set out under Note 5.

The Chair drew attention to the emergency evacuation procedure.

Councillor Lesley Mansell, Councillor Dave Harding and Suzanne Westhead, Director of Adult Services 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 4.4 Appendix 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 Officeror a member of his staff before the meeting to expedite dealing with the item during the meeting.

The Chair informed the Panel that the Knife Crime Task Group had held its initial meeting and would seek to update them further at future meetings.

There were none.

The Chair offered her apologies to the Panel for forgetting to formally write to the Cabinet Member for Adult Services to convey their disappointment at not being made aware of the impending public consultation on the Community Resource Centres.

The Chair informed the Panel that she had received comment from Councillor Dave Harding regarding his point on page 54 of the minutes. She said that he would specifically like the term ‘extractions’ added as shown below.

Councillor Dave Harding asked if figures relating to dental hygiene / extractions could be included in a future report that comes to the Panel regarding that issue.

Kevin Burnett said that he had not yet received a reply to his question on page 57 of the minutes relating to the allegations process.

The Chair on behalf of the Panel asked for a response to this question to be chased.

The Panel, with these comments in mind, confirmed the minutes of the previous meeting as a true record and they were duly signed by the Chair.

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

The Cabinet Member for Adult Services, Councillor Alison Born stated that she was happy to take questions on the update that had been submitted to the Panel. A copy of the update will be attached to these minutes as an online appendix.

Councillor Liz Hardman referred to the point in the update that average waiting times for an OT assessment have risen to 8 months and asked if a refocus of the OT workforce as suggested would actually help decrease the waiting list.

Councillor Alison Born replied that primarily there was a national shortage in Occupational Therapists and that the Council has asked HCRG to develop a plan of how this can be improved.

The Assistant Director, Operations added that they are seeking to invest in 4 Occupational Therapist Apprenticeships when the service returns in house from April 1^st 2024. She said that the Community Wellbeing Hub and Live Well have also been advised on how to help support and signpost individuals to purchase simple items of equipment.

The Chair asked if it was known at this stage whether enough young people would be interested in taking on such a role.

The Assistant Director, Operations replied that their initial discussions with the University of the West of England and Bath College had shown that there is interest in taking up these positions.

The Chair asked if they were also considering addressing issues such career progression and rates of pay for both Occupational Therapists and Social Workers.

The Assistant Director, Operations replied that last year 10 newly qualified Social Workers were recruited by HCRG following a number of apprenticeship programmes which the Council fully supported. She added that the salaries for these posts have been looked and they do compare favourably with other Local Authorities in the South West and that they do also allocate a supplement for Nurses and Mental Health Professionals.

Kevin Burnett asked what the potential impact would be following the planned reductions in expenditure.

Councillor Alison Born replied that there would be a slowdown on recruitment and only appoint where it was necessary to do so. She added that care packages would be checked for any possible areas of duplication and that they should be able to assess any initial impact in the New Year.

Kevin Burnett asked in view of a potential CQC inspection in relation to the statutory delivery of Adult Social Care how would the Council currently rate itself.

The Assistant Director, Operations replied that following the recent positive Peer Review that officers feel they are on track to receive a good rating. She added that work was ongoing to make sure they are as prepared as they can be for when an inspection will take place.

Kevin Burnett asked how the ICB’s recent withdrawal of a temporary community hospital ward (Homeward) would affect the discharge from hospital process.

The Director of Place, Bath and North East Somerset, BSW ICB replied that this facility was always supposed to be a temporary measure  ...  view the full minutes text for item 63.

The Panel will receive an update from the B&NES, Swindon & Wiltshire Integrated Care Board (BSW ICB) on current issues.

The Director of Place, B&NES, BSW ICB addressed the Panel and highlighted the following areas from her update. A copy of the update will be attached to these minutes as an online appendix.

£40.5m NHS funding boost to improve care for individuals with a learning disability and autistic people in the South West

People living with autism and learning disabilities across B&NES are set to benefit from a £40m NHS investment to improve acute mental health care in the South West.

Twenty new mental health hospital beds across the South West will help bring an end to long-distance placements, making life better both for individuals who need hospital treatment, and for their families, friends, and carers.

Two new 10-bed units, in Bristol and Devon, will be designed specifically to care for individuals with a learning disability or autistic people who would benefit from treatment in a hospital and whose needs cannot be met in a mainstream mental health hospital, even with reasonable adjustments.

The new facility has been designed with input from service users, people with a lived experience, and their families and carers and will provide the kind of specialist therapeutic mental health care which cannot be provided at home or in another mainstream hospital.

Orchard House

Orchard House is our new community crisis house based in Midsomer Norton that provides step-up and step-down support for people with mental health needs. The facility, which is provided by Bath Mind, provides accommodation 365 days a year, 24 hours a day for four people at any one time.

Orchard House includes dedicated quiet and therapy space for individuals to support their recovery and reduce preventable hospital attendances and admissions as well as expediting discharge back to the community with jointly agreed safety support plans and community engagement programmes.

Royal United Hospital performs the first HIFU non-invasive prostate cancer treatment in the South West

The Royal United Hospitals Bath NHS Foundation Trust (RUH) has successfully treated two prostate cancer patients with an innovative high-intensity focused ultrasound (HIFU) treatment, the first time this therapy has been carried out in the region.

The new HIFU unit at RUH Bath, with equipment funded by Prost8 and the UK Focused Ultrasound Foundation, integrates advanced image-guided capabilities and ultrasound energy to precisely target the prostate without any incisions or radiation, therefore sparing nearby healthy structures.

Kevin Burnett referred to the new NHS funding and asked if this would in any way fill the void for the closure of Homeward, the previous temporary community hospital ward.

The Director of Place, B&NES, BSW ICB replied that their Winter Plan is in place and although Homeward was originally within that plan, the Virtual Wards will more than compensate for its closure. She added that the Community Wellbeing Hub also has a role in discharge planning and access to other services. She explained that a focus remains on reducing the reliance on bedded care.

Kevin Burnett asked if there was just a single point of contact for  ...  view the full minutes text for item 64.

Councillor Alison Born, Cabinet Member for Adult Services introduced this report to the Panel. She stated that she believed that the services provided at all three centres had improved following their last round of inspections.

She stated that there were also a number of empty beds across all three sites.

The Assistant Director for Operations explained that the consultation was live until December 18^th and that so far 35 responses had been received.

The Chair stated that following the closure of the consultation she expected the Panel to receive a further report prior to a final decision being made.

Councillor Born said that at the present time she intended to make her decision and then return to the Panel, adding that if they disagree with it, they have opportunity to request a call-in meeting.

The Assistant Director for Strategy, Transformation and Governance said that she would discuss the timeline for a decision with the Director of Adult Services.

The Chair said that she would like to understand the rationale for the decision being made by a Single Member rather than by the full Cabinet.

Councillor Born replied that she had received advice that the decision was allowed to be made in her role as the Cabinet Member for Adult Services.

Councillor Joanna Wright said she believed any decision of this nature should be made by the Cabinet as a whole and that the Panel had shown enough concern for the decision to be transparent and accountable. She added that the Panel could have held a closed session prior to the consultation commencing so that they could have received information at an appropriate time.

The Assistant Director for Operations replied that she had been advised that closed sessions for the Panel do not normally take place.

Councillor Alex Beaumont stated that he was concerned that if a decision was taken to close Charlton House it might mean that residents would have to leave the Keynsham area. He added that he would support the Cabinet being asked to make this decision.

Councillor Paul Crossley proposed that;

i)  Following the closure of the consultation the Panel receives an outcomes report prior to a decision being made.

ii)  The final decision is made at a meeting of the Cabinet.

Councillor Wright seconded the proposal.

The Panel agreed unanimously agreed with the proposal and the Chair asked the Cabinet Member for Adult Services to take forward their decision and discuss in more detail with her Cabinet members and lead officers.

Councillor Born replied that she would take advice on what next steps to take following this recommendation from the Panel.

Kevin Burnett asked what the repercussions would be for the other two centres if Charlton House were to close and what proportion of self-funders needed to make the centres a viable concern.

The Assistant Director for Operations replied that the Council do not charge more for anyone who is self-funded than someone who is in receipt of funding from the Local Authority. She added  ...  view the full minutes text for item 65.

This report updates the Panel on local levels of food insecurity and reflects on the local support offer and work of the B&NES Fair Food Alliance since its last report to Children, Adults, Health and Wellbeing PDS Panel (May 2022).

Councillor Alison Born introduced this report to the Panel. She stated that the levels destitution locally had increased substantially in recent years and that currently 20% of children and young people in B&NES were deemed to be living in poverty, equating to around 6,500 between the ages of 0-15.

She added that there are three Trussel Trust Food Banks within B&NES and that they had seen a significant increase in use since 2017. She said that they were also fortunate to locally have additional support provided by St. John’s Foundation Crisis Programme.

The Public Health Development & Commissioning Manager added that they were asking the Panel to consider whether one of them could take up the current vacancy on the B&NES Fair Food Alliance.

She asked them to also consider what more the Panel / Council can do to help people to be in a position to afford the daily essentials. She added that the Household Support Fund had been in place for the past three years and that this was providing £2m of funding from Government. She said that they were lobbying for this to continue into 2024/25 as it provides particular support to families with young children during the school holidays.

She explained that the Holiday Activities & Food Programme was also in place, but only currently funded until March 2025.

She asked them to also consider what they could do to support social connections within neighbourhoods through community groups or Parish & Town Councils to try to identify risks at an earlier stage.

Councillor Joanna Wright asked how schools could be encouraged to participate in the Affordable Schools Programme.

The Health Improvement Officer replied that some initial funding had been received, but that this was not likely to continue. She added that that for the schools that had already been involved it has enabled them to think differently around helping families that don’t reach the Free School Meals threshold.

Councillor Wright stated that school uniform and sports kit were also areas that should be raised as issues for families on very low incomes.

The Health Improvement Officer replied that it was a matter that was raised regularly and that they are working on strategies to promote ‘pre loved uniform’ etc. She added that School Food and School Trips were also issues raised by many people.

Councillor Wright asked for any further information on the work taking place with the Great Western Credit Union.

The Health Improvement Officer replied that it was a project known as Food Savers which will look at ways of supporting people to save and borrow safely whilst helping them with their relationship with money.

The Director of Public Health informed the Panel that they could consider how to scrutinise the health impacts of both the Economic Strategy and the Local Plan to see if that would help with any issues that have been raised during the meeting.

Kevin Burnett asked how families that don’t quite fall into the Free School Meals bracket  ...  view the full minutes text for item 66.

The Policy Development & Scrutiny Panel asked for a report on the health of homeless people in B&NES, particularly the health of people sleeping rough.

The report included in this paper summarises key points for the Panel.

Councillor Alison Born, Cabinet Member for Adult Services introduced the report to the Panel. She said that homeless people experience a number of health inequalities, including both mental and physical health. She added that they are six times as likely to attend A&E and that 66% nationally will have drug and alcohol problems.

She stated that the annual rough sleeper count underestimates the scale of this problem as it does not take into account those who are staying within insecure accommodation.

She said that the cost of living crisis alongside the lack of affordable housing was putting more families at risk of becoming homeless. She added that the numbers within B&NES had increased by 40% over the past year.

She explained that healthcare provision for homeless people is provided through the Council’s Homeless Services and that currently they had additional access to forms of help for substance misuse.

The Associate Director for Public Health said that a number of departments and agencies were involved in providing services / assistance to the homeless people within B&NES.

Councillor Michelle O’Doherty said that the number of people at risk of being homeless, including children was very worrying and asked what the reasons for the increase are. She also asked what statutory duties of support were in place for rough sleepers and how does that support continue once someone has been provided with some form of housing.

The Housing Strategy & Commissioning Manager replied that the health needs of families in these types of situations are not as understood. She felt that a large degree of the increase was due to the cost of living crisis and no fault evictions from privately rented accommodation, this includes families with children.

She added that staff within the service were working under quite a sustained level of pressure.

Councillor O’Doherty asked if there was enough resources / staff in place to cope with the increased numbers.

The Housing Strategy & Commissioning Manager replied that staff were managing, but very much feeling the challenge. She added that when people become housed there is support in place through a number of services, including the DHI Reach programme. She said that the programme provides budget support and trying to make sure things in general stay on an even keel.

She added that Second Step also provide a floating mental health support as well as ongoing work with Julian House. She said that the Housing First scheme also provides accommodation for 24 households currently for those with a high degree of needs.

Kevin Burnett asked when does the Council become involved with individuals deemed to be ‘at risk of becoming of homeless’.

The Housing Strategy & Commissioning Manager replied that in 2018 the Homeless Reduction Act came into force and that this gives the Council a duty to start working with people 54 days before any legal threat of homelessness is received. She said that the Council were willing to help as many people as possible and wanted them to  ...  view the full minutes text for item 67.

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 Chair introduced this item to the Panel. She explained that the reports for the January meeting had already been confirmed and that an additional meeting was being planned for February to discuss the outcomes of the Community Resource Centres Consultation.

The following items were raised by members of the Panel as items to consider for the future.

·  Community Wellbeing Hub

·  Finances / Debt / Great Western Credit Union – Public Health

·  Community Pharmacies

·  Local Plan – Public Health

·  Health inequalities of Ethnic Minorities

·  Palliative Care

·  Children’s Healthcare Services - ICB

·  Modern Day Slavery

The Panel RESOLVED to note those proposals.