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 Paul Crossley and Councillor Michelle O’Doherty had sent their apologies to the Panel. Councillor Toby Simon was present as a substitute.

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.

There were none.

Councillor Liz Hardman referred to minute 75 (Development of the Draft Budget 2024/25) and asked that the comment made by the Cabinet Member for Children’s Services referring to the use of consultants be included.

Towards the end of the discussion of the report Councillor Paul May said that he wanted to clearly outline what we are doing both in finance and service terms so that we can have a medium term plan that shows that we are moving forward in getting our budgets down.

He added that in terms of early intervention work, there were possibly different ways in which this could progressed and that work was ongoing with the Director of Children’s Services and Education and Ernst & Young, consultants working with the Council, on how information can be presented in a more effective way in the future.

Kevin Burnett stated that he was still awaiting a detailed response to his safeguarding query from the Director of Education & Safeguarding.

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 addressed the Panel, a summary of her update is set out below and will be attached as an online appendix to these minutes.

Adult Social Care Performance at end of December 2023

The number of people with long-term services funded by Adult Social Care (ASC) at the end of December was 1,818.  This was a reduction of 53 on the previous figure of 1,872 because there were more people on interim funding at that time. Those individuals are likely to become ASC funded once their interim funding comes to an end.

601 carers were identified as receiving support from services that are funded wholly or in part by Adult Social Care. This shows a significant increase from 406 carers reported previously as we are now including people supported through the carers centre in our figures.

Occupational Therapy assessments continue to be a focus of high demand however through robust waiting list management the numbers waiting has reduced from 247 people waiting to 194 people the lowest figure for 18 months.  All referrals are risk rated and prioritised accordingly and people waiting have a point of contact should their needs become more urgent.

Finance

The ASC savings target for 23/24 was £5.45m, all of which has been achieved apart from a proportion of the savings earmarked for the LD pool where savings have been contingent on a review process that we continue to work through. The actions taken to reduce expenditure since Q2 have improved the budget position for Adult Social Care. We will be making some use of reserves and are now forecasting an overspend of £1.389m at year end.

This year’s budget setting has been extremely challenging because funding for Council’s falls far short of what is required to meet needs. However, both adults and children’s services are receiving a net investment in revenue budgets in 2024/5 to reflect cost pressures and rising demand; together with significant capital investment that will enable more services to be provided within the local area.

Since the January meeting, additional short term funding has been identified to enable a full review of commissioned services to inform any proposed reductions to funding for third sector provision. We are aware of the government’s recent announcement of an additional £500m funding for social care, but no further information has been forthcoming so we do not know what impact this may have on budgets within Bath and North East Somerset.

Workforce

We are not recruiting new staff to the three care homes and the 5 extra care facilities while we await the outcome of the consultation on the three care homes. This is to ensure that we have roles for all our staff if the decision should be taken to close the remaining 10 beds at Charlton House.

We continue to need more Occupational Therapists and have just begun an Occupational Therapy apprenticeship to help grow our own staff.

ASC Provider Services Update

United Care B&NES Home  ...  view the full minutes text for item 89.

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

Laura Ambler, Director of Place, B&NES, BSW ICB addressed the Panel, a summary of the update is set out below and a copy of the full document will be attached as an online appendix to these minutes.

Prescriptions Ordering Direct Service

The Bath and North East Somerset, Swindon and Wiltshire Prescription Ordering Direct (POD) service, which allows some patients to arrange their repeat medication by phone or email, is set to discontinue in its current form later in the year, with the practices and care homes that use the system offering repeat prescribing instead. It is expected that POD will close on or before 30 June 2024, although this date may change as plans are formed and formal timeframes agreed.

People who regularly use POD are advised to continue ordering their medicines in the usual way through POD, and not to order any more than is needed.

Improving cancer early diagnosis and survival in BSW

The NHS is working hard to save thousands more lives each year by dramatically improving how cancer is diagnosed and treated and there is some great work going on here at BSW ICB to help improve support for people with cancer.

One of the two national ambitions for cancer is to ensure more of those people who are found to have cancer, are diagnosed and treated while it is at an earlier stage, as this means that treatment is often less complex, more successful and people live longer after treatment and with fewer long-term effects. We have been doing a lot of work across BSW to help deliver this national ambition.

Councillor Toby Simon drew attention to the new screening programme for Jewish people for BRCA mutations and hoped that this would be included in the community engagement programme.

Councillor Dave Harding asked if there was sufficient capacity within the Cancer services for receiving additional patients and asked if the Panel could be assured that standards were being achieved as he was aware that they only have to report nationally on 3 targets rather than the previous 9.

Laura Ambler replied that she would be happy to bring back a full update on this matter to the Panel and would set out as much detail as possible within that report.

Kevin Burnett referred to HIP2 and asked what of future estates needs identified in 2021/22 has the ICB adopted.

Laura Ambler replied that the care model for Shaping a Healthier Future developed into the care model now in place for the ICB which focusses on personalised care within their community. She added that they were currently working with colleagues in Primary Care on how best to utilise and plan on the future use of estates and delivery of care.

Kevin Burnett asked if an update could be provided from the ICB on the future funding for the Community Wellbeing Hub as at the present time no secure funding was in place post March 2025.

Laura Ambler replied that the Hub is a significant  ...  view the full minutes text for item 90.

The report will set out the outcomes following a consultation on the future delivery model for the Council’s three Community Resource Centres (CRCs) at Cleeve Court, Combe Lea and Charlton House.

Councillor Alison Born, Cabinet Member for Adult Services introduced the report to the Panel and highlighted the following sections from it.

·  The online consultation took place between Thursday 9 November 2023 to 5pm on Monday 18 December 2023 and included the following proposals:

o  To develop Cleeve Court residential home into a centre of excellence for dementia care including nursing care.

o  To enhance our offer at Combe Lea residential home to enable younger people with more complex needs to remain closer to home.

o  To close (de-register) the remaining 10 places at Charlton House Nursing home and then develop the site to provide alternative care provision and/or housing options that would meet the needs of the local community now and into the future.

o  To offer community groups/charitable organisations use of the day centre spaces at the community resource centres at a reduced rental rate if the organisations offer services that are accessible to the care home residents and the community.

·  The Council received 45 submissions on the CRC proposals. Over half (53%) of responses were positive towards council proposals for CRCs, nearly a third (31%) disagreed and 16% were unsure.

·  When considering those who supported the proposals, there was acknowledgement that the council needed to respond to the changing social care landscape, particularly around provision of specialist dementia nursing care. The importance of a stable workforce and its impact on morale, service provision and budget were also recognised.

·  The Scrutiny Panel is asked to give feedback to Cabinet on the following recommendations:

o  Recommendation 1: To develop Cleeve Court residential home into a centre of excellence for dementia care without nursing.

o  Recommendation 2: To enhance our offer at Combe Lea residential home to enable younger people with more complex needs to remain closer to home.

o  Recommendation 3: To de-register the remaining 10 places in use at Charlton House nursing home and then develop the site to provide a residential school for young people with complex needs.

o  Recommendation 4: To offer community groups/charitable organisations use of the day centre spaces at the community resource centres at a reduced rental rate.

o  Recommendation 5: To commence a full feasibility study in relation to the change of use for Charlton House to a residential school.

The Director of Adult Social Care thanked all involved in the initial consultation, including staff, residents and the public. She added that no formal consultation would be able to take place with staff until a decision has been made by the Cabinet.

Councillor Alex Beaumont commented that as the elected representative of Keynsham North he was concerned that should the feasibility study not support a change of use to a residential school that the Council could lose an important resource in Charlton House. He asked if further information could be given on the proposals for the residential school.

The Head of the Education Inclusion Service replied that she had looked at the building alongside officers from Property Services and that it was felt  ...  view the full minutes text for item 91.

Councillor Alison Born, Cabinet Member for Adult Services introduced the report to the Panel and highlighted the following sections from it.

·  Bath and North-East Somerset Council (B&NES) and what is now the Bath and North East Somerset, Swindon & Wiltshire Integrated Care Board (BSW ICB) made a decision not to extend the HCRG Care Group contract for the three-year extension term in May 2022.

·  The current B&NES Integrated Community Health and Care Contract will cease on 31 March 2024. The Council completed a detailed options appraisal, and a decision was taken to transfer Adult Social Care (ASC – Adult Social Work, Direct Payments and Adults with Learning Disabilities and Their Families) to B&NES Council in November 2022.

·  Three programmes were set up to deliver Community Services Transformation across the Council and Integrated Care Board (ICB):

• Programme One: Adult Social Care Redesign and Community Partners (Council led)

• Programme Two: Public Health (Council led)

• Programme Three: Integrated Community Based Care (Integrated Care Board led for Children’s and Adults Health Services)

The Director of Adult Social Care said that they had worked closely with HCRG on this process and that they support the transition. She added that all buildings and computers would be prepared for the start date of 2^nd April 2024 and that 28 days prior to this the Council would receive the list of staff members that are due to be transferred.

She explained that an engagement and communications plan was in place to keep staff informed.

Kevin Burnett commented that he recalled from a previous report that there was a key ‘To do list’ for this programme and asked if a framework for staff would be in place, was their sufficient resources and were there any areas of concern.

The Director of Adult Social Care replied that a new operation model was in place, although they want staff to be able to continue to do their current roles. She added that she did not think that there were any hidden costs within this process and that there was a plan in place to deal with the additional corporate overheads and subsequent uplifts.

Councillor Liz Hardman asked what the impact will be on Public Health with the likely incoming budget cuts and how would services commissioned through the Public Health Grant be affected.

The Director of Public Health replied that the Public Health Grant was ringfenced in order that it is used to provide certain services, some of which are mandated, such as Sexual Health Services, NHS Health Checks and Health Visitor Services.

She added that the grant must be used to achieve Public Health outcomes for the Council and that the grant does not increase alongside inflation or take account of any staffing pay awards or contractual uplifts.

Councillor Liz Hardman asked what the expectations of the Community Wellbeing Hub after April 2025 were.

The Director of Public Health replied that the Council was working across all sectors connected to the Hub to find  ...  view the full minutes text for item 92.

This report has been provided to update the Scrutiny Panel regarding the Physical Activity & Leisure Services in B&NES, setting the scene around the benefits of physical activity across a wide range of outcomes and data regarding current levels of activity across the local population.

The Director of Public Health introduced the report and explained to the Panel that Leisure Services moved to within the remit of Public Health in 2021 and said that this had proved to be an excellent decision.

The Head of Leisure & Physical Activity addressed the Panel and said that producing the report had been a useful process to have undertaken. He said that the changes to the service over the years have been monumental and that it was fantastic to now be part of the Public Health service.

Kevin Burnett asked if further comments could be given regarding any barriers to participation, gaps in provision and key priorities / funding options.

The Head of Leisure & Physical Activity replied that these matters can depend on where you live within B&NES and it was known that certain populations were not so active. He added that any increase in activity is encouraged and does not have to be through a recognised sport or event.

He explained that they are working with certain community groups such as the Bath City Football Foundation to try to address the disparity and find other locations for them to hold activities.

He said that cost does remain a barrier to take part in certain activities.

In terms of gaps in provision he said that they were assessing what local leisure facilities are available and whether any can be enhanced. He added that they were looking at how green spaces can be used more and were working with the Green Infrastructure Team to look at areas across the Council.

He said that the element of ‘play’ would also be a focus to see how that can be developed in order to achieve healthy / active outcomes. He added that the team has a good relationship with GLL, the Council’s leisure facilities provider and the Dragonfly Trust that are based in Midsomer Norton who have recently opened a community garden and outdoor play space.

Kevin Burnett asked what resources would be required to expand any provision.

The Head of Leisure & Physical Activity replied that there were only two members of staff within the Physical Activity Team, but said they were creative in finding additional resources and that funding opportunities and innovative solutions were worked upon with GLL.

The Director of Public Health added that an advantage of working within a relatively small council was being able to work with other services such as the Parks Team, in terms of play and officers working on the Local Plan to see what opportunities can be maximised. She said that Active Travel was also an element to their future work.

Councillor Joanna Wright commented that she would have liked to have seen a section within the report on Active Travel and how people of all ages can be encouraged to travel to the facilities mentioned in an active way.

She said that a large focus within the report was on group / pitch based activities, but said it was known that many  ...  view the full minutes text for item 93.

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 said that through the course of the meeting they had identified the following items that could be considered to be added to their workplan.

·  Bath BID / Open Spaces use

·  Knife Crime Task & Finish Group Update

·  Under 5s Health Study

·  Homelessness Health Update

·  Dentistry Update

·  Community Resource Centres – Implementation of Cabinet decisions

·  Refugee Support Update