Agenda and minutes

Venue: Council Chamber - Guildhall, Bath. View directions

Contact: Mark Durnford  Email: mark_durnford@bathnes.gov.uk, 01225 394458

Items
No. Item

12.

WELCOME AND INTRODUCTIONS

Minutes:

The Chairman welcomed everyone to the meeting and Panel members introduced themselves.

 

13.

EMERGENCY EVACUATION PROCEDURE

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

 

Minutes:

The Chairman drew attention to the emergency evacuation procedure.

 

14.

APOLOGIES FOR ABSENCE AND SUBSTITUTIONS

Minutes:

Co-opted Members Andrew Tarrant and David Williams had sent their apologies to the Panel.

15.

DECLARATIONS OF INTEREST

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.

Minutes:

Councillor Paul May declared an other interest as he is a non-executive Sirona board member. He said that he would leave the room during the debate of agenda item 8 (Virgin Care).

 

Councillor Jess David declared an other interest as her husband is a partner in the Heart of Bath group of GP practices which operates in Bath.

 

16.

TO ANNOUNCE ANY URGENT BUSINESS AGREED BY THE CHAIRMAN

Minutes:

There was none.

17.

ITEMS FROM THE PUBLIC OR COUNCILLORS - TO RECEIVE DEPUTATIONS, STATEMENTS, PETITIONS OR QUESTIONS RELATING TO THE BUSINESS OF THIS MEETING

Pam Richards has registered to make a statement on behalf of Protect our NHS BANES with regard to agenda item 8.

 

Minutes:

Pam Richards, Protect Our NHS BANES made a statement to the Panel on the subject of Virgin Care. A copy of the statement can be found on the Panel’s Minute Book, a summary is set out below.

 

Protect Our NHS BANES is deeply concerned about the performance of Virgin Care in several key areas. Reports have come to us from staff, former staff, patients/service users and carers.

 

On 1st April 2017 1700 employees transferred to Virgin Care but by 10th September 2019 Virgin Care had only 1200 employees. We are aware of significant staff shortages and a high turnover of staff. We would like to see a detailed staffing breakdown - loss of posts through redundancies, long term vacancies, frozen posts, skill shortages number of agency and locum staff employed. Inevitably this staffing crisis will impact on the quality of the service that the public receive.

 

Many staff have told us that they have left because they no longer feel that they can deliver a safe and effective service. Others have said that their concerns are not listened to and management is poor.  Many feel pressured and overworked because of staff shortages. Staff reviews about Virgin Care on employment agency websites are very damning. The health and social care system is a people business, the way you treat people/staff is crucial to the outcomes you achieve.

 

The lack of progress on achieving key transformation targets such as the introduction of the integrated care record and the creation of care co-ordination hubs calls into question much of the basis of the Virgin Care bid. The integrated record is way behind schedule and although there is work underway to create a hub at Peasedown this does not include social care.

 

We hear reports of a significant deficit in the Virgin Care budget. Virgin Care promised a standstill budget over 7 years based on efficiency savings. If savings are not achieved what happens next – will Virgin ask for more money or withdraw from the contract?

 

We feel that there is mounting evidence that Virgin Care is not delivering what they promised and the staffing crisis is a cause for grave concern. It is the role of this Scrutiny Panel to scrutinise and it is time that it did just that. We ask you to conduct (in conjunction with the Commissioners) a thorough review of the Virgin Care contract before real harm is inflicted.

 

Councillor Liz Hardman asked what she thought the impact of Brexit would be on staffing levels within Virgin Care.

 

Pam Richards replied that she believed that it would have a severe effect on all staff within health and social care.

 

Councillor Jess David asked how many members of staff she had met to discuss their morale.

 

Pam Richards replied that she had met 10 members of staff within the last few months and said that she was aware that some have left Virgin Care due to stress and concern over their professional standards.

 

The Chairman thanked Pam Richards for  ...  view the full minutes text for item 17.

18.

MINUTES - 23rd July 2019 pdf icon PDF 96 KB

Minutes:

The Chairman referred to page 8 of the minutes and asked if the Terms of Reference and membership of the Autism Partnership Board had been shared with the Panel.

 

Councillor Rob Appleyard, Cabinet Member for Adult Services replied that this was still a work in progress and that he was due to attend a meeting regarding later in the month.

 

The Chairman asked for the following paragraph to be amended as the next meeting has actually taken place in October.

 

The Chair replied that following correspondence with Pam Richards, Protect Our NHS BANES he had agreed that this item would be discussed by the Panel in September October.

 

Councillor Andrew Wait commented that he had not had a response to the point he raised on page 5 relating to the costs raised through the RUH car park.

 

The Chairman said that a response will be chased on behalf of the Panel.

 

Kevin Burnett asked if a response has been received from the Secretary of State regarding the funding pressure in the education system.

 

Councillor Kevin Guy, Cabinet Member for Children’s Services replied that the Council had received a generic response and were seeking further information.

 

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

19.

Virgin Care - Performance Update pdf icon PDF 140 KB

This report provides members with an update on how the service has performed since transfer in April 2017 and its progress towards delivering the transformation that was part of the Your Care Your Way procurement.

Minutes:

Kirsty Matthews, Managing Director – Bath and North East Somerset,

Virgin Care Services Limited introduced this report to the Panel and highlighted the following areas from within it.

 

She stated that she had been in her role for two years and said that she was proud of all her colleagues within Virgin Care who work very hard.

 

She explained that the Bath and North East Somerset Community Health and Care Services, provided by Virgin Care, went live on 1 April 2017. The contract brings together community health and care services to deliver the objectives of Your Care, Your Way (YCYW), a document which was compiled by the Council and NHS Bath and North East Somerset Clinical Commissioning Group (CCG) over the previous two years through consultation with local people.

 

Under the contract, Virgin Care is responsible for the direct delivery and sub-contracted delivery for approximately 200 community services.

 

She said that overall, the service is performing well against both local contractual and national indicators, with significant performance improvements noted in a number of areas. Performance of the service is monitored at both local and national level, as well as by commissioners at the Council and CCG.

 

She informed the Panel that there have been a number of significant improvements in service performance since the transfer in April 2017, including:

 

·  The average length of stay on rehabilitation wards at Paulton and St Martin’s Hospital has reduced from 36 days at point of transfer to 28 in 19/20, despite increased complexity of the patients admitted. This length of stay is now in line with the national average for these types of services and brings significant benefits for patients by enabling them to return home, with support, and live as independently as possible.

 

·  Safeguarding performance has significantly improved. Decisions taken within 4 days has increased from 48% in 17/18 to 88% in 18/19. Planning meetings being held within 10 days has increased from 32% in 17/18 to 77% in 18/19

 

·  Continuing Health Care assessments completed within 28 days has risen from an average of 23% completion in 2017 when Virgin Care took on the contract to an average of 73% this year, and 100% in August 2019.

 

·  Virgin Care has worked with Royal United Hospitals, Wiltshire Health and Care and Somerset Partnership Foundation Trust and commissioners to deliver the Home First pathway. This was recognised with a Parliamentary award for Excellence in Urgent and Emergency Care in 2018.

·  A new service was developed with the Royal United Hospitals and South West Ambulance Service, a ‘falls pick up service‘ which provides an early response to people who have had a fall within their own home and avoids them having to go to hospital. Initial outcomes from this service show that 70% of people who were supported in this service were able to be instead managed in an outpatient setting

 

·  Bath and North East Somerset is now among the top performers for delivery of the Healthy Child Programme. This has improved from 82% compliance with  ...  view the full minutes text for item 19.

20.

CLINICAL COMMISSIONING GROUP UPDATE

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

Minutes:

Dr Ian Orpen, addressed the Panel. He apologised for not being able to attend their July meeting and said that he had met with the majority of members since to brief them regarding the Bath and North East Somerset, Swindon and Wiltshire (BSW) CCGs Merger Consultation.

 

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.

 

Bath and North East Somerset, Swindon and Wiltshire (BSW) CCGs Merger Consultation

 

During June and July 2019, the Governing Bodies of the three CCGs each met in public and approved plans to apply to NHS England and NHS Improvement to establish one single commissioning organisation for BSW.

 

GPs across BSW were consulted with to seek their feedback and to consider and respond to points raised. The LMC ran a formal vote on our behalf, which closed on 17 September 2019, to ensure that member practice support is demonstrated in line with each CCG’s Constitution.

 

Following the GP vote, on 25 September 2019, the Governing Bodies of the three CCGs met in common to sign off our application submission. We will now submit a formal application to merge our CCGs to NHS England and NHS Improvement and we anticipate confirmation of their decision in October.

 

Winter Planning Update

 

BaNES CCG is part of the BSW Seasonal Influenza Task and Finish Group, who are coordinating the flu campaign across BSW. The BSW flu vaccination campaign 2019/20 aims to promote flu vaccination uptake amongst the following three groups:

 

  1. Under 65s at risk (those with long term health conditions, those who are pregnant etc.)
  2. Carers
  3. Social care providers.

 

CCG and B&NES council staff based at St Martin’s hospital have again been offered their free flu jab, in line with our objective to ensure as many staff as possible are vaccinated. 

 

He urged those who are eligible and in need to receive the vaccination and stated that it was not possible to catch the flu from the vaccination.

 

EU Exit Update

 

The effect of a no-deal EU exit has been spelt out in an open letter to MPs by The King's Fund, The Health Foundation and Nuffield Trust. The letter summarises the four major areas where the impact of a no deal EU exit could be felt most sharply in health and care: a risk of intensifying the staffing crisis, shortages and price rises for vital supplies, the need to care for returning emigrants, and funding shortfalls at a time when health and care need it most.

 

Councillor Liz Richardson asked how confident he was with regard to Brexit and the impact that will have on staff and supplies.

 

Dr Orpen replied that a great deal of time and effort has been put in place on this matter to minimise the impact. He added that of course he was not in a position to give a direct guarantee, but urged people not to stockpile the  ...  view the full minutes text for item 20.

CCG Update pdf icon PDF 110 KB

21.

Cabinet Member Update

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

 

Minutes:

Councillor Kevin Guy, Cabinet Member for Children’s 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.

 

The Chairman commented that for future meetings the Panel would appreciate seeing the update in advance of the meeting.

 

Community Resource centres

 

Panel members may be aware that Sirona Care and Health has given 12 months’ notice on the contract to run community resource centres and extra care facilities in Bath and North East Somerset. The Council is looking at options for how these services will be managed in the longer term, but there is no direct impact on residents or tenants who receive support through these services, nor does it impact on the security of the jobs of staff employed in these services, though they will have a change of employer. We will keep the Panel informed as future plans are developed.

 

National funding settlement and Brexit

 

An early indication of a one year settlement that continues existing levels of grant funding for local authorities is welcome as a short term measure, but leaves a substantial level of uncertainty about how the underlying pressures and challenges might be addressed in the longer term. Local services are continuously updating their risk assessments and plans to respond as and when final details of EU Exit are confirmed. Clearly there continue to be a lot of unknowns.

 

The Chairman asked if it would be an option to bring the Community Resource Centres back ‘in house’.

 

Councillor Kevin Guy and the Corporate Director replied that was an option that was being considered.

 

Councillor Liz Hardman asked if there had been some specific funding allocated in relation to Brexit.

 

The Corporate Director replied that there has been a small amount of funding which has led to a Brexit officer being appointed to oversee the plans for the Council.

 

The Chairman thanked Councillor Guy for his update on behalf of the Panel.

Cabinet Member Update pdf icon PDF 49 KB

22.

LSCB & LSAB Annual Report 2018/19 pdf icon PDF 112 KB

People and Communities Directorate would like to set out for the Panel the work of the Local Safeguarding Children Board (LSCB) during 2018-19 and the work of the Local Safeguarding Adult Board (LSAB) in 2018-19 along with new priorities to be actioned in the Strategic Plan for 2018-21.

Additional documents:

Minutes:

The Director for Safeguarding & Quality Assurance and the Director of Public Health (former Chair of the LSCB) introduced these reports to the Panel.

 

The Director for Safeguarding & Quality Assurance acknowledged the depth of content within both reports and said that executive summaries were available for both. She explained next year would see a report that consisted of six months of activity from both Boards and six months of the new Community Safety & Safeguarding Partnership. She added that the plan will be to produce a more focussed report in future years.

 

The Director of Public Health said that it had been a privilege to hold the role of LSCB Chairman and to work within an environment that works incredibly hard for such an important cohort within B&NES. He commended the work of the Director for Safeguarding & Quality Assurance and the Safeguarding Children & Adults Boards Business Support Manager.

 

The Chairman asked if the figures in section 3.1.2 of the report represented the same children with multiple support needs.

 

The Director for Safeguarding & Quality Assurance replied that these were explicit categories.

 

The Corporate Director said that it was possible to give snapshots of the numbers of Children in Care / Children in Need at any one time.

 

Councillor Paul May commented that given the Council’s lesser role in the day to day running of schools how can it be assured that if a safeguarding issue is raised through an Ofsted inspection that it goes through the proper process.

 

The Director for Safeguarding & Quality Assurance replied that the Council tries its best to triangulate local data that it receives and if appropriate it will take steps to go into the identified setting. She added that schools also complete a Section 175 Safeguarding Self-Assessment and that the Council receives a 100% return on these. She stated that two Child Protection Forums are held a year and schools are encouraged to contact the Council if issues arise.

 

Councillor Liz Hardman asked who are assurances being sought from about the increase in children excluded and those home schooled that they are achieving good outcomes and that they are not at risk of harm and are the six monthly progress reports coming to this Panel now.

 

The Corporate Director replied that this referred to the LSCB challenging the Health & Wellbeing Board on these issues.

 

Councillor Hardman asked if the reports could be shared with the Panel.

 

The Corporate Director replied that they could.

 

Councillor Hardman asked if more resources were needed in relation to Early Help.

 

The Director for Safeguarding & Quality Assurance replied that it is a real challenge and not just a problem that this Council were facing. She added that capacity levels would be reviewed as part of the arrangements for the new Community Safety & Safeguarding Partnership.

 

Councillor Hardman asked in relation to County Lines if we have an update on our Problem Profile to highlight particular hot-spots.

 

The Director for Safeguarding & Quality Assurance replied that the Problem Profile has not been provided to the  ...  view the full minutes text for item 22.

23.

Independent Reviewing Officer (IRO) Annual Report 2018/19 pdf icon PDF 76 KB

The IRO report is produced in order to provide the Director for Children’s Services, the Lead Member for Children and the Corporate Parenting Board with information pertaining to the work of the Independent Reviewing Service (IRS) which is responsible for monitoring and reviewing the care provided to children and young people for whom the Local Authority are corporate parents.

Additional documents:

Minutes:

The Deputy Lead for Safeguarding and Quality Assurance: Children and Young People introduced this item to the Panel. She informed them that the annual report provided information on;

 

·  The profile of the Local Authorities Looked After Children,

·  The IRO Service structure and development,

·  The inclusion and participation of children, young people and their parents

·  The review and monitoring of individual care plans for Looked After Children,

·  Area’s for development over the course of 2019-2020.

 

She said that the IRO is often the most consistent relationship (after a child’s primary carer) for a child and young person who is looked after. The IRO role for children and young people is so valuable as it can prevent the needs of children being overlooked, decisions being forgotten and the journey of children and young people being lost.

 

She explained that whilst there has been an increase in the child in care population it has been possible to reduce the average caseload for the IRO’s as a result of the Independent Chair role.

 

She stated that the IRO Handbook suggests that for a full-time IRO it would be good practice for their caseload to consist of 50-70 looked after children.  The current average caseload within B&NES is 47 per IRO.

 

She said that within the reporting period the IRO Service has chaired a total of 454 review child in care meetings for children and young people and that this is only a 1.5% increase on the previous financial year. She added that given that there has been a 14% increase in the number of children and young people becoming looked after this year, this small increase could therefore be related to;

 

·  Children and young people facing less disruption and therefore not requiring additional review meetings, and

·  Sibling groups remaining together reducing the number of reviews required.

 

She informed the Panel that the gender breakdown remains stable in relation to previous years and reflects the national picture and that at the end of this reporting period, there were 87 (45%) females and 105 (55%) males accommodated by the Local Authority.

 

She said that with regard to ethnicity the data shows that whilst the majority of children and young people looked after by the Local Authority are largely White British (73.4% (141)), there are 41 children and young people from Black Minority Ethnic Groups. She added that it is important that the cultural needs of the children and young people looked after are taken into consideration when identifying placements and the services on offer.

 

She stated that to ensure children and young people in the care of the local authority remain connected to their local community, family and friends, and to limit the level of disruption in a child/young person’s life, local authorities should always first try to place a child or young person in care within the geographical area of their family home. She added that the challenge however is ensuring that the identified carers have the appropriate skills to meet the child and  ...  view the full minutes text for item 23.

24.

Children Services Representations, Compliments and Complaints Report 2018/19 pdf icon PDF 65 KB

This report informs the Panel about the number of complaints and representations including compliments received during 2018 and 2019 and demonstrates how they have been managed and how they have been used to contribute to service improvement.

 

Additional documents:

Minutes:

The Complaints & Data Protection Team Manager introduced this item to the Panel. She explained that the report considers compliments, complaints and representations received between 1st April 2018 and 31st March 2019 and also provides an analysis of outcomes, trends and learning from complaints which can be used by the service for planning and improved service delivery. 

 

She said that complaints against schools are governed by different legislation and each school is required to have its own complaints procedure and complaints about schools are not therefore included in this report.

 

She stated that during the year a total of 106 complaints were processed under the Children’s Social Care statutory complaints procedure or the Council’s Corporate Complaints Procedure. She added that the report explains how the complaints were resolved under the procedures. 

 

She said there were four referrals to complaints to the Local Government and Social Care Ombudsman. 

 

She said that during the period of the report that 36 compliments were recorded. 

 

Councillor Liz Hardman asked if there are lessons to be learnt from the number of Stage 1 complaints that are upheld (23%).

 

The Complaints & Data Protection Team Manager replied that action plans are devised following the end of the process. She added that the majority of complaints were due to a lack of good communication between parties.

 

Kevin Burnett asked if all the figures in the report were in relation to B&NES employees.

 

The Complaints & Data Protection Team Manager replied that they were.

 

The Panel RESOLVED to note the report.

25.

Care and Support Charging and Financial Assessment Framework pdf icon PDF 80 KB

B&NES Council is proposing to introduce a Care and Support Charging and Financial Assessment Framework. This will change some of the ways in which the Council allocates its resources and calculates the charge (where applicable) to individuals with care and support needs.

Additional documents:

Minutes:

The Legal Advisor introduced this report to the Panel. She explained that the following areas of the Framework will be subject to consultation as all other areas included are not discretionary within the statutory obligations:

 

·  Individuals will be required to respond within two weeks of being contacted by a Care Finance Officer to arrange a meeting to discuss the financial assessment. If no contact is made within this period, they will be deemed as self-funding.

 

·  The Council will take into account Pension Guaranteed Credit and Employment and Support Allowance benefit that a service user would have an automatic entitlement to, if an application were made.

 

·  A new third party ‘Top Up Agreement’ will be implemented for families /friends/ organisations who wish to make a top up payment on behalf of an individual. Example a larger room in a care home.

 

·  There will be an improved procedure for setting up a Deferred Payment Agreement (DPA) and an increase in the fees charged for setting up a DPA.

 

·  A new Interim Funding Policy (dependent upon criteria) is proposed for those people who have unregistered properties and for those who are waiting to obtain deputyship to allow them to act on the individual’s behalf.

 

·  The Council are reviewing the amounts that are applied to Disability Related Expenditure and some expenditure will not be allowed. Please refer to the Disability Related Expenditure Factsheet for more information.

 

·  Transport and education costs will be allowed if this is set out in the individuals Care and Support Plan and the individual is not in receipt of Disability Living Allowance or any Disability Living Allowance component of Personal Independence Payment (PIP).

 

·  The standing charge for gas, electricity, water and sewerage will be allowed as part of the financial assessment. Those individuals who have other heating systems such as oil heating, delivery costs will be allowed.

 

·  A new one off administration charge will be applied to self-funders where an individual has asked the Council to arrange for the care and support.

 

·  The Council has updated its Direct Payments Policy to provide clearer guidance and information.

 

She said that the consultation will run from the 24th September until 3rd December 2019 and that a series of consultation events for individuals, family members, care and support staff and agencies will be held. She added that a presentation by council officers will be given at the start of the session and there will be an opportunity to ask questions.

 

The Chairman asked her to confirm that this was not simply a cost cutting exercise.

 

The Legal Advisor replied that it was not and that the process will bring the Council in line with other local authorities and the National Association of Financial Assessment Officers (NAFAO) based guidance.

 

Councillor Liz Hardman asked if changes would be made if comments were received during the consultation.

 

The Director for Safeguarding & Quality Assurance replied that they were open to changes being following the consultation.

 

Councillor Hardman commented that she felt that the initial two week timescale  ...  view the full minutes text for item 25.

26.

People and Communities Strategic Director's Briefing

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

Minutes:

The Corporate Director (People) addressed the Panel. He wished to inform them that the Youth @ Risk Strategy had recently been launched and that Sian Walker had been appointed as Chair of the new Community Safety & Safeguarding Partnership.

27.

Panel Workplan pdf icon PDF 112 KB

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.

 

Minutes:

Kevin Burnett asked if the briefing to show how the various Boards and organisations fit together had taken place.

 

The Chairman replied that it had and that he would ask for that information to be forwarded to him.

 

Councillor Jess David commented that as highlighted within the IRO report she would like the Panel to receive further information to gain a level of understanding and knowledge of the use of unregulated placements.