Agenda and minutes
PDF 378 KBVenue: Ashcombe Suite, County Hall, Kingston upon Thames, Surrey KT1 2DN. View directions
Contact: Andy Spragg or Richard Plummer
| No. | Item |
|---|---|
|
APOLOGIES FOR ABSENCE AND SUBSTITUTIONS
Minutes: Apologies were received from Ken Gulati, Yvonna Lay, Chris Townsend and Helena Windsor. Bill Chapman acted as a substitute for Yvonna Lay and Bob Gardner acted as a substitute for Ken Gulati. |
|
|
MINUTES OF THE PREVIOUS MEETING: 12 MAY 2016
To agree the minutes as a true record of the meeting. Minutes: The minutes of the previous meeting were approved as a true and accurate record of proceedings. |
|
|
DECLARATIONS OF INTEREST
To receive any declarations of disclosable pecuniary interests from Members in respect of any item to be considered at the meeting.
Notes: · In line with the Relevant Authorities (Disclosable Pecuniary Interests) Regulations 2012, declarations may relate to the interest of the member, or the member’s spouse or civil partner, or a person with whom the member is living as husband or wife, or a person with whom the member is living as if they were civil partners and the member is aware they have the interest. · Members need only disclose interests not currently listed on the Register of Disclosable Pecuniary Interests. · Members must notify the Monitoring Officer of any interests disclosed at the meeting so they may be added to the Register. · Members are reminded that they must not participate in any item where they have a disclosable pecuniary interest.
Minutes: There were no declarations of interest to report. |
|
|
QUESTIONS AND PETITIONS
To receive any questions or petitions.
Notes: 1. The deadline for Member’s questions is 12.00pm four working days before the meeting (Friday 17 June 2016). 2. The deadline for public questions is seven days before the meeting (Thursday 16 June 2016) 3. The deadline for petitions was 14 days before the meeting, and no petitions have been received. Minutes: There were no questions or petitions submitted to the Board. |
|
|
RESPONSES FROM THE CABINET TO ISSUES REFERRED BY THE SCRUTINY BOARD
There are no responses to report. Minutes: The Board received a response
from the Cabinet Member for Cabinet Member for Children and
Families Wellbeing regarding the Surrey
Family Support Programme. |
|
|
UPDATE FROM THE STRATEGIC DIRECTOR OF ADULT SOCIAL CARE
The Strategic Director for Adult Social Care and Public Health will update the Board on any important news and announcements from within the Directorate. Minutes: Witnesses: Helen Atkinson, Strategic
Director for Adult Social Care and Public Health Key
points of discussion: 1. The Strategic Director for Adult Social Care and Public Health gave an update concerning: · Deprivation of Liberties (DoLs) · social care in prisons; and, ·
the review of the Accommodation with Care and Support
Strategy.
2.
The Board was informed that DoLs requests to Surrey County Council had
significantly increased over the last two years, citing that 3987
DoLs requests had been made in the
financial year 2015/2016. It was explained that steps were being
taken to meet the challenge of increased demand. This included
increasing Best Interest Assessors and improved training to
existing staff to cope with this demand.
3.
The Board was informed that the issues related to
DoLs were a national challenge for
those providing Adult Social Care. It was highlighted that the
Council was dealing well with the issue when compared nationally,
though it still presented a considerable risk to the Council. It
was clarified that cases that were considered the most at risk were
always prioritised for a DoLs
assessment. The Board requested a paper
for the next Adult Social Care themed meeting of the
Board. 4. The Board was provided with an update on the work undertaken by the service with regard to social care provisions within the prison system in Surrey. It was highlighted that those requiring services in this sector has been higher than was forecast, with the three primary areas being physical disability, mental health support and dementia. It was agreed that a further report would come to the next Adult Social Care themed meeting of the Board. Members also expressed support for a sub-group to be established to monitor progress in this area twice a year. The following Members volunteered: Barbara Thomson, Fiona White and Margaret Hicks.
5. Officers gave an update to the Board on the progress of the Accommodation with Care and Support programme, and the development of integrated commissioning with NHS Clinical Commissioning Groups (CCGs). The Board was informed that a core aim of the programme was to increase accommodation in order to meet the growth in demand for those needing care and support, improve independence, and reduce those housed long-term in cares homes.
6. The Board was informed that approximately 600 new flats were required to meet projected demand, and that the council was working in partnership with CCGs, district and borough councils, and with the market in order to meet the challenge raised by this growth in demand.
7. The Board queried whether the service was making best use of Council-owned property, and asked a specific query about the future use for the six closed care homes. It was confirmed that the Accommodation with Care and Support review would include a consideration of the appropriateness of these sites in question, and that the decision by Cabinet that these sites would ... view the full minutes text for item 46/16 |
|
|
HEALTH AND SOCIAL CARE INTEGRATION: BETTER CARE FUND 2016/2017
Purpose of report: To update the Board on the final Better Care Fund plan for 2016/17 and invite it to consider how it monitors its delivery in conjunction with the wider health and social care integration agenda.
Additional documents: Minutes: Witnesses: Key
points of discussion: 1. The Strategic Director for Adult Social Care and Public Health explained to the Board that the Better Care Fund (BCF) was part of a wider integration between CCGs and the Council. It was also highlighted that these plans were expected to work in collaboration with the NHS five year forward view, and the locally developed NHS Sustainability and Transformation Plans (STPs). The Board was informed that the integration agenda was seeking to improve preventative services, in order to reduce demand on the NHS.
2. The Board was informed that the pooled BCF budgets enabled the two organisations to achieve closer integration and realise efficiencies through this.
3.
The Board queried what challenges existed in
delivering the BCF plans. Witnesses commented that there was a
significant difference in cultures between the two organisations,
though it was highlighted that the past few years had seen closer
working together. The developing digital roadmap and information
sharing that was underway was highlighted as a good example of
this. 4. The Cabinet Member for Adult Social Care, Wellbeing and Independence explained that there were a number of common problems faced by both organisations with regard to workforce development. It was highlighted that the two organisations would work collaboratively to address this.
5. The Board queried how the metrics for measuring the delivery of the BCF had been established. Officers explained that these metrics were generally set nationally by the NHS, however that some were able to be set at a local level. The Board was informed that a locally chosen measurement for Surrey was the prevalence of dementia cases.
6.
A question was put forward by the Board regarding
the voluntary sector of care, and whether it can realistically
provide care with reduced funding, and queried how the service is
forward planning to meet this contingency. The Strategic Director
for Adult Social Care and Public Health reassured the Board that
the service was working with partners to ensure that these issues
were resolved. It was explained that any decisions made financially
must be made in partnership and that the service was building
relationships with local business and charities to reduce
risk.
7.
The Board commented on the complex structure of CCGs
and questioned why there were presently three STPs covering the
region rather than one. It was explained that there was not a cohesive
boundary in Surrey evolving for the STPs, and that these had been
decided centrally by NHS England. It was, however, clarified that
these boundaries were permeable to encourage interconnectivity and
that the CCGs were working closely with the Council to ensure that
they are closely linked. Recommendations 1. That the Board monitor the financial position of the Better Care Fund as part of regular service budget updates to the Performance and Finance sub-group. ... view the full minutes text for item 47/16 |
|
|
CONSULTATION ON A REVISED CHARGING POLICY FOR ADULT SOCIAL CARE SERVICES
Purpose of the report: Scrutiny of Services and Budgets. Policy Development and Review
Income from charging is an important contribution to Adult Social Care’s budget. In the light of the very significant pressures facing the Council, a review of the charging policy was undertaken to ensure that services are not subsidised unnecessarily. Proposals to revise the charging policy were considered by the Cabinet and approved for consultation. This report outlines the proposed changes to the charging policy in advance of the further report to Cabinet on 14 July 2016. Additional documents: Minutes: Witnesses: Key
points of discussion: 1. The Board was given a preliminary summary of the responses to the consultation and heard from representatives from the Surrey Coalition of Disabled People and Action for Carers.
2. It noted that there was strong resistance to the proposed changes and concerns about the detrimental impact on disabled people, their carers and families given the reduction in disposable income. The Board expressed the view that there was not sufficient evidence of how the proposed changes would affect individuals in the Equalities Impact Assessment.
3. The Board queried whether the negative feedback from those consulted would have an effect on the proposals. The Cabinet Associate for Adult Social Care, Wellbeing and Independence informed the Board that the Council would move in line with other local authorities in its charging policy. It was highlighted by the Board and external witnesses that the cost of living in Surrey was comparable to London, and not the local authorities cited in the consultation document.
4. The Board commented that it was not apparent whether the additional revenue generated as a result of the proposed changes would also mean additional implementation and administrative costs to the Council. It was commented by witnesses that the cost of assessing a large group of individuals and implementing the proposals could prove prohibitive in the immediate term. It was also highlighted by witnesses that there were case law rulings regarding the raising of charges against night-time attendance allowances, and that they believed this should have been reflected in the proposals.
5.
The Board questioned whether the low response rate
was a result of those being consulted being unclear on the
proposals and their impact. The Board queried whether the negative
response to it would have an impact on the proposals.
6.
The representative for Action for Carers expressed
concern that these proposals may deter residents from seeking
support from the service, and highlighted that these proposals
could also impact on carers and families.
7.
The Cabinet Member for
Adult Social Care, Wellbeing and Independence offered to provide a
full breakdown of the concerns put forward by the
representative for Action for Carers and the representative for the Surrey Coalition for Disabled
People, and circulate that response to the witnesses and to the
Board. Recommendations:
1.
That the Board understood the need for
potential cost saving measures, but did not endorse the proposals
as they currently stood, with the exception of the administration
set-up fee.
2.
That Cabinet provide greater evidence for the
cost-benefit of implementing the proposed changes to Adult Social
Care charging policy 3. That the Cabinet demonstrate they have taken the impact of carers and families into account and have sought to mitigate this impact ... view the full minutes text for item 48/16 |
|
|
NHS CONTINUING HEALTHCARE
Purpose of the report: Performance Management/Policy Development and Review
This report provides an overview regarding NHS Continuing Health Care (CHC) and how it is operated in Surrey. The report reflects progress and issues as they relate to Surrey County Council. The Board is asked to note its content and consider the recommendation. Minutes: Witnesses: Key
points of discussion:
1.
The Head of Continuing Care, Adult Social Care
explained the role that the team has in conjunction with Surrey
Downs CCG, the area lead on Continuing Health Care (CHC). It was
highlighted that this was a partnership approach with a joint
action plan that was aimed at finding efficiencies that can be made
as a result of this partnership.
2.
It was noted by the officer that social care and
health being delivered by different organisations could lead to
unnecessary tension. It was suggested that the organisations needed
to work together to ensure they could meet the needs of the most
vulnerable.
3.
The Board queried how much the Continuing
Healthcare team cost the service and how much was being saved.
Officers responded that, for the financial year 2015/16, the team
cost the Council circa £400,000, while the Council had
avoided potential liabilities of circa £3.5
million. 4. The Cabinet Member for Adult Social Care, Wellbeing and Independence noted that disputes over continuing healthcare were often a barrier to early discharge from hospital, and that the team’s work was highly valued in seeking resolutions in this regard.
The Board was informed that the law surrounding the subject was complex, particularly because of the financial implications arising from the failure of statutory provision. It was also highlighted that decisions were reliant on clinical assessments and this was a significant factor in the outcome of any decision.
5.
It was noted that a robust dispute
resolution team was required in order to avert cases from going to
the courts, which was a costly and time consuming process for the
service.
6.
It was suggested by the Board that it may
be helpful to give hold a Member’s Briefing session based on
the work of the CHC team to raise awareness among members on the
work they undertake.
The Board thanks the Continuing Healthcare team for
the valued work it undertakes. · That officers develop a Members’ briefing to outline the valued work of the Continuing Healthcare team, and the key challenges it faces. |
|
|
RECOMMENDATIONS TRACKER AND FORWARD WORK PROGRAMME
The Board is asked to review its Recommendation Tracker and Forward Work Programme providing comment as necessary. Additional documents: Minutes: The Board approved the current
recommendations tracker and forward work programme. |
|
|
DATE OF NEXT MEETING
The next meeting of the Board will be held at 10.00am on Friday 2 September 2016 at County Hall
Minutes: The next meeting will be held at 02 September 2016, 10.00am, at County Hall. |