To agree the minutes of the previous meeting
as a true and accurate record of proceedings.
Minutes:
The minutes of the previous meeting were
approved as a true and accurate record of proceedings.
66/16
DECLARATIONS OF INTEREST
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All Members present are
required to declare, at this point in the meeting or as soon as
possible thereafter
(i)Any disclosable pecuniary interests and /
or
(ii)Other interests arising under the Code of Conduct in
respect of any item(s) of business being considered at this
meeting
NOTES:
·Members are reminded that they must not participate
in any item where they have a disclosable pecuniary
interest
·As well as an interest of the Member, this includes
any interest, of which the Member is aware, that relates to the
Member’s spouse or civil partner (or any person with whom the
Member is living as a spouse or civil partner)
·Members with a significant personal interest may
participate in the discussion and vote on that matter unless that
interest could be reasonably regarded as prejudicial.
Minutes:
There were no declarations of interest
made.
67/16
QUESTIONS AND PETITIONS
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To receive any questions or
petitions.
Notes:
1. The deadline for Member’s questions is
12.00pm four working days before the meeting (20 October
2016).
2. The deadline for public
questions is seven days before the meeting (19 October
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
received.
68/16
RESPONSES FROM THE CABINET TO ISSUES REFERRED BY THE SCRUTINY BOARD
The Board noted and
approved the recommendations tracker and forward work
programme.
The Board were also
provided an update from the Performance and Finance sub-group of
the Board which are attached to the minutes as Annexe A.
70/16
ADULT SOCIAL CARE STRATEGIC DIRECTOR'S UPDATE
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Purpose of the report:
The Board will receive a verbal update from the
Strategic Director of Adult Social Care and Public Health regarding
any news or updates within the service.
Minutes:
Witnesses:
Helen Atkinson, Strategic Director for Adult Social Care and
Public Health Mel Few, Cabinet Member
for Adult Social Care, Wellbeing and
Independence Tim
Evans, Cabinet Associate for Adult Social Care, Wellbeing and
Independence
Declarations of interests:
None
Key
points of discussion:
The Strategic Director for Adult Social Care
explained to the Board that the service was currently prioritising
winter planning for 2016, noting that there was in place an
integrated campaign with partner organisations to ensure that there
was a single, clear message. Officers also pointed out that there
was available an updated response from the Emergency Management
Team in response to the work undertaken regarding winter planning,
noting the updated business continuity plan that had been
implemented. It was highlighted that there was a focus within the
service on updating the vulnerable individual reporting
system.
The Board was informed of the following actions that
the service had undertaken with regard to winter
planning:
a)updated the public webpage with the information
relating to the updated Winter Plan;
b)promoting influenza vaccinations;
c)use of NHS England toolkits in Care Homes to assist
with Winter Planning; and
d)worked with partners, such as electricity companies,
to ensure that information was shared to prevent vulnerable people
suffering significant loss of amenity.
Members questioned the effect on local pharmacies as
a result of recent central government announcements and if the
service was working closely with partners to feed into any updated
plans. The Cabinet Member for Adult
Social Care, Wellbeing and Independence commented that the service
would be looking into the effects and feed back any issues to the
Board. Officers also noted that communications made were
county-wide, but that any information regarding borough, district
and partner response will be looked into and considered with Surrey
County Council’s proposals.
Officers highlighted the work that was being
undertaken by the service with the NHS Sustainability and
Transformation Plans (STPs) and that meetings with the groups had
taken place in late October 2016, noting that the Surrey Heartlands
Committee in Common had good representation from Surrey County
Council officers with the aim of positively influencing the
development of the STP.
Purpose of the
report: Scrutiny of
Budgets/Performance Management
This report provides an opportunity for the
Board to scrutinise the Adult Social Care budget.
Minutes:
Witnesses:
William House, Finance Manager Mel Few,
Cabinet Member for Adult Social Care, Wellbeing and
Independence Tim
Evans, Cabinet Associate for Adult Social Care, Wellbeing and
Independence
Declarations of interests:
None
Key
points of discussion:
Officers highlighted the challenging budgetary
situation facing the service, noting that a core reason for the
budget overspend were the high savings targets set out in the
Medium Term Financial Plan (MTFP). It was highlighted that the
updated September 2016 projected overspend for 2016/17 was
£20.9 million. Officers explained that increased demand for
adult social care placed a burden on the service, however, it was
also noted that this was a national pressure, and one that was not
limited to Surrey County Council.
It was highlighted that the
introduction of the national living wage had seen care costs
increase.
The Cabinet Member for
Adult Social Care, Wellbeing and Independence highlighted that
briefings had taken place between the Council’s Cabinet and
Members of Parliament for Surrey to focus on the issue of the
overspend within Adult Social Care. The Cabinet Member noted in particular the limitation of
the powers regarding the adult social care 2% council tax increase.
This was highlighted as benefitting the service by £12
million and reducing the impact of savings requirements. However,
the possible limitation of this increase as a one-time occurrence
was a key risk for the service budget. Equally, the £12
million of income raised from the precept is substantially less
than the £35 million of pressures budgeted in 2016/17
relating to increased demand and market prices.
Members questioned whether the budget
setting method used by the service was appropriate,querying how the financial planning process could be
improved to better reflect the trends in demand. Officers explained that the issue was not to do
with the methodology used to predict demand, but the difficulties
experienced in delivering savings plans to reduce demand to
budgeted levels. Demand is currently
running at 6-7% which is very close to the level modelled prior to
including the impact of savings plans which intended to bring
demand down to 4%. It has not been
possible to achieve this level of reduction in light of increased
demand across the whole health and social care system in
Surrey.
It was questioned by the Board whether
direct payment reclaims were an achievable target. The Cabinet
Member for Adult Social Care, Wellbeing and Independence noted
that the introduction of prepaid
accounts for direct payments (which automatically prevent monies
being paid out to individuals who have surpluses in their accounts)
in the previous financial year will considerably reduce manual
reclaims in future years.
Officers and the Cabinet Member for Adult
Social Care, Wellbeing and Independence noted that budget changes
as a result of winter were not possible to predict accurately due
to changing pressures from winter conditions, however that the
service was expecting a maximum of £25 million overspend up
to the end of the financial year.
Purpose of
report:To provide background information
and progress on implementation of the Multi Agency Safeguarding Hub
(MASH)
Minutes:
The Board agreed to combine items 10 and nine in
order to aid the flow of the discussion.
Witnesses: Garath Symonds, Assistant
Director for Commissioning and Prevention
Clare Curran, Cabinet Member for Children
and Families Wellbeing
Mary Lewis, Cabinet Associate for
Children, Schools and Families
Declarations of interests:
None
Key
points of discussion:
The Assistant Director for Commissioning and
Prevention highlighted that the Surrey Multi-Agency Safeguarding
Hub (MASH) went operational on the 5 October 2016. It was noted
that the MASH was based at Guildford Police Station and served as
the first point of contact for all safeguarding queries, in
contrast to the multiple points of contact that were present prior
to the introduction of the MASH. It was noted that this represented
a significant culture change away from siloed working and the prior
“multi-door” approach for the service and its
partners.
It was noted that the initial implementation of the
MASH had been positive, with several key benefits being identified:
better co-ordination of response, greater capability for
information sharing and a more consistent response to
challenges.
Officers noted that one of the key challenges for
the MASH following its inception was a backlog of calls. It was
noted that there were two avenues of contact for the MASH: email
and telephone calls. It was queried by Members whether the service
had looked into the idea of instant messaging services. Officers
responded that they would look into the feasibility of the
idea.
It was noted that there was some initial down time
in the email system at the inception of the MASH which led to a
backlog of cases. It was also highlighted that there was a high
volume of contacts for the MASH at its inception, and that the
majority of these were repeat or already open cases. It was
expected that this would reduce as more became familiar with the
function of the MASH. It was noted that the service expected to be
on target for call handling by the end of 2016.
Another key challenge that was noted by officers was
the resilience of computer systems and databases to reliably cope
with information required by MASH operators. It was noted that the
Early Help Module (the way to access and use the databases) had a
long response time, and caused some backlog. It was highlighted
that, to resolve this issue, the service was working together with
Information Management Technology to resolve any issues arising as
a matter of urgency.
The Board was informed that the MASH programme would
transition to business as usual in January 2017, and this would see
new governance arrangements being introduced.It was emphasised that, as part of this transition, there would
be a governance board which would consist of representatives from
Surrey Police, Clinical Commissioning Groups, the Surrey
Safeguarding Children Board (SSCB), the Surrey Safeguarding Adults
Board and the Children’s Service directors. It was noted that
this board would be accountable to all statutory partners through
the SSCB.
Purpose of
report:To provide an update on the Early
Help System
Minutes:
Witnesses: Garath
Symonds, Assistant Director for Commissioning and Prevention
Clare Curran, Cabinet Member for Children
and Families Wellbeing
Mary Lewis, Cabinet Associate for
Children, Schools and Families
Declarations of interests:
None
Key
points of discussion:
It was noted that that the programme of change was
part of an overall strategy forthe
improvement plan following the Ofsted inspection in
2015.
Officers explained that there was in excess of
64,000 contacts made to the service per annum with regard to
safeguarding children. It was highlighted that the MASH served to
allow the service to determine whether a child was able to receive
Early Help as a preventative measure, or if formal social care
service was required.
It was highlighted that the new service would
provide help to all children and adults, noting that all who had
requested a safeguarding referral for children were provided help
through either a formal service or through the Early Help
system.
Hazel Watson left the meeting at 12.30pm
The Board questioned whether the service had a
resource bank of information relating to partner organisations in
the voluntary, community and faith sector. Officers confirmed that
this was the case and that there was an attempt to work closer with
partner organisations going forward, noting work with church
organisations that was due to take place as part of phase two of
the development process. It was agreed that, as part of this closer
working with partners, the Assistant Director for Commissioning and
Prevention would work closely with the Voluntary, Community and
Faith Sector (VCFS) Task Group of the Social Care Services Board in
future.
The Cabinet Member for
Children and Families Wellbeing andCabinet Associate for Children, Schools and Families
highlighted the Safer Surrey approach to practice with children and
families, and the that this a strength based
approach..It was noted that the MASH and EH were a key aspect
of this new strong and collaborative approach between the service
and its partner organisations.
TheCabinet
Member for Children and Families Wellbeing informed the Board that
once the MASH had been embedded, it would create additional
capacity in the system and there would be scope to restructure
teams in the four quadrants. The Cabinet Member acknowledged that
the VCFS had a key role to play in the delivery of early help.
The Cabinet Member highlighted that there had been a
need to increase capacity to deliver Early Help and address actions
set out in the improvement plan. The Board was informed that this
was being supported by external consultants, funded through an
additional investment that had been agreed as part of an Early Help
transformation fund.
Recommendations
The Board thanks officers for the report, and recognises the
good progress made to date in establishing the MASH. It
recommends:
1.That officers report progress of Early Help and the
MASH in six months, including how benefits are being realised and
how emerging key issues have been addressed
Purpose of report: To update
the members of the Social Care Services Board on the position and
impact of the significant increase in Deprivation of Liberty
Safeguards (DOLS) requests.
Witnesses: Andy Butler, Principal
Social Worker andSenior Practice Development
Manager
Mel Few, Cabinet Member for Adult Social Care, Wellbeing and
Independence Tim
Evans, Cabinet Associate for Adult Social Care, Wellbeing and
Independence
Declarations of interests:
None
Key
points of discussion:
Officers highlighted the complexity of Deprivation
of Liberties Safeguards (DoLS) and the issues that arose out of the
implementation of the Mental Capacity Act (2005) and the ruling of
the Supreme Court in 2014, which had lowered the threshold for DoLS
requests. It was noted that, as a result, numbers of referrals had
increased significantly.
It was noted that Surrey County Council was the
authorising body for referrals and that the service planned to
mitigate risk regarding these referrals through the implementation
of a triage process.
The Board queried why there were currently a high
number of unassessed cases. It was highlighted that the data that
was presented to the Board was a snapshot of a few weeks, but that
any referrals made that do not require action and may remain in a
low priority backlog. Members questioned if there was any measure
in place to clear this backlog of cases. It was highlighted that
there were a number of methods that had been undertaken by the
service to do this; including expanding theDoLs team, working with social work agencies to increase
capacity and working closely with partners.
Officers highlighted that if an urgent referral was required, the
service would undertake rapid assessments. It was noted that most
work undertaken by the service were urgent assessments, causing
some backlog of lower priority cases.
Members questioned if any representation had been
made to Central Government regarding raising DoLS thresholds and if
there were any opportunities to increase funding levels for DoL
Safeguarding.Officers noted that this was a
national problem, and not unique to Surrey. It was noted that
representations were being made by a number of local authorities,
but that the legislative changes brought into effect by the Law
Commission recommendations would not take place until 2018. It was
also noted to the Board that these legislative changes were
unlikely to reduce the pressure created by the DOLs
assessments.It was additionally highlighted
that any Supreme Court ruling would be difficult to
challenge.
Recommendations
The Board expresses continued concerns regarding the backlog in
DOLS assessments, and the increase of those requiring of
assessments.
It
recognises the efforts of officers to manage risk to individuals
through prioritisation and thanks them for their continued work. It
recommends:
1.That a quarterly update is reported through to the
Performance and Finance sub-group, with matters being escalated to
the Board if required.
Witnesses: Toni Carney,Head of Resources Denis
Fuller, Vice Chairman, Audit and Governance Committee
Tim Hall, Member, Audit and Governance
Committee Mel Few, Cabinet Member for
Adult Social Care, Wellbeing and Independence Tim Evans, Cabinet Associate for
Adult Social Care, Wellbeing and Independence
Declarations of interests:
None
Key
points of discussion:
Officers highlighted that, as a result changes
brought in by the Care Act 2014, the service was no longer able to
place charges upon property, shifting the between secured and
unsecured debt.
It was indicated by officers that the impact of debt
recovery on individual wellbeing was considered as a key
aspect.
It was noted by officers that there was a £17
million social care debt owed to the service. It was noted that the
service was working to establish the amount that was unrecoverable
and what could be claimed through a small claims court where
possible.
The Board questioned whether the increase to
£17 million was in proportion to the increase in demand for
social care. Officers responded that this could be a cause, but
that the root causes would need to be ascertained through further
study.
Officers informed the Board that conversations with
recipients of Adult Social Care were held to highlight the issue of
social care cost. However, it was acknowledged that there were
extenuating circumstances for individual cases.
Denis Fuller and Tim Hall entered the meeting at
1.15pm.
The Members of the Audit and Governance Committee
noted that the key challenge facing the service was to create the
resources within the service to focus on this issue effectively. It
was highlighted that an immediate cause and assessment process
needed to be implemented more effectively.
It was queried by Members whether the service could
increase its number of Direct Debits collected to be higher than
60% of those on adult social care, as a means of reducing the
possibility of a user incurring social care debt. It was noted by
officers that Direct Debits are advertised as the preferred choice,
but stressed that it was a personal choice for individual
users.
Officers informed the Board that, as part of the
improvement process, those who are in danger of being indebted were
being visited by the service. It was noted that these face-to-face
meetings had been responsible for the collection of £150,000
and that they are a good means of remaining in contact.
Yvonna Lay and Chris Townsend left the
meeting at 1.34pm
Recommendations
The Board notes the improvement with the number of those
payments collected by Direct Debit. It recommends:
1.That officers explore the business case for the
additional temporary resource referred to in paragraph 14 to be
made permanent, as a means for ensuring early and regular contact
with debtors and their representatives.
Purpose of
report:This report provides an update on
the implementation of the new IT systems Liquidlogic and Controcc
Minutes:
Witnesses: Toni Carney,Head of Resources Mel Few, Cabinet Member for Adult
Social Care, Wellbeing and Independence Tim Evans, Cabinet Associate for
Adult Social Care, Wellbeing and Independence
Declarations of interests:
None
Key
points of discussion:
Officers highlighted that there was positive
progress with the new systems and that there were no major problems
to report with implementation.
It was noted that phase two of implementation was to
go ahead on the 9 November 2016.
The Cabinet Member for
Adult Social Care, Wellbeing and Independence thanked the service
for its good delivery of the project on time and on budget. It was
highlighted that a key part of the success was that the system was
service led in its implimentation.
Recommendations
None
77/16
DATE OF NEXT MEETING
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The next public meeting of the
Board will be held at County Hall on the 9 December 2016,
10.00am.
Minutes:
The next public meeting of the Board will be
held on the 9 December 2016, 10.00am at County Hall.
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