Agenda and minutes

Adults and Health Select Committee - Thursday, 10 October 2019 11.00 am

Venue: Ashcombe Suite, County Hall, Kingston upon Thames, Surrey KT1 2DN

Contact: Joss Butler, Democratic Services Officer 

No. Item




    Apologies were received from David Mansfield and Daryll Ratiram.





    To agree the minutes of the previous meeting of the Adults and Health Select Committee as a true and accurate record of proceedings.


    The minutes were agreed as a true record of the meeting.



    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



    ·         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.


    None received.



    To receive any questions or petitions.


    1.     The deadline for Member’s questions is 12.00pm four working days before the meeting (4 October 2019).


    2.     The deadline for public questions is seven days before the meeting(3 October 2019)


    3.     The deadline for petitions was 14 days before the meeting, and no petitions have been received.


    None received.



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    For the Select Committee to receive an update on work that has been undertaken by Cabinet Members and areas of priority work/focus going forward.


    To be published in a supplementary agenda prior to the meeting.

    Additional documents:



    Sinead Mooney, Cabinet Member for Adults and Public Health

    Liz I Deputy Director – Adult Social Care


    Key points raised during the discussion:


    1. The Cabinet Member introduced the item and highlighted that the Cabinet Member update included in the supplementary agenda had previously been considered at the meeting of the County Council on 8 October 2019. Members attention was drawn to the Adult Social Care budget where it was confirmed that significant work was being put into achieving the budget target for the year. The Cabinet Member further confirmed that the Cabinet meeting in October would consider a report on Accommodation with Care and Support which would include details of the three pipeline schemes. In regards to the Integrated Sexual Health, the Cabinet Member informed Members of a recent visit to the service providers and stated that it was very positive and that the continuous improvement plan was clear and focused.
    2. The Select Committee requested details of the officer responsible for implementing the Accommodation with Care and Support ambitions. The Cabinet Member explained that the process was underway to recruit to a position which would have the responsibility to lead and develop the schemes.
    3. The Select Committee further asked what the budget saving would be for an additional 80 units per year within the extra care and supported housing schemes over the next nine years. The Cabinet Member confirmed that the saving within the Adult Social Care budget would be between £750,000 and £1 Million. Members further requested information on how the timescale and number of units were decided and if it was possible for the timescale to be reduced. The Cabinet Member clarified to Members that the figure of 725 units by 2028 highlighted in the report was specifically for affordable social housing needs and that the overall target was 2000 units. It was further highlighted that Cabinet had previously agreed to allow the Council to have the option to purchase private units if there was need. The Select Committee noted that the overall figures of the programme would be circulated by the Cabinet Member after the meeting.
    4. The Select Committee asked when the continuous improvement plan for the Integrated Sexual Health providers would be available for Members to view. The Cabinet Member agreed to circulate an executive summary once it was available. 
    5. Members asked what partnership work was underway between the Substance Misuse Service and mental health workers within the Children’s Services family safeguarding model. The Deputy Director for Adult Social Care informed Members that she now sat on the Family Safeguarding Board and that work was ongoing to finalise any information sharing protocols and that they would be looking to work in a joint up way with Children’s Services.
    6. Members requested information on the work being undertaken to shorten the amount of time it took for those with mental health needs to access appropriate services. The Deputy Director for Adult Social Care explained that part of the review of Section 75 would allow the Council to  ...  view the full minutes text for item 11.





    This report is to inform the committee of the impact of winter 2018/19 on the Surrey Heartlands system, including reference to previous winter pressures; and to describe the whole system measures being put in place to promote resilience throughout the upcoming winter period.




    To outline the impact and risks associated with winter pressures and the measures put in place by the whole System for mitigation and promotes resilience throughout the winter season.  

    To assure the Select Committee that appropriate measures are in place in preparation for seasonal winter pressures, ensuring that local people receive services at the right time in the right place and have the best possible outcomes.


    Additional documents:



    1. Surrey Heartlands Winter Preparedness




    Dr Claire Fuller, Senior Responsible Officer for Surrey Heartlands

    Karen Thorburn, Director of Performance, Surrey Heartlands Integrated Care System

    Giles Mahoney, Integrated Care Partnership Director - Guildford and Waverley

    James Thomas, Chief Operating Officer, Ashford and St Peters NHS Foundation Trust

    Jackie Raven, Associate Director for Urgent and Integrated Care, Surrey Heartlands

    Liz Uliasz, Deputy Director, Adult Social Care


    Key points raised during the discussion:


    1. The Chairman introduced the item and highlighted that an addendum to the report was published in a supplementary agenda on 8 October 2019. The Director of Performance, Surrey Heartlands provided Members with a presentations which has been included in these minutes as Annex 1.
    2. Members raised concern with the figures in the report related to flu vaccination for NHS staff which stated that the percentage of staff from the Surrey and Boarders Partnership (SABP) which received vaccinations had lowered from 54% to 47%. It was also highlight that the percentage of NHS staff in the Royal Surrey Hospital receiving a flu vaccination had reduced from 71% to 55.8%.  The Senior Responsible Officer stressed that this was a wider problem as there was an emergency situation in Surrey due to the lack of people receiving vaccinations. In regards to SABP and Royal Surrey Hospital, the Senior Responsible Officer informed Members that there were ongoing campaigns to work to increase the number of vaccinations in these organisations. Members further asked if staff were asked the reason why they were choosing not to receive a flu vaccination. The Chief Operating Officer, Ashford and St Peters NHS Foundation Trust, explained that there were a number of factors which led to people not receiving vaccinations which included lack of communication, lack of access and simply not wanting to be injected. Following on from this, Members noted officers comments which highlighted that more could be done to maximise the joint working with Local Authorities and Councillors to improve communications around the subject.
    3. Members highlighted that there was a lack of knowledge in local communities that flu vaccinations could be received in pharmacies. The Director for Performance informed Members that pharmacies were commissioned by NHS England to provide flu vaccinations and that there was a communication plan in place to outline that flu vaccinations could be received in community pharmacies. The communication programmes were in the processes of being delivered and includes the use of social media. 
    4. In regards to GP Access, Members requested further information on the number of people who failed to obtain and appointment on the same day as requested. The Director of Performance stated that additional GP appointments were being well used and that there were a number of programmes in place to increase the number of hours GPs were available. Members noted that data was not recorded on the number of people not able to access a GP on the same day as requested.
    5. Officers confirmed that extended access to primary care was now standard in Surrey Heartlands and  ...  view the full minutes text for item 12.



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    To provide an update on the progress of the Adult Social Care (ASC) transformation programmes of work. The report sets out the operational performance indicators which tell a story of transformation, the status of financial benefits delivered and forecast in 2019/20, together with a summary of achievements and key milestones planned for each of the transformation programmes.  This update will be a standing item at future Select Committee meetings



    Liz Uliasz, Deputy Director - Adult Social Care

    Sinead Mooney, Cabinet Member for Adults and Public Health


    Key points raised during the discussion:


    1.     The Deputy Director – Adult Social Care introduced the item and highlighted to Members the key themes of the report. Members noted that, following the Local Government Association peer review, the Council had been working closely with the Social Care Institute of Excellence (SCIE) as the Council’s improvement partner. Officers also provided details of the Council’s programmes for Accommodation with Care and Support, Practice Improvement and Integrated Models of Care.

    2.     The Select Committee highlight details around Direct Payments in the report and asked what challenges the Council was facing to increase its use. Officers explained that this was part of the Council’s work with SCIE to better understand challenges and that it had been identified that, in some cases, the process was considered to be unwieldy therefore the Council recognised improvements could be made.

    3.     The Select Committee requested further detail on the new Learning Disabilities and Autism team and whether the team was sufficiently resourced. Officers confirm that the team’s lead was in post but that there were still some vacancies to recruit to.

    4.     Members highlighted that some residents were unhappy with Direct Payments as it reduced the options they had to spend the money they received.

    5.     Members asked for clarification on whether the savings outlined in the report would affect service users receiving care. Officers highlighted that eligibility for care was set by the Care Act and that the Council did not intend to reduce care to service users although, if appropriate, care plans could be adapted following a review of need. 

    6.     The Select Committee raised concern over the report stating that the Council would use stronger commissioning to make savings while also requesting more from providers. Officers stated that the Council was aware that commissioning could be improved and that an Assistant Manager for Transformation and Commissioning was recently appointed to restructure the Council's commissioning team. The Council would be using strength based commission to ensure providers worked closely with the Council to improve outcomes for residents.

    7.     Members noted that the percentage of people referred on to community solutions was low and asked how the Council was promoting this option. Officers informed Members of the Communities and Prevention Team and Social Care Development Coordinators who worked to identify what community facilities were available to support residents. Members stated that it would be beneficial for these teams to work closely with Local Committees. 

    8.     The Select Committee requested further information on technology enabled care and asked how this was being integrated into services. Officers confirmed that engagement events had taken place with providers and district and boroughs and that the commissioning team were in the process of putting together a specification to go out to procurement next year to find a provider. Officers further highlighted that it would be beneficial for the Select Committee to  ...  view the full minutes text for item 13.



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    To inform the Adults and Health Select Committee of the content of the Surrey Safeguarding Adults Board Annual Report for 2018-19 and invite the Select Committee to review.


    Additional documents:



    Simon Turpitt, Independent Chairman of the Surrey safeguarding Adults Board

    Dr Amanda Boodhoo, Surrey Wide Associate, Director of Safeguarding

    Liz Uliasz, Deputy Director, Adult Social Care


    Key points raised during the discussion:


    1. The Independent Chairman of the Surrey safeguarding Adults Board (SSAB) introduced the items and provided Members with an overview of the Annual Report. Specific reference was made to:

    a.  the Board’s structure had recently improved following the appointment of a new Board Manager.

    b.  that there had been a change in committee structure to move towards delivery and scrutiny. In regards to scrutiny, there had been an improved process which involved an annual focus on a particular area to consider.

    c.  stronger relationships had been built with the Children’s Partnership.

    d.  good contacts had been built with the Community Safety Partnership and the Health and Wellbeing Board.

    e.  training programmes had been improved and are being provided to organisations without access to sufficient training.

    1. The Independent Chairman highlighted that one of the key challenges for the Board was ensuring the quality of safeguarding enquiries was at a high standard and that the process was being carried out in a smart and quick fashion when making decisions. Members further noted that the Board recently organised a training course focused on how to contribute to a Section 42 Safeguarding enquiry. The Independent Chairman also highlighted that he felt private care homes in Surrey were not engaging appropriately with the Board and Adult Social Care and that more assurances were needed to ensure appropriate safeguarding processes were in place.
    2. The Select Committee noted that a majority of fraud cases happened on the telephone or a door step for people aged 65 years and over. There was ongoing work with the Police and Trading Standards to combat those affected. 
    3. Members noted issues around identifying people affected by domestic abuse and asked the Independent Chairman what more could be done to support those affected. The Independent Chairman highlighted that the domestic abuse strategy was written by the Community Safety Board of which the Surrey Safeguarding Adults Board (SSAB) was a part of. The Board did feel as if domestic abuse was under reported but that it was beginning to get more visibility through the various relevant structures. The Director of Safeguarding highlighted to the Committee that training provided to GPs had a focus on domestic abuse. The Deputy Director also informed Members that Adult Social Care had recently reviewed all safeguarding policies to ensure a focus on domestic violence.
    4. The Select Committee noted that the percentage for referrals for non-professionals was low and asked how this could be increased to ensure all safeguarding concerns were raised. The Independent Chairman stated that knowledge and understand were key to ensuring people understand what is considered a safeguarding concern and that it is reported.




    The Select Committee noted the report.




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    The Select Committee is asked to review and approve the Forward Work Programme and Recommendations Tracker and provide comment as required.


    Additional documents:


    Key points raised during the discussion:


    1.     The Select Committee highlighted that the following subjects should be considered for future items on the Select Committee’s Forward Plan:

    a)     Technology Enabled Care

    b)     GP Access

    c)     Recruitment

    2.     The Select Committee noted that Adult Social Care Debt would be scrutinised within the draft budget.




    That the Committee reviews the attached forward work programme and its recommendations tracker, making suggestions for additions or amendments as appropriate.




    The next public meeting of the committee will be held on 4 December 2019 in the Aschombe Suite, County Hall.


    The Committee noted its next meeting would be held on 4 December 2019.