To
agree the minutes of the previous meeting of the Adults and Health
Select Committee held on 5 June 2020 as a true and accurate record
of proceedings.
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.
Cllr Clare Curran declared that she had an
interest in the Learning Disabilities
and Autism Service Update item, as she was Chairman and
Non-Executive Director of Surrey Choices. She would withdraw from
the meeting when that item was discussed.
Cllr Bernie Muir declared that she was a
patron of Mary Frances Trust.
Due
to the Covid-19 pandemic, all questions and petitions received will
be responded to in writing and will be contained within the minutes
of the meeting.
NOTES:
1.The deadline for Members’ questions is 12:00pm
four working days before the meeting (8 July
2020)
2.The deadline for public questions is seven days
before the meeting(7 July 2020)
3.The deadline for petitions was 14 days before the
meeting, and no petitions have been received
Karl Atreides, Chair,
Independent Mental Health Network
Jonathan Lillistone, Assistant
Director of Commissioning (Adult Social Care)
Nick Markwick, Co-Chair, Surrey
Coalition of Disabled People
Sinead Mooney, Cabinet Member
for Adults and Health
Kate Scribbins, Chief Executive
Officer, Healthwatch Surrey
Liz Uliasz, Deputy Director of
Adult Social Care
Simon White, Executive Director
of Adult Social Care
Patrick Wolter, Chief Executive
Officer, Mary Frances Trust
Ernest Mallett joined the meeting at 10:34am.
Key
points raised during the discussion:
Members enquired
whether the scope of the Market Management work mentioned in the
report included market frailty and the actions the Council would
take to prevent market failure. The Executive Director of Adult
Social Care (ASC) confirmed that it did include market frailty.
While Surrey County Council had a particular interest in protecting
parts of the care market with which it did business, it also had a
more general duty to ensure the care market in Surrey was
successful. Moreover, the Covid-19 pandemic had brought particular
challenges to the care market.
A Member noted that
in the report, Practice Improvement had been ‘RAG’
rated as amber/red, and expressed concern that this programme had
been slow in implementing the strengths-based approach. He asked
what impact that had had, including impact on the budget. The
Executive Director of ASC responded that the Council had been
taking steps on the strengths-based approach since 2018 and the
strengths-based approach was still central to its philosophy.
Unfortunately, the Covid-19 pandemic had had an impact on the
service and shifted the focus towards hospital discharges and
funding requirements, which had somewhat overshadowed the
strengths-based approach. The Deputy Director of ASC added that
training on the strengths-based approach had started again
virtually and tools for implementing the strengths-based approach
were being rolled out, so after the difficulty of the pandemic, the
approach was now back on track.
A Member asked for a
general update on care package reviews and queried whether the
reviews had resumed yet following the Covid-19 lockdown. The
Executive Director of ASC said that reviews were still taking place
and the most challenging area was Learning Disabilities (LD). The
Council was not reaching the level of savings from the review
process that it had anticipated; this may be because the reviews
were being conducted virtually.
A Member expressed
concern about the topic of rates of pay for domiciliary carers. He
asserted that some contractors paid one rate of pay for the time
spent caring and another for the time spent travelling between
clients, which could mean carers are paid below minimum wage. The
Executive Director of ASC responded that there was no evidence that
any of Surrey County Council’s contractors were using
different rates of pay to subvert the minimum wage. Moreover,
different businesses treated travel times differently. The
Assistant Director of Commissioning (ASC) added that the Council
was very clear from a commissioning perspective that providers were
expected to comply with legal obligations, and if they did not
comply, this would be investigated.
Steve Hook, Assistant Director
of Disabilities, Autism & Transition
Wil House, Strategic Finance
Business Partner (Adult Social Care and Public Health)
Jonathan Lillistone, Assistant
Director of Commissioning (Adult Social Care)
Sinead Mooney, Cabinet Member
for Adults and Health
Peter Walsh, Property Account
Manager for Adult Social Care
Key
points raised during the discussion:
The
Assistant Director of Commissioning (ASC) introduced the report. It
referred back to the October 2019 Cabinet report. The aim of the
programme was to create housing that increased independence for
residents and was more cost-effective.
The Cabinet
Member added that the Council was committed to the delivery of the
programme. She was aware of concerns around the pace of the
programme, but pacing would now be a priority and the programme
would be a consistent item on the Cabinet agenda and, she hoped, on
the Select Committee’s agenda too.
Members
expressed dissatisfaction with the late delivery of the reports to
the Select Committee.
A Member
expressed frustration at the slow pace of the programme and asked
what the reason was behind the delay, what the ongoing challenges
were, and how sure the Cabinet Member for Adults and Health was of
a successful process. The Cabinet Member for Adults and Health
expressed sympathy with Members’ concerns but said that the
three sites for accommodation with care and support had been
approved by Cabinet in October 2019, and her previous references to
issues with pace were from that date onwards only. A Member
acknowledged that the proposal had been approved by Cabinet in
October 2019, but said that there had been conversations between
Members and officers about the Pond Meadow site as long as three or
four years ago. The Assistant Director of Commissioning (ASC) added
that the focus since October 2019 had been on the Pond Meadow
tender and a number of other aspects: approaching the market,
structuring the lease, and linking that back into care and support.
It was important to note that the Covid-19 pandemic had been a
challenge for the Council and its partners; for example, the
Council had had to redeploy commissioning staff, which had had an
impact on progress. However, progress had been made since the end
of May 2020 and the Council would be in a position to launch the
Pond Meadow tender next week (week commencing 20 July 2020) and
award contracts in autumn 2020. Market engagement had suggested
that there was very much an appetite to bid for Pond Meadow. The
Assistant Director also assured Members that the accommodation
would be built in a way that was flexible and allowed the Council
to respond to changes in the model of care in the long
term.
The Cabinet
Member for Resources emphasised the progress that had been made in
recent months, thanks to the restructuring of the property team as
well as private property expertise.
That under Section 100(A) of
the Local Government Act 1972, the public be excluded from the
meeting during consideration of the following item of business on
the grounds that it involves the likely disclosure of exempt
information under the relevant paragraphs of Part 1 of Schedule 12A
of the Act.
It was agreed that the meeting would enter
confidential discussion of commercially sensitive information under
Part 2 of Section 100(A) of the Local Government Act
1972.
22/20
ACCOMMODATION WITH CARE AND SUPPORT PROGRAMME UPDATE
Purpose of the
report: To consider the Part 2 Cabinet report (attached as
a supplementary agenda).
Minutes:
Discussion of the Accommodation with Care and
Support Programme continued in Part 2. The recommendations were
agreed.
Marsha Moseley left
the meeting at 1:27pm.
Jeff Harris left
the meeting at 1:48pm.
Recommendations:
The Select Committee:
1.
Agrees that a report is formulated and submitted to Cabinet to
outline its view on the decision on the Change of Route to Market
for Two Extra Care Housing Sites and any related
recommendations;
2.
Asks for a follow-up report outlining plans for further sites for
Independent Living and Extra Care Housing.
Karl Atreides, Chair,
Independent Mental Health Network
Steve Hook, Assistant Director
of Disabilities, Autism & Transition
Jonathan Lillistone, Assistant
Director of Commissioning (Adult Social Care)
Nick Markwick, Co-Chair, Surrey
Coalition of Disabled People
Sinead Mooney, Cabinet Member
for Adults and Health
Kate Scribbins, Chief Executive
Officer, Healthwatch Surrey
Simon White, Executive Director
of Adult Social Care
Patrick Wolter, Chief Executive
Officer, Mary Frances Trust
Fiona White left the meeting at 1:56pm.
Clare Curran left the meeting for discussion of this
item.
Key
points raised during the discussion:
The CEO of
Healthwatch Surrey asked how effective the LD Partnership Board,
Autism Partnership Boards and Valuing People Network groups were at
engaging with residents and gathering a diverse cross section of
views. The Assistant Director of Disabilities, Autism &
Transition said that the Council was commissioning Voluntary Action
Surrey to work with the Council on its communications and
engagement plan. This piece of work would go out to the Valuing
People Network groups; however, because of the pandemic it had
moved more slowly than initially anticipated. There was also a
reference group and delivery group with some providers, and the
lead for that network was Maria Mills, the CEO of disabilities
organisation Active Prospects.
The Assistant
Director of Disabilities, Autism & Transition confirmed that
the Valuing People Network included mental health
representatives.
A Member highlighted
that the proportion of people with LD receiving annual health
checks was lower in Surrey than in many other parts of the country.
She emphasised the value of these checks but said that publicity
was poor, and suggested that the annual health check could be
included as part of the Education, Health and Care Plans that
people with LD already received in order to increase take-up of the
checks. Members emphasised the importance of publicising these
checks, both to encourage GPs to offer them and to encourage public
take-up. The Assistant Director of Disabilities, Autism &
Transition replied that the responsibility for annual health checks
lay with GP practices, who were paid for offering extra services
through the Direct Enhanced Service (DES) system. For example, GP
practices were given higher DES payments for offering appointment
slots longer than the usual 10 minutes to patients with LD. He
acknowledged that the health checks could make a significant
difference, and that there was room for improvement when it came to
Surrey’s performance on providing the checks. Therefore, the
Council had employed two health facilitation workers, who would
work with GPs to encourage, upskill and train them in order to
increase the number of people with LD and autism receiving health
checks every year. It was important to target people living at home
with their families or in supported living, for whom the rate of
uptake for health checks was particularly low.
A Member commented
that the report did not give a sense of dealing with the transition
from children’s to adults’ LD and autism services. The
Assistant Director of Disabilities, Autism & Transition
responded that ASC was working with colleagues in Special
Educational ...
view the full minutes text for item 23/20
Purpose
of the report:To review the attached
recommendations tracker and forward work programme, making
suggestions for additions or amendments as appropriate.
A Member observed
that in the recommendations tracker, there was a mention of the
level of the Public Health budget. It said that “the level of
activity for this service has been structured in accordance with
the overall reduction in funding of £9m by central
government”. However, the Member did not see this as a
sensible way to proceed, as the budget for the service should be
arranged to fit its activity level, not the other way around. The
Council’s Public Health service provided leadership and
information not only to the Council but also to partners. The
Council should be more mindful of this and set the Public Health
budget at a more optimal level. The Cabinet Member for Adults and
Health acknowledged the Member’s point and agreed to look
into this carefully at the next budget setting.
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