Agenda and draft minutes

Adults and Health Select Committee - Friday, 10 May 2024 10.00 am

Contact: Sally Baker, Scrutiny Officer 

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Items
No. Item

10/24

APOLOGIES FOR ABSENCE AND SUBSTITUTIONS

    Purpose of the item: To report any apologies for absence and substitutions.

    Additional documents:

    Minutes:

    Apologies were received from Cllr Abby King and Cllr Michaela Martin. Cllr Dennis Booth attended virtually.

    .

     

11/24

MINUTES OF THE PREVIOUS MEETINGS: 7 MARCH 2024

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

    Additional documents:

    Minutes:

    The minutes were agreed as a true and accurate record.

     

12/24

DECLARATIONS OF INTEREST

    Purpose of the item: 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.

    Additional documents:

    Minutes:

    Cllr Trefor Hogg declared he was a community representative to Frimley Health. Cllr Carla Morson declared she had a close family member working in Frimley Park Hospital. Cllr Sinead Mooney declared she was a Council nominated governor for Surrey and Borders Partnership.

     

13/24

QUESTIONS AND PETITIONS pdf icon PDF 123 KB

    Purpose of the item: To receive any questions or petitions.

    NOTES:

    1.    The deadline for Members’ questions is 12:00pm four working days before the meeting (3 May 2024).

     

    2.    The deadline for public questions is seven days before the meeting (3 May 2024).

     

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

    Additional documents:

    Minutes:

    Key points raised during the discussion:

    1. Six public questions were received.

     

    1. A Member of the public asked a supplementary question on why the specific advice from NHS England (NHSE) regarding autism diagnosis was not taken on board. The Associate Director for Integrated Children’s Commissioning stated that the NHSE report was correct in the ambition it set out, and it was a national challenge to implement it. There was hope with the work set out in the report that Mindworks could, more clearly, join up with the ambitions of the NHSE report and meet the needs of Surrey’s population through support and an improved access to diagnosis.

     

14/24

MINDWORKS pdf icon PDF 802 KB

    Purpose of the item:

    1.    The Adult and Health Select Committee have asked for evidence and information on the system wide response to support the needs of Children and Young People (CYP) who may have Autism (ASD) or Attention Deficit Hyperactivity Disorder (ADHD), including details of the Neurodevelopmental (ND) diagnostic pathway provided by Mindworks.

    2.    Mindworks is an alliance of emotional wellbeing and mental health providers that includes Surrey and Borders NHS Partnership (SABP) as the NHS Trust, Tavistock and Portman leading on system change (i-Thrive in Surrey model described in Appendix 1) and 13 Voluntary and Community Sector (VCS) partners coming together under Surrey Wellbeing Partnership (SWP), of which three VCS partners also provide specific support in the ND pathway. SABP and third sector partners provide support and assessment for ASD and ADHD as part of the ND Pathway for children over six years of age.

    3.    This report provides an overview of the status of provision and performance. It acknowledges that providers of support are challenged in their ability to provide a comprehensive response as are schools and families, and that change is required within the context of; increased needs and demand, pressure on staff (including those in schools) and families and diminished financial resources across health, local government, and schools. 

    4.    The proposed cultural shift, described in the report, to a social model of support, requires action across the system and continued recognition that there remains considerable work still to be done in meeting the needs of CYP with Autism Spectrum Disorder (ASD) or ADHD. The work detailed within the ND Transformation Plan builds on that of the All-Age Autism Strategy, helping to provide a focus on specific areas for improvement through a needs-led ND pathway.

     

    Additional documents:

    Minutes:

    Witnesses:

    Sinead Mooney, Cabinet Member for Adult Social Care

    Clare Curran, Cabinet Member for Children and Families, Lifelong Learning

    Rachael Wardell, Executive Director – (CFLL)

    Suzanne Smith, Director of Commissioning for Transformation (CFLL)

    Trudy Pyatt, Assistant Director- Inclusion and Additional Needs (SCC)

    Kerry Clarke, Head of Emotional, Mental Health & Wellbeing Commissioning- Surrey Heartlands Health and Care Partnership (ICS)

    Harriet Derrett-Smith, Associate Director, Integrated Children’s Commissioning- Surrey Heartlands Health and Care Partnership (ICS)

    Graham Wareham, Chief Executive (SaBP)

    Professor Helen Rostill, Deputy Chief Executive and Director of Therapies Surrey and Borders Partnership Trust (SaBP)

    Justine Leonard, Director of Children and Young People’s (CYP) Services (SaBP)

    Ann Kenney, Independent Chair at Surrey Wellbeing Partnership

    Emma Ellis, Service Manager, National Autistic Society (NAS)

    Kerry Oakly, Head Teacher at Carrington School

    Alison Simister, SENCo

     

    Children, Families, Lifelong Learning and Culture Select Committee (CFLLC) Members:

    *Fiona Davidson

    *Jeremy Webster

    *Liz Townsend

    *Fiona White

    *Jonathan Essex

    rChris Townsend

     

    Key points raised during the discussion:

     

    1. The Chairman of the Adults and Health Select Committee (AHSC) introduced the Mindworks item and highlighted it was a joint scrutiny item in conjunction with Members of the Children, Families, Lifelong Learning and Culture Select Committee (CFLLC). The Associate Director for Integrated Children’s Commissioning introduced the Mindworks report.

     

    1. The Chairman of AHSC invited the Head Teacher of Carrington School to speak. The Head Teacher outlined that the school had a share of young people facing neurodevelopmental conditions, presenting with the need for Mindworks referrals. These children had difficulties accessing aspects of the curriculum and the social aspects of the school day. There was an increasing sensory need, such as requiring ear defenders and an amended timetable. Quieter spaces for young people also had to be found and as a new build school, this was not considered as part of the Department for Education (DfE) programme. The biggest challenge was getting Mindworks’ referrals through quickly to people that could provide the support, as schools did not necessarily have the skills to manage young people with neurodevelopmental need. Process changes to Mindworks was a challenge, with long lead times such as for consultations. The pausal of Mindworks referrals resulted in school backlogs and an increasing number of non-attenders, whose complex needs were not being managed. It was acknowledged this was now changing, with some referrals now coming through. The working hours of Mindworks’ telephone service was between 9am and 12pm which was during teaching hours, making it difficult to contact Mindworks. Parent’s felt frustrated with the system, which led to schools being looked upon to provide young people with the help needed, which impacted on the relationship between schools and parents. Staff felt challenged despite work undertaken with NurtureUK and using trauma-based approaches with young people. The Mindworks process was time consuming, which took time away from the young people.

     

    1. The Head Teacher of Carrington School wanted to see a greater ability to cope with the young people going through the Mindworks service. Mindworks’ work hours outside of the school day was a suggested  ...  view the full minutes text for item 14/24

15/24

ADULT SAFEGUARDING UPDATE pdf icon PDF 170 KB

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    Purpose of the item: To provide an update on adult social care performance for safeguarding adults.

    Additional documents:

    Minutes:

    Witnesses:

    Sinead Mooney, Cabinet Member for Adult Social Care

    Luke Addams, Interim Director, Practice, Assurance, and Safeguarding

    George Kouridis, Head Of Safeguarding

    Children, Families, Lifelong Learning and Culture Select Committee Members:

    Fiona Davidson, Chairman of CFLLC

     

    Key points raised during the discussion:

     

    1. The Interim Director for Practice, Assurance and Safeguarding introduced the report.

     

    1. The Chairman of AHSC asked what improvements were implemented to the Improvement Plan since Healthwatch Surrey’s reports, and how coordinated working amongst Integrated Care Boards (ICB) and Integrated Care Services (ICS) had improved the experience for families and carers. The Chairman also asked where the adult safeguarding team felt there were still issues. The Head of Safeguarding explained there was a series of individual cases highlighted in the Healthwatch reports that were noted by the adult safeguarding team. The main improvements were driven through the Safeguarding Improvement Plan. There was an existing Improvement Plan set up, in relation to preparations for CQC assessments, which was being updated for completion. A range of areas were being looked at such as how the volume of safeguarding enquiries was managed and the different trends across a range of areas.

     

    1. The Cabinet Member for Adult Social Care added that there was commitment within Adult Social Care to improve safeguarding practice, which was highlighted in the report, along with a focus on improving communication across agencies. Since the Healthwatch report was published, the Cabinet Member met with the Chief Executive of Healthwatch Surrey to discuss the report and understand how adult social care and Healthwatch Surrey could improve communications and outcomes for vulnerable residents.

     

    1. The Interim Director for Practice, Assurance, and Safeguarding explained that the senior director team met with Healthwatch Surrey. Data and case tracking audits were used to ensure understanding of the experiences in the Healthwatch report. At the Safeguarding Adults Board (SAB), system partners and health partners were worked with closely. The Executive Director of Adults Wellbeing and Health Partnerships met regularly with the Chief Nurse of Surrey Heartlands Health and Care Partnership. In terms of remaining safeguarding issues that needed addressing, there had been a risk-averse culture which led to significant volumes of safeguarding referrals. The Adult Safeguarding team wanted to shift to positive risk management, rather than risk averse. There was a risk enablement board to promote this proactive and positive approach to risk management within the Council’s Adult Safeguarding framework. The primary goal was to facilitate a practice culture shift toward risk enablement that focussed on wellbeing, managing risk effectively, and reducing unnecessary section 42 enquiries.

     

    1. The Chairman of CFLLC asked how poor communication was measured and improved amongst carers, NHS England, other organisations such social workers and between different family members that were often contacted at different times. The CFLLC Chairman also asked if there was a complaints process. The Interim Director for Practice, Assurance, and Safeguarding explained that the safeguarding team tried to engage more with users of the safeguarding service. There was a user survey, take-up of which had traditionally been low. The  ...  view the full minutes text for item 15/24

16/24

RECOMMENDATIONS TRACKER AND FORWARD WORK PROGRAMME pdf icon PDF 375 KB

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    Purpose of the item: For the Select Committee to review the attached recommendations tracker and forward work programme, making suggestions for additions or amendments as appropriate.

    Additional documents:

    Minutes:

    The Committee noted the recommendations tracker and forward work programme.

17/24

DATE OF THE NEXT MEETING

    The next public meeting of the committee will be held on 10 October 2024 at 10:00am.

    Additional documents:

    Minutes:

    The Committee noted its next meeting would be held on 10 October 2024.