Agenda and minutes

Adults and Health Select Committee - Tuesday, 14 July 2020 10.30 am

Venue: REMOTE MEETING

Contact: Ben Cullimore, Scrutiny Officer 

Note: Please note that due to the Covid-19 situation this meeting will take place remotely. 

Media

Items
No. Item

1.

APOLOGIES FOR ABSENCE AND SUBSTITUTIONS

    To receive any apologies for absence and substitutions.

    Additional documents:

    Minutes:

    None received.

2.

MINUTES OF THE PREVIOUS MEETINGS: 5 JUNE 2020 pdf icon PDF 156 KB

    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.

    Additional documents:

    Minutes:

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

3.

DECLARATIONS OF INTEREST

    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 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.

4.

QUESTIONS AND PETITIONS

    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

    Additional documents:

    Minutes:

    None received.

5.

ADULT SOCIAL CARE TRANSFORMATION UPDATE pdf icon PDF 794 KB

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    Purpose of the report: To receive an update on the progress of the Adult Social Care transformation programmes.

     

    Additional documents:

    Minutes:

    Witnesses:

    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:

    1. 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.
    2. 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.
    3. 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.
    4. 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.
    5. The Co-Chair of  ...  view the full minutes text for item 5.

6.

ACCOMMODATION WITH CARE AND SUPPORT PROGRAMME UPDATE pdf icon PDF 104 KB

    Purpose of the report: To review and scrutinise the ongoing Accommodation with Care and Support programme of work.

    Additional documents:

    Minutes:

    Witnesses:

    Mel Few, Cabinet Member for Resources

    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:

    1. 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.
    2. 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.
    3. Members expressed dissatisfaction with the late delivery of the reports to the Select Committee.
    4. 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.
    5. 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.
    6. The Chair of the IMHN noted that mental health had been omitted from the Equalities Impact Assessment (EIA), and  ...  view the full minutes text for item 6.

7.

EXCLUSION OF THE PUBLIC

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    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.

    Additional documents:

    Minutes:

    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.

8.

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.

 

9.

LEARNING DISABILITIES AND AUTISM SERVICE UPDATE pdf icon PDF 379 KB

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    Purpose of the report: To review and scrutinise plans for the new Learning Disabilities and Autism Service.

    Additional documents:

    Minutes:

    Witnesses:

    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:

    1. 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.
    2. The Assistant Director of Disabilities, Autism & Transition confirmed that the Valuing People Network included mental health representatives.
    3. 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.
    4. 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 9.

10.

RECOMMENDATIONS TRACKER AND FORWARD WORK PLAN pdf icon PDF 96 KB

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    Purpose of the report: To review the attached recommendations tracker and forward work programme, making suggestions for additions or amendments as appropriate.

     

    Additional documents:

    Minutes:

    Clare Curran returned to the meeting.

     

    Key points raised during the discussion:

    1. 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.

11.

DATE OF THE NEXT MEETING

    The next public meeting of the Select Committee will be held on 15 October 2020.

    Additional documents:

    Minutes:

    The next meeting of the Adults and Health Select Committee would be held on 15 October 2020 at 10:30am.