Agenda and minutes

Adults and Health Select Committee - Thursday, 17 December 2020 10.30 am

Venue: REMOTE MEETING

Contact: Ben Cullimore, Scrutiny Officer 

Media

Items
No. Item

1.

APOLOGIES FOR ABSENCE AND SUBSTITUTIONS

    Purpose of the item: To receive any apologies for absence.

    Additional documents:

    Minutes:

    Apologies were received from Bob Gardner, David Mansfield and Darryl Ratiram.

     

2.

MINUTES OF THE PREVIOUS MEETING: 15 OCTOBER 2020 pdf icon PDF 319 KB

    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 record of the meeting.

3.

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:

    Clare Curran declared a personal interest in item 5 (Scrutiny of 2021/22 Draft Budget and Medium-Term Financial Strategy to 2025/26) as a non-executive director of Surrey Choices.

4.

QUESTIONS AND PETITIONS

    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 (11 December 2020).

     

    2.    The deadline for public questions is seven days before the meeting(10 December 2020)

     

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

    Additional documents:

    Minutes:

    None received.

5.

SCRUTINY OF 2021/22 DRAFT BUDGET AND MEDIUM-TERM FINANCIAL STRATEGY TO 2025/26 pdf icon PDF 146 KB

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    Purpose of the item: To scrutinise the Draft Budget and Medium-Term Financial Strategy.

    Additional documents:

    Minutes:

    Witnesses:

    Anna D’Alessandro, Director of Corporate Finance

    Wil House, Strategic Finance Business Partner (Adult Social Care and Public Health)

    Ruth Hutchinson, Director of Public Health

    Jon Lillistone, Assistant Director of Commissioning (Adult Social Care)

    Sinead Mooney, Cabinet Member for Adults and Health

    Liz Uliasz, Deputy Director of Adult Social Care

    Simon White, Executive Director of Adult Social Care

    Rachel Wigley, Director of Financial Insight

     

    Key points raised during the discussion:

    1.    The Cabinet Member for Adults and Health introduced the report, stating that, while 2020 had been a difficult year due to the Covid-19 pandemic, the 2021/22 budget was one of stability. There were significant challenges in Adult Social Care (ASC). With regards to Public Health (PH), there was a particular need for increased attention on and funding for mental health.

     

    2.    The Director of Corporate Finance presented slides on the budget, stating that the report as presented to the Select Committee showed the draft budget as had been approved by Cabinet on 24 November 2020. The draft iteration had a gap of circa £18m. The Council expected a provisional settlement from central government today (17 December 2020), which would provide details of Surrey-specific funding, against the current £18m gap[1]. The Medium-Term Financial Strategy (MTFS) gave a longer-term view on budgetary implications for the Council. Estimates were indicative and were iterated every year, meaning that they were prone to change in future, and as the spending review released by central government this year was only a one-year spending review, it gave little certainty across the medium term. The Council had been informed by central government that they aimed for the Fair Funding Review (FFR) and business rates reset to take place when the pandemic had finished; therefore, it was estimated that these would take place in 2022/23.

     

    3.    A Member noted that there had been many statements from central government that Covid-19 costs would be met in full. Did the Director think that was correct, and was she confident it would continue? The Director of Corporate Finance responded that the only information the Council had received on Covid-19 funding in 2021 was that £1.5bn of spending review funding would be allocated across all costs nationally next year. Surrey County Council did not know yet what proportion of that it would get, and it wouldn’t know this until the provisional settlement was released. As at December 2020, Surrey County Council had a surplus of circa £10m that it could use to cover Covid-19 costs for 2020/21 or to carry over any surplus into 2021/22. However, the Council had no guarantee that its Covid-19 costs would be met in full in 2021/22.

     

    4.    The Strategic Finance Business Partner presented slides on the draft ASC budget, which forecast a gap of £5m; it was anticipated that this £5m gap would be closed with the provisional settlement, as a proportion of the circa £18m gap to close. Looking ahead, an increased spending requirement of £75m was anticipated, leading to a gap of  ...  view the full minutes text for item 5.

6.

ADULT SOCIAL CARE COMPLAINTS

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    Additional documents:

6a

ASC COMPLAINTS APRIL - SEPTEMBER 2020 pdf icon PDF 471 KB

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    Purpose of the item: The report provides a detailed summary of complaint activity in Adult Social Care for the period April – September 2020.

    Additional documents:

    Minutes:

    Witnesses:

    Sinead Mooney, Cabinet Member for Adults and Health

    Kathryn Pyper, Senior Programme Manager (Adult Social Care)

    Liz Uliasz, Deputy Director of Adult Social Care

     

    Key points raised during the discussion:

    1.    The Deputy Director of Adult Social Care (ASC) introduced the report and stated that the ASC service welcomed all feedback, whether that was complaints or compliments. It took complaints seriously and aimed to resolve them in a timely way.

     

    2.    The Senior Programme Manager presented slides and detailed that there was a statutory timescale of three working days to acknowledge complaints, and a statutory obligation to respond to them in a timescale that was reasonable and less than six months. Surrey County Council’s ASC service had adopted its own timescale of 20 working days for responding to complaints. Sometimes it was necessary to extend this, but the Council always kept the complainant updated. If dissatisfied, complainants had the right to go to the ombudsman.

     

    3.    Showing a slide detailing the number of complaints received in the period from April to September 2020, the Senior Programme Manager explained that while the 22 complaints received in learning disabilities and autism (LD&A) was larger than the number of complaints received in other areas, it was proportional to the caseload the LD&A service accounted for. The Deputy Director added that LD&A was a county-wide service, while others were largely area based. She also explained that timelag was the reason why there were seven complaints received for the Guildford area, but ten complaints responded to.

     

    4.    The Senior Programme Manager continued to state that as part of the new complaints management system, quarterly meetings were held with the commissioning and quality assurance teams, and a summary of complaints for each area and learning was provided to members of the leadership team each month. Key learning areas for April to September 2020 were better communication, timely assessments and reviews, effective record keeping and improving the quality of the service and staff practice. Furthermore, the complaints teams were supported and trained across ASC. Finally, a leaflet called Listening to Your Views had recently been updated.

     

    5.    A Member requested more detail on complaints resolved outside the complaints process, as mentioned in the report. The Senior Programme Manager said that this meant where a complaint was raised in the first place, but the ASC service had spoken to the resident, resolved the issue and found a solution the resident was happy with, without going through a full complaints procedure. Nonetheless, this sort of process was still recorded.

     

    6.    A Member enquired how the service was explaining complaint pathways to residents, apart from the Listening to Your Views leaflet. The Deputy Director replied that there was information on the Council’s website and that, if a resident was unhappy with the care received, ASC staff would advise them of their right to make a complaint.

     

    7.    A Member noted that needs assessments were the reason behind a large proportion of complaints. Why were people dissatisfied  ...  view the full minutes text for item 6a

6b

HEALTHWATCH SURREY - WHAT ARE WE HEARING ABOUT ADULT SOCIAL CARE? pdf icon PDF 1 MB

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    Purpose of the item: The report provides an overview of feedback about Adult Social Care received by Healthwatch Surrey through its engagement with residents and targeted project work.

    Additional documents:

    Minutes:

    Witnesses:

    Sinead Mooney, Cabinet Member for Adults and Health

    Katharine Newman, Intelligence Officer, Healthwatch Surrey

    Kate Scribbins, Chief Executive, Healthwatch Surrey

    Liz Uliasz, Deputy Director of Adult Social Care

     

    Fiona White left the meeting at 13:06.

     

    Key points raised during the discussion:

    1.    The Chief Executive of Healthwatch Surrey outlined that Healthwatch conducted Adult Social Care (ASC)-specific engagement, which would usually involve entering care homes and talking to residents (using Enter and View powers), as well as agenda-free engagement carried out in high-footfall areas, but because of Covid-19, Healthwatch was currently quite reliant on residents approaching Healthwatch themselves to give feedback. The Chief Executive of Healthwatch Surrey met quarterly with the Surrey County Council Deputy Director of ASC to share findings. Most of what Healthwatch heard was feedback rather than complaints; Healthwatch largely heard the sub-complaint level of feedback, whereby a resident might not want to make a formal complaint. The organisation recognised that hearing more complaints was a good thing, as it showed effective engagement, and believed in the importance of encouraging residents to give feedback and to complain. There were reasons why some residents did not feel able to speak up. Furthermore, Healthwatch had the ability (via the Independent Health Complaints advocacy service) to support residents to register complaints with the NHS, but this service did not exist for ASC.

     

    2.    A Member asked what the thresholds were for advocacy when registering a complaint about ASC. The Deputy Director of ASC stated that under the care act, people had to have a specific need for advocacy in order to receive it.

     

    3.    The Co-Chair of the Surrey Coalition of Disabled People remarked that obtaining advocacy was difficult and had become more so since the service was last procured. He also expressed concern that a lot of issues went unheard as they were either anecdotal and not quite complaints, or residents were reluctant to raise a complaint for fear of experiencing retribution or not being listened to. There was lack of trust in care managers among some residents. The Cabinet Member for Adults and Health agreed with the Co-Chair that the notion that residents felt afraid to complain was concerning, and emphasised that the service worked well and residents should not feel as though they have to hold back from complaining. Hearing vulnerable residents’ voices was important, as they helped shape the service going forward. The Cabinet Member suggested looking into introducing care navigators, a person-centric contact who could help signpost residents. This would help alleviate people’s fear and reduce failure in the system. It could be an integrated service, developed in partnership with third sector organisations. The Select Committee was in agreement with this suggestion.

     

     

    Action/further information to be provided:

    1.    The Cabinet Member for Adults and Health is to keep the Select Committee updated on the progress made regarding the possible introduction of a care navigators system.

7.

RESPONSES TO RECOMMENDATIONS MADE BY THE ADULTS AND HEALTH SELECT COMMITTEE pdf icon PDF 126 KB

    Purpose of the item: To outline responses received from Cabinet; the Children, Families, Lifelong Learning and Culture Select Committee; Frimley Health and Care ICS; Surrey and Borders Partnership NHS Foundation Trust; and Surrey Heartlands ICS to recommendations made by the Mental Health Task Group and endorsed by the Adults and Health Select Committee at its public meeting on 15 October 2020.

    Additional documents:

    Minutes:

    Witnesses:

    Sinead Mooney, Cabinet Member for Adults and Health

     

    Key points raised during the discussion:

    1.    The Chairman of the Select Committee set out the progress made on the recommendations of the Mental Health Task Group since they had been endorsed by the Select Committee at its October 2020 meeting. Since then, meetings had been conducted with officers and with the Cabinet Member for Adults and Health, to ensure the recommendations were put into effect.

     

    2.    The Chairman of the Mental Health Task Group updated the Select Committee on the following points:

    a.    The Task Group had asked for confirmation as to how the £2.3bn mental health funding provided nationally a few years previously was spent, and would keep the Select Committee updated on this.

    b.    The Task Group had discussed at length its concerns regarding the Abraham Cowley Unit at St Peter’s Hospital with Surrey and Borders Partnership NHS Trust.

    c.    It was important that the Task Group liaised with the Children, Families, Lifelong Learning and Culture Select Committee with regards to transition arrangements.

     

    3.    A Member praised the work of the Mental Health Task Group and suggested that a Task Group on health inequalities be convened at some point in the future, incorporating issues such as perceived ease of access to services in deprived areas.

     

    4.    The Chairman of the Select Committee informed Members that further progress on the Mental Health Task Group recommendations would be reported on at the 3 March 2021 meeting of the Select Committee.

     

    5.    The Cabinet Member for Adults and Health expressed her support for the recommendations of the Mental Health Task Group.

8.

APPOINTMENT OF A NAMED SUBSTITUTE TO SOUTH WEST LONDON AND SURREY JHOSC pdf icon PDF 118 KB

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    Purpose of the item: To appoint a named substitute for the South West London and Surrey Joint Health Overview and Scrutiny Committee.

    Additional documents:

    Minutes:

    It was agreed that Bernie Muir would be the named substitute on the Joint Health Overview and Scrutiny Committee.

9.

RECOMMENDATIONS TRACKER AND FORWARD WORK PROGRAMME pdf icon PDF 24 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 Select Committee noted the Recommendations Tracker and the Forward Work Programme.

10.

DATE OF THE NEXT MEETING

    The next public meeting of the committee will be held on 19 January 2021.

    Additional documents:

    Minutes:

    The next meeting of the Adults and Health Select Committee would be held on 19 January 2021.