The Strategic Director for Adult Social Care will update the Committee on important news and announcements.
Minutes:
Witnesses:
Dave Sargeant, Strategic Director for Adult Social Care
Mel Few, Cabinet Member for Adult Social Care
Steve Cosser, Cabinet Associate for Adult Social Care
Cliff Bush, Chair, Surrey Coalition of Disabled People
Declarations of interest: None
Key points raised during the discussion
The Cabinet Member for Adult Social Care wished to update the Select Committee on a recent Cabinet decision. His update follows:
1. The Committee were informed that the Cabinet had approved a consultation on the future of six in-house residential care homes for older people in Surrey. It was acknowledged that there may be some tough decisions ahead. It was noted that that the care homes included in the consultation were under occupied and were not fit for purpose in the long term. It was highlighted that renovating the care homes would cost in the region of £60 million to make the structural changes required to bring the homes to the standard required for modern day residential care. The Committee was advised that all local Members in the areas where the homes are have been briefed on the process. Following the consultation, should there be a decision to close any of the care homes, the Committee was assured that residents would not be moved during the winter months so that their health was protected.
2. Members asked for clarification on the consultation process with the residents and requested assurances that this would be a transparent process. The Cabinet Member for Adult Social Care indicated that the consultation would be a fair and frank process to ensure that the views and opinions gathered were accurate. It was further highlighted that every effort would be made to gather the thoughts of the friends and families of those residing in the care homes. .
3. The Committee asked what the future might hold for staff working in these homes should, following the consultation, there be a decision to close any of them, and whether there were an opportunities for them to continue their employment elsewhere within Surrey County Council, alternatively the adult social care sector is an area which currently has a high demand for staff. .
4. The Cabinet Member was asked by the Committee whether it would be possible to amalgamate the residents into a few of the homes and close the remaining ones given that they are operating below capacity. The Cabinet Member stressed that the primary problem was with the condition of the homes and the fact that they will become unfit for purpose rather than it being an issue of having additional capacity. The Strategic Director highlighted that the care homes meet current regulatory standards but indicated that under the new CQC framework could be viewed as sub-standard by inspectors. The Committee was also advised that these homes had now stopped accepting permanent new admissions residents to relieve pressure on staff.
5. The Strategic Director (SD) informed the Committee that Surrey has now submitted its plans for the Better Care Fund (BCF). Members were advised that all partners had been involved in the process and that the council worked closely with the six CCGs to develop an innovative strategy for the delivery of adult health and social care services. The plans for BCF funding have been accepted with conditions based on further engagement with acute hospitals in Surrey.
6. The SD provided further information about the realignment of the Adult Social Care (ASC) Directorate. The SD highlighted that, to allow for closer collaboration and a more integrated approach to commissioning, the structure of ASC in Surrey had been amended to bring it in line with the number of Clinical Commissioning Groups (CCGs) operating in Surrey. The small caveat to this is that, while there are six CCGs in Surrey there are five Area Directors (AD) one of which will work with two CCGs. It was highlighted that the Directorate is currently working to disaggregate the county-wide commissioning function to the 6 CCG areas thereby amalgamating operational and commissioning functions. Staff affected by this exercise are now in the 30 day consultation process. The SD further advised that the realignment had saved the Directorate £500k in management costs.
7. Members expressed concern with the flow of information between the boards and committees scrutinising health and social care in Surrey and suggested that communication between Health and Wellbeing Board, Health Scrutiny Committee and Adult Social Care Select Committee should be encouraged especially given that they frequently consider similar issues. The SD commented that there is certainly an overlap between the work of these committees and suggested exploring how these priorities should be considered in the near future to ensure that they function most effectively The Chairman was advised that guidance on local authority health scrutiny clarifies the governance. It was agreed these would be circulated to each Member of the Committee.
8. The Committee highlighted the growing trend towards the integration of healthcare and adult social care and concerns were raised by Members about the potential loss of democratic accountability as integration deepens over time. The Chair of Surrey Coalition of Disabled People advised that his organisation was supportive of further integration but cautioned the Committee about the operation and leadership of an integrated care service for service users.
9. The SD advised that work on finding savings in the ASC Directorate’s budget was continuing. Particular attention was being paid to transition services in order to integrate these services more. It is hoped that, by ensuring that all services involved in transitions are integrated, savings can be made while providing a better, more –rounded service for users aged 0 to 25 years old. As such, the SD advised that, in conjunction with the Strategic Director for Children, Schools and Families, a piece of work has been commissioned which will explore how transition services can be more closely integrated and that they could learn from other authorities such as Kingston, Richmond and Suffolk who are doing similar work. The results of this project would be fed back to the Committee once it had been completed. Members asked whether there would be any opportunity for them to get involved in the piece of work to which the SD responded that he would very much welcome input on the project from Members of the Committee.
10. Members were advised by the SD that the guidance documents on the Care Act are forthcoming. Once this guidance has been received, further information and plans on the implementation of the Care Act will be shared with the Committee.
Recommendations:
· That the Committee is updated on the co-design process for a new 0-25 service.
Action points/ further information to be provided:
· The Chairman to distribute governance guidelines for the Health Scrutiny Committee to Members.
· Adult Social Care will share weekly updates on the preparations for the Care Act, following the publication of the guidance, in the Directorate's ‘e-brief’. If Members have specific information requests they can contact Tristram Gardner (Care Act Project Manager).
Committee next steps:
None