Agenda, decisions and minutes

To receive any apologies for absence.

Apologies were received from Councillors Graham Oates, Christine Lawrence, Rosemary Woods, Emily Pearlstone, Ben Fergusson, Tony Robbins and Hilary Bruce.

To approve the minutes from the previous meeting.

Resolved that the minutes of the Scrutiny Committee - Adults and Health held on 03 August 2023 be confirmed as a correct record.

Resolved that the minutes of the Scrutiny Committee - Adults and Health held on 03 August 2023 be confirmed as a correct record.

To receive and note any declarations of interests in respect of any matters included on the agenda for consideration at this meeting.

(The other registrable interests of Councillors of Somerset Council, arising from membership of City, Town or Parish Councils and other Local Authorities will automatically be recorded in the minutes: City, Town & Parish Twin Hatters - Somerset Councillors 2023 )

There were no new Declarations of Interest.

The Chair to advise the Committee of any items on which members of the public have requested to speak and advise those members of the public present of the details of the Council’s public participation scheme.

For those members of the public who have submitted any questions or statements, please note, a three minute time limit applies to each speaker and you will be asked to speak before Councillors debate the issue.

We are now live webcasting most of our committee meetings and you are welcome to view and listen to the discussion. The link to each webcast will be available on the meeting webpage, please see details under ‘click here to join online meeting’.

There were no public questions.

The Committee discussed the forward Work Programme and made the following amendments:-

·         Add and additional meeting in October as a joint meeting with Scrutiny Children and Families,

·         Include an update on Suicide Prevention in the December update on Mental Health Services response times,

·         Update on the Ambulance Service performance,

·         Consideration be given to moving the December meeting to Yeovil.

The Committee discussed the forward Work Programme and made the following amendments:-

·         Add and additional meeting in October as a joint meeting with Scrutiny Children and Families,

·         Include an update on Suicide Prevention in the December update on Mental Health Services response times,

·         Update on the Ambulance Service performance,

·         Consideration be given to moving the December meeting to Yeovil.

The Committee discussed the latest Adult Social Care budget report and noted the details. The Committee asked for details on what is covered by Statutory requirements and what aspects fell in to Discretionary and the interdependence of each.

The Committee received a budget report covering the period up to the end of June 2023 from the finance team. This showed an overspend of £12.1m, representing 6% of the overall budget. The pressure on the budget was attributed to higher costs, inflation and increasing demand. Mitigations in place were: -

•      Providers charging VAT

•      Medium Term Financial Planning – Review fees for 24/25

•      Reduce overreliance of bed placements

•      Reablement Service

•      Voids

•      Review high cost/complex placements – re Continuing Health Care/Joint Funding

•      Any additional funding from Integrated Care Board – System Solution

•      Review all interim placements – no longer commission

•      Effective use of Disabled Facilities Grant.

The Committee were also informed that the expected savings from the My Life, My Future programme were going to be £0.2m in the current year due to longer roll out than originally anticipated and will now be achieved in 2024/25.

The Committee discussed the report, asked for clarification around some of the mitigations and an explanation of some of the terminology; voids and Newton Europe.

The Committee asked if the high costs were attributed to out of area individuals, children and families or care packages not meeting current need. It was confirmed it was all three.

The Committee asked if they could be supplied with clear definitions of ‘statutory’ and ‘discretionary’  provision. Recognising the interdependencies of the two and the risk of not delivering discretionary support could led to higher statutory costs in the long term. This detail was promised.

Resolved:

The Committee discussed the latest Adult Social Care budget report and noted the details. The Committee asked for details on what is covered by Statutory requirements and what aspects fell in to Discretionary and the interdependence of each.

The Committee discussed the report on Recovering Access to Primary Care. The requested more detail on the Somerset position in relation to ‘hot spots’ and details of the Quality based KPI’s being used. The Committee asked for regular updates and details on the communications being used to ‘sell’ Somerset as a location  as this may inform other areas.

Sukeina Kassam and Luke Best from Somerset Integrated Care System gave a presentation on the local implementation of the national recovery plan Access to Primary Care. The plan seeks to address the significant downward trend in patient satisfaction since 2019/20 on two main elements: say day disposition and appointments within 14 days. The Committee heard about the vision for delivering quality responsive and effective primary care in Somerset. Tis plan was submitted to the Department of Health on 31^st July 2023. There were 12 key elements to the plan and these were set out in the published report pack for the Committee meeting.

The Committee welcomed the report and asked what was being done locally to both attract and retain experience GP’s as well s encouraging new GP’s to Somerset. More portfolio working, a campaign using the British medical Journal to extol the virtues of Somerset and the amenities it offers and greater use of part-time working to relieve the pressure. The Committee wanted to know about particular ‘hot spots’ and the age profile of the existing GP cohort. This information was not to hand but the Committee were promised it would be circulated.

Managing demand was discussed with emphasis on self-help and local community groups for particular conditions proving helpful in addressing some concerns.

The Committee asked about Quality Measure and Key Performance Indicators. The were also interested in when improvements could be expected. This Committee was informed that his current plan had a 1 year timescale but that the work would continue after that as demand is expected to continue at the current level.  The Committee were concerned to make clear that the digital solution my help some but was not necessarily the solution for all and overreliance should be avoided.

Resolved:

The Committee discussed the report on Recovering Access to Primary Care. The requested more detail on the Somerset position in relation to ‘hot spots’ and details of the Quality based KPI’s being used. The Committee asked for regular updates and details on the communications being used to ‘sell’ Somerset as a location as this may inform other areas.

The Committee considered the Safeguarding Adults Annual Report and thanks the new Chairman for the comprehensive detail. The Committee asked for the priorities for the forthcoming year and supported these. The Committee invited the Michael Preston-Shoot to attend the Joint meeting in October and indicated they would welcome some further training on Safeguarding Adults for all Councillors.

Michael Preston-Shoot was appointed Chair of the Board in January 2023 he presented the Annual Report of the Somerset Safeguarding Adults Board. The Somerset Safeguarding Adults Board (SAAB) is a statutory body established by the Care Act 2014. Is role is to provide assurance that local safeguarding arrangements are in place to prevent the neglect and abuse of adults.

The Board has three statutory functions: -

·         To develop and publish a strategic plan setting out how it will meet its objectives and how members will contribute to these,

·         To publish an annual report detailing how effective its work has been and finally,

·         To commission Safeguarding Adults Reviews (SAR’s( for any cases meeting the criteria.

The Committee heard that the highest percentage of risks and concerns over the last year have been adult males. This reflects the national findings.

The Committee asked Mr Preston-Shoot to list his top three priorities for the coming year.  He opted to list four:

·         Ensure the Board is effective and focus on hoarding and self-neglect,

·         Consider the transition from Children’s to adult services

·         Support the introduction of ‘Right Care, Right Person’,

·         Work closer with the ICB.

The Committee asked about the recent announcements regarding Police response to Mental Health cases and Mr Preston-Shoot made it clear tht the responsibilities of the police were clear and they still had a responsibility to safeguard ‘life and limb’ .

Resolved:

The Committee considered the Safeguarding Adults Annual Report and thanked the new Chairman for the comprehensive detail. The Committee asked for the priorities for the forthcoming year and supported these. The Committee invited the Michael Preston-Shoot to attend the Joint Scrutiny meeting in October and indicated they would welcome some further training on Safeguarding Adults for all Councillors.