Items
No. |
Item |
81. |
Apologies for Absence
To receive any
apologies for absence.
Minutes:
Apologies were received from
Cllr Ben Ferguson and Cllr Andrew Govier.
Cllr Christine Lawrence was
in attendance online.
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82. |
Minutes of Previous Meeting 15 August 2024 PDF 157 KB
To approve the
minutes from the previous meeting.
Minutes:
Subject to an amendment
regarding Cllr Claire Sully’s apologies, not included in the
minutes, the committee resolved that the minutes of the Scrutiny
Committee - Adults and Health held on 15th August 2024
be confirmed as a correct record.
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83. |
Declarations of Interest
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 )
Minutes:
There were no new declarations of interest
received.
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84. |
Public Question Time
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’.
Minutes:
No public questions were received.
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85. |
Work Programme PDF 70 KB
To discuss the work
programme.
To
assist the discussion, the following documents are
attached:-
(a) The Committee’s work programme
(b) The Committee’s outcome tracker
Please
use the following links to view the latest Somerset Council Forward
Plans and Executive Forward Plan of planned key decisions that have
been published on the Council’s website:
Somerset Council Forward
Plans
Somerset Council Executive Forward
Plan
Additional documents:
Minutes:
There was a request for an update on the
Dentistry item heard at last year’s Joint Scrutiny Committee
with Children and Families, as well as a briefing on pathways into
accessing adult social care. There was also a request for an item
on CQC inspections and how that impacts our Adults Services.
|
86. |
Budget Monitoring Report PDF 323 KB
Additional documents:
Minutes:
Mel Lock, Executive Director of Adult Social
Care, presented this report. She highlighted the current underspend
of £2.1m, with particular underspends in residential and
nursing beds for over 65s and learning disabilities, and the
savings accounted for in the Medium Term Financial Plan have been
achieved or are currently on track.
During the discussion, the following points
were raised and responded to:-
- What does the underspend mean for
the budget?
- At this time of year it is very good
to have an underspend when we don’t know what the winter
holds.
- If we finish the year with an
underspend, will that be carried forward into the next financial
year?
- The budget is reset every year. We
are predicting a £34m in ASC need next year. The budget is
also dependent on living wage, which we won’t know until
30th October.
- Great to see the progress on budgets
and finance
- Some savings seem to clash with the
My Life, My Future programme, e.g. Learning Disability Supporting
Employment Service is getting less money but doing more. Can you
talk through that?
- We are continuing to deliver the
service but looking at alternative funding, government funding
coming in via other areas for employment. Outcomes achieved are as
good if not slightly better.
- What about the floating dementia
support? Has that had a negative impact?
- The organisation that was delivering
felt that wasn’t the right service. We are looking at
Alzheimer’s Society and what they can do, how we can
commission and work with partners to support us. Every cut has an
impact, it is about cutting the right things. Health colleagues
have enhanced their Intensive Dementia Support (IDS) service.
- The focus should be on prevention
- We are still working on the
prevention agenda, with NHS Colleagues at the health and wellbeing
conference. We are talking about housing, houses that keep people
healthy for longer and they can stay for longer. We are working
more in partnership and making sure we get the best use of the NHS
money available.
- Do we have a plan for need
increasing, what the next five years look like?
- We do have projections, they are
that life expectancies will decrease rather than increase, and we
are keeping people fitter and at home for longer in their 60s and
70s.
- Can you clarify the figures on the
bottom line of the savings spreadsheet? They don’t add up.
- We are overachieving on the savings.
There other aspect is fees and charging. The money has been
profiled from the Newton programme.
The Chair thanked officers for the
presentation and the Committee noted the report.
|
87. |
My Life My Future PDF 138 KB
Additional documents:
Minutes:
Mel Lock, Executive Director of Adult Social
Care, presented on this topic. She highlighted the work Newton have
done and that they are slowly decreasing the support they are
providing, that the transformation is on track to deliver
£10m savings and a minimum of £10m year on year savings
with additional expected, that they have improved reablement
services and supported people to become more independent and stay
in their home longer, as well as support for young people in
transition and the progression model. The results of the work were
shown in the staff survey where staff now agree their work makes a
difference to the life of people in Somerset.
During the discussion, the following points
were raised and responded to:-
- If Newton have been working with our
staff, how is it going to be impacted by redundancy programme?
- We are having to make cuts to our
staffing, we are also looking at technology that can aid us. We are
looking at all sorts of ways to do this as the council goes through
‘rightsizing’ to balance our budget. We can’t say
that there will be no impact, we will have to change.
- What steps are we taking to ensure
the necessary corporate support from digital and IT teams are still
in place? It’s clear this is delivering results.
- We can’t discuss the wider
council restructure today. Newton have a good tool around
sustainability, they will not leave us until we are all at silver
sustainability, some will be at gold. Newton will review every 3
months and if things aren’t working they will come back. This
sustainability matrix is working well. We have been able to upskill
other parts of the services and other parts of the council.
Downsizing the organisation will inevitably have an impact.
- Pathway 1 – Discharge from
hospitals – aware of issues from other councillors, and want
to ensure that our staff is knowledgeable on what is up to patients
and that they can go home.
- This isn’t just about us in
Adult Social Care – health staff are also involved in this. A
multi-agency team prescribes to individuals. There needs to be a
cultural shift and the hospitals are aware of this, Peter Lewis
(CEO – NHS Somerset Foundation Trust) is working to help
cultural change happen ward by ward.
- Is there anything we can do to
pressure the Integrated Care Board (ICB) to do this properly?
- We can do our best to influence but
we can’t change behaviour. We have a joint post starting with
us that will be linked with the hospital to look at this. Nowhere
has cracked it totally, the whole system has recognised the need
for behavioural change.
- Should we as a committee be writing
to the ICB and central government to stress this point?
- Yes, we will take that away.
- I would like to see examples of how
this transformation is improving the lives of people in Somerset?
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88. |
ASC (Adult Social Care) Performance and Assurance Report PDF 110 KB
Additional documents:
Minutes:
Jon Padfield, Service Manager – Policy,
Performance and Assurance – Adult Social Care, presented the
report. He highlighted the data around front door demand for ASC,
overdue care act assessments and reviews, unmet care home needs,
CQC inspection outcomes, care provider contract
‘handbacks’, intermediate care flow, and stakeholder
feedback.
During the discussion, the following points
were raised and responded to:-
- We are currently awaiting a CQC
assessment as a local authority, is that likely to be long?
- We don’t know when exactly
– but they have already done several in the South West and
North Somerset is going to be done at Christmas. We are hoping we
will get notification soon. We are ready for it.
- Would be very interested to hear
more about the staff survey?
- This was a council wide staff survey
– a temperature check of staff morale. There was some
analysis in the report about how ASC compares to the wider council.
There were real positives in terms of staff being proud to work for
ASC. Plan is that corporately there will be a follow-up staff
survey in the spring.
- Really good to see improvements in
unmet need and care provider contract ‘handbacks’. Was
there a post-covid effect in that?
- There are several factors – we
have supported international recruitment for homecare. If we can
get the career pathway right we will see more coming in.
- CQC inspection outcomes – how
recent are those inspections? Failings have been pointed out at
CQC, how much does that apply to us and our providers? Can we
include information on how valid/recent inspections are?
- We know that CQC hasn’t
necessarily gone back to those that required improvement, so they
asked us for a list of those to come back to. Because we do quality
audits we have sent a list of those we think have improved –
because it is impacting their business.
- For international recruitment, are
we making best use of the people brought in? Are many overqualified
and do we monitor that?
- No – people come because they
want to do the role and are managed by the organisation that
sponsors them. We do have international recruits in social workers,
we help them continue to grow their careers in Somerset.
- The higher risk for us is that they
go to the NHS who can pay them more.
- For practice quality audits (page
45) – we are amber on three of those. Concerned about
communication between parties regarding personal budgets and mental
capacity act assessments. What steps are we taking?
- These findings are reported to our
practice quality board. In the three that are amber, the
predominant factor was that there wasn’t clear evidence
– so the theme is around case recording. This week is our
‘Carnival of Practice’, a learning and development
week. One of those elements is case recordings.
- MCA is addressed in the safeguarding
report, 85% is very good and we are doing work around
communication. Anything that is amber we have a plan for
...
view the full minutes text for item 88.
|
89. |
Safeguarding Adults Annual Report PDF 1 MB
Additional documents:
Minutes:
During this item Cllr Gill Slocombe had to
leave so Cllr Claire Sully acted as Chair of the committee.
Professor Michael Preston-Shoot, Independent
Chair of Somerset Safeguarding Adults Board, presented this report.
He explained: the statutory duties the board holds; the
multi-agency work with statutory partners; the work relating to
preparing for CQC assurance and undertaking mental capacity audits;
the concerns around self-neglect, homelessness and placement
reviews.
During the discussion, the following points
were raised and responded to:-
- Can the committee have a closer look
at homelessness?
- There is ongoing outreach to rough
sleepers that is successful. The Lead Member for Adults Services is
now also portfolio holder for housing and homelessness so can work
on this.
- Shared data is very important.
- Concerned about board attendance
– no attendance from the voluntary sector or SWAST. What is
the reason?
- For SWAST there have been issues
with other Boards in the South West, they have undertaken a
management review and additional resources have been injected so
there is now a named representative. We hope that this will improve
SWAST representation.
- We are aware there is more to do
with third sector and faith communities. It is on the agenda to
reach out to community organisations including faith
organisations.
- Would also like to see
representation of someone who used the service.
- This is a priority – we have
had case presentations delivered by practitioners about what people
with lived experience have told services, but it is not the same.
There is more to do.
- For location of abuse, surprised by
the percentage taking place in service providers. More information
would be helpful
- There are examples of this in
Somerset, e.g. the Mendip House Safeguarding Adults Review (SAR)
and an ongoing SAR where we are concerned about neglect and acts of
omission.
- Some of the abuse is systemic and
organisational rather than due to individual practitioners.
- There is also a need to be aware of
abuse in own homes by care providers.
- For the ethnicity data, is this in
line with our population or are there communities that we do not
hear about?
- Yes, this is a national issue. The
vast majority of safeguarding is a response to White British and
White Irish individuals. There is an underrepresentation of
safeguarding in relation to Black British, Black African, and Black
Caribbean communities. We need to look at how our services are
perceived by people of different cultures and whether we are
culturally aware and culturally informed and our offer is
culturally appropriate.
- It’s important to prioritise
community engagement and listening to those with lived experience.
Some of the finds in the report are shocking – safeguarding
is everyone’s business.
- Service providers covers a wide
range, it would be useful to know what kind of service provider.
- Abuse and neglect within residential
nursing is something SARs have recognised nationally. There is a
national review for this on the LGA website. The percentage of
abuse or neglect in Somerset is very similar to what we know
...
view the full minutes text for item 89.
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90. |
Item for Information: Forthcoming Key Decisions PDF 46 KB
To note the forthcoming Key Decisions relating
to Adults Services in the Executive Forward Plan.
Minutes:
The committee noted the upcoming key
decisions.
During the discussion, the following points
were raised and responded to:-
- Specialist Dementia Block Beds
– will these be coming to the committee?
- No, but it will be circulated.
- What is the Advocacy Service?
- Previously this was SWAN
advocacy.
- Why do some key decisions come to
scrutiny and not others?
- A written answer will be
provided.
- Would request more information
regarding the CQC.
- A response will be provided outside
of the meeting.
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