Agenda and draft minutes

To receive any apologies for absence.

Apologies were received from Cllr Christine Lawrence (Cllr Frances Nicholson attending as substitute), Cllr Tony Robbins (Cllr Dawn Johnson attending as substitute), Cllr Emily Pearlstone (in attendance online) and Cllr Edric Hobbs.

To approve the minutes from the previous meeting.

Resolved that the minutes of the Scrutiny Committee – Adults and Health held on 27^th February 2025 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’.

No public questions were submitted.

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

There was a request for an item on the recently announced changes to NHS England and Integrated Care Boards (ICBs) and how that would impact the partnership work Somerset Council carries out with NHS Somerset. It was agreed that it would be appropriate for this to come later in the year once the ICB had more information to share.

There was a request for an update on the changes to Yeovil hospital. It was agreed that that would also be after the changes had had time to progress sufficiently.

Head of Finance Business Partnering, Christian Evans, gave a presentation on the Month 10 Budget Monitoring Position for 2024/25. He highlighted: that there was a forecast underspend of £4.266m, 1.8% of the total budget; the positive work on the Adult Social Care Operations budget as a result of the My Life, My Future transformation; the underspend in Mental Health services; that the underspend in Learning Disability services will result in a pressure in Commissioning as a proportion will be returned to the ICB; the impact of depletion of funds and the ongoing work to gather information around this; the Housing budget was included in the paper and is forecast to be on budget; the overspend in intermediate care.

There was a brief discussion clarifying the details of graphs and tables in the paper.

During the discussion, the following points were raised and responded to:

• We need to ensure that home care is working for people. Do we need to scrutinise this?
  • We can share stories of how it is working for people.
  • We have had our CQC notification and are currently submitting stories about how we are working really well.
  • Every care package is individually designed.
• Why are there no mitigations in the report?
  • Because we are reporting an underspend there is no need to mitigate.
• The number of people in all placements is increasing despite the work to keep people in their homes. What is the explanation for that?
  • Some of that is because of a growing demographic. Some of that is due to depleted funds where people have already moved into residential placements.
  • We are doing early help and preventative work to tackle the growing demographic.
• There are savings from permanent staffing budgets, can you explain this?
  • There are vacancies in Housing that are creating savings to offset the loss of grant funding and other funding sources.
  • Written response will be provided.
• Can you clarify the overspends in Housing Options and Housing Strategy?
  • Written response will be provided.
• What is being done to address the lower income and the lower staff numbers?
  • The housing team has been reorganised under the new structure.
  • There are vacancies in the team but we are addressing it.
  • We are one of the worst in the country for temporary accommodation.
  • There are challenges with ensuring affordable housing is prioritised, losing some to viability on new developments.
• Is viability a problem across the country?
  • Yes, we are trying to address it in Somerset.
  • Both smaller and bigger developments are losing affordable housing, it can be pushed out by other asks such as Section 106 agreements.
• We need an integrated approach with transport and affordable housing.
• New team, new structure, how many gaps are there in the new team? When are you likely to have recruited?
  • The team has all of its Heads of Service in place. There are vacancies but there is a recruitment plan, working with HR and communications.
• Concerned about older people who are not in suitable accommodation, need to think  ...  view the full minutes text for item 115.

Service Director – Adults Operations, Emily Fulbrook, gave a presentation (included as Annexe A to the minutes) explaining: the changes to the CQC assessment framework, the challenges of the new technology platform, and the care market quality in Somerset.

During the discussion, the following points were raised and responded to:

• With planning applications, is there a concern of providing the wrong types of bed provision or overproviding in some areas?
  • We can’t turn down planning applications on the basis of it not being needed.
  • We do have commissioners who talk to people thinking of setting up a care home to explain that there isn’t demand.
  • When people go into residential care too early they may need to pay for it for 5-10 years.
• Is there demand for dementia/Alzheimer’s care homes?
  • Yes. It can be high risk to support someone with advanced dementia living at home.
  • We have some block beds at the moment but they are not always where they need to be.
  • It can be difficult to monitor quality for people placed from out of county.
• There is a care home planned for Wellington that is not needed. We need more control over what kind of homes are built.
  • Shaping the market is important.
• We need to start the process of people living in affordable, accessible homes earlier, we need suitable accommodation for older people.
  • People do need to take some responsibility for it.
  • It is a big thing we want to get on the local plan, the local plan will be for the next 30-40 years. We want integrated accommodation for the population we have, an older population.
• Work needs to be done to bring back the welfare state, to make decisions if it will be care from the cradle to the grave. A large number of bungalows is not the answer. We need to influence government to get mixed developments.

The Chair thanked the presenters and concluded the discussion.

Senior Commissioning Officer, Sarah Codling, introduced the report. She was accompanied by Christine Brewer from the Carers Support Service that is commissioned through Community Council for Somerset. They explained: the work they do to support unpaid carers; legal rights for unpaid carers; the ‘no wrong door’ approach; the village agents and carers agents; the specialist mental health carers support service run by Somerset NHS Foundation Trust; Somerset’s Commitment to Carers; and Carers information day.

During the discussion, the following points were raised and responded to:

• What is the right approach for someone to get support?
  • Anyone can refer to an agent, they just need to have consent of the person being referred unless there is a safeguarding issue.
  • The majority of our referrals are self-referrals, followed by family, followed by GP
  • There are 23 carer groups across Somerset that may be good at persuading someone to come along and have an informal chat.
• Who funds respite care and what budget is there?
  • There are short breaks, a sitting service to give a carer a break. We are exploring the use for direct payments.
  • Not all care homes can offer respite provision. Not everyone wants to leave their home for respite.
  • For learning disabilities there is specific respite provision available.
  • If personal care is needed then there needs to be an assessment under the care act and it will be subject to funding thresholds.
  • If there is no personal care it can be handled differently, with different options.
• Where can people find information about it?
  • There are carers packs and we are working to improve them.
• Are there ways of supporting people within the workplace who can’t access support during working hours?
  • We have started working on this, making connections through the Chamber of Commerce.
  • We have done that internally within the Council, there is a monthly forum for unpaid carers.
  • There is an evening carer group in Bridgwater starting soon.
  • We also have a carers employment policy and try to provide support.
• We owe carers a debt of gratitude, it can be very challenging. Practical help is valuable for carers, having someone that understands.
• What about young carers, how does the transition work when they turn 18 and the definition of carer changes?
  • There is a team within Childrens who look at young carers. It is an area we are working on, meeting regularly.
  • There is funding specifically for young carers.
  • Don’t have an answer specifically on preparing for adulthood but we will take it back to the working group to talk about it more. 
• For a lot of unpaid carers, we want to support them to provide support. How do we do that?
  • We need to look at preventative approaches, which include respite and having contingency plans.
  • For example, what happens if the carer is admitted to hospital, planning ahead when life is calm to ensure things can swing into action.
• Is there support after providing end of life care?
  • Still happy to work with unpaid carers in that  ...  view the full minutes text for item 117.