Agenda, decisions and minutes

Apologies were received from Councillors Connolly, Randall and Sharps.  Councillor Julie Davenport attended as a substitute for Councillor Sharps.

Members are asked to declare any interest and the nature of that interest which they may have in any of the items under consideration at this meeting.

There were no declarations of interest.

To receive notification of requests from members of the public to address the meeting on an item on the public part of the agenda.

There were no requests from members of the public to address the meeting.

To confirm the Minutes of the meeting of the Committee held on 21 September 2021.

RESOLVED that: the People Overview and Scrutiny Committee agreed the minutes of the People Overview and Scrutiny Committee meeting on 21 September 2021.

Councillor Roberts highlighted that at the previous meeting the Committee had recommended that minutes should attribute comments to individual councillors in future. She had since been advised that this would not be implemented because it was not in line with the style that West Northamptonshire Council (WNC) would be using for minutes.  Councillor Roberts asked for it to be noted that she disagreed with this approach.

RESOLVED that: the People Overview and Scrutiny Committee agreed the minutes of the People Overview and Scrutiny Committee meeting on 21 September 2021.

To receive any communications from the Chair.

The Chair advised that she had continued to build links with key partners relevant to the remit of the Committee and had recently met with Naomi Eisenstadt, the Independent Chair of the Northamptonshire Health and Care Partnership and prospective Chair of the new Integrated Care Board.  Ms Eisenstadt had an extensive background of work on child poverty, which could be very useful to the Committee’s anti-poverty work.

The Chair thanked Councillor Cooper, the Vice-Chair, for chairing the previous Committee meeting in her absence.

To consider an update on performance and trends in the residential and nursing care sector in West Northamptonshire.

RESOLVED that: the People Overview and Scrutiny Committee:

a)     Agreed to write to the Leader of the Council and the Cabinet Member for Adult Care, Wellbeing and Health Integration supporting representations to the government concerning the need for adult social care to be funded at a level that recognises current pressures on services.

b)     Requested to be provided with a geographical breakdown of the care homes in West Northamptonshire subject to performance improvement plans or contract terminations in 2021/22.

c)     Requested to be provided with further information on the number of care home contract defaults and terminations in West Northamptonshire’s neighbouring authorities. 

d)     Requested that the further information to be provided to the Committee on Disabled Facilities Grant utilisation be circulated to Committee members as soon as it is available.

The Executive Director – Adults, Communities and Wellbeing introduced the agenda item and highlighted the following contextual points:

·         Mandatory COVID-19 vaccination for care home staff from 11 November 2021 increased recruitment and retention challenges in the care sector.  This requirement was due to be extended further to all services subject to inspection by the Care Quality Commission (CQC) from 1April 2022.

·         Vacancy levels in West Northamptonshire care homes were quite low.  However, there was a challenge in how data on this was captured.  Care homes were required to complete a national tracker, which reported vacancies but not the reasons for them.  This could lead acute care colleagues to question why delayed transfers of care occurred when there were apparently vacant care beds in the area.

·         There was a continuing need to lobby the government for a better settlement for adult social care, which would support recruitment and retention.

·         WNC needed to consider potential future scenarios that could arise from pressures on the care sector, given that service users could look to WNC as a provider of last resort.

The Assistant Director – Commissioning and Performance presented the report and gave an overview of current performance and trends relating to residential care provision in West Northamptonshire, highlighting the following points:

·         The profile of performance ratings for care homes took into account that the CQC had not been able to carry out inspection visits during the pandemic and was now working on a risk-led basis.

·         Comparisons of performance with neighboring authorities showed that WNC was not where it wanted to be but was broadly comparable with those authorities.

·         WNC had terminated seven contracts with providers in 2019 and two in 2020, reflecting that fewer monitoring visits were possible during the pandemic.  There had been five terminations so far in 2021.  This was due both to the situation of care homes after the pandemic and an increase in WNC monitoring capacity.

·         Approximately 60% of WNC’s contracted providers had been subject to recent assurance visits.  WNC was committed to reaching 100% by 31 March 2022.  Additional resources had been employed to support providers and to sustain performance improvement.

·         Four contracts had been terminated since July 2021 due to the quality of care.  WNC aimed to work with providers to ensure effective care and did not take this decision lightly.  However, the ultimate priority was to keep residents safe.

·         There were 16 providers currently subject to improvement plans, who were receiving additional support.

·         The current overall position regarding occupancy and declared vacancies in residential care homes for older people suggested that providers were declaring fewer unused beds or that some providers were ceasing to operate.  Providers were reporting concerns about accepting placements that WNC needed to make, due to pressures on staffing. 

·         WNC had worked with care homes following the announcement of mandatory vaccinations to support them in meeting this requirement and to mitigate associated risks as far as possible.  As of 1 November 2021, 96% of care home staff had received one vaccination  ...  view the full minutes text for item 26.

To scrutinise outcomes from the implementation of the Adult Social Care Target Operating Model (TOM).

RESOLVED that: the People Overview and Scrutiny Committee:

a)    Recorded its thanks to staff involved in the successful implementation of the Adult Social Care Target Operating Model.

b)    Requested to be provided with aligned data for the outcomes produced by the Adult Social Care Target Operating Model in the periods before and after vesting day for the new Northamptonshire authorities.

The Assistant Director – Safeguarding and Wellbeing presented the report, which gave an overview of the aims, development and implementation of the Adult Social Care Target Operating Model (TOM).  The TOM had been introduced and funded by Northamptonshire County Council (NCC).  It had now been operating for 13 months and it was important to review that it was achieving its purpose.  The Assistant Director highlighted the following points:

·         The need to develop a new approach had been informed by feedback from service users that the previous service model was not clear to them, involved too many different contacts and not enough coordination between organisations providing services.

·         Diagnostic work had made clear the proportion of time that practitioners were spending outside of contacts with service users and their families, which added to the need for a different approach.

·         Newton Europe had provided expert support for the development of the new TOM.  The fact that they were also now supporting the Integrated Care across Northamptonshire (iCAN) programme gave continuity.

·         The design of the new TOM had been led by practitioners and had included work with Northamptonshire Healthwatch on service users’ views.

·         New care pathways had operated from 19 October 2020 using the footprint for the unitary authorities.  Services were linked in to local communities, used the ‘three conversations’ approach and supported a more flexible, outcome-focussed response to service users’ needs.

·         The TOM was delivering clear benefits in terms of outcomes for service users.  It was ahead of target on financial delivery in all areas, which was assisting WNC to manage current demand on services.  The iCAN programme would further build on this progress.

·         WNC would continue to develop its service offer using a place-based model to deliver positive outcomes for service users and staff and that left flexibility for partnership working.  The next phase of development would focus on linking in to wider issues around housing and communities and the Integrated Care System. 

The Committee considered the report and members raised the following points:

·         It appeared that one of the challenges in getting appropriate care in a timely manner was the need for occupational therapy (OT) assessment.  Could this be carried out in a different way?

·         Where did the voluntary and community sector (VCS) fit into the model for care provision?  Age UK had lost staff at Northampton General Hospital due to the termination of a previous NCC contract.  There seemed to be a better position at Kettering General Hospital.

·         How did WNC deal with the implications of people being discharged from hospitals in neighbouring areas into the authority?

·         How could WNC ensure that support was in place before people reached the point of being unable to cope, particularly if this resulted in them feeling unable to engage with reablement support?

·         The reported performance outcomes for the TOM pre- and post-vesting day did not align.  It would be helpful to have further information that would enable a better comparison to be made.

·         What risk to WNC would result if  ...  view the full minutes text for item 27.

To consider carried motions relevant to the Committee’s remit, provide comment and consider whether to add details to the Work Programme for 2021/22.

RESOLVED that: the People Overview and Scrutiny Committee:

a)    Agreed that no further action is necessary on those motions within its remit where it has been identified that the matter is already closed, as indicated by notes included in the report.

b)    Agreed that the Committee is not in a position to identify that other motions within its remit are closed and therefore recommended that these motions should be considered for re-adoption by Full Council.

The Democratic Services Assistant Manager presented the report, which invited the Committee to comment on carried motions on notice from predecessor councils within its remit.  This matter was being considered by each of the Overview and Scrutiny committees at meetings in November.  This was intended to inform action by the Democracy and Standards Committee and Full Council in response to a motion agreed by Full Council on 15July 2021.

The Committee considered the report.  In response to questions from members the Committee was advised that the identification in the report of motions that could be treated as no longer required was not definitive.  It was open to the Committee to consider whether issues raised by previous motions should be included in its work programme or to comment on motions that might be adopted again by the Council.  However, when doing so, the Committee was asked to recognise that it might not serve a useful purpose for the Council to re-adopt an original motion that was now several years old even if the subject of the motion was still a live issue.

Committee members commented that it was not feasible for the Committee to consider in detail each of the previous motions within its remit to establish whether or not they had been adequately resolved.  However, this work needed to be done by WNC to avoid losing previous motions that were still valid.  It was felt that the Committee should comment to the Democracy and Standards Committee that previous motions should be considered for re-adoption by the Council unless it was clear that they were closed.

RESOLVED that: the People Overview and Scrutiny Committee:

a)     Agreed that no further action is necessary on those motions within its remit where it has been identified that the matter is already closed, as indicated by notes included in the report.

b)     Agreed that the Committee is not in a position to identify that other motions within its remit are closed and therefore recommended that these motions should be considered for re-adoption by Full Council.

To approve the scope for the task and finish scrutiny panel on child and adolescent mental health and the risk of self-harm.

RESOLVED that: the People Overview and Scrutiny Committee agreed the scope for the task and finish scrutiny panel on child and adolescent mental health and the risk of self-harm.

The Chair advised that the task and finish scrutiny panel had met to agree the proposed scope for the scrutiny review, which was now presented to the Committee for approval.

The Chair invited members to raise any points concerning the proposed scope that they wished the Committee to consider.

RESOLVED that: the People Overview and Scrutiny Committee agreed the scope for the task and finish scrutiny panel on child and adolescent mental health and the risk of self-harm.

To confirm the Committee Work Programme for 2021/22, for presentation to the Coordinating Overview and Scrutiny Group for approval.

RESOLVED that: the People Overview and Scrutiny Committee:

a)    Agreed the inclusion in its work programme for 2021/22 of topics arising from the work programming event, as set out in the report.

b)    Agreed that items of business be scheduled at forthcoming Committee meetings in 2021/22 as follows:

·         25 January 2022: scrutiny of children’s services performance; school improvement; special educational needs and disability (SEND) support and alternative provision; and an initial briefing on the Healthwatch function

·         1 March 2022: scrutiny of the interim housing strategy; anti-poverty strategy; and Healthwatch function

The Democratic Services Assistant Manager introduced the report inviting the Committee to review and update its work programme for 2021/22 following the work programming event on 21 October 2021.  The final work programme would be presented to the Coordinating Overview and Scrutiny Group for approval.

The Committee considered potential topic areas identified at previous meetings and at the work programming event.  Members discussed the best way of scheduling forthcoming business to group together relevant items and to take account of the departure of the Director of Children’s Services early in 2022.

RESOLVED that: the People Overview and Scrutiny Committee:

a)     Agreed the inclusion in its work programme for 2021/22 of topics arising from the work programming event, as set out in the report.

b)     Agreed that items of business be scheduled at forthcoming Committee meetings in 2021/22 as follows:

·      25 January 2022: scrutiny of children’s services performance; school improvement; special educational needs and disability (SEND) support and alternative provision; and an initial briefing on the Healthwatch function

·      1 March 2022: scrutiny of the interim housing strategy; anti-poverty strategy; and Healthwatch function.

The Chair to advise whether they have agreed to any items of urgent business being admitted to the agenda.

There were no items of urgent business.