Agenda and draft minutes

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.

Councillor Roberts declared an ongoing interest as:

·         Chair of Food Aid Far Cotton

·         A board member of Food Aid Alliance West

·         A board member for the Community Training Partnership contract to be delivered by the Community Law Service.

The Chair welcomed everyone to the inaugural meeting of the Adult Social Care and Health Overview and Scrutiny committee. The Chair shared that she recently attended the Centre for Governance and Scrutiny annual conference at the King’s Fund on 14 June 2023 and found it to be an insightful and enjoyable experience learning about scrutiny in the sector, building public trust and the challenges facing local services.

To approve the minutes from the final People Overview & Scrutiny meeting on 3 May 2023.

RESOLVED: That the Adult Social Care and Health Overview and Scrutiny Committee agreed the final minutes of the former People Overview and Scrutiny Committee of the meeting on 3 May 2023 as an accurate record.

The Committee to consider:

a)    An update from the Task and Finish Panel formed to scrutinise progress with the iCAN programme

b)    Future direction of iCAN

The Chair invited the Assistant Director Commissioning and Performance to deliver the presentation on iCAN “The Story So Far December 2022”. The Assistant Director summarised that iCAN started in 2021 as a transformation programme across Northamptonshire with the aims to reduce bed days in hospitals, to reduce unnecessary hospital admissions and provide holistic care to older members of the community to maximise independent living.

Members heard the presentation from the Assistant Director Commissioning and Partnerships and following a group discussion the following points were raised:

§  A blend of clinical and reablement support was needed to support people leaving acute hospital settings and an equipment store had been created as the iCAN programme found this was one of the challenges preventing hospital discharges.

§  Complex discharge pathway 1 had been redesigned as officers looked at how healthcare services were being delivered and changed shift patterns to create additional capacity, this led to 50% of discharges being processed through pathway 1.

§  There were some challenges around pathway 1 in respect of staff loss and recruitment issues so there is not a full complement in reablement staff, but this has been mitigated by the Council engaging with an independent care provider and a contract will be in place by September to ensure staff cover in this area.

§  Digital work was still ongoing, but the vision was for a central dashboard which all partners have access to, to be able to scrutinise and challenge to demonstrate patient matters and system matters.

§  There has been an improvement in the deficit in home care staffing in the last 12 months, capacity has increased, and this has helped people being able to move back home and out of hospital.

§  Productivity in acute settings had increased with discharge hubs making decisions quicker with detailed patient requirements to enable more effective decision making, coupled with the availability of more equipment and social care support to allow people to remain at home.

§  Programmes were in place to lower the number of older residents needing hospital care under local area partnerships and improvements were now under the business as usual activity and Age Well programme as the iCAN programme had concluded.

§  Prevention was needed to look at how people could be better supported before admission into acute service, how community volunteers could support with daily activities, and a rapid response service that prevents the use of ambulance service.

§  In terms of budget, £270k had been funded by business rates and £8m had been funded by the Integrated Care Board (ICB) for the iCAN programme. Funding for this programme had ceased, but ICB were now able to fund other programmes making a difference, and preventing hospital stays and promoting independence.

Members asked a question surrounding the impact of the iCAN programme and if there had been an increase of incidences and admission rates as a result of the approach to reduce bed stays. Members wanted information to demonstrate if getting residents home early was  ...  view the full minutes text for item 4.

The Committee to provide scrutiny input and constructive challenge regarding West Northamptonshire Council’s self-assessment for the CQC inspection.

The Chair introduced the agenda item and shared that at the pre-meet the Executive Director of People Services requested that the preparatory Adult Social Care Self-Assessment that would form as part of the Care Quality Commission (CQC) Inspection of Adult Care could come to scrutiny and the Committee could act as a critical friend and ask inquisitive questions and areas for improvement before the formal inspection.

The Chair invited the Assistant Director Safeguarding and Wellbeing Services to deliver the presentation on CQC Single Assessment Framework: Local Authority Assurance. The Assistant Director Safeguarding and Wellbeing Services explained the background to the CQC Inspection and shared that the Health and Care Act 2022 gave new regulatory powers to the CQC to undertake an independent assessment of care functions delivered by local authorities.

The Portfolio Holder for Adult Care, Wellbeing and Health integration commended the Assistant Director Safeguarding and Wellbeing Services as the Self-Assessment document that he has produced has been held up regionally as an excellent exemplar of work. The Portfolio Holder also shared he had recently attended a Local Government Association (LGA) course with fellow Cabinet members which addressed the CQC inspection and one of the key aspects of the inspection is how local people were experiencing Adult Social Care, with the service users at the core of the work and how their experience linked with the provision of care offer.

Members discussed the CQC inspection and felt that the self-assessment demonstrated the challenges in place and how the Council had evaluated its work. Members suggested that the reporting could include more on diversity, referencing the socio-economic impacts and challenges in West Northamptonshire and signposted to the Council’s Anti-Poverty Strategy which detailed that the authority included areas of high deprivation in Northampton experiencing different levels of care and the highest proportion was safeguarding needs.

Members asked a question regarding the timescales for residents to access care services. The Assistant Director Safeguarding and Wellbeing Services responded that the timescale was dependent on the level of support required and urgency as there were various steps in place. Those with genuine need would be responded to within hours to prioritise their safety. Where a person had a support package then the aim would be to have support plans in place within 28 days. Members echoed the concern regarding response times and the pressure on access to services, for example in relation to Child and Adolescent Mental Health Services (CAMHS).

RESOLVED: That comments by the Adult Social Care and Health Overview and Scrutiny Committee be taken into account during further development of West Northamptonshire Council’s self-assessment for the CQC inspection.

To consider and approve the Annual Report on activity by the Committee in 2022/23 to be presented to Full Council.

The Chair introduced the People Overview and Scrutiny Committee Annual Report for 2022/23 and explained the report contained the breadth of work taken by the Committee over the last year and would go to full council at the next meeting in September 2023.

Members discussed the report and raised that scrutiny would like the debt and money advice service to come back to the Committee for an update. Members felt the report suggested scrutiny was wholly in agreement with the proposed approach that had been presented, but members were concerned what the remodel would look like, and further work still needed to be done. The Assistant Manager Democratic Services suggested revised wording to reflect this.

RESOLVED: That the Adult Social Care and Health Overview and Scrutiny Committee approved the People Overview and Scrutiny Committee Annual Report 2022/23, subject to the amendment of the section on scrutiny of the debt and money advice service to read that the Committee supported the proposed hybrid model as its preference from the options presented to it but requested the opportunity to scrutinise detailed proposals before they were agreed.

To review and approve the Committee Work Programme for 2023/24.

At the Chair’s invitation, the Assistant Manager Democratic Services introduced the Draft Committee Work Programme 2023/24 and invited the Committee to consider and agree its work programme and consider working methods and what information scrutiny wished to review. He explained that section 5.2 and 5.3 of the report detailed the key principles of Overview and Scrutiny and the development of scrutiny work programmes. He highlighted Appendix A which was the former work programme for the People Overview and Scrutiny Committee which had been divided between the Adult Social Care and Health, the Children, Education and Housing and the Place Overview and Scrutiny Committees according to their remits. Appendix B was the draft Committee work programme which consisted of items carried over from the former People Overview and Scrutiny Committee and suggestions from the Adult Social Care and Health premeeting which took place in May.

The Assistant Manager Democratic Services clarified that the premeet was an opportunity for members to engage in discussion about upcoming scrutiny work, but the Committee formally decided and agreed its work programme and would decide on areas for review and items to add, remove and modify from the work programme.

Members discussed the work programme and suggested the Committee could engage with Healthwatch and pick up issues arising from their annual report. Members suggested the Assistant Director Commissioning and Partnerships could attend the next premeet to give scrutiny assurance on the Age Well programme and future work. The Assistant Director Commissioning and Partnerships shared that he would be happy to share a report outside of the meeting for members to review in readiness for a discussion at the premeet and members could decide on their approach to scrutiny and any further information they required for the Committee meeting.

Members suggested that the Adult Social Care directorate dashboards could regularly be brought to scrutiny on a quarterly basis so that members could review the team's KPIs and metrics to inform any topics for scrutiny to review performance. In addition, members suggested a regular review on the Local Area Partnerships (LAPs) work and their successes and challenges and any changes in the sector or upcoming work could be communicated by the Portfolio Holder for Adult Care, Wellbeing and Health Integration and the Executive Director for People at the premeets.

Members suggested that the provision of blue badges be removed from the work programme as any specific issues could be pursued by ward councillors in the first instance.

RESOLVED: That the Adult Social Care and Health Overview and Scrutiny Committee:

a)   Agreed the draft work programme subject to the following amendments:

·         The Committee to carry out regular scrutiny of the development of Local Area Partnerships and the outcomes being delivered

·         The Committee to request to receive information about performance against relevant Key Performance Indicators to inform scrutiny

·         The Committee to consider the topic of care quality in care homes

·         The Committee to consider the topic of support for independent living by older people following on from the original iCAN  ...  view the full minutes text for item 7.

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.