To consider any decision of the Executive referred to this Committee for review  in accordance with Procedure Rule 10.10 of Part D2. 

None

To approve as a correct record the Minutes of the meeting of the Social Care Health and Housing Overview and Scrutiny Committee held on 16 December, 2013 and to note actions taken since that meeting.

RESOLVED that the Minutes of the meeting of the Social Care Health and Housing Overview and Scrutiny Committee held on 16 December, 2013, be confirmed and signed by the Chairman as a correct record subject to the addition of Cllr P N Aldis to the attendance list.

To receive from Members any declarations of interest and of any political whip in relation to any agenda item.

·         Cllr Mrs G Clarke declared an interest as a family member worked for the Clinical Commissioning Group

·         Cllr Dr R Egan declared an interest as a sheltered housing tenant.

To receive any announcements from the Chairman and any matters of communication.

The Chairman announced she would provide an update on the progress of the Joint Health Overview and Scrutiny Committee at the next meeting.

To receive petitions from members of the public in accordance with the Public Participation Procedure as set out in Annex 2 of Part A4 of the Constitution.

None

To receive any questions, statements or deputations from members of the public in accordance with the Public Participation Procedure as set out in Annex 1 of part A4 of the Constitution.

The Committee were informed that two speakers had registered to speak.  The Chairman announced the speakers would be invited to speaker in advance of the relevant item.

To consider any items referred to the Committee at the request of a Member under Procedure Rule 3.1 of Part D2 of the Constitution.

None

To receive for information a verbal update from the Executive Member for Social Care Health and Housing.

The Executive Member for Social Care Health and Housing updated the Committee on issues that were not included on the agenda, these included:-

·         An informal budget discussion that had taken place for Members and had been well attended.

·         Hoarding at the Priory View site (formally known as Dukeminster), which were now in place and provided excellent branding for the Council.

·         An anniversary event at the Terence Higgins Trust that she had recently attended.

·         Attendance at performance meetings with officers.

To receive an update from the Chief Executive at Bedford Hospital on the latest CQC inspection.

The Chairman welcomed Stephen Conroy who was pleased to announce that the Care Quality Commission (CQC) had lifted all of the warning notices that had been imposed last summer, apart from one concern relating to governance.  Arrangements to improve governance arrangements were now in place.  The challenge remained for Bedford Hospital to ensure consistent standards were maintained.  Two Members of the Committee attended a tour of the Hospital in December and were impressed with the enthusiasm and commitment of staff and the cleanliness of the wards.

Members congratulated Stephen Conroy on the turnaround at Bedford Hospital and noted the steps taken to ensure all governance measures had improved.

NOTED the update

To consider the report of the Hospital Discharge Task Force.

The Corporate Policy and Scrutiny Manager introduced the Hospital Discharge Task Force report.  The report outlined recommendations of the task force review of performance relating to the pathway for leaving hospital and set out the implications of several of the recommendations for implementation.  It was noted that the content of the report was largely historical in nature due to the time taken to gather information and events that had overtaken the initial piece of work.

Members of the Committee wished to thank the Task Force for a good report and requested that a letter of thanks be sent to those witnesses that had attended meetings.

RECOMMENDED

1.    That the recommendations contained in the report of the Task Force be endorsed.

2.    That the appropriate NHS bodies submit an update to the Committee in two months time outlining progress in implementing the recommendations detailed in the Task Force report.

3.    That the Committee receive regular monitoring reports on hospital discharge performance.

A presentation relating to the End of Life Care Pathway in Central Bedfordshire.

Penny McNamara of the Sue Ryder Trust gave a presentation that explained the End of Life Pathway in Central Bedfordshire.  Public and media concern was raised last year following the publication of the Neuberger Report into the Liverpool Care of the Dying Pathway (LCP).  The Neuberger report findings established an inconsistent approach by care providers and LCP had become a ‘toxic brand’.

From July 2014 all providers would be required to deliver care to an agreed set of standards, this included communication with relatives. 

In light of the presentation, Members discussed the following issues:-

·         The importance of communication and transparency with relatives and patients.

·         The importance of managing the expectations of relatives and patients when providing care.

The Chairman and Members of the Committee expressed their thanks for the informative presentation.

NOTED the presentation

To receive an update on performance relating to the East of England Ambulance Trust Turnaround Plan.

Ross Brand, General Manager, Bedfordshire, East of England Ambulance Service NHS Trust (EEAT) and Mark Titcombe, Programme Director, East of England Ambulance Service NHS Trust, presented a report which provided an update on the Trust’s turnaround plan to deliver better services for patients and explained the specific picture for Central Bedfordshire.  The report included performance against national Ambulance Care Quality Indicators in the Bedfordshire area compared to the rest of the Trust’s region.  The Trust had achieved all national standards with the exception of Cardiac Arrest survival to discharge from hospital, which was slightly below target.

Dr Anthony Marsh had been appointed as the new Chief Executive of the Trust with effect from 1 January 2014.  In Bedfordshire there was a fully staffed establishment and steps had also been taken to recruit 350 student paramedics.  Staff training had been delivered on new respiratory intervention procedures and end of life care pathway at the request of staff members.

The Chairman thanked the EEAT representatives for their update report that displayed all the properties of a good service.

NOTED the report.

To receive a progress and approach update report on SEPT Services including Biggleswade Hospital.

A member of the public expressed their concern to the Committee that no action had been taken since the last meeting where concerns were raised regarding Biggleswade Hospital.  In particular the need to admit patients to the men’s ward and the need for beds for patients from the surrounding area.

Another member of the public also expressed the need for a bed at Biggleswade Hospital for his wife who was currently being cared for at Bedford Hospital.

The Director of Strategy and System Redesign, Bedfordshire Clinical Commissioning Group (BCCG) and the Director of South Essex Partnership Trust (SEPT) introduced a report that set out the position on the utilisation of the commissioned beds at Biggleswade Hospital.

The Director of SEPT Services advised that all beds at Biggleswade Hospital were available for use and the criteria had been flexed for admissions, however, to date the beds had not been required.  Assurances were given that work was underway behind the scenes and there had been an increase of 38% of patients being safely cared for at home.

The Chief Executive Bedford Hospital advised there was a gap in provision and there was a bigger requirement for patients with advanced dementia than rehabilitation.  Provision for dementia patients was not available at Biggleswade Hospital.

In light of the report Members raised the following issues:-

·         Whether a clear action plan to implement the Community Bed Review was available.  The Director BCCG advised that work had been carried out behind the scenes.  The Director of Social Care Health and Housing explained that the Better Care Fund report, due to be considered by Members at their next meeting would include integration information which would help clarify matters.

·         Whether plans to provide a Short Stay Medical Unit (SSMU) in the north of Central Bedfordshire for residents would be considered.  The Director BCCG advised that any plans for a SSMU would be drawn out from the Bedfordshire Health Services Review that would be complete later in the year.

In light of the discussion Members requested to be kept informed of the monitored use of rehabilitation beds at Biggleswade Hospital.  The Director of SEPT agreed to update the Committee at their next meeting and continue to keep Members informed.

NOTED the report and requested the Director of SEPT Services update the Committee at their next meeting

A 6 month progress report on the implementation and operation of the Domiciliary Care Framework Agreement.

The Assistant Director, Strategic Commissioning introduced a report that provided the Committee with a six month update on the operation of the framework agreement in respect of domiciliary care.  To date the new Framework had attracted new high quality providers to Central Bedfordshire and customers had more information and choice.

In light of the update, a Member asked if the Council required providers to meet a standard on pay, sick pay, holiday pay and travel time as part of the contract.  The Assistant Director agreed to provide a written response to this question that outlined contract terms.

With regards to the good feedback received to date on the web portal, a Member asked what steps had been put in place to ensure self-funded patients access the information.  The Assistant Director acknowledged this was an important point and work was underway to develop access.

A Member requested background information on providers to determine a meaningful decision based on their ranking.  The Assistant Director advised this information was being collated and would be available in addition to customer satisfaction ratings.

RECOMMENDED that the Framework Agreement for Domiciliary Care Services be scheduled into the work programme for May 2014 to provide a full year’s update and officers look to include provision in contracts to include providers staff retention packages criteria.

To consider and comment on the Park Homes Licensing Fees Policy and provide comments to the Executive.

The Head of Housing Solutions introduced the draft Park Home Site Licensing Fees Policy.  The Policy gave the Council the ability to recover costs associated with the licensing of park home sites through the fees as set out and enabled the Council to monitor conditions on sites more effectively.  In order for the Council to charge site owners a fee for a site licences the Policy needed to in place by 1 April 2014.

A consultation and a residents event had recently been held to explain the changes in legislation that would allow all local authorities to charge fees for issuing and monitoring site licenses and to take enforcement action if conditions were not met.  Residents had welcomed the event that had given them the opportunity to raise their concern that site owners would pass on the new charges to park home residents.  Residents were also aware of the Council’s role under the new legislation.

In light of the report, Members discussed the following issues:-

·         Whether site owners could pass on the new costs of site licences to residents and what support officers would provide to vulnerable residents in such cases.   The Private Sector Area Housing Manager advised that the new legislation would see the introduction of a new procedure for increasing pitch fees.  Residents would be able to challenge unfair charges at a tribunal, however, officers would not be able to get involved in private contract arrangements. 

·         Whether site owners were aware of the changes in legislation.  The Private Sector Area Housing Manager advised there had been a consultation on the proposals to the industry, local authorities and housing associations and the Council had held a Site Owners Engagement Event in September 2013. Whilst annual fees would apply to all non-exempted sites, transfer and amendment fees would only apply where a site owner requested a transfer or amendment of an existing licence, and initial licence fees only where an application was made for a new site not previously licenced.

·         That the Park Homes Strategy reflect that officers would intervene and offer assistance to help vulnerable residents who are victims of harassment and asked for help

RECOMMENDED

1.    That a section be incorporated in the Park Home Strategy to ensure assistance to vulnerable residents is available.

2.    That the Committee endorse the draft Park Home Site Licensing Fees Policy.

To consider the following pertaining to the Social Care Health and Housing Directorate:-

(i) draft Budget (2014/15);

(ii) Medium Term Financial Plan (2014-18); and

(iii) Capital Programme (2014/15 to 2017/18).

Papers relating to these items were circulated to Members in the Executive agenda for 14 January 2014 (Items 08and 09 refer). In addition to the covering report included in this agenda Members are requested to bring their copies of the Executive report with them to the meeting. The report is available to view and print at the following website:-http://www.centralbedfordshire.gov.uk/modgov/ieListDocuments.aspx?CId=577&MId=4397&Ver=4

The Assistant Director Resources gave a presentation that outlined the Social Care Health and Housing draft Budget, Medium Term Financial Plan in addition to the efficiencies and key pressures for the directorate.  In light of the report and the further clarification provided by the Executive Member the Committee and officers present, Members discussed the following issues in detail:-

·         Whether the Director was confident that the directorate could respond to the pressure of an ageing population and whether the level of need arising from this pressure was adequately monitored.  The Director assured Members she was confident that the Council could meet the additional pressure arising from an ageing population. Performance measures would be introduced in light of the Better Care Fund that would hold various agencies to account to ensure need in Central Bedfordshire was being met.

·         Whether the Council could effectively support the transition from childhood to adulthood in light of proposed reductions in budgets.  The Director confirmed that colleagues in Children’s Services and Adult Social Care were working together to provide the best care for those in need.

·         Concerns regarding the increase in variations to residential care costs and care packages.  The Executive Member shared her concern and would monitor these costs very closely.

RECOMMENDED that the Council’s draft budget for 2014/15 Medium Term Financial Plan and Capital Programme 2014/15 to 2017/18 in relation to Social Care, Health and Housing be endorsed.

To receive the revised fees and charges rates for 2014/15 pertaining to the Social Care, Health and Housing Directorate.

The Assistant Director Resources introduced the proposed revised fees and charges for Social Care Health and Housing, which included a 2% increase.

Cllr Dr Egan declared a personal interest in relation to Supporting People Charges and asked for a written explanation as to how these charges had been prepared.  A member also requested additional information regarding the charges for the Lifeline Service.

NOTED the proposed fees and charges for the Social Care, Health and Housing directorate.

RECOMMENDED

1.         That a Briefing note on the charges applied to sheltered accommodation be prepared for circulation to Members of the Committee.

2.         That further details be supplied on the Lifeline charges.

To consider the Council’s draft budget report for the Housing Revenue Account (Landlord Service) Business Plan and provide comments to be considered by the Executive.

Papers were circulated to all Members as part of the report to Executive on 14 January 2014. Members are requested to bring their copy of these papers (Item 10) with them to the meeting. These papers can be viewed on the Council’s website at:-

http://www.centralbedfordshire.gov.uk/modgov/ieListDocuments.aspx?CId=577&MId=4397&Ver=4

The Assistant Director Resources introduced the Housing Revenue Account Budget and Investment Plan 2014/15 – 2019/20 and gave a presentation on the key issues.  The average increase in rent was proposed at 5.46% and a review of services charges had been undertaken, given the current charges did not cover costs.

In light of the presentation and report, Members discussed the rent increases for tenants in 1 bedroom housing in the south of Central Bedfordshire compared to charges for tenants in bigger houses.  The Executive Member advised the charges continued to be below the market rent and offered good value to tenants.

Cllr Dr Egan declared a disclosable pecuniary interest and asked the Committee to consider a freeze in rents for tenants in sheltered housing accommodation because of the inequity in charges.  The Executive Member agreed to share a comprehensive briefing note that explained how rents at Council properties were calculated and the comparisons used in the private sector (market rents).

Members asked what plans were being considered to create more extra care housing in the north of Central Bedfordshire.  Members were concerned that some residents had not been offered the same level of service as those in the south of Central Bedfordshire because of a lack of extra care housing.  In response the Executive Member agreed to hold an informal session with Members to share the plans and ambitions currently being discussed.

RECOMMENDED

1.         That the Housing Revenue Account Budget and Investment Plan for 2014/15 – 2019/20 be endorsed.

2.         That comments received during the Executive Member Budget briefing session be circulated separately to the Committee.

3.         That an informal briefing session be arranged for Members on the proposals to deliver more extra care housing currently being discussed.

To consider the currently draft Social Care Health and Housing Overview and Scrutiny work programme for 2013/14 and the Executive Forward Plan.

The Committee considered the current draft work programme which would be updated to include the two items detailed in the body of the Minutes

RECOMMENDED that the work programme be approved subject to the addition of two items detailed in the body of the Minutes.