To approve as a correct record the Minutes of the meeting of the Social Care Health and Housing Overview and Scrutiny Committee held on 03 March 2014 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 7 April 2014 be confirmed and signed by the Chairman as a correct record.

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 D Bowater also declared an interest as he was a governor of SEPT.

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

The Chairman had prepared a briefing note on the Joint Health Overview and Scrutiny review and distributed copies at the meeting.  The Chairman drew Members’ attention to the dates of  the Stakeholder events and public meeting arranged by Bedfordshire CCG.

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.

None.

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 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 a brief 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:-

·         Attendance at a ‘Singing for the Brain’ event, a service for dementia sufferers.

·         A visit to a Care Home for dementia suffers.

·         Attendance at the LGC Awards evening

·         The completion and approval of the Better Care Fund at the Health and Wellbeing Board meeting.

·         A television interview on the Spare Bedroom subsidy

·         The official start of the construction of Priory View in Dunstable would take place on Friday 11 April.

To receive performance monitoring data relating to Hospital Discharge.

The Chairman welcomed Nina Fraser, Director of Nursing at Bedford Hospital who provided an update to Members on the changes to Hospital Discharge at Bedford Hospital.  These changes included:-

·         Matrons leading on the planning of hospital discharge;

·         Daily meetings with SEPT and Social Services on patient discharges;

·         The introduction of a discharge planner on each ward;

·         The implementation of 7 day working;

·         Support that was provided for carers through a ‘carers lounge’.

In light of the update Members discussed several issues and comments in detail as follows:-

·         The procedures that were in place to inform GP practices of those patients who were about to be discharged from hospital.  Mrs Fraser explained that improvement in this area was very important and a joint system was needed, however, this would take time to put in place.  A Member raised a specific concern regarding this practice, which Mrs Fraser agreed to consider outside of the meeting.

·         The improvements that had been made in dispensing prescriptions from the hospital pharmacy on discharge.  Mrs Fraser confirmed the pharmacy was open for a longer period of time and better planning on the wards had ensured that prescriptions were available for patients at the appropriate time.

·         Carers were fully engaged to ensure a smooth transition of care into the Community including the use of schemes like the Good Neighbour Scheme.

·         The need for other care providers to offer a 7 day working service.  Representatives from SEPT confirmed they provided this service and a rapid care service was available if required.  The Director of Social Care Health and Housing advised that the Better Care Fund would pick up on hospital discharge and 7 day working.  Data sharing was a national problem between hospitals and GP surgeries and other care providers.

NOTED the update.

To consider the information update on Biggleswade Hospital.

Richard Winter, Executive Director of SEPT introduced a report on the utilisation of commissioned beds at Biggleswade Hospital that also included the current admissions criteria.  Mr Winter confirmed that the six patients referred to in admissions caseload table in the report were female admissions. A Member of the Committee suggested patients on the Cambridgeshire/Hertfordshire border might be offered places at the Hospital to utilise a greater number of beds, the Executive Director agreed to feed this suggestion back to the Commissioners.  The Director of Social Care Health and Housing explained the use of the Hospital would be considered through the Better Care Fund and she would bring to the Committee any concerns conveyed to her by SEPT.

SEPT officers were thanked by Members for their work on the production of this report.

NOTED the report.

To consider the proposals for a Cost Improvement Programme in the provision of Mental Health and Community Services.

Richard Winter, Executive Director of SEPT introduced a report that he clarified related to the planned changes to the provision of the Community Continence Services.  The proposal was to adjust the current provision by changing the supply of products to new patients and removing the provision of pads to Nursing Homes in order to provide a cost saving.

Members congratulated SEPT on the excellent service provided to the Community and welcomed the changes proposed in the report.

NOTED the report.

To consider and comment on the proposed models of care and plans for consultation on Mental Health procurement.

Michelle Bradley, Head of Mental Health and Wellbeing Bedfordshire CCG, introduced a report that outlined the proposed new models of care and consultation on Mental Health Procurement.  The changes had been necessary following notice from SEPT to withdraw from the current contract, although they would continue to deliver the service whilst a new provider was sought.  It was proposed that BCCG introduce a new outcome based framework to allow outcomes to be measured consistently across all levels of service.  The process had been informed by stakeholder engagement and a consultation exercise.

The Assistant Director of Commissioning described to Members the involvement of officers in the proposed new models of care.  Given the partnership approach to the proposal, the Assistant Director was confident it would deliver a good service for residents. An easy read version of the models of care would also be available to service users that explained the care pathway.

In light of the report, a Member raised a concern that a high level of children suffered with mental health problems and whether prevention advice was available. The Head of Mental Health Services, BCCG, advised that prevention work was on going, with Public Health, various charities and other  partners.

Members thanked SEPT for the improvements in Mental Health services they had provided in Central Bedfordshire.

RECOMMENDED

1.    That an informal briefing on Mental Health Services be provided to Members of the Committee.

2.    That the process for the procurement of Mental Health Services be fully supported.

(Meeting adjourned at 11.30 and reconvened at 11.40)

To consider a report prepared and presented by Members of the Tenant Scrutiny Panel.

The Head of Housing Management explained to Members the requirement for co-regulation of Housing Services.  Members of the Tenant Scrutiny Panel (TSP) explained the background and methodology used to determine that they should investigate the Council’s handling of reports of anti-social behaviour. The TSP report outlined 28 recommendations for improvement, which were welcomed by the Head of Housing Services in order to improve the service.  Work had been undertaken to improve communications and web presence and a Learning and Development Plan would be implemented to drive through the changes.  Officers would seek out best practice models from high performing councils to ensure continued improvements in handling anti-social behaviour complaints.

Arrangements were in place for the TSP to shadow Housing Services staff with a view to identifying new areas of the service to investigate in detail.

In light of the report and presentation Members discussed that it would be useful to be made aware of the TSP’s next area of investigation. In addition Members were keen to be kept aware of the implementation of the Panel’s recommendations for which timescales should be added so as to identify where improvements had been made.

Members fully supported the review that had taken place and commented on the importance of anti-social behaviour not being underestimated.  The Head of Housing Services was requested to advise Members of changes in relation to staffing that were made in order to improve the delivery of services.

RECOMMENDED that the Tenant Scrutiny Panel inform the Committee of their next review and that Members be advised of the progress in relation to implementing the Panel’s recommendations in 6 month time.

To receive a presentation on the progress made in meeting the accommodation needs of older people.

The Head of Meeting the Accommodation Needs of Older People (MANOP) gave a presentation that outlined the programme’s key aims that included:-

·         Increase the availability of extra care housing schemes to meet demand.

·         Transfer the Council owned care homes back into CBC management.

·         In the longer term, reprovide the places in those homes in new buildings

·         Ensure future housing developments meet the needs of older people.

The Head of MANOP updated Members on the current position of each of the key areas and plans for the service in the coming year.  The smooth transition of the Bupa care homes back into Council management would be undertaken following formal Council approval.  The construction and delivery of Priory View in Dunstable and support to Aldwyck Housing Association in the delivery of the new Greenfields in Leighton Buzzard would be provided.  Work to progress two new extra care schemes in Ampthill and Biggleswade areas was underway and the outcome of a Homes and Communities Agency bid was awaited.

In light of the presentation Members raised the following issues:

·         The need for officers to take account of the successful Step-up Step-down facility in Dunstable when considering the type of care that should be provided in the currently run BUPA care homes. 

·         Whether facilities for carers/relatives were included in the Strategy.  The Head of MANOP advised this had not been included but agreed to raise this with stakeholder/partnership groups.

·         The need for the Council to promote the building of accessible homes for the older community.  The Head of MANOP advised that a Market Position Statement would encapsulate the need of accessible housing in communities.

NOTED the presentation.

To receive a presentation on Q3 Budget reports for relevant services.

The Assistant Director Resources provided a presentation that highlighted the key points in relation to the forecast capital expenditure and external funding for Q3 2013/14 for the  Social Care Health and Housing Directorate. The presentation outlined the key variances and indicators and attention of the Committee was drawn to residential placement activity for older people, which had increased to 86 with the equivalent figures for last year was two.

Housing General Fund schemes continued to be well managed and the indicated spend would be broadly in line with the forecast figure.

The Head of Finance for Public Health reported that at Q3 the forecast was for a balanced budget, however, an underspend of £761k was presently recorded.  The main reason was the unspent strategic reserve, vacancies and a saving on the SEPT contract.  A risk highlighted in the report referred to Public Health liability for certain prescribing costs.  The impact would be a cost of approximately £435k that would be covered from unspent strategic reserve.

NOTED the presentation.

To receive  Q3 performance monitoring reports for relevant services.

The report provided information on the Social Care Health and Housing and Public Health performance against the Medium Term Plan and their continued good performance.  Those areas not achieving target had been reported to Members previously.  Public Health had reported exceeding its target a on Health Checks to residents.

NOTED the report.

To consider the currently drafted Social Care Health and Housing Overview and Scrutiny work programme for 2014/15 and the Executive Forward Plan.

The Chairman drew the attention of Members to a meeting attended with partners and colleagues to consider further work programme items.  The outcomes of this meeting were outlined at Appendix B, which identified those items that were currently considered to be an issue.  Members of the Committee were asked to consider which of those items they would like to see added to the work programme and to contact the Scrutiny Policy Adviser.

RECOMMENDED

1.    That the work programme be approved subject to the inclusion of additional items outlined in the body of the Minutes.

2.    That Members contact the Scrutiny Policy Adviser to discuss and additional items they wished to see included on the work programme.