To approve as a correct record the Minutes of the meeting of the Social Care, Health and Housing Overview and Scrutiny Committee held on 22 September 2014 and to note actions taken since that meeting.

Also attached for information purposes are the Minutes of the Co-convened OSC meeting held on 23 September 2014 at which Members discussed the proposed fees and charges schedule.

RESOLVED

That the minutes of the meeting of the Social Care Health and Housing Overview and Scrutiny Committee held on 22 September 2014, be confirmed and signed by the Chairman as a correct .  This was subject to an amendment to the attendance record to show Cllr Susan Goodchild was in attendance as a Member of the Committee and Cllr Ann Sparrow was in attendance as a substitute.

Members also resolved that the minutes of the meeting of the Co-Convened Overview and Scrutiny Committee held on 23 September 2014 be confirmed and signed by the Chairman as a correct

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

None

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

The Committee were advised of the content of the Bedfordshire Clinical Commissioning Group’s interim report on the Healthcare Review.  The Joint Health Overview and Scrutiny Committee would be considering the next steps to be taken on the review at their meeting on 17 December 2014.  Members were briefed on two events that had been arranged for December.

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 Deputy Executive Member for Social Care Health and Housing updated the Committee on issues on behalf of the Executive Member, that were not included on the Agenda, these included:-

·         Attendance at an employment event in Downside, Dunstable.

·         Attendance at Stakeholder event for Older People in Leighton Buzzard.

·         Attendance at a Housing Investment event held in Stansted at which Ken Livingstone urged authorities to build the right type of homes in the right place.  Officers and Members would meet with Aragon Housing Association to discuss future schemes.

·         Progress on the Priory View development that had attracted significant amount of public interest in the scheme.

·         Attendance at a Carers Forum held for residents of Park Homes sites and the ambition to extend the Village Care Schemes to Park Home sites.

NOTED the update.

To consider and comment on the Care Act report.

The Director of Social Care Health and Housing introduced the Care Act Report that outlined in detail the requirements on the Council and included new responsibilities for local authorities in supporting and caring for adults

The Head of Partnerships and Performance delivered a presentation that highlighted the key changes from existing legislation and the timescales to deliver the key requirements of the Act.  Members were advised that the Council had made good progress in a number of key areas of the Act and that the biggest challenge would be the implementation of the new funding reforms and the significant increase in demand for services.

Successful implementation of the additional requirements of the Care Act needed a Council wide approach and a programme board had been established and chaired by the Chief Executive to coordinate the implementation of the Care Act alongside other transformational programmes.  The Funding and resource implication was also significant for the Council and would be mapped alongside national estimates and models.

An event to advise the Voluntary Sector and Members in December would explain the process element of the new legalisation and what this means for the Council.

The light of the report and presentation the Committee discussed the detailed proposed changes to be implemented as follows:-

·         What the financial cap on care for older people currently stood at.  The Assistant Director Resources advised the cap for older people was £72,000.  No cap existed for children turning 18 years and a figure was not known for the 18-65 age group.  A consultation on the second part of the Care Act would pick up on this area.

·         What influence the Council might bring to bear on rates of pay for care workers.  The Director of Social Care Health and Housing advised it was employers’ responsibility to pay their staff fairly.

·         Given the different financial modelling that had been undertaken, what overall cost did officers expect?  The Assistant Director Resources explained it was not possible to give a figure as the demand was not known.

·         Whether consideration had been given to initial assessments for care to be undertaken by an administrative officer rather than a social worker.  The Director of Social Care Health and Housing advised that a social worker would usually undertake an initial assessment, however, a move toward an initial self assessment was being carefully considered.

·         Whether additional financial support would be available to help implement the changes from Central Government.  The Assistant Director Resources advised that a figure would be included in the December grant settlement.

·         Who would provide the information, advice and advocacy services to residents?  The Director of Social Care Health and Housing explained the Council would not necessarily provide this role, however, it must provide access to this information.  Members, the voluntary sector and stakeholders would be provided with the right information to help residents.

Noted the presentation

To consider and comment on decommissioning of the Sub-acute South Services Pilot, including the Short Stay Medical Unit.

The Interim Director, Strategy and System Redesign, Bedfordshire Clinical Commissioning Group (BCCG) introduced a report that set out the original ambitions for the Sub-acute South Services Pilot.  The services included the Short Stay Medical Unit (SSMU); Rapid Intervention Team, Multi-Disciplinary Team and Clinical Navigation Team. 

The basic cost of the pilot was £2.8m annually and although it had provided good quality services and patient were happy with their care, none of the financial targets had been achieved including a 10% reduction in admissions to the Luton and Dunstable Hospital for the 75+ age range. 

The BCCG Governing Body had taken the decision to close the Short Stay Medical Unit by 5 December 2014.  An improved Clinical Navigation and Rapid Response service would work alongside new services including the hospital at home service.

In light of the update the Committee raised the following concerns:

·         Whether GP’s fully supported the concept of the SSMU.   The Interim Director of Strategy and System Redesign advised the SSMU was not sufficiently staff at night or at weekends and GP were not able to send patients during these periods.

·         Whether patients would be given a choice in their care and access the hospital at home model.  Members were advised that clinicians would judge where the best care lay on a case by case basis.  The new model would be monitored carefully and Member would receive a report on its progress.

·         Concern that a similar line might be taken with Biggleswade Hospital.  The Interim Director of Strategy and System Redesign advised that Biggleswade Hospital would provide support to Residents over the winter months.  A joint piece of work would be undertaken by the Director of Social Care Health and Housing and the BCCG on proposals for Biggleswade Hospital and a report would be submitted to the Committee for consideration and comment.

NOTED the report.

To consider and comment on the Bedfordshire Clinical Commissioning Group’s Finance Recovery Plan.

The Finance Director, Bedfordshire Clinical Commissioning Group (BCCG) introduced a report that briefed Members on the BCCG’s financial position that forecast a deficit of £14m and had seen the of BCCG placed in formal turnaround.  The BCCG faced challenges with some service contracts and hoped the Healthcare Review would bring in efficiencies to reduce the deficit.  A new interim Turnaround Director had been appointed to produce and implement a recovery plan.

In light of the report, The Committee commented and discussed the following points:-

·         Concern that such a new organisation had been placed in a negative financial position, inherited from legacy issues. 

·         Support in the approach to remodel services to achieve efficiencies that included extended hours at GP surgeries and liaison with paramedics and GP on patients to avoid A&E admissions.

·         Concern that nationally CCG’s faced similar budget deficits.

Recommended

1.    The detailed BCCG financial recovery plan be submitted to the SCHH OSC meeting in January.

2.    That Members support the drive to make changes and remodel services provided by the BCCG.

To receive an update on the work of the Tenant’s Scrutiny Panel.

The Head of Housing Management introduced a report that updated the Committee on the progress of the Tenant Scrutiny Panel’s (TSP) investigation into Anti Social Behaviour (ASB) in the Housing Landlord Service. Many of the recommendations and actions highlighted in the investigation had been implemented and had helped to improve the service to residents. 

Work on a recommendation to introduce an ABS policy had been put on hold whilst the implications of the new ASB Crime and Policing Act 2014 and the significant changes proposed had been incorporated into the policy.  Members would be asked to comment on the policy at a future meeting.

The Chairman of the TSP introduced a new Member to the Panel and a presentation that highlighted the actions and evidenced improvements made to the service.  The use of diary sheets was of concern to the Panel, however, additional budget would be required to purchase new equipment to resolve this issue.

Members commented on the improvements in the service and that suitable resources had be put in place to deal with complaints on ASB.  The Panel reported that ASB was not as prevalent as first thought and many complaints were in the nuisance category.

The TSP advised they would start a new piece of work to investigate complaints made to the Housing Service.

In light of the update, Members discussed the following points:-

·         Whether the TSP had shared areas of learning and good practice with fellow TSP locally and regionally.  The Chairman of the TSP confirmed meetings with other TSPs had taken place, however, the TSP’s work on ASB had not yet been shared with Aragon Housing Association.

·         Whether work had been undertaken to establish the underlining reasons for ASB by residents.  The Head of Housing Services advised that officers had been given additional training and the restructure had allowed them to get closer to residents and signpost them to the service that would help them.

RECOMMENDED

·         The Tenant’s Scrutiny Panel’s Anti Social Behaviour leaflet be circulated to Members.

·         That the Tenant’s Scrutiny Panel be invited to attend a future meeting of the Committee to update Members on the work on complaint to the Council in Housing Services.

To consider the quarter one performance report.

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. 

The Senior Health Check Officer, Public Health, advised that a drop in performance relating to Health Checks was largely due to the shortage of staff in GP’s surgeries that provided the checks and the high number of people who had not attended the two appointments scheduled.  Proposals to change the process would see at move to one appointment and it was hoped this would improve performance.

In light of the update, the Committee discussed  the following:

·         That future reports on health checks include the numbers of people helped in the scheme.

·         The actual number of houses that did not meet the decent homes standard be reported.

·         The numbers of residents helped by the Village Care Scheme continue to rise.  The Director of Social Care Health and Housing would provide a briefing note for Members on the latest position.

RECOMMENDED

1.    That the figures requested by Members be included in future performance reports.

2.    That the Director of Social Care Health and Housing provide a briefing note for the Committee on the Village Care Scheme.

The report provides members with details of the currently drafted Committee work programme and the latest Executive forward plan. http://www.centralbedfordshire.gov.uk/modgov/mgListPlans.aspx?RPId=577&RD=0&bcr=1

The Committee considered the current draft work programme.

RECOMMENDED that the work programme be approved subject to the additional items detailed in the Minutes above.