To approve as a correct record the Minutes of the meeting of the Social Care Health and Housing Overview and Scrutiny Committee held on 14 December 2015 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 14 December 2015 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.

None.

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

The Chairman advised the Committee of his attendance at the opening of the Evergreen Step Up, Step Down facility in Ampthill that would serve residents in the north of the Central Bedfordshire.  The Chairman also attended the Health and Wellbeing Board and encourage employers to respond to the campaign to look after the wellbeing of their workforces.

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.

With the approval of the two members of the public that had registered to speak, it was agreed the Chairman would invite them to speak before the relevant item.

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 and Housing advised the Committee of their attendance at the opening of the Evergreen Step Up, Step Down facility in Ampthill and funding for a neurological nurse that had been reinstated by the Bedfordshire Clinical Commissioning Group for suffers of motor neurone disease.

The Executive Member also raised her concerns regarding the budget settlement from the Government and resulting shortfall in funding.  The 2% precept awarded for Social Care did not meet the shortfall in Grant Settlement.

The Deputy Leader and Executive Member for Health announced the appointment of the Accountable Officer at Bedfordshire Clinical Commissioning Group and the good settlement that had been received from the Government.  The Executive Member advised of the opening of the Ivel Medical Centre in Biggleswade.

The budget settlement for Public Health was expected in January 2016.

To scrutinise the report and results of the consultation on the future of Greenacre Older Persons home and to provide the Executive with recommendations on the proposals for its future.

In accordance with the public participation procedure, two members of the public were invited to speak.  The first speaker raised the following:

·         Suggestions that any closure of the home be put on hold until the new provider had been registered with the Care Quality Commission.

·         The importance of undertaking checks on the financial viability of a provider prior to the start of a consultation phase.

·         Concerns that a provider could walk away from their contract should they fail to deliver.

·         That the Committee ought to consider a recommendation to keep the Greenacre Care Home open.

The second speaker raised the following:-

·         That consideration be given to the closure of the home, which is not fit for purpose for wheelchair users and the land be used by the Council to build and operate a new home.

·         Support for Council owning and running care homes rather than the private sector.

·         That when deciding on the new location of the step up, step down facility, the Council consider sites near public transport routes.

In response the Executive Member for Social Care & Housing advised that funding was not available for the Council to provide and run new care homes, however work with the private sector on recent developments had been successful.  Comments from the speakers and responses to the consultation had been taken into account and learning would be taken into account in the future.

The Head of Managing the Needs of Older People (MANOP) delivered a presentation that outlined the need for change to meet the accommodation needs for older people.  Greenacre did not meet the modern expectations and it would be expensive and impractical to update.

The Committee were also informed that other services located at Greenacre included a small day centre and a step up, step down short term residential reablement service.  It would be necessary to move these two services to new sites should it be decided to close the home. Residents, their families and staff at Greenacre had been invited to 1:1 meetings held at the home to discuss the proposals.  A full consultation had been published and the Director had asked for delegated authority to keep Greenacre open for as long it was necessary based on residents need.

A Member raised a concern regarding the registration of one of the care homes with CQC. In response the Head of MANOP advised the Council would need to reconsider its approach to the future of the home should Only Care Ltd not be successful in achieving registration.

Following the closure of Caddington Hall, a Member asked if lessons had been learnt and if learning would be used in preparation of the proposed closure of Greenacre?  In response the Head of MANOP advised residents would receive an early assessment of their needs and abilities.  Activities would be continued to maintain a positive atmosphere for those residents who remained at the home.

Members of the Committee were satisfied that the consultation process had been carried out in a comprehensive and diligent manner,  ...  view the full minutes text for item 70.

To consider the draft Budget, updated Medium Term Financial Plan, Capital Programme and HRA  pertaining to the Social Care Health and Housing Directorate only.  Information that is relevant to the other directorates will be considered in the other relevant OSC meetings.   Members are requested to submit their comments, observations and recommendations in respect of the Executive’s proposals with particular reference to the Social Care Health and Housing Directorate proposals, to the meeting of the Executive on 09 February 2016.

Members are requested to bring their copies of the Executive report with them to the meeting (hard copies will not be provided).  The report is available at the following website:-

http://centralbeds.moderngov.co.uk/ieListDocuments.aspx?CId=577&MId=4921&Ver=4

The Assistant Director Resources introduced the Draft Budget 2016/17 and Medium Term Financial Plan for Social Care, Housing and Public Health that had been presented to Executive in January 2016. 

The Financial Settlement had been significantly worse than anticipated for the Council and exacerbated the substantial efficiencies contained in the draft budget and MTFP.  The proposed 2% precept proposed by Government would not make up for the shortfall in funding.

A member raised his concern regarding the introduction of the living wage and the effect on care providers.  In response the Assistant Director advised that an hourly rate template had been developed and used by providers to recognise the effect on all staff, and not just at the lower end of the pay scale. Officers continued to revisit and review care packages to find efficiencies and Members were aware of the continued community resilience support required within Social Care.

The Assistant Director Public Health advised that the Government had not divulged the grant settlement to be provided, but it was lower than in previous years.  The settlement would, however, continue to be ring fenced.

The Assistant Director Housing advised of continued changes and reductions in Housing Revenue Account (HRA) that had caused a more cautious approach to the business plan, as a result of which the supported housing scheme was at risk  Members of the Executive had lobbied their MP regarding this concern. 

RECOMMENDED

1.    That the pressures and efficienciesacross Public Health and within the Social Care, Health & Housing directorate and the proposed delivery of the latter to meet budget constraints be noted.

2.    That reserves be replenished from time to time to help meet deficits.

3.    That the general approach concerning the General Fund Revenue budget, Medium Term Financial Plan and the Capital Programme be agreed.

4.    That the Committee notes the inconsistencies in rents across the range of facilities, the challenges presented and that representations have been made to local Members of Parliament.  In light of these concerns the Committee otherwise agreed to the proposals set out regarding Housing Revenue Account budgets.

To provide comment and challenge to the Q2 2015/16 performance monitoring information.

The Committee received the Q2 performance for the month of July to September 2015.  Members were advised there had been no movement in the historic red indicators, however, extra care flats had been completed and engagement with village care scheme was strong.

The Assistant Director Public Health advised of a below target in the number of Health Checks provided and officers would focus on those residents who declined a health check.  Members were advised of a point of care blood testing service that would see the need for patients to attend hospital cease.

RECOMMENDED

1.    That the Committee welcomed the generally good progress;

2.    That the Committee Recognised ‘prevention rather than cure’ when offering health checks and the need to have a positive response from individuals.

The purpose of the attached report is to provide Members with an update on the Winter Resilience Plan produced by the Bedfordshire Clinical Commissioning Group (BCCG) and scrutinise the exceptions reported.

The Acting Director of Strategy and System Redesign outlined the success in dealing with anticipated seasonal pressures in urgent care that had been experienced across Bedfordshire.  The complex needs of some patients had caused workforce pressures in hospitals and social care, however in general the services had coped well.

A Member raised concerns that some residents required between 4 and 6 visits a day by domiciliary carers.  The Assistant Director Adult Social Care advised that capacity to support patients for short time periods was not feasible, which was both a local and national challenge.

RECOMMENDED

1.    That the Committee welcomed extensive and varied campaigns advising the public on how to survive the winter.

2.    That the Committee recognised the tenner of the various campaigns, that success lies as much with individuals responding and taking care of their own health and taking up offers of vaccinations and health checks.

3.    That the Committee receive a final Winter Resilience Report in June that looks solely at Central Bedfordshire Performance.

The purpose of the attached report is to provide Members with an update on the Bedfordshire Mental Health and Wellbeing Service provided by the East London Foundation Trust.  The Committee is asked to consider and comment on the progress that has been made on the implementation of the ELFT plan, the key achievements since April 2015 and the future focus.

The Managing Director and Deputy Medical Director of ELFT Bedfordshire introduced a report that outlined the progress made by the Trust, to provide high quality and integrated services through a single point of access for with patients with mental health illnesses.  Partnership working had been established and the Trust’s implementation of the one year plan was well advanced. 

The need for patients to be cared for outside of area had been resolved and ELFT were confident that all patients on the inherited waiting list would have been seen.  ELFT sought help and advice in their accommodation search that was required for therapists and working closely with officers to resolve this.

A Member raised a concern regarding Child and Adolescent Mental Health service and work with schools.  The Managing Director advised ELFT had reduced the waiting list and was working with 12 schools in a specialist schools link project and that further details would be provided to the Children’s Services Overview and Scrutiny Committee later that week.

The Assistant Director Public Health advised Members that new measures put in place by ELFT had ensured that patients in touch with the Drug and Alcohol Service had been seen quickly and effectively.

RECOMMENDED that the Committee welcomed a very positive and extensive report and the speed at which issues were being addressed.  The Committee looked forward to further positive reports and further information relating to those schools that had taken part in the specialist schools link project.

The report provides Members with details of the currently draft Committee work programme and the latest Executive Forward Plan.

The Committee consider the current work programme and a Member request that a report be provided to a future meeting of the Committee on Homelessness.

RECOMMENDED that subject to the addition of those items noted in the Minutes the work programme be approved.