To approve as a correct record the Minutes of the meeting of the Social Care Health and Housing Overview and Scrutiny Committee held on 20 September 2016 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 20 September 2016 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 announced the Enquiry Team set up to look into Integration of Health and Social Care had met.  Members of the Team would provide proposed principles for discussion at their 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.

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 and Housing announced the LGA had carried out a Peer Review of the Reablement and Rehabilitation Service.  The formal report would be submitted to a future meeting of the Committee.

Congratulations were extended to Ferndale Residential Home in Flitwick, who had received a ‘good’ rating by the CQC.

The Deputy Leader and Executive Member for Health advised Members the Sustainable and Transformation Plan (STP) had been submitted on 21 October 2017.  The Executive Member also announced the reprocurement process for Community Health Services (0-19 children) had started.

To receive and update on the Better Care Fund and consider the progress made.

The Director of Social Care and Housing introduced a report that updated the Committee on the Better Care Plan that had recently been approved.  Members were advised  that Social Care and Bedfordshire Clinical Commissioning Group colleagues had started joint working on a number of small joint projects in Central Bedfordshire.  The Better Care Fund (BCF) priorities would continue to be implemented and the findings of the SCHH OSC Enquiry into Integration and the Peer Review findings would be amalgamated and introduced.

The Head of Partnerships and Performance advised the aim of the BCF was to ensure the funding and care was where it is most needed.  Three themed schemes to deliver improvements had been identified:

·         Out of hospital care

·         Prevention

·         Protecting Social Services including support for carers.

Members welcomed the direction of travel, that would see the focus of care and funding on the individual and the challenges faced to integrate all services.

RECOMMENDED

The Committee

·         Welcomed the key priorities of the Plan.

·         Appreciated the pressures on health and social care in a demand led service and the consequent financial pressures.

·         Noted the concern expressed about delays in patient discharge and the need for health and social care to work more closely together to provide any necessary support in the community.

·         Looked forward to the developing, clearer vision for integrated health and social care and urged all parties to embrace the vision in the Plan.

Noted and welcomed the full approval from NHS England.

To receive an update and consider the progress made on the Sustainable and Transformation Plan.

The Director of Social Care Health and Housing introduced a report and outlined the STP footprint that included our partners Bedford, Luton and Milton Keynes.  Following the recent second submission to NHS England, work was underway to ensure the correct funding was in place and plans supported the vision for Central Bedfordshire going forward.  It was noted that within the footprint, some services would remain standalone, however, joint working would continue where is was in the best interests of the patient to do so.  A set of principles had been developed that included:-

·         Prevention, Health and wellbeing

·         Quality of care provision

·         Financial stability.

Managing demand was a key area of focus as well as the wider engagement of key stakeholders.  The importance  of volunteers and a clear plan to digitalise records was noted and that Central Bedfordshire would use this opportunity to ensure residents received the best services possible.

RECOMMENDED

The Committee

1.    Expected the STP to help drive a way forward regarding the review of services provided in Bedford and Milton Keynes and Luton & Dunstable Hospitals and looks to see positive outcomes for the residents of Central Bedfordshire.

2.    Noted the delay in prioritising the services offered at Bedford and Milton Keynes Hospitals and any impact on those offered by the Luton and Dunstable Hospital.

3.    Expected to see financial balance across the local health system and an improvement in the efficiency of National Health services.

Consider and comment on the annual report of the Safeguarding Adults Board, with a particular focus on how awareness raising and knowledge of adult safeguarding could be improved for the public and within the wider community.

The Director of Social Care Health and Housing introduced the Joint Adults Safeguarding Board Annual Report and explained that a new independent Chairman had been appointed.  The Head of Adult Safeguarding advised Members of main areas of focus in the Service and referred to a serious concern that culminated in the closure of a care home and a serious case review concerning a resident in Dunstable.  The Head of Service advised that learning from these events had been shared and training given to staff and carers to ensure a consistent approach was given in the area of reablement, record keeping and managing those with complex needs.

Work to improve safeguarding and to make safeguarding personal was in hand and would meet the change in Law to be implemented in December regarding Deprivation of Liberty Safeguards (DoLS).

RECOMMENDED

The Committee

1.    Welcomed the many positives in the report and the positive joint working.

2.    Stressed the importance of ensuring good, detailed record keeping and recommended any training deemed appropriate to ensure such.

3.    Recognised that safeguarding is the responsibility of all of us.

To receive a verbal update on the government's plans to increse rents for council and housing association tenants with incomes over £30,000 also known as "Pay to Stay" and to be implemented in April 2017 for council tenants.

The Director of Social Care Health and Housing introduced a presentation that outlined a new Government initiative that proposed households living in social housing, considered to have ‘high incomes’, pay more for their home if their rent is below average private sector (market) rents in their local area.  Known as Pay to Stay, the arrangements are required to be implemented by April 2017.  However, these changes have not yet been given final approval by the Government and may be

subject to change.

Government guidance had not been published, however, work was underway to prepare tenants for the changes including a new tenant app., a helpline service and letter/leaflet to be sent out.  Members wished to be kept informed in order to support tenants.  The Head of Housing advised that a formal report be would submitted to the Committee when details of the scheme had been published.

RECOMMENDED

The Committee

1.    Recognises a national steer which seeks to draw a balance between those in need and those who are in a position to better provide for themselves; recognises that there is a gap between those for whom a social rent is appropriate and those who can pay a potential market rent, yet have not the capital to move away from social housing.

2.    Accepts that in the latter case a more appropriate market rent has to be investigated by reason of the national steer yet recognises the apparent excessive work which may need to be done to assess such rents.

3.    Is concerned with a possible effect on the short term housing plan and the ‘right to buy’.

4.    Expresses its considerable concern at the potential administrative costs in progressing this policy.

5.    Seeks to ensure a close working relationship with the Revenue and Benefits Office to counter fraud.

To receive a presentation regarding the directorate’s capital and revenue budget monitoring information for Q1 (April to June 2016).

A link to the more detailed Executive report can be found here:-

http://centralbeds.moderngov.co.uk/mgChooseDocPack.aspx?ID=5157

The Assistant Director Resources advised Members on the current Budget position for the Directorate.  Overspends in older people’s care packages and  an increase in the staffing levels in care homes were noted.  Plans to reprofile the capital budget were in hand and delays in the Croft Green development had resulted in an underspend in the Housing Revenue Account.

The Assistant Director Public Health advised that plans to spend the strategic reserve were under consideration and Members would be advised to proposals at a future meeting.

RECOMMENDED

The Committee:

Accepts the Budget Monitoring 2016/17 Quarter 1 report.

The report provides Members with details of the currently drafted Committee work programme and the latest Executive Forward Plan. Members will be provided the opportunity to discuss in depth the comprehensive list of items proposed for the Committee work programme, helping shape the future direction of travel.

The Committee considered the current work programme and a long list of possible items identified at a Member Workshop and from residents that had replied to the Overview and Scrutiny Survey and included:-

• The Peer Review
• BCCG Financial Report update
• Services for Dementia Care
• Report outlining support for pharmacies and their services and education of the public.
• Integration of Health and Social Care Enquiry
• BCCG regarding the Musculoskeletal Service performance.

RECOMMENDED that the items identified in the minute above be included on the work programme.