To approve as a correct record the minutes of the meeting held on 26 June 2010.

RESOLVED

that the Minutes of the meeting of the Social Care, Health & Housing Overview and Scrutiny Committee held on 28 June 2010 be confirmed and signed by the Chairman as a correct record.

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

There were no announcements or matters of communication.

To receive petitions in accordance with the scheme of publication set out in Annex 2 of Part 4 of the Council’s Constitution.

The Chairman announced that no petitions had been referred to this meeting.

This is an opportunity for questions, statements and deputations from members of the public in accordance with the Public Participation Procedure set out in Part A4 of the Council’s Constitution.

The Chairman announced that no questions, statements or deputations had been received.

To consider any matter referred to the Committee in relation to the calling in of a decision.

The Chairman announced that no call-ins had been referred to this Committee.

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

The Chairman confirmed that no requests for agenda items had been received.

To receive an update from Bedfordshire LINk on local health matters influencing LINk activity as defined by the Health and Social Care Act 2001.

The Committee received an update from the Finance Officer of the Bedfordshire LINk, which highlighted local matters relating to the transition of LINks into local HealthWatch organisations in April 2012.  The Committee heard that the Bedfordshire LINk had recently provided a response to the consultation on the white paper 'Equity and Excellence: Liberating the NHS' and had also approached Luton LINk and Bedford LINk in order to discuss cross-authority matters, Bedford LINk however had expressed a view that they did not feel this was necessary at the current time.

The Committee was informed that LINks were established by all Local Authorities with three years of funding provided from the Department of Health to support their operation. This funding would cease in 2011 and it was not clear how the LINk would be funded during 2011/12 prior to the transition to the HealthWatch Organisation. Members agreed it was important that a full briefing be provided to a future meeting of the Committee outlining the implications of the white paper 'Equity and Excellence: Liberating the NHS' and the implications of the transition from LINks to local HealthWatch organisations. 

The Finance Officer of the Bedfordshire LINk stated that he was grateful for the support that the LINk had received from Councillors at Central Bedfordshire Council.

RESOLVED

1.                  that the update be noted.

2.                  that a briefing be provided to a future meeting of the Social Care, Health and Housing Overview and Scrutiny Committee regarding the issues in the health white paper and specifically relating to the transition from LINks to local HealthWatch organisations.

To consider commissioning an Joint Health Scrutiny Committee to review NHS Bedfordshire’s public consultation for this strategy.

The Committee received a presentation from NHS Bedfordshire and Horizon Healthcare in relation to the Urgent Care Strategy being developed to respond to the changing demand for urgent care facilities in the Borough.

The Urgent Care Strategy had been considered by both the National Clinical Assessment Team (NCAT) in June 2010 and as part of a Gateway Review by the Office of Government Commerce Review in July 2010.  The aim of the strategy was to reduce hospital admissions, delayed hospital discharge, and the number of hospital readmissions within 30 days and to increase preventative care.

The Director of Social Care, Health & Housing reminded the Committee that whilst there was no hospital in Central Bedfordshire; arrangements were in place with surrounding hospitals in Luton, Bedford and Stevenage and agreed that a joined up approach was needed to provide services in the most cost-effective manner.

The Committee felt that extensive local engagement of stakeholders was a more pragmatic approach than a full public consultation.  It was agreed that an impact assessment and implementation plan would be brought to a future meeting of the Committee by the end of 2010.

It was noted that Bedford Borough Council’s Adult Social Care and Health Policy Review and Development Committee had agreed that a joint Health Scrutiny Committee was not required for this Strategy.  Bedford Borough Council’s policy review and development committee had fully endorsed the approach of extensive local engagement of stakeholders instead of undertaking a full public consultation.

RESOLVED

To receive the Budget information for the Social Care, Health and Housing Directorate.

The Committee received and considered the Budget Management Report for the period ended 30 June 2010 for the Social Care, Health and Housing Directorate.  The Director of Social Care, Health and Housing informed the Committee that the year-to-date position at 30 June 2010 was an overspend of £780k and a projected full year overspend of £1,110k.  The following key reasons had been identified:-

Under-spends on salaries of £550k and additional income of £280k on the Rapid Intervention and Intermediate Care Teams will help offset the overspends.

Efficiencies in the amount of £2,753k were budgeted, of this £2,382k are forecast to be achieved.  The shortfall of £371k would be met through compensatory efficiencies as follows:-

In addition, the following opportunities had been identified which should further help savings:-

• Review of the Residential Care contracts will provide more cost effective service provision
• Service delivery options within Learning Disability contracts may lead to improved VfM

In response to a question from Members, the Portfolio Holder for Social Care and Health stated that the forecast in relation to the Emergency Duty Team was shown as the gross annual figure for the entire service.  The forecast did not inlcude the income for the service that was received through payments charged to Bedford and Luton Borough Councils.  It was noted that the payments from the other Authorities were not received until the end of the financial year, thus currently making the overspend appear larger than it would be.  It was requested that where possible commentary be added to the spreadsheet to provide clarification on the levels of overspend.

RESOLVED

1.                  that the forecast outturn of £52m and projected £0.840m overspend be noted.

2.                  that the key management actions as detailed in paragraph 7 of the Budget Management Report for the Social Care, Health and Housing Directorate for the period ended 30 June 2010 be noted.

To receive the current position in the development of the LET’S RENT housing option since the Committee’s meeting held on 5 November 2009.

The Committee received and considered the six-monthly progress report on the Let’s Rent – Housing Option, which was ratified by the Executive on 9 February 2010.  The innovative private sector housing option allows households in Central Bedfordshire the choice to access a regulated private sector home, with all requisite support mechanisms for tenancy sustainment, if required. 

The Head of Housing Needs informed the Committee that since the Scheme’s inception on 19 April 2010, eighteen families had successfully found a new home.  The Scheme incorporates the following six outcomes, of the Rugg Review “The Private Rented Sector: Its Contribution and Potential” (2008):-

Following comments by some of the landlords regarding the fee charged by Letting Agents, negotiations were ongoing between the Council and the Letting Agents to secure a reduction in the management fee from the current 12%.  An alternative approach being considered was for the Council to secure properties directly from private landlords with only a 2 or 3% management fee, thus enabling the scheme to become self financing.  The Committee noted that the future security of the Council’s housing grant was not certain and alternative approaches to the delivery of the scheme would need to be considered.

The Committee congratulated the Head of Housing Needs on a well organised and run scheme and requested a further update in six months.

RESOLVED

1.                  that the content of the Let’s Rent – Housing Option report be noted.

2.                  that the Social Care, Health & Housing Overview and Scrutiny Committee fully supported the Let’s Rent – Housing Option Scheme.

3.                  that a report be presented to the Social Care, Health & Housing Overview and Scrutiny Committee in six months to review the performance of the scheme and to consider any necessary alternative approaches in relation to its financial management.

To consider the report providing feedback and recommending a strategy for implementing the Transformation Programme including a new customer pathway.

The Committee received and considered the report which provided a summary of the progress on the transformation programme, previously considered by the Social Care, Health and Housing Committee and formally approved by the Executive at its meeting on 9 February 2010.

The programme has been developed, in consultation with NHS Bedfordshire local voluntary/community organisations and provider agencies, for people who fund their own care as well as individuals directly supported by the Council.  The four main elements of Putting People First are:- universal services, early intervention and prevention, social capital and choice and control.

By April 2011 the Council must have met the following five national milestones:-

·              Effective partnerships with people using services, carers and other local citizens

·              Self directed support and personal budgets

·              Prevention and cost effective services

·              Information and advice; and

·              Local commissioning

The Committee noted that the main focus was the introduction of personal budgets for cared for people.   There was a local and national target for 30% of people in receipt of community based support to have self directed support (SDS) by the end of March 2011.  It is noted that at present Central Bedfordshire has 262 people in receipt of SDS’ and provides 900 direct payments which gives an overall percentage of 21% of cared for people.  Improvements in this process would result from streamlining and better use of reviews.  The Director of Social Care, Health & Housing informed the Committee that Central Bedfordshire residents should have the same options available to them as the rest of the East of England.  The East of England target for people in receipt of community based support to have SDS by the end of March 2011 was 50%.

The Committee then watched a DVD which showed three people who were benefiting from SDS.

The Committee thanked David Jones, Assistant Director for Transformation for all of his work during his time with Central Bedfordshire and at his legacy authority.

RESOLVED

that the issues highlighted in the Transforming People’s Lives’ report be noted and congratulations be given for the work carried out thus far.

To review the report of the Task Force prior to the policy’s consideration at the Executive on 28 September 2010.

The Committee received and considered the report of the Task Force Review of the Charging Policy for Non-Residential Social Care Services. 

The Chairman of the Task Force informed the Committee that the Local Government Association (LGA) had stated “central government funding – which accounts for a significant proportion of a council’s budget – has not kept pace with the needs of an ageing population”.  Increased funding had been given to the NHS but not the social care providers, which had resulted in Local Authorities struggling to provide enough trained social care workers for service delivery.

The Task Force were informed of the following:-

• There are 1000 people in receipt of non-residential care services at any one time in Central Bedfordshire.
• The Council’s annual income from charging for these services is currently £785,000.
• There are 550 new Financial Assessments carried out each year.
• On average only 50% of customers are assessed to pay is £48.00 per week
• There are approximately 400 people on Direct Payments

The Committee were informed that over three thousand consultation packs had been issued by the Council regarding the review of charging for non-residential social care services.  A total of 200 responses had been received to this consultation.  In addition there were consultation events and meetings and information was published on the Central Bedfordshire Council’s website, in News Central and the Social Care, Health and Housing Connect staff newsletter.  The Task Force also considered benchmarking data from fifteen other local authorities within our comparator group.

In response to a question regarding the length of time financial assessments were taking to complete, the Director of Social Care, Health & Housing informed the Committee that a significant backlog of financial assessments had been inherited from the legacy County Council.  The Council was working to resolve the backlog as it was not allowed to backdate any charges.  It was noted that other Councils were known to give estimates of potential charges but this was not the approach which Central Bedfordshire wished to take.  The process for making financial assessments was being reviewed and would be made more cost effective and timely.

RESOLVED

1.                  that the Task Force report be approved the accompanying recommendations be endorsed for submission to the Executive and Full Council.

2.                  that a vote of thanks be recorded for the officers involved in supporting the Task Force.

To consider the Social Care Health and Housing Overview and Scrutiny Committee draft work programme for 2010 – 2011 and the Executive Forward Plan for the period 1 October 2010 – 30 September 2011.

Members considered the Committee’s work programme, it was noted that the Draft Budget 2011/2012 would be considered at the 20 December meeting at the request of the Portfolio Holder for Finance, Governance and People.

RESOLVED

that, subject to the above change, the work programme be noted.

The next meeting of the committee will be held on 18 October 2010 in Room 14 at Priory House starting at 10.00am.

The next meeting of the Social Care, Health & Housing Overview and Scrutiny Committee will be held on Monday 18 October 2010 in Room 14, Priory House, Monks Walk, Shefford.

The site visit to the Ambulance Service to be rearranged for a future date.