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 October 2012 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 22 October 2012 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.

The following Councillors declared interests in the business to be transacted:-

·              Cllr M Smith (Item 17) as the Chairman of the Ampthill and District Good Neighbour Scheme.

·              Cllr Mrs S Goodchild as a Member of the Houghton Regis Good Neighbour Scheme and as a member of her family was a service user.

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

The Chairman informed the Committee that the presentations on the Prevention Strategy (Item 14) and Village Care Schemes (Item 17) covered many of the same issues.  As a result the Chairman had agreed to consider these items together (Minute SCHH/12/76 refers).

The Scrutiny Policy Adviser updated the Committee on the outcomes of a meeting with the Care Quality Commission (CQC) regarding communication.  The Committee were informed that in order to encourage communication between CQC and the Overview and Scrutiny Committee (OSC) the following would take place:-

·        CQC would receive the Committee’s work programme to consider if there were any items that may support inspections;

·        Task Force reports would be sent to CQC to support any inspections;

·        CQC will attend work programming sessions to determine if there are any meetings they might attend or to suggest items that may be of interest to Members;

·        An annual compliance report would be presented by CQC to the Committee to identify any areas of concern.

A Member suggested that as other OSCs met in the Council Chamber the Social Care, Health and Housing OSC may also wish to do so.

RECOMMENDED that the Scrutiny Policy Adviser consider the possibility of the Committee meeting in the Council Chamber in future.

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.

No petitions were received from members of the public in accordance with the Public Participation Procedure as set out in Part D2 of the Constitution.

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.

No questions, statements or deputations were received from members of the public in accordance with the Public Participation Procedure as set out in Annex 1 of Part A4 of the Constitution.

To consider any decision of the Executive referred to this Committee for review  in accordance with Procedure Rule 10.10 of Part D2. 

The Panel was advised that no decisions of the Executive had been referred to the Panel under the Call-in Procedures set out in Appendix “A” to Rule No. S18 of the Overview and Scrutiny Procedure Rules.

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.

No items were referred to the Committee for consideration at the request of a Member under Procedure Rule 3.1 of Part D2 of the Constitution.

To receive for information a verbal update from the Executive Member for Social Care, Health and Housing.

Cllr Mrs C Hegley, the Executive Member for Social Care, Health and Housing updated the Committee on issues that were not included on the agenda, these included:-

·              Recent visits to day centres in Central Bedfordshire.

·              A recent meeting of the Health and Wellbeing Board.  Members were encouraged to attend future meetings.

·              A recent presentation on European funding that encouraged authorities to bid for money to support the delivery of health services.

·              Recent workshops on housing that had gathered the thoughts of older people on several issues including Extra Care schemes.

·              A recent presentation on the Central Bedfordshire voids process.

·              A film that had recently been published by Right Track in relation to “My Place”.

·              The recent annual general meeting of Age UK.

·              The positive nature of the recent staff awards.

·              A recent meeting of the Landlord’s Forum.

·              Current investigations by the directorate into an invoice error.

·              A recent Local Government Association Improvement Board Meeting that had presented an innovative IT solution to minimise loneliness.  It was hoped that Central Bedfordshire could be involved in a pilot scheme to test this solution.

In response to questions from a Member the Executive Member commented that there had been a big improvement in relation to voids and the number of days for which a property remained void had reduced from 32 days to 24 days.  There was an aspiration to improve performance still further to 18 days.

To receive for information an update from Bedfordshire LINk on health matters affecting LINk activity.

The Committee received an update from Mr B Smith, Chairman of the Bedfordshire LINk, on the key work and issues the LINk was presently engaged with.  The LINk had recently been informed they would no longer be invited to attend meetings of the Bedfordshire Clinical Commissioning Group (BCCG) as a lay member had been appointed.  The manner in which this change had been handled had not been positive.  The Committee were also informed that the BCCG had recently produced an Economy Winter Plan, the LINk were surprised that this had not been considered by the OSC.

In response to the update the Committee discussed the following issues:-

·              The use of agency staff in care homes and whether this was perceived to be a problem.  In response the Chairman of Bedfordshire LINk commented there was evidence that care homes suffered from a lack of continuity meaning agency staff were crucial.

·              The benefit of using life books to stimulate the minds of care home residents.  In response the Chairman of Bedfordshire LINk suggested that a report on best practice, including the life books scheme, be drafted by the LINk to be made available for future visits.

·              Concerns relating to the issues highlighted at the Swiss Cottage Care Home, Leighton Buzzard and the importance of resolving these.  The Executive Member also commented on the need for stronger recommendations for required action.  It was suggested that to wait 12 months for a further visits was unacceptable in light of the issues raised.  The Committee were informed that CQC and the Council could use the outcomes of the visits to inform their inspections, as a result a further inspection of Swiss Cottage could be brought forward.

·              The high levels of staff sickness, which may be a result of stress.  It was suggested that contact be made with other agencies such as the fire or ambulance service to see how they address these problems.

NOTED the update

RESOLVED that the BCCG’s Health and Social Care Economy Winter Plan 2012-13 be circulated to Members outside of the meeting.

To receive a presentation relating to the implications of the health reforms for Central Bedfordshire and an update on progress.

The Director of Strategy and System Redesign for Bedfordshire Clinical Commissioning Group provided a presentation that outlined the implications of the NHS reforms for Central Bedfordshire.  In response to the presentation the Committee discussed several issues, including:-

·              Concerns that staff would be retained unnecessarily during the course of the NHS reforms.  In response the Director of Strategy and System Redesign commented that staff had been made redundant during the reforms and the use of interim staff meant that people would not be retained unnecessarily.  The NHS had provided a general redundancy fund to support the implementation of reforms.

·              Whether a minor injury unit would be provided in Leighton Buzzard.  In response the Director of Strategy and System Redesign commented that services were currently being reviewed.  The review would consider whether a facility was necessary.

·              The need to ensure the growth of the NHS Commissioning Board did not detract from the principle of developing a more localised NHS.

·              The importance of the continued growth of patient groups.

·              The importance of accessibility when discussing whether or not to refer patients to services at another location.

·              The complexity of the new NHS organisational model and whether in practice it could be delivered.

·              Whether there were adequate proposals in place to deliver a service if a qualified provider went out of business.  In response the Director of Strategy and System Redesign stated the BCCG was presently developing an alert system to identify early warnings of problems.  The Committee requested to be kept informed of developments during the implementation of health reforms so as to be aware of any such problems.

·              How the BCCG would learn from its mistakes.  In response the Director of Strategy and System Redesign commented the BCCG would be open about its mistakes and would provide evidence of the way they have addressed problems.

·              The importance of focusing on improving outcomes for patients.

·              The need to provide more information to patients to increase awareness of the choice of services and quality of care throughout Central Bedfordshire.

·              The complication that would arise from deciding to relocate GPs to another building and the extensive consultation that would be required.

·              The national discussions that were ongoing within the NHS regarding their culture and whether it could provide a 7 day a week service.

·              Whether there was any update on proposals for Biggleswade Hospital.  In response the Director of Strategy and System Redesign stated that a report on the Community Bed Review was due to be completed by the end of January and would be presented to the OSC in March 2013, the outcomes of which would have implications for Biggleswade Hospital.

·              Concerns relating to the fragmentation of commissioning and the implications of this approach .

RESOLVED that a further update on the implications of the health reforms be provided to the Committee in 6 months to include specific references to the fragmentation of commissioning.

To consider a 6-month review of performance in relation to the short stay medical unit at Poplars and the Step Up Step Down facility at Greenacres and proposals for the future.

The Chairman informed the Committee that this report was not currently available for consideration as an evaluation of the pathway was still underway.  A report was currently being developed and it had been agreed to defer this item until such time as the evaluation had been completed.

RESOLVED that the item be deferred and the evaluation of the short stay pathway be presented to a future meeting of the Committee.

To receive the outcomes of a 12-week consultation in order to comment on the draft policy prior to consideration by the Executive.

The Interim Head of Operations presented a report that detailed the outcomes of a recent consultation on the Local Lettings Policy for Rural Exception Sites.  In addition the Director for Social Care, Health and Housing drew attention to the equalities/human rights implications and suggested that Members consider these implications in detail before agreeing their recommendations.  In light of the report the Committee discussed the following issues in detail:-

·              The importance of access to properties with affordable rents and the Council taking a lead on what it considered to be a fair/affordable rent.  In response the Interim Head of Operations commented that the Sustainable Communities directorate was responsible for negotiating affordable rents and Central Bedfordshire was currently considered to be an area that provided value for money.  A Supplementary Planning Document was to be produced in 2013 in relation to affordable housing.

·              The extent of indirect discrimination that could arise due to a local connection being considered a greater priority than someone with a greater housing need when allocating homes in rural exception sites.  It was suggested by a Member that the proposals did not amount to social engineering, which would be a more serious implication.  The Interim Head of Operations commented there was evidence that some local residents had not been able to get into the properties that had been built for them locally due to the Council’s allocations policy.  The Committee considered that the number of instances people in greater housing need were disadvantaged by the policy was small and the Council could defend its position if necessary.

·              The importance of addressing the need for transport and facilities in local communities to ensure that Central Bedfordshire was a great place to live.

·              Whether the expectations of residents in Central Bedfordshire for accommodation were too high.  The Committee felt the Council should provide more basic accommodation to make it more affordable, similar to the old ‘starter homes’.  It was also queried whether the cost of building on government owned land had any impact on the affordability of properties.  Members agreed this was an issue the Task Force review of the strategic changes in housing could consider.

RECOMMENDED to Executive

1.                  That the Committee has considered the equalities/human rights implications detailed in the report and did not feel that proposals would lead to indirect discrimination such that the policy should not be approved.

2.                  That the Local Lettings Policy for Rural Exception Sites in Central Bedfordshire be adopted.

RECOMMENDED to the task force review of the strategic changes in housing that issues relating to the affordability of housing be considered within the context of their review.

Councillor Ray Berry left the meeting during consideration of this item.

Meeting adjourned at 12 noon and reconvened at 12.10pm

To receive a presentation on the Prevention Strategy, to include Ageing Well and the Arlesey Village Agent.

The Committee received a presentation from the Assistant Director for Commissioning relating to the Ageing Well Programme, prevention, timebanking and village care schemes.  The presentation also provided a specific update on the Arlesey Village Agent Pilot.  In light of the presentation and clarification provided by officers the Committee discussed in detail the organisation of timebanking schemes.  Members discussed specific issues in relation to:-

·              The benefit of involving GP practices at an early stage in the development of schemes.

·              The importance of a coordinator for timebanking schemes.

·              Safeguarding and insurance.

·              The need to identify funding that might be available to set up or support timebanking schemes.

·              The need for effective coordination and promotion of timebanking schemes to support their success.

In response the Director of Social Care, Health and Housing commented that local Parish Councils had asked the Council to take on a coordinating role for timebanking schemes.  The remaining issues raised by the Committee would be considered as more schemes were developed.

In addition to the issues relating to timebanking the Committee also considered:-

·        The benefit of extending the use of an information hub throughout Central Bedfordshire to include village care schemes.

·        An evaluation report that was presently being developed by the Bedfordshire Rural Communities Charity in relation to the Arlesey Village Agent Pilot, which would be presented to Committee when available.

RESOLVED that the evaluation report on the Arlesey Village Agent Pilot be presented to the Committee once available.

To receive a presentation on performance and service outcomes in relation to self-directed support.

The Committee received a presentation from the Personalisation Team Manager that informed the Committee of the benefits of self-directed support, explained user-led organisations and considered current challenges and opportunities in Central Bedfordshire.  In response to the presentation the Committee discussed the following issues in detail:-

·              The need to understand why some residents did not want self-directed support.

·              The ways in which the Council felt it could develop the social care market further, which included formalising the approach micro-enterprise and social enterprise and developing stronger working relationships.

·              The importance of making available information and advice to self-funders of social care services and promoting stronger purchasing power for self-funders.  In response the Personalisation Team Manager commented that a focus was being placed on self-funders and the Council would expect purchasing power to improve as there became greater awareness of the choice that was available.

·              The action that could be taken if a resident spent their personal budget prior to the end of the year.  In response the Personalisation Team Manager commented that the Council monitored those persons where there was a risk of this occurring and there were safeguards in place.  Generally it was more likely that a person would underspend their budget than overspend.

·              The need to be aware of the risk of voluntary groups ceasing to operate where the Council encouraged the development of additional groups.

·              The need to ensure accountability of personal assistants that were employed and paid for using personal budgets.  In response the Personalisation Team Manager commented that training was provided both to personal assistants and those who employed personal assistants to promote accountability.

·              The excellent performance in relation to self-directed support, which was far ahead of others in the region.  The Director for Social Care, Health and Housing commented that although the national performance indicator might be reduced the Council would retain the 100% target in the Medium Term Plan.

RESOLVED that the Social Care, Health and Housing directorate be congratulated for their performance in relation to self-directed support.

Councillor Mrs S Goodchild left the meeting during consideration of this item.

To receive a report detailing the statistics for 2011/12 on the number of complaints received; complaint outcomes (upheld/not upheld); performance; issues complained about; and learning and improvements resulting from complaints for Adult Social Care.

The Committee received the annual report on complaints and compliments for 2011/12 in respect of Adult Social Care.  Members discussed the ways in which the Council’s literature encouraged residents to complain or compliment services, which was considered to be appropriate.

NOTED the report.

To receive feedback on village care schemes in Central Bedfordshire, their impact, outcomes and how they support future commissioning decisions.

As agreed by the Committee this item was considered under Minute SCHH/12/76.

To receive the quarter 2 performance monitoring report for the Social Care, Health and Housing directorate.

The Committee received the quarter 2 performance monitoring report for the Social Care, Health and Housing directorate.  The Assistant Director for Business and Performance drew Member’s attention to the content of the report, which now included the Medium Term Plan indicators and an indicator in relation to public health.

NOTED the report.

To receive the quarter 2 capital budget monitoring report for the Social Care, Health and Housing directorate.

The Committee received the quarter 2 capital budget monitoring report for the Social Care, Health and Housing directorate.  Members raised issues in relation to disabled facilities grants (DFG), the ways in which the Council promoted these grants and whether the Council got this money back.  The Director for Social Care, Health and Housing commented that a review of DFGs was presently underway but monies awarded through DFG were not returned to the Council.  The Director undertook to provide a written response on both of these aspects.

Members also queried delays in relation to the refurbishment of Timberlands, which were a result of delays in the procurement process.

RESOLVED that a written response be provided by the Director of Social Care, Health and Housing in relation to the issues raised by Members on disabled facilities grants.

NOTED the report.

To receive the quarter 2 revenue budget monitoring report for the Social Care, Health and Housing directorate.

The Committee received the quarter 2 revenue budget monitoring report for the Social Care, Health and Housing directorate.  

NOTED the report.

To receive the quarter 2 revenue and capital budget monitoring report for the Housing Revenue Account.

The Committee received the quarter 2 revenue and capital budget monitoring report for the Housing Revenue Account.  The Executive Member informed the Committee that in the future the report would be received by both the Social Care, Health and Housing and Corporate Resources OSCs as it was a corporate report.

NOTED the report.

To consider the currently drafted Committee work programme for 2012/13 and the Executive Forward Plan.

The Committee received their work programme and the Executive Forward Plan.  The Committee noted the following amendments to the agenda:-

·              Item on the Council’s approach to Healthwatch to be added in January 2013.

·              Item on Extra Care housing in Dunstable to be added in January 2013.

·              Item on the Community Bed Review to be added in March 2013.

·              Prevalence of problem drug use to be considered in March 2013.

·              Opthamology services to be considered in March 2013.

·              Adult/child eating disorders no longer to be considered.

·              Commissioning for outcomes in domiciliary and residential care to be received as an off-agenda briefing.

·              NHS 111 care number update to be received as an off-agenda briefing

Members also requested that an update on the current position of the Committee’s Task Forces be circulated by email.  In addition Councillor Bowater submitted his apologies for the next two meetings of the Social Care, Health and Housing OSC.

A Member also commented that due to the length of the agendas officers might consider all day meetings for the OSC in the future with a break for lunch.  The Scrutiny Policy Adviser suggested that rather than all day meetings work could be prioritised and those items ‘for information’ circulated outside the meeting in order to shorten the agenda.

RESOLVED that the work programme be approved subject to the amendments as detailed in the Minute above.