To approve as a correct record the Minutes of the meeting of the Social Care Health and Housing Overview and Scrutiny Committee held on 28 July, 2014 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 28 July 2014 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.

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

The Committee were advised that the Bedfordshire Clinical Commissioning Group had announced its report on the Review of Healthcare Services in Bedfordshire and Milton Keynes would be published on 25 September, 2014. 

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 Health and Housing updated the Committee on issues that were not included on the Agenda, these included:-

·         Attendance at officer meetings associated with safeguarding, the Coroner’s Office and finance (including the Better Care Fund).  Officers were thanked for their hard work on the Better Care Fund submission.

·         Attendance at the SEPT AGM and the topping out ceremony arranged by the Quantum Care Homes Group in Dunstable.

·         A meeting on the proposed refurbishment of housing stock at Croft Green, Leighton Buzzard

·         The successful transfer to the Council of seven homes for older people previously managed by BUPA

·         Attendance at a Dementia Workshop.  A media training package on the workshop was to be developed for those Members unable to attend the event.  Other Members training events had been timetabled.

In light of the update, Members of the Committee raised the following:-

·         A request for a briefing on the housing allocation bidding system be arranged for the Committee.

·         A Member’s  thanks on the excellent safeguarding training for the voluntary sector, which ensured that the sector was equipped with the correct reporting pathway and officer contacts.

·         Concern that steps had not been taken to deliver additional social housing with Aragon and other Housing Associations. There was a sense of urgency to provide housing for an increased population who could not afford to buy a home.  In response the Executive Member confirmed that a multi-directorate officer group had been established to develop a framework to deliver additional houses.

·         Suggestions that officers meet with local estates agents to understand what their customers requirements were and where a housing gap existed.  Officers were asked to investigate the private housing trust developments including a development in Eversholt.

To consider and comment on the Winterbourne View progress report and Joint Action Plan.

The Head of Strategic Commissioning introduced a report co-written with colleagues at the Bedfordshire Clinical Commissioning Group (BCCG) that outlined the delivery and actions undertaken in light of the Winterbourne View Panorama undercover programme and subsequent Department of Health enquiry.

A positive review was carried out by the Specialist Improvement Adviser that had identified the good working relationship between the Council and the BCCG.  The Director of Social Care Health and Housing advised the Committee of the concerns raised by the Minister, Norman Lamb, surrounding the number of patients that had been admitted and remained in hospital.  In Central Bedfordshire there were 3 individuals with very special needs that had remained in hospital.  Officers and the BCCG were working with patients and families to find the right care for these individuals once their treatment had been completed.

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

·         Whether there had been input from the voluntary sector or engagement with patients or their families concerned.  In response the Director of Social Care, Health and Housing advised there had been engagement with patients, families and some voluntary organisations. 

·         Whether care plans had been provided in the cases of the three individuals in specialist hospitals.  The Committee was advised that care plans did exist, however, there was a concern that these plans had not been reassessed.  Officers would ensure care plan reviews continue to be carried out.

In light of the update Members of the Committee requested that a further update be provided in relation to the Campus Closure Project.

NOTED the update and requested that an briefing on the Campus Closure Project be provided to Members.

To receive a report on the current NHS stroke service provision across the stroke pathway in Bedfordshire.

Natasha Fox, Deputy Director, System Redesign, Urgent and Integrated Care, BCCG, introduced a report on Stroke Services in Central Bedfordshire that highlighted the number of stroke victims and survivors in the area and the range of services available to patients.

The Community Stroke Pathway was a key area of concern and the lack of specialist community rehabilitation provision available in the south of the County for patients waiting discharge from the Luton and Dunstable (L&D) Hospital was raised as a key concern. 

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

·         Concern that the provision purchased through SEPT at the Knowles and Taymar Care Centres did not meet the full need.  The Deputy Director BCCG advised that work towards early supported discharge service would help to alleviate the delays in discharge from the L&D.  Members proposed that empty beds at Biggleswade Hospital or SSMU might be used for recuperation of patients to alleviate the pressures on beds at acute hospitals. Reference was made to the imminent closure of the Short Stay Medical Unit (SSMU) in Houghton Regis that would impact on the ability for these beds to be considered for this alternative purpose.  The discharge of stroke patients from the Lister Hospital had not been included in the report and Members requested that this be circulated separately.

·         That consideration be given to the establishment of a local network of Stroke Carers Central Bedfordshire, if this was not already available.

·         That consideration be given to the BCCG providing music therapy as part of their rehabilitation service to stroke patients.  A Member suggested there was an opportunity to link up with the ‘Singing for the brain’ workshop provided for Dementia victims.  The Deputy Director, System Redesign, Urgent and Integrated Care, BCCG agreed to refer this suggestion to BCCG colleagues.

·         Concern was raised that the Committee had not be made aware of the proposed closure of the SSMU.  The Committee was advised that the SSMU was commissioned as a pilot and the CCG faced a large deficit in funding.

RECOMMENDED

1.    That the Bedfordshire Clinical Commissioning Group be requested to submit a report on their financial position that would impact on services as a result, including the Short Stay Medical Unit in Houghton Regis.

2.    That a briefing be provided on the discharge of stroke patients from hospitals, other than Bedford and the Luton and Dunstable (to include the Lister Hospital).

To receive an update on the latest Better Care Fund Submission.

The Director of Social Care Health and Housing delivered a presentation that informed the Committee of the changes in the Better Care Fund (BCF) plan following the July submission and the re-submission on 19 September, 2014.  The submission had entered a two week moderation period during which the Plan would be scrutinised.  The Assistant Director Resources drew the Committee’s attention to the joint financial model and pooled budget investment plan and highlighted the key risk that some funding could be transferred to acute hospital providers if reductions to unplanned admissions were not achieved.

In light of the presentation the Committee commented and discussed the following points:-

·         The significant amount of effort undertaken by officers to submit the plan within the timescales.

·         The need for a communication work stream to be rolled out to educate residents in the role of hospitals to reduce the numbers of residents presenting themselves at A&E.

·         Concern that work to provide an integrated IT system had not been realised.  The Deputy Director System Redesign, Urgent and Integrated Care, advised that almost all GP’s in Central Bedfordshire had the same IT system and work was in progress to ascertain the key pieces of information that were required to be shared.  A bid for national funding had been requested to support the roll out.

·         The need to submit an update on Better Care Fund plan to the Committee following the publication of the Review of Healthcare Services in Central Bedfordshire.

NOTED the update and requested that a further update be scheduled with regards Better Care Fund.

To receive a presentation on the implications of the Special Educational Needs and Disability (SEND) reforms.

The Assistant Director Adult Social Care and Assistant Director School Improvement delivered a presentation on the reform of Special Educational Needs and Disability (SEND) support for Children  The presentation outlined the key changes in relation to the reforms and the process to deliver these reforms in partnership with multi-agencies and other professionals

In light of the update Members raised the following:

·         Whether the Council, as the Corporate Parent, would care for children until they reach the age of 25 years.  The Executive Member advised there was a lack of clarity about this from Government, however, if a child had special educational needs, they would be cared for until the age of 25 years old.

·         Queries regarding the plans that had been put in place to ensure social workers would support a child into adulthood.  The Assistant Director, Adult Social Care advised that there would be a seamless service in place and training was planned for social workers.

·         Whether engagement with young people and Looked After Children had taken place in light of the reforms.  The Assistant Director explained that engagement work would be rolled out shortly and that this would include children with special needs.

NOTED the presentation and requested that a further update be provided to the Committee regarding the implications of the SEND reforms in six months.

To receive a presentation on the Revenue, Capital and Housing Revenue Account Q1 budget reports for relevant services.

The Committee was provided with a presentation that highlighted the key points in relation to the forecast revenue outturn for 2014/15.  The attention of the Committee was drawn to a forecast outturn of £64.3m after use of reserves resulting in a £0.5m or 1% overspend.  The Assistant Director Resources also advised that the capital forecast showed a gross spend of £8.2m on budget along side the Housing Revenue Account capital expenditure forecast of £17.9m, also on budget.

The Public Health forecast position for 2014/15 showed a balanced budget at the end of the first quarter.

NOTED the presentation.

The report provides Members with details of the currently drafted Committee work programme and the latest Executive forward plan.

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.