Agenda for Adult Care & Health Committee on Monday, 25th November, 2013, 4.00pm
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Agenda, decisions and draft minutes
PDF 218 KBVenue: Council Chamber, Hove Town Hall. View directions
Contact: Caroline De Marco
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Procedural Business (a) Declaration of Substitutes: Where Councillors are unable to attend a meeting, a substitute Member from the same Political Group may attend, speak and vote in their place for that meeting.
(b) Declarations of Interest:
(a) Disclosable pecuniary interests not registered on the register of interests; (b) Any other interests required to be registered under the local code; (c) Any other general interest as a result of which a decision on the matter might reasonably be regarded as affecting you or a partner more than a majority of other people or businesses in the ward/s affected by the decision.
In each case, you need to declare (i) the item on the agenda the interest relates to; (ii) the nature of the interest; and (iii) whether it is a disclosable pecuniary interest or some other interest.
If unsure, Members should seek advice from the committee lawyer or administrator preferably before the meeting.
(c) Exclusion of Press and Public: To consider whether, in view of the nature of the business to be transacted, or the nature of the proceedings, the press and public should be excluded from the meeting when any of the following items are under consideration.
NOTE: Any item appearing in Part Two of the Agenda states in its heading the category under which the information disclosed in the report is exempt from disclosure and therefore not available to the public.
A list and description of the exempt categories is available for public inspection at Brighton and Hove Town Halls. Minutes: 30A Declarations of Substitute Members
30.1 Councillor Jones declared that he was substituting for Councillor Wakefield.
30B Declarations of Interests
30.2 Councillor Jones declared an interest in Item 42 – Extra Care Housing – Brooke Mead, as he is Deputy Chair of the Planning Committee. He informed the Committee that he would leave the meeting room during this item.
30C Exclusion of the Press and Public
30.3 In accordance with section 100A(4) of the Local Government Act 1972, it was considered whether the press and public should be excluded from the meeting during the consideration of any items contained in the agenda, having regard to the nature of the business to be transacted and the nature of the proceedings and the likelihood as to whether, if members of the press and public were present, there would be disclosure to them of confidential or exempt information as defined in section 100I (1) of the said Act.
30.4 RESOLVED - That the press and public be not excluded from the meeting.
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To consider the minutes of the meeting held on 23 September 2013 (copy attached). Minutes: 31.1 Councillor Mears referred to paragraph 17.4 in relation to allocations policy. Councillor Mears had received a written response to her query after the last meeting but considered that the response was not clear. The Executive Director confirmed that there was a Housing Allocation Policy. Councillor Mears replied that she wanted confirmation in writing that the council was only operating one housing allocation policy.
31.2 The Executive Director referred to paragraph 22.7 in relation to the numbers of people in residential care. She reported that with regard to long term care admissions, for people with mental health aged 18-64 there were 8 long term admissions in 2012/13 to care homes. Of the 8 admissions, 2 were in privately rented, 2 in supported accommodation, 1 Housing Association tenant and 1 in temporary accommodation.
31.3 RESOLVED – (1) - That the minutes of the meeting held on 23 September 2013 be agreed and signed as a correct record.
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Chair's Communications Minutes: Healthwatch
32.1 The Chair reported welcomed Jane Viner to the meeting as Healthwatch representative. Jane reported that representatives would be trained in the new year and that she would be attending further meetings of the Adult Care & Health Committee.
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Call Over (a) Items 36, and items 38 to 42 will be read out at the meeting and Members invited to reserve the items for consideration.
(b) Those items not reserved will be taken as having been received and the reports’ recommendations agreed. Minutes: 33.1 RESOLVED – That all items be reserved for discussion.
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Public Involvement To consider the following matters raised by members of the public:
(a) Petitions: to receive any petitions presented to the full council or at the meeting itself; (b) Written Questions: to receive any questions submitted by the due date of 12 noon on the 18 November 2013; (c) Deputations: to receive any deputations submitted by the due date of 12 noon on the 18 November 2013. Minutes: 34.1 The Committee noted that there were no petitions, written questions or deputations from members of the public.
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Member Involvement To consider the following matters raised by councillors:
(a) Petitions: to receive any petitions submitted to the full Council or at the meeting itself; (b) Written Questions: to consider any written questions; (c) Letters: to consider any letters; (d) Notices of Motion: to consider any Notices of Motion referred from Council or submitted directly to the Committee. Minutes: 35.1 The Committee noted that there were no petitions, written questions, letters or Notices of Motion received from councillors.
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Finance Report at TBM5
Report of Executive Director of Finance & Resources (copy attached). Additional documents: Decision: (1) That the financial position for the 2013/14 financial year as reported at TBM5 (August 2013) be noted.
Minutes: 36.1 The Committee considered a report of the Executive Director of Finance & Resources which set out the financial position on Adult Services, NHS Trust Managed S75 Budgets and Public Health budgets as assessed at August 2013. The Head of Business Engagement reported that she would include more information on capital in the TBM7 report.
36.2 Councillor Meadows referred to the section on the Corporate Critical Community Care Budget (older people), relating to extra care. She asked if the overspend would leave people in unsatisfactory accommodation. Councillor Meadows asked for more information about projected shortfalls in residents’ contributions (Adult Provider). Councillor Meadows asked about the NHS overspend in adult mental health. How could further pressures be predicted? There was a further pressure in community equipment and options on service models reported to the Committee in September. Councillor Meadows asked how further growth could be funded. She asked how the £1m risk on prescribing costs would affect the Section 75 budget and public health. Councillor Meadows asked why there was a small pressure in civil contingences. She asked if this was due to severe winter weather pressures.
36.3 The Executive Director explained that people would still be placed in suitable accommodation, the placement would be based on their assessed needs. It was difficult to predict the client contribution. This varied as people were not financially assessed until they required the service, the budget assumption is based on previous trends. There was a 9% growth pressure in mental health and more people were entering the service making it difficult to predict. There would be a need for more supported living. With regard to the Integrated Community Equipment Store, there was a need to think about supporting more people at home. There would be further report about this matter.
36.4 The Head of Business Engagement informed members that there was a small staffing pressure against the civil contingencies budget. Civil Contingencies was a Public Health function. The Chair stated that the Director of Public Health could be asked to give a briefing on this matter. On this query on prescribing costs officers have gone back to the local assumptions agreed with health in setting the 2013/14 budget – prescribing costs were not included in the calculations of grant. Negotiations were taking place with Public Health England.
36.5 Councillor Norman referred to prescription costs. He asked when and how this matter would be resolved. The Head of Business Engagement stated that this matter had been highlighted at the Policy & Resources Committee. It was a national issue. An update would be provided at the next meeting.
36.6 Councillor Mears referred to vacancy management. She asked how many vacancies had been offered as budget savings. The Executive Director stated that she did not have figures to hand but could share the figures later.
36.7 Councillor Summers referred to the Community Care Budget (Older People). She asked if the 1.64m saving target was for the whole year. The Head of Business Engagement confirmed that the variances were for the whole year as at month 5. There had been a 1.3m overspend. There was a 1.64 saving target which was unlikely to be achieved. This would be partly offset by other savings. . 36.8 Councillor Mears stated that only way to reduce the 1.64m deficit would be to change 30 housing units to extra care housing. Unless the budget projection changed the deficit would be carried forward. The Chair stated that this matter would be dealt when the budget was considered.
36.9 RESOLVED - (1) That the financial position for the 2013/14 financial year as reported at TBM5 (August 2013) be noted.
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Integrated Transformation Fund Presentation by the Chief Operating Officer, CCG and Executive Director, Adult Services. Minutes: 37.1 The Board considered a presentation with slides from the Executive Director of Adult Services, BHCC and the Chief Operating Officer, CCG. The presentation set out the background to the Integrated Transformation Fund and the financial implications for Brighton and Hove. Members were informed how councils and CCGs would develop and agree a joint plan and how they would be rewarded. The presentation stressed the need for joint working with providers.
37.2 Members were informed how the ITF would be managed. The Department of Health was considering what legislation was required for the ITF. Options would be laid out in the Care Bill. Members were informed of the draft template for developing an integrated plan and were informed about the national conditions.
37.3 Members were informed that plans needed to be in place by 14 February 2014.
37.4 The Chief Operating Officer reported that the plans would prioritise frailty.
37.5 Councillor Marsh asked why the frail elderly were a priority and asked if there would be other priorities. She commented that the timescale was challenging and that she would like reassurance about data sharing among organisations.
37.6 The Chief Operating Officer replied that frailty would be prioritised rather than the frail elderly specifically. This would include frail people of all ages, although many would be elderly. She stressed that many younger people had complex needs. There needed to be strengthened capacity and better planning within teams. The Chief Operating Officer agreed that the timescales were challenging as plans needed to be in place quite quickly. The guidance had not yet been received and the Council and CCG were being proactive. The Chief Operating Officer agreed that there was a need to invest in IT over the next year. A working group would consider how data was shared across all organisations.
37.7 The Executive Director reported that some mechanisms were already in place. The independent sector provided a great deal of care as well as the NHS. She was working with colleagues to resolve these issues.
37.8 Councillor Bowden queried the figure in the presentation slide for New under financial implications for Brighton & Hove. It was confirmed that this figure should be 10.1 (not 10.0). It was agreed that this would be corrected before the Health & Wellbeing Board meeting on 27 November.
37.9 Councillor Jones asked how funding would be allocated and what the criteria would be. He asked how the money would make a difference to young people. He mentioned camh (Child and Adolescent Mental Health) as an organisation that might benefit from the fund.
37.10 The Chief Operating Officer replied that she was not sure about the allocation of funding. She would have to ask her Finance Director to provide this information. The Executive Director informed the Board that there had been mixed messages about how the money would be allocated and who could receive it.
37.11 Councillor Mears expressed concern about information sharing and IT. She mentioned that the council were currently going through a process of having gcsx encrypted email addresses. She asked if the CCG were going to have the same system. She stressed that systems needed to be compatible if information was to be shared.
37.12 The Executive Director explained that officers were currently investigating having a warehouse where all data could go. There was a pilot in West Sussex and officers were looking at how other areas were dealing with this issue.
37.13 Councillor Meadows asked for information about the membership of the ITF Programme Board and whether there would be representatives of the community and voluntary sector.
37.14 The Chief Operating Officer explained that the Integrated Transformation Fund Programme Board would involve commissioners, the CCG, Council, hospital and independent sector and third sector.
37.15 Dr Mack expressed concern that there would be a risk in the first year if half of the funding was payment by result. This could penalise the more efficient. The Executive Director agreed with Dr Mack. There would be a real risk in setting targets.
37.16 Councillor Bowden asked who would be setting Key Performance Indicators. The Chief Operating Officer explained that the programme would be overseen by the Health and Wellbeing Board, who would authorise the plans. Having a risk sharing agreement would be essential.
37.17 RESOLVED – That the presentation be noted. |
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Report of Executive Director of Adult Services (copy attached). Additional documents: Decision: (1) That the support available for carers, funded jointly between Adult Social Care and the Clinical Commissioning Group, is noted.
(2) That the projects and activities, aimed at further improving the services for carers, are noted.
Minutes: 38.1 The Committee considered a report of the Executive Director of Adult Services which gave information on the current support available for carers within Brighton and Hove, funded through joint commissioning arrangements between Adult Social Care and the Clinical Commissioning Group. The report also outlined the future developments aimed at further improving the support to carers locally. The report was presented by the Commissioning Manager.
38.2 Councillor Meadows referred to Appendix 2 – Outcomes and Action Plan. She asked about the cost implications of having services in place long enough for carers to work full day (8am to 6pm). Councillor Meadows referred to Appendix 3 which reported that the government were providing additional funding. She asked what the percentage would be for Brighton & Hove and whether the money would be ring fenced for carers. Councillor Meadows referred to the fourth bullet point on the first page of Appendix 4 relating to local intelligence. This showed that most carers who did not feel safe had either been jointly assessed, assessed by non-statutory agencies or assessed at access point. Councillor Meadows asked how agencies disseminated information.
38.3 The Commissioning Manager replied that there was an aspiration for carers to be in employment. There would be a work plan in the New Year which would support carers in obtaining employment. Officers would work with local businesses to help achieve this aim. The funding would be made from the community care budget. Work would be commencing in the New Year to look at data regarding carers. The Commissioning Manager said she would be happy to bring this information back to the Committee. The percentage of government funding was not yet known. Meanwhile, there was a great deal of work being achieved around training and assessment.
38.4 The Executive Director reported that there was yet to be an announcement about funding.
38.5 Councillor Mears stated that it was an excellent report and presentation. She expressed concern that some young carers were as young as 7. She would be very interested in seeing further information on that subject.
38.6 Councillor Marsh hoped the 7 year olds had a dedicated person they could talk to. She wanted reassurance that young carers could go to school. She asked how branding could be taken forward.
38.7 The Commissioning Manager replied that young carer’s assessments were carried out by the young carer’s project. There were still some concerns about who took responsibility for young carers. Joint assessments were now planned. The role of adult social care was to eliminate inappropriate assessments. With regard to carers in school there was a project which helped children use Skype in school. With regard to rebranding, carers were now given a voucher or token.
38.8 Councillor Meadows asked how the health service impacted on this work. The Commissioning Manager explained that her role was jointed funded by the council and CCG. She stated that all health professionals should be more aware due to the carers register. The council and CCG worked closely with the hospitals.
38.9 Geraldine Hoban informed the Committee that carers support was a key part of the service. She stressed that carers support would need to be strengthened even further.
38.10 RESOLVED - (1) That the support available for carers, funded jointly between Adult Social Care and the Clinical Commissioning Group, is noted.
(2) That the projects and activities, aimed at further improving the services for carers, are noted.
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Day Activities Review Progress Report 25 November 2013
Report of Executive Director of Adult Services (copy attached). Additional documents: Decision: (1) That it is noted that, in consultation with the Chair of Adult Care & Health Committee, the Executive Director of Adult Services used her constitutional Delegated Authority on 5th November 2013 to approve the relocation of the Connaught Day Service to the Belgrave Day Options base in Portslade following consideration of the outcomes from the formal consultation.
(2) That the outcomes of the social care assessments be noted.
Minutes: 39.1 The Committee considered a report of the Executive Director of Adult Services which focused on the consultation about the relocation of the Connaught day service and also provided information about the outcomes of the individual social care assessments that have been undertaken as part of the Day Activity Review. The report was presented by the Commissioning Manager, Learning Disabilities and the General Manager, Learning Disability Provider Services. Members were informed that 38 assessments had been carried out to date. The assessments were summarised in appendix 2. Appendix 1 set out the analysis of the consultation about the move of the Connaught Day Service to the Belgrave Day Options Base in Portslade. A paper setting out case studies was also made available to members.
39.2 Councillor Norman asked about ongoing work and particularly mentioned the art project moving to Montague Place. He thanked the officers for their involvement in the project. The Executive Director replied that a more detailed report would be submitted to the January 2014 meeting of the committee in terms of day activities.
39.3 Councillor Meadows referred to paragraph 3.3.1 which stated that no specific concerns had been raised during the consultation period. She reported that not all carers had been consulted and some carers had only been given 2 hours notice to attend a carers’ meeting. Councillor Meadows considered that the consultation document gave the impression everything had gone well when it did not go well.
39.4 Councillor Meadows referred to paragraph 5 of appendix 1 concerning the estimated costs of the building works at the Belgrave Day Options Base. She asked if the money would come from Children’s Services or Adult Social Care.
39.5 The Executive Director noted the issues raised by Councillor Meadows. She stated that lessons had been learnt from the process and officers were doing everything to ensure the process was managed smoothly. With regard to the budget, the estimated cost was £150,000. It had been agreed that £100,000 would be funded from Children’s Services. Adult Social Care would pay the difference.
39.6 Councillor Mears thanked officers for the report and said she had found the tour of sites interesting. She referred to paragraph 2.5 of the appendix relating to assessments. Councillor Mears noted that 2 people required an alternative service but no alternative service had been identified due to the complexity of need. Councillor Mears asked for an explanation of paragraph 2.7. This stated that 1 person had been assessed as needing an alternative service (to the Longer Lives service) but was waiting to identify someone to share the service with.
39.7 The Commissioning Manager, Learning Disabilities explained that for some people specialist input is required from, for example Psychology or the Behaviour Support Team around certain behaviours (paragraph 2.5). It might be necessary in this case to commission a specialist service for the 2 people concerned. With regard to Paragraph 2.7 officers want to maintain friendship groups and not leave people isolated. Once more assessments have been completed officers will ensure that individuals who have similar needs or interests are grouped together.
39.8 The Chair asked for a further update on the two people mentioned in paragraph 2.5, where specialist support was required.
39.9 Councillor Summers noted that 20 people with complex needs currently used the Connaught Learning Disability Day Options Service. 14 had been assessed. Did this mean 6 had not been assessed? Councillor Summers asked for clarification about the number of people moving to the Belgrave Day Options Base.
39.10 The General Manager, Learning Disability Provider Services explained that all assessments were now complete. 14 people had been identified as needing to move to the Belgrave Day Options Base.
39.11 RESOLVED - (1) That it is noted that, in consultation with the Chair of Adult Care & Health Committee, the Executive Director of Adult Services used her constitutional Delegated Authority on 5th November 2013 to approve the relocation of the Connaught Day Service to the Belgrave Day Options base in Portslade following consideration of the outcomes from the formal consultation.
(2) That the outcomes of the social care assessments be noted.
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Report of Executive Director of Adult Services (copy attached). Additional documents: Decision: (1) That the report be noted.
(2) That the new model for community meals should be introduced in a phased way across the city.
(3) That the new model of volunteer support suggested by the RVS should also be adopted and introduced across the city.
Minutes: 40.1 The Committee considered a report of the Executive Director of Adult Services which informed members that the community meals service was retendered in March 2013 and the Royal Voluntary Service (RVS) were successful in retaining the contract. A new model for meal provision and for the role of volunteers was outlined within the tender document and RVS ran a pilot to test the new arrangements during August 2013. The report gave details of the outcomes of the pilot and described the future plans for introducing the new model across the city. The report was presented by the Contract Manager.
40.2 Councillor Norman thanked the Contracts Manager for the excellent report and stated that the only issue he wished to raise was the chronology of events as set out in paragraph 3.1. Councillor Norman mentioned that he had had a vision for better, more locally sourced meals and that he and the Executive Director had visited City College three or more years ago to discuss a way of providing locally sourced and locally cooked food. Councillor Norman stated that he had sampled the old meals and the new Steamplicity meals and he considered the new product was excellent. He hoped the meals could be sourced more locally in the future and looked forward to the meals being rolled out across the city.
40.3 Councillor Meadows referred to the safe and well check referred to in paragraph 3.4.3 and appendix 1, paragraph 2.1. She asked about the timeframe for this check. Councillor Meadows further referred to section 11 of the quality statement set out in the appendix, concerning the supply of freezers and microwave ovens to customers who required them. She asked how this was carried out along with the safe and well check.
40.4 The Executive Director replied that the model allowed volunteers to spend a great deal more time with customers. The rounds could be carried out according to what the person required. The Contract Manager reported that the service could deliver meals a day in advance. Local volunteers could then visit to heat the meal and spend time with the customer. The delivery van also had a microwave which could be used when customers did not have that facility. The RVS would also consider lending microwaves or funding the cost of microwaves.
40.5 Councillor Bowden asked if the contractors had stated how many volunteers they had and whether they had a sufficient number. Councillor Bowden made the point that St Albans was still a long way from the City.
40.6 The Contracts Manager replied that there were a large number of volunteers in Brighton and Hove and there had never been a problem in recruiting RVS volunteers.
40.7 Councillor Barnett asked if there was a start date for the new contract. The Contract Manager replied that if the report was approved, she would meet with the RVS later in the week. The proposal was to start the process in January 2014 and have everything in place to enable all customers to receive the service by March 2014.
40.8 RESOLVED - (1) That the report be noted.
(2) That the new model for community meals should be introduced in a phased way across the city.
(3) That the new model of volunteer support suggested by the RVS should also be adopted and introduced across the city.
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Market Position Statement: Adult Social Care Intentions Report of the Executive Director of Adult Services (copy attached). Decision: (1) That the key messages in the summary document attached in Appendix 1: Market Position Statement: Adult Social Care Intentions be noted.
Minutes: 41.1 The Committee considered a report of the Executive Director of Adult Services informed members that the Department of Health had urged Local Authorities to create a Market Position Statement that would be useful for providers of care services in planning their businesses. The Market Position Statement would outline what adult social care services Brighton & Hove City Council would commission in the future, and what services the council would need to provide directly. A completed market position statement would be presented to Adult Care & Health Committee in March 2014.
41.2 The Head of Commissioning & Partnerships set out the report and stressed the need for a different way of working to make best use of declining resources. She referred to paragraph 6 of Appendix 1, concerning Adult Social Care’s commitment in challenging times. She highlighted the need to commission services that offered more choice and more flexible support to individuals and exploring cost effective and innovative accommodation solutions to meet individual outcomes.
41.3 RESOLVED - (1) That the key messages in the summary document attached in Appendix 1: Market Position Statement: Adult Social Care Intentions be noted.
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Extra Care Housing - Brooke Mead Update Report of Executive Director of Environment, Development & Housing and Executive Director Adult Services (copy attached). Decision:
(1) That the Policy & Resources Committee is recommended to agree to fund up to £2.1 million (with maximum increase limited to 10%) to enable Brooke Mead to be built.
Minutes: 42.1 The Committee considered a report of the Executive Director of Environment, Development and Housing and the Executive Director of Adult Services which sought approval for HCA and Housing Revenue Account (HRA) capital and HRA and Adult Social Care (ASC) revenue funding to support the Brooke Mead extra care scheme and authority to enter into a Funding Agreement with the HCA for provision of extra care housing under the Care & Support Specialist Housing Fund; and to award a contract or contract following procurement to secure the development of the scheme as outlined in the report.
42.2 The Head of Housing Strategy informed Members that the Housing Committee had approved the report at their meeting on 13 November 2013. The scheme was subject to final planning approval at the Planning Committee to be held on 11 December 2013. Any significant variations to the proposed capital scheme and funding would need to be reported back to Policy & Resources Committee.
42.3 Councillor Bowden thanked the Head of Housing Strategy and his team for their work on the report and asked if 45 units was a viable economic option. The Head of Housing Strategy confirmed that it was a viable scheme.
42.4 The Project Officer, Housing Commissioning, informed Members that at one point, the scheme had dropped from 45 to 40 units due to planning issues. This had led to doubts about the viability of the scheme. However, this matter had been resolved and the scheme would have 45 units. 44 units would be one bedroom and one unit would be a 2 bedroom ground floor flat. All would be affordable units to rent. Originally, some two bedroom homes had been proposed for sale.
42.5 Councillor Bowden asked if the height issue was resolved. The Project Manager confirmed that this matter had been resolved following extensive discussions with planning officers. Planning officers were satisfied with the scheme and would be recommending approval.
42.6 Councillor Meadows referred to paragraph 3.7 of the report and asked if the change in the proposals to have all affordable units for rent would affect the grant from the Homes & Communities Agency. The Project Manager replied that the total grant from the HCA would remain intact regardless of the changes. The Head of Housing Strategy confirmed that the HCA were happy with the scheme and had stated that it was possible to substitute shared ownership funding with affordable rented funding.
42.7 Councillor Mears commented that she considered that planning had made the process unnecessarily difficult. She also commented that this was the only extra care scheme that would have no parking. This concerned her as it was a highly congested area in the evening. Councillor Mears stated that she had been told in the past that the scheme would lead to Adult Social Care saving £300,000 per year; however there was no mention of this in the report. Councillor Mears further commented that there could be difficulties in only having 1 bedroom units. Some couples did not share a bedroom and some people might need a carer to stay on site.
42.8 The Executive Director of Adult Services reported that it was often more difficult in practice to let 2 bedroom units. The Head of Finance – Business Engagement explained that with regard to savings, the original model was based on 39 units at £330,000 a year. The new modelling was £330,000 to £500,000 a year based on 44-45 units.
42.9 RESOLVED - (1) That the Policy & Resources Committee is recommended to agree to fund up to £2.1 million (with maximum increase limited to 10%) to enable Brooke Mead to be built.
NOTE: Councillor Jones left the meeting during discussion of this item as he is Deputy Chair of the Planning Committee. |
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Items Referred For Council To consider items to be submitted to the 12 December 2013 Council meeting for information.
In accordance with Procedure Rule 24.3a, the Committee may determine that any item is to be included in its report to Council. In addition, any Group may specify one further item to be included by notifying the Chief Executive no later than 10am on the eighth working day before the Council meeting at which the report is to be made, or if the Committee meeting take place after this deadline, immediately at the conclusion of the Committee meeting. Minutes: 43.1 RESOLVED - That no items be referred to Council
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