Agenda and minutes

Apologies were received from Councillor Reg Adams, Mr Richard Lane, Mr Keith Marshall and Mrs Gill Rose.

Councillor William Huntington-Thresher and Councillor Ruth Bennett tendered apologies for lateness.

Councillor Roger Charsley declared a personal interest as a Member of Bromley Autistic Trust and a Member of SLAM.  Councillor William Huntington-Thresher declared a personal interest as the Council appointed representative on the Board of Affinity Sutton.  In relation to Agenda item 11 (Minute no 64), Mrs Leslie Marks declared a personal interest as a Trustee of Bromley Mind. 

To hear questions to the Committee received in writing by the Legal, Democratic and Customer Services Department by 5pm on Wednesday 27^th October 2010 to respond.

Questions were received from four Members of the Public and these are attached at Appendix A.

RESOLVED that the minutes of the meeting held on 21^st September 2010 be agreed.

Report LDCS10191

The Committee considered a report updating Members on recommendations from previous meetings.

The Chairman reported that the issue of pressure ulcers had been covered in great detail at the Health Care Working Group.

The Committee also requested that Ms Hall provide feedback as to how the issues that had been publicly raised by clinicians had been resolved.

The Committee agreed that it would be helpful to have a written report from the Health Care Working Group.  It was also agreed that the link to the Health, Social Care and Housing Partnership Group would be circulated to all Members of the Committee.  The Chairman suggested that it would also be helpful to have a diary page outlining all the Partnership meetings that had taken place since the previous meeting.

RESOLVED that progress on recommendations be previous meetings be noted.

To hear questions to the Adult and Community Portfolio Holder received in writing by the Legal, Democratic and Customer Services Department by 5pm on Wednesday 27^th October 2010 and to respond.

No questions were received.

The Committee noted decisions taken by the Portfolio Holder since the last meeting.

The Adult and Community Portfolio Holder to present scheduled reports for pre-decision scrutiny on matters where he is minded to make decisions.

The Portfolio Holder informed the Committee that he had recently attended the Adult Information Day which had been a good example of how well internal partnerships could work.  The Portfolio Holder had also attended the very successful Diversity Day which had been hosted at the Civic Centre.

Since the last meeting the Portfolio Holder had also attended the Carers AGM and the Mencap AGM.

The Portfolio Holder had recently attended the opening of a supported living scheme for people with learning disabilities in Mottingham.  The Landlords Forum had also been a very well attended event.

The week after the meeting the Portfolio Holder would be visiting the 60 Extra Care housing units at Meadow Court, Bromley Common.  The Portfolio Holder also reported that funding had now been secured for an additional 60 units.

Finally, the Portfolio Holder highlighted that the Health White Paper was beginning to have an impact and it was suggested that the Committee should receive an update on how the proposals were progressing.

Report ACS10064

The Portfolio Holder introduced a report outlining the proposed development of a pre-paid card in Bromley.  The pre-paid card provided an effective mechanism for assisting recipients of Direct Payments in managing their budget and purchasing social care services.

The Portfolio Holder suggested that it would be helpful to have a demonstration of how the cards work and asked that something be provided at the Portfolio Planning Day.

The Programme Manager, Supporting Independence in Bromley (SIB), introduced the report and highlighted that the pre paid cards would assist LBB Officers in tracking and auditing the way in which direct payments were spent.  The cards would simplify the auditing process for the Care Management Team.

The Committee explored a number of issues arising from the use of pre-paid cards.  A couple of Members expressed concerns regarding the appropriate use of the cards.  The Programme Manager, SIB, provided assurances that the auditing process would identify if the  cards were being used for inappropriate spending.  Paper statements would be issued once a month to help individuals manage their spending and Officers would be able to follow trends in expenditure.  Certain elements of the card could be switched off in order to limit the opportunities for individuals to use the card inappropriately.  The Programme Manager SIB highlighted that this would have to be managed carefully as there were a number of implications surrounding switching off elements of the card.

Officers confirmed that the pre-paid card would look different from and distinctive to other payment cards that service users may possess.

The Committee explored a number of safeguarding issues and sought assurances that adequate security arrangements were in place to protect service users.  The Programme Manager SIB stressed that the pre-paid cards were similar to standard credit card with a PIN number in that if service users gave their PIN to other people the card could be used.  Banks would be insuring the card to protect against possibilities of cloning and fraud.  In order to maintain security and safeguard individuals, it would be possible to issue a second card for a relative or carer to use.  Any users of the cards would have to sign a standard security agreement that would be in place; this would set out the expected security standards to be adopted and Officers would monitor appropriate use of the card.

The Committee considered the set up arrangements for the cards and Officers confirmed that accounts could be set up in service user’s homes.  A Member suggested that as an incentive the cards should be provided free of charge.  Following discussion, it was suggested that in order to manage the limited resources available sponsorship for the cards could be pursued.  Officers agreed that they would investigate this possibility and report back to the Committee. 

A Member also raised the issue of the charges for the card.  The Director ACS explained that the 1% transaction charge to  service users was only for agreed cash advances, not for general use of the  ...  view the full minutes text for item 58.

Report ACS10067

The Portfolio Holder introduced a report providing the PDS Committee with progress  on the Portfolio Plan priorities for 2010  and an  outline of the Care Quality commission (CQC) framework for rating Adult Social Care performance.  Development of the 2011/12 Portfolio Plan would commence with the Portfolio Holder’s planning conference which was due to be held on 23^rd November 2010 and information from this event would be incorporated into the draft plan for presentation to the Committee in the spring.

The Portfolio Holder reported to the Committee that targets were largely being met.  The outcomes from the mid-year performance review had been positive and the Care Quality Commission had noted good areas of progress.

The Director ACS reported that there had been significant progress on the work around assessments and reviews, an area in which the committee had previously expressed concern.  Real improvement had been seen in this area and performance monitoring had proven to be beneficial.

The Chairman acknowledged that there appeared to be an improvement in the speed and quality of assessments and  acknowledged that  ACS continued to demonstrate to PDS that performance targets were used to good effect to inform and improve the business with managers “owning” performance in  their service areas.

The Co-opted Members on the Committee commented that the voluntary services they represented found the targets in place useful and that the annual review of targets helped with negotiations that took place with the Local Authority.

The Committee noted that where the Department had not met targets, it was largely down to circumstances beyond the control of the Local Authority, a clear example of this was the Foyer Scheme.

Members considered services that were provided to people recovering from mental health difficulties.  The Committee also considered the services available to individuals on the autistic spectrum.  The Director ACS suggested that a detailed report should be presented to the Committee in the new year as the department’s response to the recent guidance from the  Department of Health 'Fulfilling and rewarding lives':  -  guidance for local authorities and NHS organisations to support implementation of the autism strategy.

A Member asked whether grants received by the Department would come to an end and whether this would cause any problems in the delivery of services.  The Director ACS reported that there was still uncertainty surrounding what would happen to the grants.  Officers suspected that grants were likely to be rolled together and once further information was known Officers would provide a report to Members.

The Portfolio Holder reported that Bromley was a  successful Borough in terms of providing employment opportunities for people with learning disabilities.  The Entry to Employment Initiative had been Borough-wide and the Portfolio Holder was pleased that the Local Authority had been able to deliver this in partnership with the PCT. The Portfolio Holder also reported that he was disappointed that the Local Authority had missed the target regarding the Foyer Scheme.

REOLVED that the Portfolio Holder be recommended to note the areas  ...  view the full minutes text for item 58a

Report ACS10063

The Portfolio Holder introduced a half year overview of the performance of Housing and Residential Services against the key objectives and targets for 2010/11, together with a summary of the priorities for the remainder of the year.

The Assistant Director (Housing and Residential Services) and the Head of Housing Need introduced the report and outlined the progress that had been made during the first half of the year.

The Assistant Director (Housing and Residential Services) outlined the work that was being undertaken as part of the Fraud Initiative, funding for this work had been received from the Department for Communities and Local Government.  Members were asked to report any tenancies that they were concerned about.

There had been a 30% reduction in the number of available lettings during the first half of the year and there was now London-wide competition for temporary accommodation.

A Members asked whether the Council would be pro-active in managing any rising rents charged by Housing Associations and the Assistant Director (Housing and Residential Services) suggested that Officers present a detailed report to the Committee once further information had been gathered.

Members of the Committee stressed the need to ensure that the housing supply was maximised.  The Assistant Director (Housing and Residential Services) reported that 46 empty properties had now been brought back into use through direct action (the target had been 20 properties).

The Committee considered the possibility of bringing some of the properties in Bromley North Village back into use.  The Assistant Director (Housing and Residential Services) reported that a mail out had been undertaken a few months before the meeting of the Committee and a very low response had been received.  Officers would continue to pursue this.

The Committee were told that the Local Authority ran an initiative which supported people who under-occupy properties to move to smaller properties by providing practical support to them to bid for properties and with the actual moving.  The Head of Housing Need agreed to email all Members of the Committee with the half-yearly update setting out statistics surrounding the number of people who have been supported through this initiative.

The Director ACS reported that Officers were reviewing the feasibility of including more work on and investment in bringing back in to use empty properties as part of the Portfolio Plan.  The Chairman suggested that it would be helpful to have a report back to the Committee regardless of the outcome of the feasibility review.

RESOLVED that the Portfolio Holder be recommended to agree the actions being taken to meet the range of housing duties and needs in Bromley and to deal with increased pressures on the service resulting from the recession.

Report ACS10068

The Portfolio Holder introduced a report advising Members of the outcomes of the consultation on the review of the Housing Allocations Scheme and presenting the finalised scheme for consideration.

The Portfolio Holder reported that currently 37% of applications were being received from out of Borough and the new allocation scheme would assist local people making applications

The Head of Housing Need reported that the target for implementation of the new scheme was April 2011 but that this was dependant on having a software development in place. .

Officers explained that with the new policy service users expectations could be better managed and it would be easier to explain the system to users.  Currently around 30% of those who submitted applications for housing were not eligible and the new system was designed to improve support and signposting to service users in accessing the housing services and options for which they were eligible and to help meet their housing needs.

The Director ACS confirmed that the process would not be implemented until the Department knew that Auto Banding was working and was able to support the new allocations scheme.

A Member expressed concern regarding the re-banding and the pressure that it could place on the Department.  The Head of Housing Needs explained that the new policy was dependant on the automatic banding process to ensure the re-registration and the system ran efficiently and the re-registration process should see quite a number of households not renew their application as they had moved and/or resolved their housing need and not de-registered or no longer wished to pursue the housing register as an option.

The Committee considered the bands that current and ex-Members of the armed forces would be placed in.  Officers explained that if there was a housing need they would go though the Housing Options Team if there were medical reasons why they needed housing a medical assessment would be undertaken. It was stressed that they would certainly not be disadvantaged.

The Portfolio Holder thanked Officers for the work they had undertaken throughout the review and for the work that was being undertaken to implement the policy.

RESOLVED that the Portfolio Holder be recommended to agree the revised draft scheme and note that the adoption will happen following implementation of the necessary amendments to the IT system supporting “Bromley Homeseekers” and that a review will take place in year 2 in order to assess the success of the changes in managing expectations and reducing time assessing applications.

Report ACS10066

The Portfolio Holder introduced a report seeking agreement to the development of a targeted hospital admission avoidance service and seeking Members’ comments on the proposal to reduce the number of hospital based intermediate care beds.

A Member expressed concern surrounding the increased travel times for the two CARTs teams.  Officers provided assurances that the additional time implications of travelling to patients homes had been taken into consideration throughout the development of the proposals.

Dr Angela Bhan highlighted that the proposals were focused on managing patients expectations around the length of stay in hospital and that they should be viewed in the context of re-ablement and giving people independence.

In response to a question, Officers confirmed that services would be provided seven days a week and that the hours of the service were approximately 7am to 7pm.  There would be a dedicated Care Manager available at the hospital.  Services at Urgent Care Centres would have to be reviewed and GPs would be able to refer directly to the service.

A Member highlighted that without partnership work with other Boroughs, residents of the Borough who attended hospitals in neighbouring Boroughs (for example Lewisham Hospital) would not be covered by the proposals.

Another Co-opted Member highlighted that most people would welcome the chance not to remain in hospital for long periods but sought assurances that there was an acknowledgement that for some people this was not the right approach and they may need to remain in hospital.  Officers provide these assurances.

The Portfolio Holder reported that that patients would have to be considered on a case-by-case basis.  The Committee acknowledged that the proposals would have to be considered sensitively as closure or reductions in hospital beds could cause anxiety amongst patients.

RESOLVED that the Portfolio Holder be recommended to agree to the development of a targeted hospital admissions avoidance service and note the launch of a formal consultation by the PCT on the reduction in the number of hospital based intermediate care beds.

Report ACS10061

Officers provided an overview of the operation of the Taxicard scheme in Bromley. A higher than anticipated increase in the number of Taxicard trips taken throughout London during 2010/11 had resulted in significant projected overspends of the cumulative Taxicard budget.  A number of measures to bring spend within budget had been proposed by London Councils and these would be considered at the Transport and Environment Committee (TEC) on 11^th November 2010 with a view to implement the approved measures by 1^st January 2011.

An update to the report was tabled and this outlined further information that had been received from London Councils.  The changes that would affect Bromley were highlighted including:

-  an increase of 50p in the charge to £2.50;

-  ending double swiping for longer trips

-  a reduction of £1 in the minimum subsidy to £8.30

Together these changes would result in an increase in cost to the user of between 50p to £1.50.

The Committee was reminded that if no action was taken, the budget for Bromley would be spent by 27^th February 2011 and no further trips could be taken. 

The Portfolio Holder highlighted that this was a TfL pan-London scheme and this meant there were limitations on how it could be operated.  The opportunity for the Committee to consider the proposals had been secured by the Portfolio Holder for the Environment who was the Council’s representative on London Council’s Transport and Environment Committee.

The Chairman noted that London Council’s had stated that they planned to use underspends elsewhere to cover overspends.

The Committee considered the impact that the end of double swiping would have on the residents of Bromley.  Following discussion the Portfolio Holder was asked  to lobby TfL and the London Council’s Transport and Environment Committee regarding the ending of double swiping.  Members felt that residents of Bromley would be disproportionately affected by this proposals as Bromley was the largest Borough.

RESOLVED that (1) the Portfolio Holder be recommended to agree to the recommendations from London Councils on measures to offset the projected overspend; namely:

• Increase the minimum customer contribution from £2.00 to £2.50
• Reduction in maximum borough subsidy by £1 per trip
• End double swiping for longer trips.

(2) that the Portfolio be asked to lobby TfL and the London Council’s Transport and Environment Committee regarding the ending of double swiping

Report ACS10065

The Committee considered a report outlining the budget monitoring position for the Adult and Community Portfolio based on expenditure and activity levels up to 31^st August 2010.

The Portfolio Holder highlighted that at the last meeting an increase in the overspend had been anticipated and this report reflected that increase.  The Portfolio Holder expressed hope that the figures for September would demonstrate an improvement in the overspend.

The Committee recognised that it was difficult to reduce costs when more people needing care were coming forward.

RESOLVED that the Portfolio Holder be recommended to note that a projected overspend of £598,000 is forecast on the controllable budget for the Adult and Community Portfolio as at 31^st August 2010.

The Chairman provided a verbal update from the Health Care Working Group which had met on 28^th October 2010.  The Working Group had been disappointed that that the Chief Executive of South London Healthcare NHS Trust had been unable to attend the meeting despite adequate notice, but he would be invited to a future meeting of the Working Group.

The Working Group had asked for clarity between the services provided at A&E and those provided at Urgent Care Centres and Ms Hall had agreed to provide further information to the Working Group.

Ms Hall had provided assurances that the Trust was working towards filling staff vacancies and were looking to attract the highest calibre of staff.

There had been a great deal of discussion surrounding pressure ulcers.  Levels of pressure ulcers had been unacceptably high; however the Trust had undertaken work on this issue and in September and October there had been no instances of grade 4 ulcers.  The Trust was now working on grade 3 ulcers.  The Chairman reported that the Working Group had asked for information regarding where people who attended hospital with pressure ulcers had come from.

The Working Group was informed about the patient transport service which was currently going through a contract tendering process.

Ms Hall had also provided assurances that the Trust was reviewing food and nutrition across the three sites and the Trust Board had set up a Sub-group to monitor this issue.

The next meeting of the Working Group would take place on Wednesday 1^st December and London Ambulance Service had been invited to attend.

Report ACS10062

The Committee received an update on the work undertaken to monitor the quality of domiciliary care services provided in the Borough by internal and external providers.

The Strategic Manager for Procurement and Contract Compliance reported that this was the second report presented to the Committee on domiciliary care services.  The Council was constantly monitoring external providers and was seeking to achieve continuous improvement from providers.

The Chairman highlighted that it would have been helpful to have the number of complaints received included in the report rather than the percentages.  The Committee were informed that 46 formal complaints had been received but that the Department also collected information on informal complaints that were received over the telephone and resolved on the day of complaint.

The Committee heard that feedback was sought from services users during the contract compliance process and that findings were fed to the Care Quality Commission (CQC) and that the Department would not hesitate to report serious concerns to the CQC.

RESOLVED that the report be noted.

Report LDCS1092

The Committee considered its work programme for 2010/2011.  Members noted that the Drug Action Team Annual report would be considered at the next meeting in January 2011 and that there would also be an update on the Health White Paper.  At the meeting in March 2011 the Committee would receive the presentation given to the Accommodation and Care for Older People Reference Group and the report reviewing services to individuals on the Autistic Spectrum would be considered.

RESOLVED that the work programme for 2010/2011 be approved.

The Chairman to move that the Press and public be excluded during consideration of the items of business listed below as it is likely in view of the nature of the business to be transacted or the nature of the proceedings that if members of the Press and public were present there would be disclosure to them of exempt information.

RESOLVED that the Press and public be excluded during consideration of the items of business listed below as it is likely in view of the nature of the business to be transacted or the nature of the proceedings that if members of the Press and public were present there would be disclosure to them of exempt information.

The Committee noted Exempt (Part 2) decisions taken since the last meeting on 21^st September 2010.