Agenda and minutes

Apologies for absence were received from Councillor David Jefferys and Councillor Terry Nathan. 

There were no declarations of interest.

In accordance with the Council’s Constitution, questions to the Care Services Portfolio Holder or to the Chairman of this Committee must be received in writing 4 working days before the date of the meeting.  Therefore please ensure questions are received by the Democratic Services Team by 5.00pm on Wednesday 22^nd June 2016.

Nine written questions were received from members of the public and these are attached at Appendix A.

The minutes were agreed subject to the following amendments to the minutes of the meeting held on 10^th March 2016:

Item 7d: Gateway Review of Sexual Health Services: Resolution:

“RESOLVED that the Council’s Executive be recommended to extend the contract for the following services for a period of six months from 1^st April 2017 to 30^th September 2017.”

Item 7e: Gateway Review of Health Visiting and National Child Measurement Programme: Resolution:

“1) Extend the contract with Bromley Healthcare for Health Visiting and National Child Measurement Programme for a period of six months from 1^st April 2017 to 30^th September 2017.”

Item 7i: Welfare Benefits Contract Extension: Resolution:

“2) Agree that an integrated benefits advice service be tendered for a period of one year from 1^st July 2016 to 30^th June 2017…”

RESOLVED that the minutes of the meetings held on 10^th March 2016 and 11^th May 2016 be agreed, subject to the amendments outlined above.

Report CSD16072

The Committee considered its work programme for 2016/17, matters arising from previous meetings and Care Services PDS Committee Co-opted Membership appointments for 2016/17.

In considering the work programme for 2016/17, the Chairman requested that updates on extra care housing and temporary accommodation, including the Manorfields and Belle Grove provision and out-of-Borough placements be provided to the next meeting of Care Services PDS Committee.

With regard to the Our Healthier South East London Joint Health Overview and Scrutiny Committee, Councillor Hannah Gray notified Members that she would be standing down as a Local Authority representative to this committee. 

RESOLVED that:

1)  The Care Services work programme for 2016/17 and matters arising from previous meetings be noted.

2)  The following non-voting Co-opted Members and their alternates be appointed to the Care Services PDS Committee for the 2016/17 municipal year:

With the agreement of the Chairman, the Portfolio Holder for Care Services made a statement to the Committee with regard to the recent Ofsted Inspection of Children’s Social Care which is attached at Appendix B.

In response to a query by a Member, the Portfolio Holder for Care Services confirmed that it was expected that additional resources would be identified to deliver the required improvements, but that this was likely to be as a standalone improvement budget rather than within the Care Services Portfolio budget. 

Report CS17002

The Care Services Portfolio Holder introduced a report outlining the provisional budget outturn position for the Care Services Portfolio for the 2015/16 financial year.  This showed an underspend of £4,350k on controllable expenditure, which was an increase from the last reported figure of an underspend of £3,646k based on activity at the end of December 2015.  A number of carry forward requests had been agreed by the Council’s Executive at its meeting on 15^th June 2016, which related to either unspent grant income or delays in expenditure where cost pressures would follow through into 2016/17.

The Portfolio Holder for Care Services reflected on the difficulties experienced following a significant in-year grant reduction of between £900k-£1m for Bromley’s Public Health budget for 2015/16, and commended Dr Nada Lemic and her team in managing to balance the Public Health budget during a challenging time.

In considering the report, a Member queried if savings made within the Care Services Portfolio had contributed to the outcome of the recent Ofsted Inspection of Children’s Social Care and underlined the need to ensure services were funded at an appropriate level.  A Co-opted Member suggested that an impact assessment be routinely undertaken where any savings were proposed.  The Portfolio Holder for Care Services emphasised the pressures on the Local Authority to deliver considerable budget savings across all Portfolios, and that the implications of any proposed savings within the Care Services Portfolio were fully scrutinised by Members.  The amount of spend across the Care Services Portfolio was often linked to the number of service users and their level of need, and as a result could vary extensively throughout the year. 

A Member noted the underspend in staffing in the Assessment and Care Management Division which reflected the continuing difficulties in recruiting qualified social workers across services for both adults and children, and the Chairman  highlighted the potential to review the Recruitment and Retention package if it was not sufficient.  Another Member underlined the additional cost if the staffing levels were not right within a team, including increased sickness, and suggested that a comparative exercise be undertaken to assess this.

The Vice-Chairman was concerned at the variation between the amount paid in rent by clients leaving care and the amount reclaimable as Housing Benefit.  The Head of Education, Care and Health Services Finance confirmed that the costs of leaving care continued to rise and that Housing Benefit levels could only be estimated.  There was also a cost associated with the increasing care needs of these clients. 

RESOLVED that the Portfolio Holder be recommended to:

1)  Note the underspend of £4,350k on controllable expenditure at the end of 2015/16 and any issues arising from it;

2)  Note a number of carry forward requests agreed at the meeting of the Council’s Executive on 15^th June 2016; and,

3)  Approve the provisional budget outturn for the Care Services Portfolio for 2015/16.

To Follow.

Report CS17003

The Care Services Portfolio Holder introduced a report setting out the budget monitoring position for the Care Services Portfolio based on expenditure to the end of May 2016. 

The controllable budget was forecast to be in an overspend position of £3,333k following overspends across a number of services including Adult Social Care, Temporary Accommodation (Bed and Breakfast), Children’s Social Care and Commissioning which was due to a number of reasons including higher than expected demand for services and the need for further efficiency savings to be identified.

Members were advised that on 15^th June 2016, the Council’s Executive approved a number of carry forward requests for funding to be transferred into contingency for 2016/17.  These carry forward requests which totalled £861k related to either unspent grant income or delays in expenditure where cost pressures would follow through into 2016/17.

In considering the report, the Chairman was concerned at the increasing demand for Temporary Accommodation (Bed and Breakfast) and how this impacted on individuals.  A Member also noted the result of the recent EU Referendum and highlighted the need for contingency plans to be put in place.  The Head of Education, Care and Health Services Finance confirmed that implications of the EU Referendum result would be factored into the Care Services Portfolio budget as they were identified.

The Portfolio Holder for Care Services advised Members that a full range of Care Services provision continued to be delivered but that gateways had been strengthened to ensure that the available support was provided to those most in need.  Significant savings had been realised through commissioning services in previous years, however the majority of the most substantial savings had now been realised and further savings from this area would be more limited.

RESOLVED that the Portfolio Holder be recommended to:

1)  Note the latest projected overspend of £3,333k forecast on the controllable budget, based on information as at May 2016;

2)  Note the full year effect of cost pressures of £4,241k for the Care Services Portfolio budget for 2016/17;

3)  Agree the release of carry forward amounts held in contingency relating to Adult Social Care Invest to Save schemes, Integration Funding – Better Care Fund, Better Care Fund and Adoption Reform Grant; and,

4)  Approve the Care Services Portfolio Budget Monitoring Report 2016/17.

Report CS17009

The Care Services Portfolio Holder introduced a report presenting the Foster Service Annual Report 2015/16 which was required to be produced by the fostering agency on an annual basis under the Fostering National Minimum Standards 2011.

The Fostering Service primarily worked to identify and support stable placements for children and young people looked after for whom foster care was the identified plan.  As at 31^st March 2016, there were 281 Bromley children looked after, 174 of whom were placed with foster carers approved and supported by Bromley and 31 with independent fostering agencies.  The remaining children looked after were placed in residential units, residential schools, supported lodgings or in semi-independent accommodation.  The total number of fostering households approved by Bromley as at 31^st March 2016 was 123, which was a decrease of 11 households from the previous year.  A review of foster carer allowances had been undertaken in 2015/16 to identify possible savings, following which the recommended Department for Education weekly maintenance allowance had been adopted. 

Priorities for the 2016/17 financial year included continuing to work to recruit and retain high quality foster carers to ensure that sufficient local placements were available to meet the needs of Bromley children looked after.  This would include work with internal and external stakeholders to improve practice and opportunities for foster carers to be actively involved in foster carer recruitment.

In response to a question from a Member, the Head of Social Care: Care and Resources confirmed that Bromley worked to recruit foster carers across a distance of up to 20 miles away from the Borough.  There continued to be difficulty in securing independent foster carer placements due to the high number of unaccompanied child asylum seekers in Kent and the South East, and there had recently been recruitment drives for areas of particular shortage, including foster carers for adolescents.

Members were concerned at the disparity between the number of foster carers recruited against the number of initial enquiries, and further information on the assessment process would be provided to Members following the meeting.  A Co-opted Member suggested that former foster carers be approached to return to the role, and the Committee recommended that this should be included as an element of future recruitment drives.  The Head of Social Care: Care and Resources explained that records of former foster carers could only be held for three years, but that the potential to recruit former foster carers would be further explored.  Another Member suggested that the Local Authority advertise in Jobcentres for prospective foster carers. 

The Vice-Chairman underlined the importance of providing the right level of support to foster carers in engaging young people in their care who were not in education, employment or training (NEET).  The Head of Social Care: Care and Resources reported that the Executive Working Party on Child Safeguarding and Corporate Parenting had established a Task and Finish Group to look at the support provided to foster carers of children with complex needs or challenging behaviour and  ...  view the full minutes text for item 11c

Report CS17010

The Care Services Portfolio Holder introduced a report presenting the Adoption Service Annual Report 2016/17 which was required to be produced by the adoption agency on an annual basis under the National Minimum Standards 2014.

The Adoption Service was responsible for all adoption work undertaken by the Local Authority, supporting domestic, inter-country and step-parent adoption, birth parent counselling, post-placement and post-adoption support and a range of intermediary services.  Of a total of 33 children with an adoption plan and awaiting an adoption placement during 2015/16, 16 children were matched with an adoptive family, 2 children had their adoption plan rescinded and 14 children were actively being found an adoption placement as at 31^st March 2016.  A total of 17 adoptive units were approved during 2015/16, with 13 adoptive units left in the pool of approved adopters as at 31^st March 2016.

Priorities for the 2016/17 financial year included working with South London Consortium local authorities regarding the ongoing development of regionalisation, to implement ‘foster to adopt’ and to develop an adoption website.  Work would be undertaken to develop processes and procedures to meet post-adoption support needs and make applications to the Adoption Support Fund, which would continue to be available to all children adopted and their families across England who were in need of therapeutic services for at least the next four years.  It was proposed that a report be presented to the Executive Working Party on Child Safeguarding and Corporate Parenting every six months in addition to the annual report to the Care Services PDS Committee to meet Standard 25.6 of the National Minimum Standards 2011 which required the Adoption Agency to produce a six monthly report on adoption activity to the Agency Executive.

In response to a query from a Member around the length of time children waited between entering care and moving in with their adoptive families, the Interim Director of Children’s Services confirmed that the issue of pace of the adoption process had been highlighted in the recent Ofsted Inspection of Children’s Social Care.  A range of measures would be introduced to improve pace, but the levels of adoption had also been impacted by a significant increase in Special Guardianship Orders and Connected Persons.  The Local Authority would continue to work as part of the South London Consortium which increased the choice of adoptive families available for children and also supported joined-up working and a shared recruitment process.

The Chairman requested that work to undertake parallel assessment between the Foster Care and Adoption teams for children entering the care system be reported to the meeting of Care Services PDS Committee on 15^th November 2016.  It was also requested that information around the assessment process for Special Guardianship Orders and Connected Persons be provided to Members following the meeting.

RESOLVED that the Portfolio Holder be recommended to endorse the Adoption Service Annual Report 2015/16.

Report CS17017

The Care Services Portfolio Holder introduced a report requesting approval to extend the call monitoring contract for CareLink (community alarm and telecare service) for a period of 6 months from 1^st October 2016 to 31^st March 2017 to facilitate the market testing of the service.

As a community alarm and telecare service, CareLink supported approximately 1700 Bromley service users to live more independently and with the ability to call for assistance if required.  The current service was managed through separate contracts for supply and installation of equipment and call monitoring/handling of the alarms, as well as an in-house mobile response service.  The Local Authority was market testing for an end-to-end managed service for one provider (or lead provider if a consortium) to deliver an holistic service covering all elements of service provision with the new contract expected to be in place for early 2017.

To facilitate the market testing process of the service it was requested to extend the existing call handling contract with Centra Pulse for a further period of six months from 1^st October 2016 to 31^st March 2017, with a one month break clause.  The existing contract with Centra Pulse was priced at a monthly rate of £1.73 per client. 

RESOLVED that the Portfolio Holder be recommended to agree the extension of the call monitoring contract for CareLink (community alarm and telecare services) for a period of six months from 1^st October 2016 to 31^st March 2017.

Report CS17020

The Care Services Portfolio Holder introduced a report seeking permission for an exemption from competitive tendering to extend the existing contact for support services to children at risk of sexual exploitation which was due to expire on 30^th June 2016 for a further nine month period.

A contract was currently held with a provider to deliver a specialist programme of support to divert young people identified as being at risk of sexual exploitation by undertaking engagement and reducing risk taking behaviour.  The existing contract, which had been held by the same provider since 2012/13, allowed for up to twelve young people to be supported at any one time through one-to-one counselling, drop-in sessions and group work.  The provider also delivered training sessions to Bromley social workers as well as attending social work panel meetings.  The existing contract was due to expire on 30^th June 2016 and the retendering process had commenced in early 2016 following which an evaluation process of the submitted tenders was undertaken.  During this period, there had been an Ofsted Inspection of Children’s Social Care services and initial feedback suggested that the current service specification might be insufficient to meet a wider range of identified service user needs.  To allow a review of the service specification to be undertaken it was proposed to continue with the existing provision and provider for a further period of nine months with an increase in capacity to accommodate a waiting list of six children and the continuation of planned training sessions for practitioners, via an exemption to competitive tendering, until a new contract could be put in place. 

In response to a question from a Member, the Interim Director of Children’s Services confirmed that the service specification would be reviewed to ensure that appropriate support was in place for three particularly vulnerable cohorts identified in the Ofsted Inspection report, which comprised children at risk of sexual exploitation, missing children and children involved in gangs.  Work had already begun to identify the services required by these children, as well as the potential for more joined-up and partner working.  Whilst the specification for the service was under review, it was proposed to continue with the existing provision as the provider was meeting the requirements of the current contract and the Local Authority recognised the value that this service had for the children receiving support.

The Interim Director of Children’s Services reported that Bromley was working with other local authorities to identify examples of best practice in this area.  A progress report on developing the revised service specification would be reported to a future meeting of Care Services PDS Committee, and further information regarding the number of children and young people supported through the scheme on an annual basis would be provided to Members following the meeting.

RESOLVED that the Portfolio Holder be recommended to approve a further award of contract to the existing provider via an exemption to competitive tendering for a nine month period from 1^st July  ...  view the full minutes text for item 11f

Report CS16027

The Portfolio Holder presented a report outlining three welfare benefits advice contracts from the voluntary sector commissioned by the Local Authority for which a three month contract extension to 30^th June 2016 had been agreed to allow providers time to prepare for forthcoming changes and for commissioners to retender the service as a single contract.  Significant Transfer of Undertakings (Protection of Employment) Regulations 2006 (TUPE) issues had since arisen which had impacted on the funding required to be able to contract for a reduced service for a further year, and it was requested that the existing contracts with Age UK Bromley & Greenwich, Bromley Mencap and Broadway be extended for a further nine month period to 31^st March 2017, following which a reduced welfare benefits advice service would be included in the wider retendering of voluntary sector support services.  This proposal would allow for the future merging of any services required under one contract, allowing savings to be achieved in 2017/18 as part of the wider corporate savings and setting of an overall Council budget, and reduce the level of contract monitoring required.

In response to a question from a Co-opted Member, the Portfolio Holder for Care Services confirmed that it was proposed that these specialist advice services be included in the wider retendering of voluntary sector support services to deliver them in a more effective way, and that specialist welfare benefits advice support would still be available to Bromley residents.

RESOLVED that the Portfolio Holder be recommended to:

1)  Agree to the proposed extension of the three existing welfare benefits advice contracts for a period of nine months from 1^st July 2016 to 31^st March 2017 under Contract Procurement Rule 3.7; and,

2)  Agree that future specialist welfare advice can be included in the retendering of voluntary sector support services.

Report CS17007

The Care Services Portfolio Holder introduced a report providing an update on progress towards replacing the information systems used by the Housing Division.

The Housing Division used two information systems to support its business.  These comprised Home Connections which offered Choice based lettings functionality, and the Northgate Housing System which provided a range of services including an online housing application form, a case management service for housing advice, homeless cases and rent accounts, and a document management system, as well as supporting statutory reporting functions. 

Following consideration of a Gateway Review of Housing Information Systems in January 2015, Members had agreed to fund the procurement of a new information system which would meet the current and future statutory requirements of the Housing Division.  An initial tendering exercise had been undertaken which had not been successful in attracting bids.  Following this, a range of alternative procurement options had been explored.  Having considered supplier feedback, the fact that this was a one-off capital project and reviewed the evaluation options available, it was proposed that the option for a mini-competition using the CCS RM1059 Framework be progressed, with additional scoring criteria and weightings aligned to the cost weighting.  To maximise the chances of success of the tendering process, the Project Team had shortened and simplified the requirements document, and had built up relationships with suppliers.  It was also planned to send out the tender during Summer 2016 when suppliers were less likely to be busy, give an eight week period for the production and submission of bids and make it clear to suppliers that joint bids could be made.

The Assistant Director: Housing Needs advised Members that Bromley had explored potential joint working but that this had not fitted with the recommissioning timescales or service needs of other local authorities.  It was planned to take a phased approach to moving to the new system which would include a short period of parallel running with the existing systems, and break clauses were in place to end the maintenance contracts for the existing systems when the new system had been introduced.

RESOLVED that the Council’s Executive be recommended to agree the Project Team re-tender on the Crown Commercial Services (CCS) RM1059 Framework.

Report CS17016

The Care Services Portfolio Holder introduced a report outlining a gateway review undertaken on four learning disability (LD) supported living schemes with contracts due to terminate in Spring/Summer 2017 which had a combined expenditure of £1.126m.  The schemes collectively accommodated 20 people with various learning and physical disabilities, including some with mental health issues.  The co-termination of schemes provided an opportunity for these schemes to be grouped together, which was expected to realise a range of benefits including lower bids resulting from economies of scale, more efficient use of resources, tenders that were more attractive for providers, and for specialist expertise to be shared across schemes.

The four schemes, comprising 109 Masons Hill, 111 Masons Hill, 18/19 Century Way and Dunstonian Court, had been commissioned during the past six years to provide care and support services for adults with learning and physical disabilities within supported living services, which aimed to maximise the independence of clients and support them to participate in activities within the community.  The schemes had a high occupancy rate, with three of the schemes experiencing no voids since being first commissioned and the fourth filling the small number of voids reasonably quickly, and the projection of supply and demand indicated that these schemes would be required for the foreseeable future.  It was proposed that the four schemes be progressed as a single tender for a period of three years with an option to extend for a maximum of two years to commence on 1^st July 2017.

In considering the report, Members discussed the 60% price, 40% quality criteria for the tender specification which was standard across all Local Authority contracts, and suggested that Members might want to review this going forward.  The Business and Planning Manager (ECHS) confirmed that robust quality assurance measures were in place to ensure that the standard of provision was maintained.  A recent analysis of a limited number of contracts under a 40% price, 60% quality criteria had shown that there would have been a different outcome from the tender process in some cases.

RESOLVED that the Council’s Executive be recommended to:

1)  Agree to group the four schemes for tendering in order to drive the best possible quality/pricing;

2)  Agree an exemption to enable the extension of the 109 Masons Hill scheme for 10 weeks from 23^rd April 2017 to 30^th June 2017 with a value of approximately £60,684, and co-termination with the 111 Masons Hill scheme; and,

3)  Approve the commencement of the procurement procedure to enable award in accordance with the Council’s financial and contractual requirements.

Report CS17006

The Care Services Portfolio Holder provided an update on service activity following a Supreme Court judgement made in 2014 relating to Deprivation of Liberty Safeguards and to the deprivation of liberty of individuals.  The report also outlined the existing procurement arrangements under a service agreement to spot-purchase these assessments and recommended a framework for procurement of specialist assessments be established.

The Deprivation of Liberty Safeguards (DoLS) was introduced as an amendment to the Mental Capacity Act in April 2009, which aimed to prevent decision making which deprived people of their liberty unless properly authorised.  The safeguards covered people, regardless of the funding source, in registered care or nursing homes and in hospitals who had a mental disorder and who lacked the capacity to consent to the care provided, where that care might include the need to deprive them of their liberty.  It did not apply to people detained under the Mental Health Act 1983.  Hospitals and care homes were the ‘managing authorities’ and under the Act were responsible for identifying when a deprivation of liberty was occurring within their own service provision and for making referrals to the designated ‘supervisory body’, which was the Local Authority for both health and social care.

Between 1^st April 2015 to 31^st March 2016, 1,280 Deprivation of Liberty Safeguard applications were received by the Local Authority and of those that had resulted in an assessment, 991 had been granted, 73 had not been granted and 8 had been withdrawn.  Whilst the current service, delivered by a small central team, was operating well and was compliant with financial and HMRC regulations, the market provision for Deprivation of Liberty Safeguards was changing and the number of assessments required was clearer which made it an optimum time to consider other delivery models.  Three models had been explored as part of the review and it was proposed to progress Option Twowhich would enable efficiencies to be made on the current arrangements by setting up a Framework to call-off Best Interest Assessors and Section 12 Doctors, with options for annual review and adjustments depending on the requirements of the Deprivation of Liberty Safeguards service.

RESOLVED that the Council’s Executive be recommended to:

1)  Agree that the future model for the service should be Option 2 which was to employ external Best Interest Assessors and Section 12 Doctors via ‘Lots’ on a Framework established for four years; and,

2)  Delegate authority to the Assistant Director: Adult Social Care (ECHS) in consultation with the Portfolio Holder for Care Services to make any subsequent appointments of suitably qualified providers to the framework if there were insufficient providers on the framework following the annual review.

Report CS17018

The Portfolio Holder presented a report outlining a gateway review undertaken of a range of community contraceptive and sexual health services which were currently delivered via a joint block contract with the Bromley Clinical Commissioning Group which would end on 30^th September 2017, and seeking approval to re-procure a Sexual Health Early Intervention Service to commence on 1^st October 2017.

The Local Authority had a statutory obligation to commission comprehensive, open access and free sexual health services, including Sexually Transmitted Infection (STI) testing and treatment, partner notification and contraception provision.  To meet these obligations, the Local Authority commissioned a range of sexual health services from different providers in different settings.  The block contract the Local Authority had with Bromley Healthcare for Contraception and Community Sexual Health Service would end on 30^th September 2017 after which services would have to be re-tendered in accordance with the Local Authority’s contract procedure rules. 

In considering proposed future commissioning arrangements for these services, two options had been explored and it was recommended that Option 2 be progressed as this would restructure existing services and build in extra capacity within the existing budget, as well as allow a level of integration which would support a wider and more sustainable prevention programme to empower individuals to take responsibility of their own health and wellbeing.  It would also enable the Local Authority to meet its statutory obligations.  Under this option, the local school-based Sex and Relationships Education programme which was not a statutory function would be decommissioned allowing schools to develop their own more ‘issue specific’ programmes as part of the Personal, Health and Social Education curriculums and realising a potential saving of £60k per annum.

In response to a question from the Chairman, the Assistant Director: Public Health confirmed that the online STI testing service was restricted to people aged over 25 years who were identified at being in an ‘at risk’ group and that eligibility was assessed via a questionnaire to ensure the kits were provided to those who were most in need.  The programme was subject to stringent information governance criteria to protect client confidentiality and regular tests were undertaken to ensure security remained robust.

A Co-opted Member was concerned at the abortion rate in the Borough.  The Assistant Director: Public Health advised that work to promote the use of Long Acting Reversible Contraception was ongoing, and that options for contraception were discussed with women following abortion. 

RESOLVED that the Council’s Executive be recommended to:

1)  Approve Option 2 as the commissioning approach for a Sexual Health Early Intervention Service;

2)  Consider the investment from the existing budget of £30k per annum for the online Sexually Transmitted Infection (STI) testing service; and,

3)  Note the recurring saving of £60k from decommissioning the Sex and Relationships Education (SRE) programme and that the saving would contribute towards the reduction of grant.

Report CS17019

The Care Services Portfolio Holder introduced a report outlining proposed commissioning arrangements for the Health Visiting Service and the Family Nurse Partnership from 1^st October 2017.  The report also set out work being undertaken by Officers to explore options around integrating these services with the Early Intervention and Family Support service and requesting that this work be continued as a priority to ensure that services were run as efficiently and effectively as possible.

The Health Visiting Service was a universal service from pregnancy to five years which undertook five mandated reviews, referred families to additional support where appropriate, and had a key safeguarding role which included providing long term support to vulnerable families.  The responsibility for commissioning the Health Visiting service, which had an annual budget of £3,454k, had been transferred to the Local Authority in October 2015, and was delivered by Bromley Healthcare via a joint block contract with the Bromley Clinical Commissioning Group which would end on 30^th September 2017.

The Family Nurse Partnership was a small team of four family nurses and a full-time coordinator that provided intensive support to up to 50 vulnerable young mothers in each of Bromley and Bexley, and had demonstrated a number of beneficial outcomes, including in the performance of Public Health Outcome Indicators on the rate of under 18 years conceptions, with the proportion of teenage mothers in Bromley significantly lower than the England average.  This service, which had an annual budget of £180k, was a non-mandated service and was currently delivered by Bromley Healthcare through a joint block contract with the London Borough of Bexley which would end on 31^st March 2017.

In considering proposed future commissioning arrangements for these services, two options had been explored and it was recommended that  Option 1 be progressed which proposed to tender for reconfigured Health Visiting and Family Nurse Partnership services as a single contract which would focus on the mandated parts of the service and identify savings by delivering the service in a more efficient way, and that Officers continue to consider how an integrated service would best work to realise maximum efficiencies in the longer term.

RESOLVED that the Council’s Executive be recommended to:

1)  Agree the extension of the contract with Bromley Healthcare for the provision of the Family Nurse Partnership service for a period of six months from 1^st April 2017 to 30^th September 2017 at an estimated cost of £90k in order to align with the Health Visiting Service;

2)  Agree the Local Authority tenders the Health Visiting and Family Nurse Partnership services as a single contract for a period of three years from 1^st October 2017 to 30^th September 2020 at an estimated cost of £10,902k; and,

3)  Note the work being undertaken by Officers to identify future opportunities around integrating these services with the Early Intervention and Family Support service and agree that this work be continued as a priority to ensure that services are  ...  view the full minutes text for item 11l

Report CS17021

The Care Services Portfolio Holder introduced a report outlining the proposed procurement strategy for the National Child Measurement Programme, which was currently delivered via a joint block contract with the Bromley Clinical Commissioning Group which would end on 30^th September 2017, and seeking approval to procure a new contract to start on 1^st October 2017 with an estimated contract value of £120k per annum.

The National Child Measurement Programme was a mandated programme measuring height and weight in Reception year and Year 6 in all children in Bromley in maintained schools and academies.  The aim was to measure at least 85% of children in maintained schools and academies, with 91% of children measured in Bromley in 2015.

In considering the proposed future procurement strategy for the National Child Measurement Programme, three options had been explored and it was recommended that Option 3 be progressed which proposed to procure the National Child Measurement Programme as a standalone service.  As there were no other commissioned Public Health services in schools from April 2017, there were also no obvious services to jointly tender the National Child Measurement Programme with.

RESOLVED that the Portfolio Holder be recommended to:

1)  Agree to procure the contract for the National Child Measurement Programme starting 1^st October 2017; and,

2)  Agree Option 3 which proposed to procure the National Child Measurement Programme as a standalone service as the best option for procurement.

Report CS17008

The Committee considered a report providing an update on outcomes from a time-limited project funded through the Social Care Innovations Grant which had been designed to develop a programme of innovation in connection with assessments for short breaks which would be linked to Education, Health and Care Plans for children and young people with disabilities, and reporting on further work being undertaken with a view to testing identified outcomes prior to implementation in September 2016.  The initial funding period for the project ceased in March 2016. 

The Social Care Innovation Fund (SCIF) was a national programme funded by the Department for Education and led by the Council for Disabled Children. The Local Authority had been successful in securing funding of £100k to develop and test innovative solutions to the assessment procedure and the processes by which families received social care services from the statutory sector, with the aim of engaging parents, carers, young people and professionals to develop a seamless and innovative process which delivered improved outcomes for all involved whilst offering value for money.  The project was designed to explore a new approach to proportionate assessment for children and young people as they entered the statutory system and to understand the opportunities for streamlining links to other existing assessment processes, particularly Education, Health and Care plans, to direct resources to support those children and families in most need.

The project had been undertaken in three initial phases which had been completed in March 2016.  Outcomes from the project had so far included the development of an online assessment tool for parents and carers to request low level short breaks, an increase in contracts managed by self-assessment, and a range of other identified service improvements which would require further testing and consideration around how to embed.  The final phase of the project was to review the outcomes from this process and refine and build a pilot programme, for which further funding of £25k had been identified.  As part of this, Bromley’s Local Offer would need to be updated to ensure that relevant services within the community were recorded, and a separate piece of work was underway to identify short break provision in neighbouring boroughs to enable alternate signposting opportunities.

The Interim Director of Children’s Services confirmed that an update on the pilot programme would be provided to a future meeting of the committee, and that mapping information on short break provision in neighbouring boroughs would be provided to Members following the meeting.

RESOLVED that the update be noted.

Report CS17014

The Committee considered a report outlining the performance of the Bromley Community Wellbeing Service for children and young people in the first year of the three year contract period which was awarded to Bromley Y for a period of three years from 1^st December 2014 to 30^th November 2017, and how performance data was being used to identify and address potential gaps in the system.

The Bromley Community Wellbeing Service had been developed in consultation with all stakeholders to ensure that the emotional and mental wellbeing needs of children and young people aged up to 18 years, and up to 25 years for young people subject to an Education, Care and Health Plan, were met at the earliest opportunity, with information on the service available via a wide range of stakeholders including GPs and schools who were able to make referrals to the service. 

Between 1^st December 2014, and 31^st March 2016 there had been 3,416 referrals to the service, 28% of which were within the highest range as measured by the Strengths and Difficulties Questionnaire.  Those accepted for treatment were being offered short term interventions, and good outcomes were being realised with 79% of young people reducing their difficulties score on the Strengths and Difficulties Questionnaire following treatment.  Positive outcomes from the service included young people returning to full-time education, reductions in self-harming behaviours and improved family relationships.  Concerns had been identified regarding delays in referrals to CAMHs and the Bromley Clinical Commissioning Group was working to address this issue.  Other gaps in the service had also been identified and additional provision had been put in place for the diagnosis of individuals with Autistic Spectrum Disorder and Attention Deficit Hyperactivity Disorder, and specialist support in schools.

In response to a question from a Member, the Commissioning Manager (ECHS) confirmed that the Bromley Community Wellbeing service was advertised by a number of key partners including GPs, the Youth Offending Service and schools, but that the service also had a website and young people or their parents and carers could self-refer.  The Chairman was pleased to note the introduction of a specialist eating disorder service which was delivered by the South London and Maudsley NHS Trust, an international leader in this area which was also working in three Bromley schools where pupils were identified as being most at risk of eating disorders.

The Portfolio Holder for Care Services advised Members that the Local Authority would continue to work with the Bromley Clinical Commissioning Group to increase capacity for the Child and Adolescent Mental Health Service, and the planned introduction of Tier 2.5 would ensure children and young people with a medium level of need were referred to appropriate specialist support in a timely manner.

RESOLVED that the report be noted.

The briefing comprises:

• Care Services Portfolio Plan Priorities Update
• Virtual School Annual Report 2015/16
• Contract Activity 2016

Members and Co-opted Members have been provided with advance copies of the briefing via email.  The briefing is also available on the Council’s website at the following link:

http://cds.bromley.gov.uk/ieListMeetings.aspx?CId=559&Year=0

Printed copies of the briefing are available on request by contacting the Democratic Services Officer.

The Care Services PDS Information Briefing comprised three reports:

• Care Services Portfolio Plan Priorities Update
• Virtual School Annual Report 2015/16
• Contract Activity 2016

RESOLVED that the Information Briefing be noted.

RESOLVED that the Press and public be excluded during consideration of the items of business listed below as it was 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 exempt minutes of the Care Services PDS Committee meeting held on 10^th March 2016 be agreed.

The Committee noted the Part 2 (Exempt) information relating to the report on Authorisation for Exemption to Continue the Contract for Support Services to Children at Risk of Sexual Exploitation.

The Committee considered the report and supported the recommendations.

The Committee considered the report and supported the recommendations.

The Chairman requested that it be noted in the Part 1 (Public) minutes that the Local Authority commissioned 30, 45 and 60 minute Domiciliary Care visits, and that 15 minute visits were not commissioned for any reason.  Service users with personal budgets could choose to fund 15 minute visits if it met their individual care needs.