Agenda and minutes

Apologies for absence were received from Councillor Robert Evans and Councillor Keith Onslow attended as his substitute.  Apologies were also received from Councillor Ruth Bennett and Councillor Angela Page.

Apologies for lateness were received from Councillor Will Harmer.

Linda Gabriel declared that she was the Chairman of Healthwatch Bromley and Bromley and Lewisham Mind and left the meeting during consideration of Item 14a: Contract Award for Primary and Secondary Intervention Services Part 2 (Exempt) Information.

Justine Godbeer declared that she was Campaigns and Development Officer at Bromley Experts by Experience and left the meeting during consideration of Item 14c: Formal Consultation on Outline Service Proposals and Procurement Strategy for the Management of Lewis House.

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 28^th June 2017.

No questions had been received.

RESOLVED that the minutes of the Care Services PDS Committee meetings held on 21^st March, 10^th May and 13^th June 2017 be agreed.

Report CSD17068

The Committee considered its work programme for 2017/18, the schedule of Council Members’ visits and matters arising from previous meetings.

In considering the work programme, Members were advised that a report providing an update on the CareLink (community alarm service) tender would be circulated electronically to the Care Services PDS Committee for Members’ comments prior to consideration of the report at Executive and Resources PDS Committee on 13^th July 2017, which Members were welcome to attend.  A Co-opted Member requested that the item on ‘Work of the Bromley Adult Safeguarding Board’ due to be considered at Care Services PDS Committee on 5^th September 2017 be deferred to 14^th November 2017. 

The Chairman reported that subsequent to the Health Scrutiny Sub-Committee agreeing to reconvene the Task and Finish Group for Dementia Services for 2017/18, concerns had been identified around the need to ensure that the Task and Finish Group did not duplicate the work of the Dementia Working Group, which was a working group of the Health and Wellbeing Board.  This was currently being explored and further clarification would be provided to Members when available.

With regard to matters arising from previous meetings, a Member suggested that the findings of the Adult Social Care User Survey 2015/16 be considered alongside those of other local authorities to identify best practice and gain a better understanding of service levels.  A Co-opted Member was concerned at the low response rate to the survey by domiciliary care users and suggested that service user focus groups be established.  The question, ‘has someone helped you complete this survey’ might also be added to future surveys to help identify where domiciliary care providers were assisting a service user to complete their survey.  Information regarding two survey responses where service users had indicated that they were extremely dissatisfied with the care and support they received would be provided to Members following the meeting.

Reflecting on the recent tragic events at Grenfell Tower, the Chairman led Members in thanking the Director: Housing and her team for their excellent work in supporting those affected as part of the pan-London response.

RESOLVED that the Care Services work programme for 2017/18, the schedule of Council Members’ visits and matters arising from previous meetings be noted.

The Deputy Chief Executive and Executive Director: Education, Care and Health Services gave an update to Members on work being undertaken across the Education, Care and Health Services Department.

The ‘Our Journey to Excellence’ document which reflected on the work taken during the 100 days since the Deputy Chief Executive had joined the Local Authority and outlined the future vision for education, care and health services had now been shared with staff.  Key areas for development that had been identified included greater integration with the Bromley Clinical Commissioning Group, a review of processes within Education, Care and Health Services and the development of a wider commissioning strategy for the Department.  Recruitment and retention of staff and closer working with the Bromley Safeguarding Adults Board also remained key priorities within the improvement programme.

In response to a question from a Member, it was confirmed that the contract for provision of Reablement Services had recently been awarded following a joint tender exercise by the Local Authority and Bromley Clinical Commissioning Group which had grouped together a range of rapid response and hospital discharge services with the aim of providing an integrated and holistic service.

RESOLVED that the update be noted.

Report CS18014

The Committee considered a report setting out the budget monitoring position for the Care Services Portfolio for 2017/18, based on expenditure to the end of May 2017. 

The controllable budget was forecast to be in an overspend position of £990k, assuming further management action was taken throughout the year to maintain this position.  This was a result of predicted overspends across a number of services including Assessment and Care Management, Learning Disabilities and Temporary Accommodation which was due to a number of reasons including higher than expected demand for services and increased costs due to the impact of the National Living Wage on some care contracts.

Members were advised that at its meeting on 20^th June 2016, the Council’s Executive approved a number of carry forward requests for funding to be transferred into contingency for 2017/18.  These carry forward requests which totalled £513k related to either unspent grant income or delays in expenditure where cost pressures would follow through into 2017/18.

In considering the report, the Chairman was concerned to note the overspend position of £990k for the Care Services Portfolio for 2017/18, and emphasised that this would have a full year effect of £3,127k unless further management action was taken.  The Chairman advised Members it was proposed that a series of meetings to scrutinise the budget be held between the Chairman, Vice-Chairman, Portfolio Holder for Care Services and Executive Support Assistant with the Deputy Chief Executive and the Head of Education, Care and Health Services Finance, and that the findings of these meetings would be reported to the Care Services PDS Committee.  This proposal was supported by the Care Services PDS Committee.  The Chairman noted that the aim of these meetings was to identify a range of management actions to reduce the overspend, but that there was also a need to confirm if the agreed budget for 2017/18 continued to be realistic to deliver the required services.  A Member underlined the importance of reviewing the experience of service users as part of this process.

The Deputy Chief Executive confirmed that an action plan to address the budget overspend was in development and further information would be reported to the Care Services PDS Committee as it became available.

RESOLVED that:

1)  The Chairman, Vice-Chairman, Portfolio Holder for Care Services and Executive Support Assistant  attend regular meetings with the Deputy Chief Executive and the Head of Education, Care and Health Services Finance to scrutinise the budget and report findings to the Care Services PDS Committee; and,

2)  The Portfolio Holder be recommended to:

i)  Note the latest projected overspend of £990k forecast on the controllable budget, based on information as at May 2017;

ii)  Note the full year effect of cost pressures of £3,127k for the Care Services Portfolio budget for 2017/18;

iii)  Agree the release of carry forward amounts held in contingency relating to Integration Funding – Better Care Fund, Better Care Fund – GoodGym, Better Care Fund, Fire Safety Grant, Community Housing Fund Grant and Implementing  ...  view the full minutes text for item 19a

Report CS18030

The Committee considered a report outlining the provisional budget outturn position for the Care Services Portfolio for the 2016/17 financial year.  This showed an overspend of £4,540k on controllable expenditure, a reduction from the last reported figure of an overspend of £4,747k based on activity at the end of December 2016.  This was largely due to overspends within Children’s Social Care on staff and placement costs and Adult Social Care due to an increase in the number of Learning Disabilities placements and the non-achievement of domiciliary care savings.  Public Health had underspent by £330k in 2016/17, and these funds had been transferred to a ring-fenced Public Health Reserve for use in Public Health activities during 2017/18.  A number of carry forward requests had been agreed by the Council’s Executive at its meeting on 20^th June 2017, which related to either unspent grant income or delays in expenditure where cost pressures would follow through into 2017/18.

RESOLVED that the Portfolio Holder be recommended to:

1)  Note the overspend of £4,540k on controllable expenditure at the end of 2016/17 and any implications arising from this;

2)  Note the carry forward requests agreed at the meeting of the Council’s Executive on 20^th June 2017; and,

3)  Approve the provisional budget outturn for the Care Services Portfolio for 2016/17.

Report CS18022

The Committee considered a report setting out a proposal to engage in a procurement exercise to retender the statutory Healthwatch service, for which the existing contract would end on 31^st March 2018, and to secure a provider that delivered best value for this service.

The Healthwatch service collated and provided evidence-based intelligence relating to people’s experiences, views and concerns around health and social care services to influence the commissioning, policy, decision making, design and delivery of these services.  In addition, the Healthwatch service provided information, advice and guidance on local health and social care services and worked with the Health and Wellbeing Board, contributing to local documents such as the Joint Strategic Needs Assessment and Health and Wellbeing Strategy.  The contract for the delivery of this service was initially awarded to Community Links on 1^st April 2013 for one year and extended for a further year.  This contract was subsequently transferred with the agreement of both parties to Healthwatch Bromley on 21^st January 2015.  Healthwatch Bromley was a separate independent organisation set up by Community Links Bromley as a charity and company limited by guarantee which enabled the organisation to access funding from additional funding streams.  The existing contract with Healthwatch Bromley to provide this service would end on 31^st March 2018. 

In response to a question from a Member, it was confirmed that tenders received as part of the procurement process would be evaluated using the Local Authority’s standard criteria of 60% price and 40% quality.

RESOLVED that the Portfolio Holder be recommended to approve a procurement exercise be carried out to retender the statutory Healthwatch service, securing a provider that delivers best value.

Report CS18023

The Committee considered a report providing an update on the progress towards adopting a new homelessness strategy by 2018 to comply with statutory requirements.

The Homelessness Act 2002 placed a statutory duty on the Local Authority to carry out a review of homelessness and develop a new homelessness strategy every five years.  The Homelessness Review, which provided a comprehensive assessment of the nature and extent of homelessness in the Borough, had recently been completed in partnership with a wide range of agencies and stakeholders.  This had identified a number of key findings, including the strong track record in tackling and preventing homelessness and in increasing the supply of temporary accommodation in Bromley.  It had also recognised that the issue of homelessness was increasing in the Borough, including the number of private rental sector residents facing eviction, and that there was an overall need for services to work holistically to tackle poverty, minimise the impact of welfare reform, improve access and standards for private rented accommodation and increase education and employment activities.  The Homelessness Strategy, which set out how the Local Authority would prevent homelessness and provide support to people who were homeless or at risk of becoming homeless during the coming five year period was underway and, following a period of consultation, was due to be provided to Members in January 2018 for approval; however, key elements of the strategy could not be finalised until the new code of guidance was published by the Department for Communities and Local Government which might impact timescales.

In response to a question from a Member, the Housing Compliance and Development Manager advised that the Homelessness Strategy brought together a number of workstreams that were already in progress, and would support an increase in joint working across a range of partners as well as placing a greater emphasis on early intervention, including preventing homelessness.

A Member underlined the need for the Homelessness Strategy to address a number of key concerns including the supply of private rented homes within the Borough to tenants in receipt of housing benefit and the use of homes in multiple occupancy.  Work should also be undertaken with schools to support families placed outside the Borough to maintain their children’s school places.  The Director: Housing confirmed that the Homelessness Strategy would incorporate a full range of issues around availability and sustainability of housing.  Another Member noted the high property rental costs within the Borough and was concerned that families were being ‘priced out’ of living in Bromley.

RESOLVED that Members’ comments on the key priority areas identified from the homelessness review for the new homelessness strategy be noted.

The Sub-Committee received a presentation from John Taylor, Managing Director and Rob Murphy, Contract Manager for the Mears Group providing an update on the progress of the More Homes for Bromley scheme.

The More Homes for Bromley scheme had been established as a Special Purchase Vehicle in June 2016 by the Local Authority in partnership with the Mears Group to support the acquisition of 400 properties to be used for temporary accommodation both within Bromley and in neighbouring areas such as Maidstone, Dartford and Swale.  These properties were originally intended to be purchased over a four year period but the financial model had subsequently been revised to a shorter two year period in order to deliver budget savings earlier.  To date, 78 properties had been purchased, the majority of which were one or two bedroom properties, and a further 61 properties were in the process of being purchased.  An average of £13k was spent on refurbishing each property prior to it being let and 51 properties had now been let to tenants.  It was anticipated that by the end of October 2017, 200 properties would have been purchased, which was in line with the financial model.

The Director: Housing reported that risk assessments were undertaken for all prospective tenants, and that the most vulnerable families were placed in Bromley-based accommodation.  Where tenants were placed out-of-Borough, every effort was made to ensure that they had some connection with the area in which they were placed, such as a family support network.  The Mears Group held monthly operational meetings to consider any issues with its housing stock and every property within the More Homes for Bromley scheme had a named Portfolio Manager who visited each property at least once every three months and referred any concerns to the Housing Service.  The Local Authority continued to be responsible for the support of residents placed out-of-Borough, but where families chose to settle in their new local authority, the Local Authority worked with the Mears Group to ensure that all necessary arrangements were in place, including health services and school places.

Members were pleased to note the high quality of properties within the More Homes for Bromley scheme and discussed the potential to expand the scheme further.  The Director: Commissioning advised Members that the possibility of purchasing another 100-150 properties within the More Homes for Bromley scheme would be considered as the current scheme was progressed; however this would require additional investment from the Local Authority and would need to be cost effective.  There was also increasing competition from other local authorities across the region that were developing similar schemes.  The Director: Housing noted that there were now 1500 Bromley families in temporary accommodation and that the More Homes for Bromley scheme was helping to mitigate the costs of nightly-paid accommodation by increasing the supply of high quality temporary accommodation. 

In response to a question from a Member, the Contract Manager for the Mears Group confirmed that tenants were initially offered a six month assured  ...  view the full minutes text for item 20b

Report CS18018a

The Committee considered a report providing an overview of the tendering process for Primary and Secondary Intervention services which were being jointly commissioned by the Local Authority with the Bromley Clinical Commissioning Group.

Primary and Secondary Intervention services were universal services that provided targeted support to vulnerable residents in the community who were at risk of developing further complications or emerging needs to support them in maintaining their independence and to delay or prevent the need for high cost care packages and early admissions to care homes or hospital.  The Local Authority currently had 15 active contracts with the Third Sector to deliver these services, but had identified that this model did not represent value for money or provide the targeted outcomes required by health and social care.  The new approach to Primary and Secondary Intervention services aimed to develop a cohesive set of targeted preventative services with measurable impacts through eight services comprising Single Point of Access, Services to Residents with Long Term Health Conditions, Services to Elderly Frail, Carers’ Support Services, Services to Residents with Learning Disabilities, Services to Residents with Physical Disabilities, Mental Health Support Services and Support to the Sector.  The tender process for provision of these services had been undertaken in accordance with the Local Authority’s financial and contractual requirements. 

RESOLVED that the Council’s Executive be recommended to:

1)  Approve the contract award for Primary and Secondary Intervention Services for a period of three years from 1^st October 2017, with the potential to extend for a further period of up to two years;

2)  Delegate authorisation to extend the contract for a period of up to two years to the Chief Officer or Executive Director of Education, Care and Health Services in consultation with the Portfolio Holder for Care Services;

3)  Agree that the contract will be entered into and held by the Local Authority, and that there will be joint monitoring with the Bromley Clinical Commissioning Group;

4)  Note that the contributions from the Bromley Clinical Commissioning Group and the Better Care Fund will be secured through an agreement with the Bromley Clinical Commissioning Group under section 75 of the NHS Act 2006; and,

5)  Note that the Bromley Clinical Commissioning Group were recommended to support the contract award at Clinical Executive Group on 29^th June 2017 and will be recommended to support the contract award at Governing Body on 20^th July 2017.

The briefing comprises:

• Delayed Transfers of Care
• Occupational Therapy Services in LBB
• Progress Report from Priority Ones Learning Disabilities following on from Internal Audit

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:

• Delayed Transfers of Care
• Occupational Therapy Services in LBB
• Progress Report from Priority Ones Learning Disabilities following on from Internal Audit

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 meetings held on 21^st March and 13^th June 2017 be agreed.

The Committee considered the report and supported the recommendations.

The Committee considered the report and supported the recommendations.

The Committee considered the report and supported the recommendations.

The Committee considered the report and supported the recommendations.

The Committee considered the report and supported the recommendations.

The Committee considered the report and supported the recommendations.