Agenda and minutes

Apologies for absence were received from Councillor Judi Ellis and Councillor Keith Onslow attended as her substitute.  Apologies were also received from Rosalind Luff, Lynn Sellwood and Justine Godbeer.

Apologies for lateness were received from Councillor David Jefferys.

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 3^rd January 2018.

Three written questions were received from a member of the public and these are attached at Appendix A.

In response to a query raised by a Member in respect of Minute 53B: Homelessness Strategy, the Director: Housing confirmed that whilst other local authorities placing social care clients in the Borough retained responsibility for the placement, the Local Authority had a duty to ensure that rental properties within the Borough were maintained to a safe standard.  Whilst the Local Authority did not accommodate families or young people in Bed and Breakfast accommodation, it was possible that other local authorities might choose to do this when placing social care clients in Bromley.  When the Local Authority placed social care clients in suitable accommodation out-of-Borough, all requirements to notify and work with other local authorities were being met. 

RESOLVED that the minutes of the meeting held on 14^th November 2017 be agreed.

Report CSD18001

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

With regard to Minute 54B: Shared Lives Service, the Vice-Chairman confirmed that work was underway to explore how the Shared Lives Service might be further developed.  A number of other local authorities had developed a similar service and the Vice-Chairman would be working closely with the Portfolio Holder for Care Services to identify examples of best practice and how this might be applied in Bromley.

The Committee discussed the importance of encouraging Member participation in the Schedule of Council Members’ Visits.  The Vice-Chairman suggested a minimum number of participating Members should be required for Council visits to go ahead, and it was agreed that the Committee Members would consider how Members could be encouraged to engage with the Schedule of Council Members’ Visits.

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. 

There were currently two key areas of focus within the Care Services Portfolio comprising Adult Social Care and Housing.  With regard to Adult Social Care, the Local Authority was working with the Bromley Clinical Commissioning Group to develop integrated services and a joint strategic vision for the provision of services for older people, adults with learning disabilities and adults with mental health support needs.  The Local Authority was also working with key partners to review Occupational Therapy services and reduce any duplication of service provision.  Strategic reviews were underway on a number of adult social care services and work to increase the uptake of Direct Payments was ongoing.  Key areas of concern within Housing included the introduction of the Homelessness Reduction Act and Universal Credit in Spring 2018, and the continued increase in demand for temporary accommodation.  The Housing Service was working to prevent homelessness where possible, and the Bromley Homelessness Strategy was expected to be finalised in Spring 2018.  The need to address the issue of permanent accommodation for those in temporary accommodation had been recognised and would be an area of emphasis moving forward.

In response to a question from a Member around future pressures on the Local Authority’s budget, the Deputy Chief Executive confirmed that work would continue in considering how the statutory responsibilities of the Care Services Portfolio could best be met in future years.  It was hoped that closer working links between health and social care would support the development of efficient and cost effective service delivery models across key partners.  A Member noted that work to amalgamate health and social care services at a regional level had been undertaken in areas such as Manchester and that this could provide examples of best practice.  Another Member raised a concern around the continued delivery of supported employment services for people with learning disabilities and this would be taken forward by the Deputy Chief Executive following the meeting.

With regard to Housing, a Member underlined the importance of encouraging a more positive view of new housing development such as through pro-development movements including ‘Yes In My Back Yard’ (YIMBY) and by supporting local residents, key partners and developers to work closely together in designing sustainable developments that were appropriate to the distinctive communities across the Borough.  The Vice-Chairman noted the importance of promoting the message that Bromley was “open for business” to developers.  Another Member highlighted the success of the ‘More Homes for Bromley’ scheme and suggested that it should be expanded beyond the planned 400 properties to deliver additional temporary accommodation capacity across the Borough and sub-region.

RESOLVED that the update be noted.

Portfolio Holder decisions for pre-decision scrutiny.

Report FSD18003

On 6^th December 2017, the Council’s Executive received the 2^nd quarterly capital monitoring report for 2017/18 and agreed a revised Capital Programme for the four year period 2017/18 to 2020/21. 

The Committee considered the changes to the Capital Programme for the Care Services Portfolio which included the reallocation of £2,640k Section 106 monies set aside towards the Site G scheme to the Payment in Lieu (unallocated) scheme for Housing.  Members were advised that works to replace the water supply at Star Lane Travellers Site were progressing and that trenching work had commenced on site.  Internal pipework works were being tendered with an anticipated onsite start date of March 2018.

In response to a question from a Member, the Head of Education, Care and Health Services Finance confirmed that the majority of Section 106 receipts from developers had been allocated to forthcoming developments across the Borough.

RESOLVED that the Portfolio Holder be recommended to confirm the revised Capital Programme agreed by the Council’s Executive on 6^th December 2017.

Report CS18110

The Committee considered a report setting out the quality monitoring arrangements for Registered Care Homes, Supported Living Schemes and Extra Care Housing Schemes in Bromley and reviewing performance for 2017/18.  The report also proposed an amendment to the Local Authority's current policy to ensure that all new care placements were made with providers with a Care Quality Commission rating of “Good” or above where possible.

The Contract Compliance Team was responsible for monitoring social care contracts as well as the quality of care offered to Bromley residents in care homes, supported living and extra care housing schemes.  It also worked closely with Bromley Clinical Commissioning Group to reduce any duplication in quality assurance arrangements.  Service users requiring care were given a choice of care home placements contracted with individual homes on a spot contract basis, with 820 placements funded as at December 2017.  The majority of care homes across the Borough were rated as ‘Good’ or ‘Outstanding with 15 providers receiving an overall rating of ‘Requires Improvement’ for which improvement plans were in place.  There were no providers rated as ‘Inadequate’.  Six Extra Care Housing schemes had been established across the Borough to provide an appropriate care option for service users with a greater capacity to live independently and there were also a number of supported housing schemes within the Borough for service users with learning disabilities. 

The Head of Contract Compliance and Monitoring reported that a number of vacant posts within the Contract Compliance Team had recently been recruited to and the team was now fully staffed.

The Portfolio Holder for Care Services confirmed that the Care Services Portfolio budget was balanced for 2018/19 and that it was expected that the Local Authority would apply the annual Social Care Council Tax Precept for 2018/19 at 2% to offset the additional costs to care setting of the National Living Wage for social care staff.  A Member queried the possible financial impact of Brexit on the recruitment and cost of social care staff.  The Deputy Chief Executive reported that the Local Authority and Bromley Clinical Commissioning Group were working with care providers to develop more effective joint working in areas such as recruitment and training to help manage these costs going forward.  

In response to a query from a Member, the Head of Contract Compliance and Monitoring explained that the Care Quality Commission worked to assess the quality of social care provision.  The Local Authority had an obligation to ensure that social care services were of a safe standard, and to support this it was proposed that the Central Placement Team only make new placements with care home providers with a CQC rating of “Good” or above where possible.  The Deputy Chief Executive noted that some providers were exploring different models for future service provision which might include smaller units offering specialist care.  Members requested that a report on specialist care units be provided to a future meeting of the Care Services PDS Committee.

RESOLVED that the Portfolio Holder  ...  view the full minutes text for item 69b

Members and Co-opted Members of the Education, Children and Families Select Committee are invited to attend the meeting for consideration of this item.

Report CS18118-1

The Committee considered a report requesting approval to grant a contract award for the provision of Advocacy Services for a period of three years commencing 1st April 2018 to 31^st March 2021, with the option to extend the contract for two further one year periods.  Members and Co-opted Members of the Education, Children and Families Select Committee were invited to attend the meeting for consideration of this item as a small part of the contract related to children and young people.

Advocacy Services allowed the views and concerns of vulnerable individuals to be represented, ensuring that their voice was heard, such as in the planning or review of their care plans.  The Local Authority currently had seven contracts for Advocacy Services across four providers which were due to expire on 31^st March 2018.  These contracts would be replaced by a single Advocacy Service bringing together a range of different advocacy services including those relating to the Care Act, Mental Health, Mental Capacity, Health Complaints, Children and Young People and Learning Disabilities.  The new Advocacy Service was expected to provide a more holistic service with a single point of access for service users and professionals and would commence on 1^st April 2018.

RESOLVED that the Council’s Executive be recommended to:

1)  Approve the contract award for Advocacy Services for a period of three years commencing 1st April 2018 to 31^st March 2021, with the option to extend the contract for two further one year periods at a whole life contract value of £1,430,635.

2)  Delegate authorisation to extend this contract for the two optional one year extension periods to the Deputy Chief Executive and Executive Director: Education, Care and Health Services in consultation with the Portfolio Holder for Care Services, the Director: Commissioning, the Director: Finance and the Director: Corporate Services.

Report CS18116

The Committee considered a report providing an update on homelessness pressures and a range of initiatives that had been undertaken during 2017/18 to manage rising budget pressures and address forthcoming challenges arising from the introduction of the Homelessness Reduction Act 2017 and Universal Credit in Spring 2018.  It was also requested that £844k be released from Central Contingency to offset costs associated with homelessness and temporary accommodation budget pressures.

Homelessness and the provision of temporary accommodation continued to be an area of key concern for the Local Authority.  There were currently 1558 Bromley households in temporary accommodation (excluding those in supported accommodation as part of a rehoming pathway), with an anticipated full year spend on temporary accommodation for 2017/18 of £13.8M, with a net cost to the Local Authority of £5.8M.  It was expected that demand for temporary accommodation would continue to increase in the short to medium term, particularly in light of forthcoming legislative and financial changes.  During 2017/18, the Local Authority had achieved significant results in the prevention of homelessness including assisting households into private rented accommodation.  A number of initiatives to target homelessness and increase the supply of good quality permanent and temporary accommodation had been also introduced, including an early intervention model to identify and assist those at risk of homelessness, work to encourage private landlords to take up block booking arrangements and the provision of additional temporary accommodation units within the Borough and sub-region. 

The Director: Housing clarified that the refurbishment of Benedict House had created 40 units of temporary accommodation.

In considering the report, the Chairman noted that the Government had supplied a grant of £255k to meet new statutory requirements under the Homelessness Reduction Act 2017, with an additional £9k grant for IT updates.  The Director: Housing confirmed that whilst the cost implications of IT updates relating to the new statutory requirements were likely to significantly exceed the allocated grant, a portion of the £255k grant could be used to ensure IT systems were appropriately resourced to deliver the new statutory requirements. 

In light of the current housing shortage, a Member queried whether consideration had been given to re-evaluating the extent and usage of the Green Belt across the Borough.  The Portfolio Holder for Care Services reported that all options had been explored in identifying how the Borough could meet its future housing needs but that there would be legislative implications to any proposed change of use of the Green Belt.  In response to a question from a Member, the Director: Housing advised that part of the Housing Service’s budget was allocated to Legal Services which funded a Lawyer to deal with housing issues.

RESOLVED that the Council’s Executive be recommended to:

1)  Release £844k for 2017/18 from Central Contingency set aside to offset the current homelessness and temporary accommodation budget pressures;

2)  Agree drawdown of the ring fenced grants as set out below:

Report CS18121

The Committee considered a report providing an update on service proposals and procurement strategy for the development and management of a modular home provision in the Borough.

At its meeting of 24^th May 2017, the Council’s Executive agreed to the principle of inviting bids from potential suppliers for the development and management of a modular constructed site in York Rise, Orpington in response to the sharp increase in the number of households requiring temporary accommodation in recent years.  The proposed scheme was subject to further market engagement to inform the tender and specification, and it was requested that a feasibility study be undertaken considering both the suitability of the site to host a modular home provision and potential length of use.  This work had now been completed and it was proposed a tendering process be initiated for a supplier to deliver a ‘turn-key’ solution for the establishment and management of a modular home provision in York Rise, Orpington that would provide self-contained living accommodation to a high quality specification for a period of 15 years.  It was also proposed that a schedule of rates be developed that could be used for alternative modular sites across the Borough and would be uplifted on an annual basis using the Consumer Price Index. 

Member comments contributing towards the scrutiny of this report were received from Councillor Charles Joel and Councillor Tim Stevens and these are attached at Appendix B.

In emphasising his support for the use of modular sites to provide temporary accommodation, a Member was concerned at the lack of consultation with Ward Members and local residents.  Members discussed the importance of engaging with Ward Members, local residents and residents’ associations about potential in-Borough temporary accommodation schemes at the earliest stages to build support and allow schemes to be developed in a way that suited the distinct communities across the Borough.  Members underlined the need to review the communications strategy for proposed temporary accommodation schemes and requested that the Director: Housing arrange a meeting to brief Ward Councillors on the proposed scheme as soon as possible.

A Member noted that it was proposed that any procurement process taken forward for the proposed scheme would evaluate tenders based on 60% price and 40% quality.  The Director: Housing confirmed that this was the Local Authority’s standard weighting to evaluate tenders, and that there was a minimum quality qualifying score criteria to ensure that all tenders met a defined level of quality.  The Member suggested that tenders should be evaluated on an individual basis and would raise this as a concern at a future meeting of the Contracts’ Sub-Committee.

In considering the wording of the second recommendation of the Care Services PDS Committee, Members agreed that this be amended to state that the Council’s Executive be recommended to:

“2) Approve the use of the identified site, York Rise for the use of modular constructed accommodation, subject to appropriate planning permission being agreed”.

RESOLVED that the Council’s Executive be recommended to:

1)  ...  view the full minutes text for item 70c

Report CS18114

The Committee considered a report evaluating the new Health Support to Schools Service and requesting drawdown of £303k from the Better Care Fund to continue the existing service for 2018/19 as well as the agreement of the Council’s Executive to drawdown £300k from the Better Care Fund to appoint an additional six nurses for the remainder of the existing Health Support to Schools contract which would end on 31^st March 2019.

At its meeting on 30^th November 2016, the Council’s Executive agreed to fund a new service to support the health of school age children for a period of two years, which would funded by the Better Care Fund to a total value of £606k.  Bromley Healthcare was commissioned to deliver the Health Support to Schools Service which commenced on 1^st April 2017.  A subsequent evaluation of this service in October 2017 identified that the team was only able to offer very limited safeguarding support in schools due to capacity issues, and it was proposed that an additional six nurses be appointed to the Health Support to Schools Service with five of the proposed six posts to be dedicated to safeguarding.  Schools had indicated that they would not be willing to pay for statutory School Nurse functions such as safeguarding, and the contribution from schools to the Health Support to Schools Service would be explored in a further report to the Council’s Executive in Summer 2018.  The proposals relating to funding school nursing support for children and young people with asthma within the report were in response to a number of recent deaths from asthma in schools outside Bromley and would support a specific piece of work to develop and align systems in primary care with Individual Health Care Plans for children with asthma in Bromley schools. 

The Consultant in Public Health Medicine advised Members that school nurses worked most effectively when their specialist knowledge was contributing towards existing school systems.  Schools were very knowledgeable about their pupils’ health needs but there was a need to ensure this was supported by robust information systems which allowed an holistic Individual Health Care Plan to be developed for children with medical needs.  A Co-opted Member queried the average spend of around £11 per head on school nursing in Bromley for 2018/19 against other London local authorities.  The Consultant in Public Health Medicine explained that the areas of work included in the school nursing role varied widely across local authorities which accounted for the disparity in funding levels.  The Local Authority had undertaken a range of work to identify how the school nursing role could be delivered most effectively across Bromley and service provision would continue to be regularly evaluated.

In response to a question from a Member, the Consultant in Public Health Medicine confirmed that the Council’s Executive had agreed that the Health Support to Schools Service be funded by the Better Care Fund for the proposed two year duration of the service but that a further  ...  view the full minutes text for item 70d

Report CS18112

The Committee considered a report setting out the draft Care Services Portfolio Budget for 2018/19, which incorporated future cost pressures and initial draft saving options to be reported to the Council’s Executive on 10^th January 2018.  Members were requested to provide their comments on the proposed savings and identify any further action to be taken to reduce cost pressures facing the Local Authority over the next four years.

The Head of Education, Care and Health Services Finance advised Members that a number of pressures would continue to impact the Care Services Portfolio budget for 2018/19.  This included further increases to the National Living Wage from April 2018, escalating demand for temporary accommodation and homelessness services and the impact of recent welfare reform changes.  There continued to be significant pressure in the area of Adult Social Care for which the Government had agreed further non-recurring Improved Better Care Funding of £4.463M in 2018/19, £3.363M in 2019/20 and £1.677M in 2020/21 to be utilised in agreement with the Bromley Clinical Commissioning Group.  The Government had previously agreed that the Local Authority could apply an annual Social Care Council Tax Precept at 3% for 2018/19, subject to a maximum of 6% being applied across the period 2017/18 to 2019/20 and this could be used to offset the additional costs of the National Living Wage.

A Member highlighted concerns around how continued growth pressures in key areas such as Adult Social Care and Housing would make it more difficult to address the significant budget gap within the Local Authority budget in future years.  The Head of Education, Care and Health Services Finance confirmed that work was ongoing to manage the Care Services Portfolio budget for future years, including service transformation work with key partners and that areas of growth pressure could be offset using contingency funds where appropriate.  Another Member noted that there were both demographic and structural factors impacting the growth in demand for Care Services, including an ageing population and the impact of national changes to benefits entitlement and the National Living Wage.

RESOLVED that:

1)  The financial forecast for 2018/19 to 2021/22 be noted;

2)  Members’ comments on the initial draft Care Services Portfolio budget 2018/19 as a basis for setting the 2018/19 budget be noted; and,

3)  Members’ comments on the initial draft Care Services Portfolio budget 2018/19 be provided to the meeting of the Council’s Executive on 7^th February 2018.

Report CS18113-1

The Committee considered an extract from the Contracts Register which provided key information concerning contracts within the Care Services Portfolio with a total contract value greater than £50k.

There were 91 contracts within the Care Service Portfolio with a total contract value greater than £50k as at 30^th November 2017, none of which were currently flagged as being of concern.

RESOLVED that:

1)  The review of the £50k Contracts Register be noted; and,

2)  It be noted that the corresponding Part 2 (Exempt) Contracts Register (Report CS18083-2) contained additional and potentially commercially sensitive information in its commentary.

The briefing comprises:

• Programmes Jointly Commissioned by PHE/NHSE (Immunisation and Screening)

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 one report:

• Programmes Jointly Commissioned by PHE/NHSE (Immunisation and Screening)

RESOLVED that the Information Briefing be noted.

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 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 14^th November 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.