Agenda and minutes

Contact: Jo Partridge  020 8461 7694

Items
No. Item

31.

APOLOGIES FOR ABSENCE AND NOTIFICATION OF SUBSTITUTE MEMBERS

Minutes:

Apologies for absence were received from Co-opted Members Roger Chant and Francis Poltera.

 

The Chairman noted that the newly appointed Independent Chair of the Bromley Safeguarding Adults Board (BSAB), Teresa Bell, had been invited to attend the meeting. This offer had been politely declined, as it was considered that the previous Independent Chair had attended the Adult Care and Health PDS Committee meeting of her own volition. It was highlighted that attendance at PDS meetings was not included in the job description for the role.

 

Members expressed that they considered adult safeguarding to be an integral part of the work of Adult Social Care, and felt it was regrettable that the Independent Chair would not sit on the Committee. The Chairman advised that the Director of Adult Social Care was a member of the BSAB, and therefore provided a link for sending and receiving any information.

 

The Director of Adult Social Care said that there had often been confusion as to which of her two roles the previous Independent Chair was representing when she had attended meetings. When looking into this further, and it had been discovered that there was not a requirement for the Independent Chair of the BSAB to sit on the Adult Care and Health PDS Committee, but would attend meetings to present relevant reports. It was noted that the Independent Chair had only very recently started in post and had been unable to attend this evening due to a prior commitment. The BSAB Annual Report for 2019-20 was a “backwards looking” report, and as such would be presented to the Committee by the Safeguarding Adults Board Manager.

 

In response to a question, the Director of Adult Social Care stated that the other roles held by the Independent Chair had been taken into consideration during the appointment process, and that she was employed by the Local Authority for two days per month. During this time the Independent Chair would attend statutory meetings; provide support relating to safeguarding practice; and manage the formal meetings she was responsible for.

 

A Member questioned if the Committee was intended to have oversight over the BSAB’s operations. If so, the co-option of the Independent Chair could potentially be a conflict of interest, and therefore a representative from another organisation that covered safeguarding may be more appropriate. The Chairman agreed that this would be discussed further with the Director of Adult Social Care, outside of the meeting, and response would be provided to Members’ questions.

32.

DECLARATIONS OF INTEREST

Minutes:

Councillor Angela Wilkins declared that she worked for Hestia, who were referenced in the reports for the items relating to the Contracts Register and Contracts Database.

33.

QUESTIONS FROM COUNCILLORS AND MEMBERS OF THE PUBLIC ATTENDING THE MEETING

In accordance with the Council’s Constitution, questions that are not specific to reports on the agenda must have been received in writing 10 working days before the date of the meeting. 

 

Questions specifically on reports on the agenda should be received within two working days of the normal publication date of the agenda.  Please ensure that questions specifically on reports on the agenda are received by the Democratic Services Team by 5pm on Thursday 14th January 2021.

 

Please note that all public questions will be answered by written reply.

Minutes:

One written question was received from a member of the public and is attached at Appendix A.

34.

MINUTES OF ADULT CARE AND HEALTH PDS COMMITTEE MEETING HELD ON 24TH NOVEMBER 2020 pdf icon PDF 913 KB

Minutes:

The minutes of the meeting held on 24th November 2020 were agreed and signed as a correct record.

35.

WORK PROGRAMME AND MATTERS OUTSTANDING pdf icon PDF 506 KB

Minutes:

Report CSD21010

 

The Committee considered a report setting out matters outstanding from previous meetings and the proposed work plan for 2020/21.

 

In response to a question, the Director of Adult Social Care advised Members that a summary of the LBB day services workshop would be provide in her update to the Committee, and further details could be circulated after the meeting if required.

 

The Chairman reminded Members of the Learning Disability report which had been presented at the November 2020 meeting of the Committee. The Council had a contract in place with the Southside Partnership (usually referred to as the Certitude contract) to provide Learning Disability supported living and community-based day and respite services. The Assistant Director for Integrated Commissioning informed Members that Executive approval had been obtained in November 2019 to extend the contract for a period of up to 2 years from 1st October 2020 to 30th September 2022. However, the Council was unable to reach mutual terms to extend the contract as originally intended, and subsequent negotiation resulted in a 6-month extension of the contract to 31st March 2021.

 

This reduced contract extension required the Council to review the current service, consult with residents and carers and go to tender to procure new providers in a very short space of time. There were four procurements in train as follows:

a)  Supported Living Services

b)  Residential Respite Service

c)  Day opportunities for residents with complex needs – day centre provision

d)  Community based day opportunities

 

As it was not possible to align the tendering timetables for the Supported Living Service and Residential Respite Service with the timetable for this meeting, it was proposed to hold a special meeting of the Adult Care and Health PDS Committee to consider the award of these two contracts. It was noted that taking these contract awards to the March 2021 meeting would not leave sufficient time to both award the contract, and put in place the new contractors in time for 1st April 2021.

 

Following a brief discussion, Members agreed to a 4.30pm start time for the special meeting of the Adult Care and Health PDS Committee on Wednesday 3rd February 2021.

 

A Member noted that when commissioned providers were approached to extend a contract, incidents of demands for substantial cost increases, or no extension being possible, appeared to have become more frequent. The Assistant Director for Integrated Commissioning said that he was unable to comment on what had happened historically, but that going forward, the Director of Adult Social Care and himself would ensure that this would not be the case.

 

In response to a question, the Assistant Director for Integrated Commissioning advised Members that the original contract was for 5 years, and with the 6-month extension would expire in April 2021. Discussions had been held with Certitude in November 2019, and they agreed in principal to extend the contract by a further two years, and this approach had been agreed by the Council’s Executive. When  ...  view the full minutes text for item 35.

36.

UPDATE FROM THE DIRECTOR OF ADULT SOCIAL CARE

Minutes:

The Director of Adult Social Care gave an update to Members on work being undertaken across the Adult Social Care department.

 

The Director of Adult Social Care reiterated the message delivered to the meeting of the Health Scrutiny Sub-Committee the previous week, by Jonathan Lofthouse, Site Chief Executive – PRUH and South Sites – in Bromley, the whole system had worked well to support the community and reduce the impact of the pandemic. This was not taken for granted, but it was good to have recognition from a recent review of the discharge arrangements that they were an exemplar of how the system could work. It had also been recognised that bureaucracy had been reduced and managed efficiently across all partners at such a difficult time.

 

Away from the department’s role to support the NHS, they were continuing with “business as usual”. People were being supported flexibly, and the numbers of referrals for support had continued to increase, although this was still slightly below the normal level. In addition, the department continued to release a large number of staff to support the COVID workstreams, including support to vulnerable people; test and trace; PPE distribution; and vaccination and testing for staff, care providers and the wider community.

 

Sadly, there had been a recent increase in the numbers of both staff and service users in care settings who had returned positive COVID-19 tests. In order to manage this and provide support and oversight, daily meetings were being held, and were attended by Public Health, social care commissioners, quality assurance officers and the CCG. These meetings were proving invaluable in terms of spotting where there may be an issue arising, and providing training and support. More recently, this had been linked to the number of vaccinations given so that they could begin to estimate when problems would subside, or where more reassurance and support was required. It was noted that the department were keen to ensure that all staff working within care settings were given the COVID-19 vaccination. However, they were having to undertake work to reassure a number of these staff that this was appropriate, and they were working with the Bromley Care Practice who were rolling out the vaccination programme.

 

The Director of Adult Social Care informed Members that since the last Committee meeting, the second Infection Control Grant had been distributed.  They had also recently been notified that some additional grant monies would shortly be received to support providers with testing, which was a heavy demand on their time. It was highlighted that during this period, the relationship with providers had continued to go from strength to strength, which was a positive outcome of an awful situation, and discussions were more cooperative and supportive.

 

A positive workshop, hosted by Community Links Bromley, was held on the 16th December 2020 to examine the issues surrounding changes in demand for day centres and day activities. The session allowed time for all agencies to discuss how they could work together to rethink  ...  view the full minutes text for item 36.

37.

PRE-DECISION SCRUTINY OF ADULT CARE AND HEALTH PORTFOLIO HOLDER REPORTS

Portfolio Holder decisions for pre-decision scrutiny.

Minutes:

The Committee considered the following reports where the Adult Care and Health Portfolio Holder was recommended to take a decision.

 

37a

CAPITAL PROGRAMME MONITORING - 2ND QUARTER 2020/21 pdf icon PDF 308 KB

Additional documents:

Minutes:

Report FSD20098

 

On 18th November 2020, the Leader received a report summarising the current position on capital expenditure and receipts following the 2nd quarter of 2020/21, and agreed a revised Capital Programme for the four-year period 2020/21 to 2023/24. The Committee considered a report highlighting changes agreed by the Executive and Leader in respect of the Capital Programme for the Adult Care and Health Portfolio.

 

The Head of Finance for Adults, Health and Housing advised Members that the main item within the Adult Care and Health Portfolio Capital Programme was the learning disability element. The Head of Complex and Long-Term Commissioning noted that a programme of work relating to day services would be created. Over the coming months, the spend of capital would follow this programme, and would be aligned with the other work being undertaken around day services.

 

A Member noted that a care homes option appraisal had been included in the capital budget for the previous year, but a decision had been taken not to progress with the review. With regards to the increased costs of residential care, it was questioned what alternatives had been considered. The Director of Adult Social Care said that it was not anticipated that the borough would be short of provision over the next couple of years. Sadly, there were a large number of vacancies following COVID-19 deaths, and as such it was not recommended for the Local Authority to revisit this plan in the near future.

 

RESOLVED that the Portfolio Holder be recommended to note the changes agreed by the Leader on 18th November 2020.

37b

ADULT CARE AND HEALTH PORTFOLIO DRAFT BUDGET 2021/22 pdf icon PDF 360 KB

Additional documents:

Minutes:

Report FSD21006

 

The Committee considered a report setting out the draft Adult Care and Health Portfolio Budget for 2020/21, which incorporated future cost pressures, planned mitigation measures and savings from transformation and other budget options which were reported to the Council’s Executive on 13th January 2021. 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 Chairman noted that there was an extensive list of influences which may impact on the budget.

 

A Member noted that with regards to increased costs, a rate of 1-1.5% had been allocated to the Adult Social Care budget and queried why this was lower than the overall increase to the Council’s budget of 2%. The Head of Finance for Adults, Health and Housing advised that the Director of Finance’s report to the Executive assumed contract price increases of 2% inflation across the Council, however it was usual practice for a lower amount to be allocated to the portfolios based on the current CPI level. It was highlighted that all portfolios had been allocated the same percentage increase of between 1-1.5%. The remainder of the inflation amount remained in Central Contingency, which could be drawn down if departments incurred increased inflationary pressures during the year.

 

The Member further noted that the Shared Lives service was an excellent programme, but as there appeared to be no increase in the numbers on stream, questioned how savings of £0.5m would be achieved. The Head of Finance for Adults, Health and Housing acknowledged that so far this year, there had been not been an increase in uptake. This was partly due to staffing issues, which had been outside of the department’s control, as well as the impact of the COVID-19 pandemic. However, there was now a strong plan in place to increase uptake going forward. The Portfolio Holder for Adult Care and Health highlighted that the Information Briefing provided to the meeting had included a business case for the Shared Lives programme. It was intended to enhance the recruitment process and develop a more robust process for identifying people to provide support. Reassurance was given that this had been carefully considered, and it was anticipated that an improved service would be delivered, with more people willing to take on the role of a Shared Lives carer.

 

With regards to a question relating to the implementation of savings previously deferred, the Director of Adult Social Care noted that these were saving included in previous years with no clear plans to deliver them. This was now being corrected, and saving targets were built into the budget, and the directorate were working hard to build robust plans to provide these savings. Members were assured that there was now an “owner” for each saving target, and regular monitoring place to look at their delivery. In response to a further question regarding the strength-based provision, the Director of Adult Social  ...  view the full minutes text for item 37b

38.

PRE-DECISION SCRUTINY OF EXECUTIVE REPORTS

38a

DELEGATING AUTHORITY TO APPROVE CONTRACT EXTENSIONS pdf icon PDF 185 KB

Additional documents:

Minutes:

Report ACH21-008

 

At its meeting on the 24th November 2020, the Committee had been provided with a Leader decision Contract Award report for pre-decision scrutiny. The report (ACH20-067) concerned the award of contract for the Direct Payments and Payroll Support Service contract. It recommended an award of contract for a period of five years, with an option to extend for up to two years. The estimated annual value of the contract was £202k, with the estimated value of the initial contract term being £1,010k and the estimated value of the extension period being £404k (estimated whole life value of £1,414k).

 

The report had recommended that delegated authority be granted to the Director of Adult Social Care to approve the extension option in due course, in agreement with the Portfolio Holder and relevant officers as determined by the Contract Procedure Rules. Members had queried the request for delegated authority for the extension option. In response, the Leader approved the award of contract, but deferred a decision on the delegation of authority for the extension option to allow further investigation into the circumstances under which such authority was routinely delegated to officers, and therefore a report had been provided to the meeting.

 

The Assistant Director for Governance and Contracts noted that delegated authority was not an assumed, and it was a Member decision which must be requested at the point of Contract Award and the decision maker, whether at Portfolio Holder or Executive level, must specifically grant approval. If approved, scrutiny could still take place via various methods. Contracts with a whole life value of over £500k should be reported to Members on an annual basis which, if performance suggested, could also prompt a referral back to Members for extension options in the future. Any delegated authority was subject to ensuring that a contract extension was taken several months before its end date so that alternative action was possible.

 

If a contract was not adhering to KPI’s, a Member questioned if it was correctly assumed that it would not be extended. The Assistant Director for Governance and Contracts advised that underperformance on a contract would be looked at on a case by case basis, as it depended on the nature of the underperformance. For any extension where there was delegated authority, it needed to be taken in sufficient time to consider all factors and it would also be subject to consultation with the relevant Portfolio Holder and key officers. A governance process took place in the background, and a Gateway Report was required to justify the business case to enact the extension. Contract Database reports were provided on a quarterly basis, in which a summary was provided, and actions proposed for any contract coming towards its end. It could also be raised with the Chairman and Portfolio Holder at any point if there was a contract which Members would like brought back for scrutiny.

 

RESOLVED that:

 

i)  The report be noted; and,

 

ii)  The Executive be recommended to approve the deferred  ...  view the full minutes text for item 38a

39.

ANNUAL ACS DEBT REPORT pdf icon PDF 113 KB

Additional documents:

Minutes:

Report ACH21-005

 

The Committee considered a report providing an update on the current level of Adult Care Services (ACS) debt, and the action being taken to reduce the level of long-term debt. The Assistant Director for Exchequer Services noted that since the report had been written, the overall debt figure (£15.18m for ACS Invoices and Domiciliary Care) had decreased by £5.73m as at the end of December 2020.

 

Domiciliary Care debt had increased by £350k when compared to September 2019, which was partly due to an increase in fees, which were reviewed each year. Over the last three years, there had been above inflation increases in the charges due to the impact of the National Living Wage and the continued freeze in the cost of the living allowance (known as the Minimum Income Guarantee) for adults receiving Domiciliary Care. The COVID-19 pandemic had also had an impact, due to recovery action having to be suspended. The Local Authority was unable to take legal action, and although recovery letters were issued, they were required to make more favourable arrangements than they would usually allow.

 

As at 30th September 2020, there had been a large outstanding debt owed by the Clinical Commissioning Groups, however the Assistant Director for Exchequer Services advised Members that this had now been cleared, which had contributed to the overall reduction in debt at the end of December 2020.

 

The Assistant Director for Exchequer Services informed Members that active steps had been taken with regards to debt prevention. In 2019, two new roles had been created, one in Social Services and the other in the Debt Recovery Team. They worked primarily with clients who lacked capacity to manage their finances and who had difficulty paying their charges, which were areas identified as impacting on the build-up of debt. Some case studies had been provided, which highlighted the invaluable work being carried out by the Finance Care Manager Assistant and Visiting Recovery Office. For the six cases listed, £83.5k (78.51%) of the £106.3k debt outstanding had been paid following intervention by these officers. These roles were a bridge between care management, clients and finance in supporting service users, and/or family members, to resolve debt issues quickly.

 

A Member noted that as there were a number of specialist legal firms who assisted relatives to evade financial responsibilities for family members with a view to maximising estates, it was queried if a specialist legal adviser was used to seek debt recovery. The Assistant Director for Exchequer Services responded that there were internal legal advisers, and external legal advice was also sought, particularly in relation to debtor estates. There had been a number of successful cases where external legal advisers had been used to take possession of, and sell, properties in order to satisfy the debt owed to the Council.

 

RESOLVED that the level of Adult Care Services debt over a year old, and the action being taken to reduce this sum, be noted.

40.

BROMLEY SAFEGUARDING ADULTS BOARD - ANNUAL REPORT 2019/20 pdf icon PDF 126 KB

Additional documents:

Minutes:

Report ACH20-065

 

The Committee considered an overview of the Bromley Safeguarding Adults Board’s (BSAB) Annual Report 2019/20.

 

The Bromley Safeguarding Adults Board Manager advised Members that under the S43 (1) of the Care Act 2014, the Local Authority was required to establish a Safeguarding Adults Board. The primary objective of the Board was to help and protect adults in Bromley, by co-ordinating and ensuring the effectiveness of Board partners. The Board had an unrestricted remit in what it was able to do to achieve its objectives.

 

The Board was required, under Schedule 2 (4) the Care Act 2014 to produce an annual report outlining its achievements and those of its members in relation to the Board’s strategic objectives. The report covered the period from April 2019 to March 2020. It was noted that the Board was also required to develop and publish a strategic plan setting out how they would meet their objectives and how their member and partner agencies would contribute to these. A three-year strategy for 2020-23 had been developed in September 2019. Section 44 of the Act required the Board to publish the findings and recommendations from any Safeguarding Adults Reviews undertaken. The Board took the decision in February 2019 to commission a SAR related to a care home in the borough, the completion of which was still ongoing.

 

A Member stated that although very thorough and useful, the report was quite long, and enquired if a summary or easy-read version would be produced, particularly for adults with learning disabilities. The Bromley Safeguarding Adults Board Manager advised that this had already been pre-empted, and discussions were taking place with regards to producing an easy-read version which could be widely distributed.

 

In response to a further question, the Bromley Safeguarding Adults Board Manager said that they were mindful of the numerous implications that the COVID-19 pandemic was having. Work was being undertaken with all agencies to find ways of engaging and interacting, where possible, with residents that were isolating, or feeling isolated.

 

In response to a question from the Chairman, Councillor David Jefferys, Chairman of the Health and Wellbeing Board confirmed that the BSAB Annual Report 2019/20 had been presented at its December 2020 meeting.

 

RESOLVED that the Bromley Safeguarding Adults Board’s 2019/20 Annual Report be noted.

41.

CONTRACTS REGISTER AND CONTRACTS DATABASE (PART 1) pdf icon PDF 690 KB

Additional documents:

Minutes:

Report ACH21-012

 

The Committee considered an extract from the November 2020 Contracts Register for detailed scrutiny by the PDS Committee. Members noted that the Contracts Register contained in Part 2 of the agenda included a commentary on each contract.

 

RESOLVED that the report be noted.

42.

QUESTIONS ON THE ADULT CARE AND HEALTH PDS INFORMATION BRIEFING

The briefing comprises:

 

  • Local Account 2019-20
  • Annual Monitoring Report – Direct Payments Support and Payroll Service
  • Annual Monitoring Report – Integrated Community Equipment Service
  • Shared Lives Business Case

 

 

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.

 

This item will only be debated if a member of the Committee requests a discussion be held, in which case please inform the Clerk 24 hours in advance indicating the aspects of the information item you wish to discuss.  Questions on the briefing should also be sent to the Clerk at least 24 hours before the meeting.

 

Minutes:

The Adult Care and Health PDS Information Briefing comprised four reports:

 

  • Local Account 2019-20
  • Annual Monitoring Report – Direct Payments Support and Payroll Service
  • Annual Monitoring Report – Integrated Community Equipment Service
  • Shared Lives Business Case

 

RESOLVED that the Information Briefing be noted.

43.

LOCAL GOVERNMENT ACT 1972 AS AMENDED BY THE LOCAL GOVERNMENT (ACCESS TO INFORMATION) (VARIATION) ORDER 2006 AND THE FREEDOM OF INFORMATION ACT 2000

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.

 

Minutes:

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.

 

The following summaries

Refer to matters involving exempt information

44.

EXEMPT MINUTES OF ADULT CARE AND HEALTH PDS COMMITTEE MEETING HELD ON 24TH NOVEMBER 2020

Minutes:

 

RESOLVED that the exempt minutes of the Adult Care and Health PDS Committee meeting held on 24th November 2020 be agreed, and signed as a correct record.

45.

CONTRACTS REGISTER AND CONTRACTS DATABASE (PART 2)

Minutes:

Report ACH21-012

 

A Member noted that the Contracts Register and Contracts Database were beneficial but considered that the reports did not appear to be doing what it had hoped they would. An example was that over half of the contracts had their procurement status flagged as ‘red’, which implied there were issues, however it was often that they were just nearing renewal. The document did not facilitate looking at contracts in any depth, which in the past had not allowed sufficient time to debate possible extensions or procurement options. It was suggested that a review of how the register was used should be undertaken.

 

The Assistant Director for Governance and Contracts advised that there were two risk statuses included in the register – an overall risk status, based on its value or the nature of provider; and a procurement status, which indicated how soon a contract would be coming to an end. It was noted that even if action had been taken by the contract owner, it still was shown as ‘red’, which could give an inaccurate perception to Members. Internal discussions had been taking place regarding how to present the risk rating so as not to cause undue alarm.

 

With regards to the comments included in the report, the Assistant Director for Governance and Contracts said that a standard format was used for the commentary, the nature of which had not changed. Commentary could be limited by space, however, they included a timetable for action; what the next decision would be; who would make it; and an indication of when it would be made. It was noted that every contract over £500k was subject to an annual monitoring report, which set out the progress of its delivery and gave early indication of the plans for the contract.

 

A Member considered that the issues highlighted should be referred to the Executive, Resources and Contracts PDS Committee, asking them to undertake a review of the document. Following a brief discussion, Members agreed to this suggestion.

 

RESOLVED that:

 

i)  the report be noted; and

 

ii)  a request be made to the Executive, Resources and Contracts PDS Committee to undertake a review of the Contracts Register.

Appendix A pdf icon PDF 87 KB