Agenda and minutes

-  The Committee to note the death of Councillor Mary Cooke.

-  To appoint a Chairman and Vice-Chairman for the remainder of the Council Year.

-  To appoint a Chairman and Vice-Chairman of the Health Scrutiny Sub-Committee for the remainder of the Council Year, and to fill the vacancy for a Conservative Group Member on the Sub-Committee.

Councillor Allatt led tributes to Councillor Mary Cooke, following her sudden passing on 7^th January 2022, and a minute’s silence was held in her memory. On behalf of the Labour Group, Councillor Kennedy-Brooks offered condolences to Councillor Cooke’s family and colleagues.

Councillor Allatt put himself forward for election as Chairman of the Adult Care and Health Policy Development and Scrutiny Committee and Health Scrutiny Sub-Committee for the remainder of the 2021/22 municipal year. Members were advised that, as there were only a few meeting remaining, it was proposed that the role of Vice-Chairman be left vacant, as would the Conservative Member vacancy.

Councillor Jefferys proposed that Councillor Allatt be elected as Chairman of the Adult Care and Health Policy Development and Scrutiny Committee and Health Scrutiny Sub-Committee for the remainder of the 2021/22 municipal year, and this was seconded by Councillor Kennedy-Brooks.

RESOLVED that Councillor Gareth Allatt be appointed as Chairman of the Adult Care and Health Policy Development and Scrutiny Committee and Health Scrutiny Sub-Committee for the remainder of the 2021/22 municipal year.

Apologies for absence were received from Councillor Kim Botting, Councillor Robert Evans and Co-opted Member, Francis Poltera.

RESOLVED that the following Co-opted Member appointments be made to the Adult Care and Health PDS Committee for 2021/22:

There were no declarations of interest.

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 onFriday 21^st January 2022.

No questions had been received.

The minutes of the meeting held on 23^rd November were agreed, and signed as a correct record.

Report CSD22006

The Committee considered a report setting out matters outstanding from previous meetings and the proposed work plan for 2021/22.

The Chairman noted that the work which related to the matter outstanding on Assistive Technology was ongoing, with delivery anticipated within the next six months.

Councillor Cuthbert advised that the Tackling Loneliness Strategy had been emailed to the Leaders of the Labour Group and Independent Group, as well as to local MPs.

A Member requested that items be added to the 2022/23 work programme as soon as officers were able to do so.

RESOLVED that the report be noted.

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 recognised the impact that the sad loss of Councillor Mary Cooke had on officers within the Adult Social Care directorate. The Director of Adult Social Care said that she represented all staff when noting how much Councillor Cooke would be missed for her wise counsel, constructive challenge and her interest and support over the years – she had a unique ability to ask seemingly innocent questions, that totally hit the mark. Condolences were extended to Mr Cooke, and Councillor Cooke’s wider family.

The Director of Adult Social Care welcomed Councillor Allatt to the role of Chairman of the Adult Care and Health PDS Committee and noted that she looked forward to working with him.

Members were advised that staff had coped well with a very busy festive period. This time of year was ordinarily busy, but this was exacerbated by the ongoing pressures created by the pandemic and the drive by health partners to catch up on delayed appointments and treatments. The PRUH had survived this particular pressure point well, and there were no undue delays in getting people home when they were ready – this was a real tribute to everybody across the whole system for working well together over this extremely busy time.

The directorate’s support to care providers was stepped up once again just before Christmas, when an increase in the number of care settings dealing with both residents and staff affected by COVID-19 was being seen – at its height, over 60 care settings were being supported with outbreaks. The Director of Adult Social Care said she was pleased to report that the numbers had decreased significantly over the last couple of weeks, and care providers were coping very well. The multi-agency team had dealt with this in a calm and professional manner, taking learning from earlier in the pandemic to provide appropriate support, which had been really valued by the care sector. It was noted that staff had stepped up with a real sense of calm and control, which was testament to the energy and the commitment that staff had put into this work.

The directorate had continued to distribute COVID-19 grants to the sector in line with government requirements, although it was anticipated that going forward, these grants would become fewer. In order to provide additional capacity in Bromley, six designated beds had been commissioned at Burrows House Care Home to allow the discharge of patients who remained COVID-19 positive from hospital until they exited the infectious stage of their recovery. This service was funded by the South East London CCG, and Bromley was the only borough in southeast London that had managed to achieve this. This service would run until the end of March 2022.

The introduction of mandatory vaccinations for those working in residential care settings was introduced in Bromley, and there had been no  ...  view the full minutes text for item 57.

Portfolio Holder decisions for pre-decision scrutiny.

Report FSD22004

On 24^th November 2021, the Executive received a report summarising the current position on capital expenditure and receipts following the 2^nd quarter of 2021/22 and agreed a revised Capital Programme for the four-year period 2021/22 to 2024/25. During this cycle of monitoring, no additions or changes were made to schemes in the Adult Care and Health Portfolio Programme.

The Chairman noted the reference made in the document to Post-Completion Reports for ‘Care Homes – improvements to environment for older people’ which appeared to be historic. The Head of Finance for Adults, Health and Housing advised that some initial work had been undertaken to look into this scheme which dated back to around 2012 and had ended in 2016. The scheme had been removed from the Capital Programme following a review of dormant schemes in 2019, and therefore it may be difficult to get a complete view of what the scheme had been used for, and how it had performed, as would usually be included in post-completion reports. This was something that could be followed up and brought back to a future meeting, if possible. The Chairman suggested that if there was difficulty finding documentary evidence, the care homes could be asked to provide photographic evidence of what the money from the scheme had been spent on.

RESOLVED that the Portfolio Holder be recommended to note the current position in respect of Capital Schemes agreed by the Executive on 24^th November 2021.

Report FSD22012

The Committee considered a report setting out the draft Adult Care and Health Portfolio Budget for 2022/23, 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 12^th January 2022. 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.

It was noted that the text in variation note 7 in Appendix 1 of the Adult Care and Health Portfolio Draft Budget 2022/23 report (Item 9b, agenda page 53) should read as follows:

7. Increase uptake of the Shared Lives service (Cr £310k) – Shared Lives is a cost effective service and the further expansion of the scheme will both help to mitigate cost pressures and care for service users in a supportive setting where a high level of independence is maintained.

The Chairman highlighted that the current Adult Care and Health Portfolio budget included Phase 1 and Phase 2 Transformation Savings, totalling £1.2m per annum, however significant cost pressures remained. With regards to a query on mitigation, the Head of Finance for Adults, Health and Housing noted that there were increases, including £3.3m of inflationary increases, within the draft budget and a total of £7.1m of growth for the service budget. This totalled £10.4m, which was an increase of 13% on the 2021/22 budget. A summary of mitigations was provided in the table on page 52 of the agenda pack. This totalled £3.5m, however it was noted that the top two items (‘Use of iBCF from previous years to mitigate growth’ and ‘Allocation of unringfenced Covid funding from Reserves’) did not require any action as grant funding had already been received. The Test and Trace Public Health grant was also included, and with the savings listed under the ‘Real Changes’ section there was just under £1m of savings to be delivered. Most of this had been identified, and work was ongoing to ensure that mitigations within Public Health were identified as soon as possible.

A Member questioned how a savings target of £200k within Public Health could be justified. It was highlighted that the Public Health team had done an incredible job throughout the pandemic, and it was considered that more money should be spent within this area, rather than targets for savings being set. The Portfolio Holder for Adult Care and Health advised that some of the Public Health savings identified related to efficiencies within the commissioning of sexual health programmes. Members were reassured that the mandatory responsibilities within Public Health were being maintained and future priorities would be identified through the Health and Wellbeing Board and Joint Strategic Needs Assessments (JSNA).

In response to questions, the Director of Adult Social Care said that a piece of work was being undertaken looking at how the transition between young people and adult placements could be best managed, and a  ...  view the full minutes text for item 58b

Report ACH22-001

The Committee considered a report which sought Executive approval to commence the procurement of a new Advocacy Service to ensure the Council met its statutory duty in providing an Advocacy Service under the Care Act 2014 and Care and Support Advocacy Service Regulations 2014.

The current Advocacy Service contract would expire on 31^st March 2023 and there was no further option to extend this contract, which was in its final extension period. The contract was awarded to Advocacy for All following a competitive tender and commenced on 1^st April 2018 for a period of three years with the option to extend up to a further two years on a 1 year +1 year basis. 

The Head of Service for Community Living Commissioning advised that the report set out details of the specification and indicative key performance indicators (KPIs). The service would be delivered to both adults and children, and it was highlighted that the current provider had been delivering a very good service. During the procurement process, in co-production with providers, they would be looking at how areas of the service could be improved. The estimated annual value of the service would be £321,900.

In response to a query regarding the quality criteria, the Head of Service for Community Living Commissioning said that if the recommendation was approved by the Council’s Executive, the commissioning team would establish a Tender Project Group which would be responsible for developing the quality criteria to be used to assess the tender bids. It was not possible to share the quality criteria as it had not yet been devised.

From past experience it was evident that co-production of the quality criteria with service providers was needed in order to reflect best interests of the client group.

Previous evaluation criteria were presented to the providers and other stakeholders as a baseline. This was available in draft form and could be circulated to Members following the meeting. The Head of Service for Community Living Commissioning highlighted that additional areas of focus for the criteria would relate to social value and information governance. In response to a further question regarding social value, the Head of Service for Community Living Commissioning said that for a recent domiciliary care tender this had been factored into the service specification. Providers were encouraged to provide, via their tender bids, information on the number of apprenticeships; supported internships for people with learning disabilities; and outreach with local schools.

A Co-opted Member enquired about what had accounted for the increase in referrals for Children and Young People Advocacy, Independent Mental Health Advocacy and Learning Disability Advocacy. The Head of Service for Community Living Commissioning said that providers had indicated that this was mainly due to the impact of the pandemic, and with more people accessing social care, and supply had been increased to meet this demand.

A Member noted that if changes were to be made to the contract there should be provision within the timescale for it to be  ...  view the full minutes text for item 59a

Report ACH22-004

The Committee considered an overview of the Bromley Safeguarding Adults Board’s (BSAB) Annual Report 2020/21. Teresa Bell – Independent Chair of the Bromley Safeguarding Adult Board (“Independent Chair – BSAB”) and Bulent Djouma – Bromley Safeguarding Adult Board Manager (“BSAB Manager”) delivered a presentation on the work of the BSAB, which is attached at Appendix A.

The Independent Chair – BSAB advised Members that the Local Authority had a duty to establish a Safeguarding Adults Board under S43 of the Care Act 2014. An Independent Chair was appointed to provide an impartial and objective steer to fulfil its statutory obligations. The BSAB had three main functions which are to:

-  Develop a strategic plan which described the Board’s objectives and how members of the Board would achieve these;

-  Publish an annual report detailing how effective the Board’s work had been; and,

-  Undertake Safeguarding Adults Reviews (SARs) and publish the findings and recommendations from these.

The BSAB included representatives from the statutory sector; health and blue lights services; the private health, care and housing sector; and the private, voluntary and independent (PVI) sector. The membership of the BSAB was broad and inclusive and meetings were very well attended. To ensure that there was the ability to make decisions in an effective and timely way, the BSAB had an Executive Committee which consisted of the core partners.

The Independent Chair – BSAB said that the purpose of the annual report was to provide a summary of the work carried out by its members throughout the year. The document was produced in consultation with all members, and provided an overview of the local safeguarding context, the Board’s core strategic priorities and how partners had supported in achieving these. The work of the individual subgroups was also summarised, providing transparency in the work that was achieved. It was highlighted that an easy read version of the annual report had been produced for the first time. Key highlights had included:

-  Focus on COVID-19 and areas of related work whilst ensuring business continuity with its strategic priorities;

-  Effective transition to virtual ways of working and its challenges;

-  Community engagement during the pandemic – via resources, targeted contact with most vulnerable (Trading Standards, Metropolitan Police Services); and,

-  BSAB website developed during the reporting year, therefore much emphasis was on this as a platform for key communications and source of Board information, access to various training, guidance and policies, etc.

The main sections of the report focussed on:

- Local context:

-  Demography of service users;

-  Number accessing services (23,399);

-  Number of calls made to Adult Early Intervention Service (14,000+);

-  Number of referrals made to Adult Social Services (6,276); and,

-  Number of adults accessing long-term support (2,803).

- Strategic priorities:

-  Domestic Abuse;

-  Financial Abuse;

-  Self-Neglect;

-  Modern Day Slavery;

-  Transitional Care of Children into Adulthood; and,

-  Vulnerable Adults in Specialist Care and Residential Homes.

- Work of Board partners:

-  Achievements  ...  view the full minutes text for item 60.

Report ACH22-003

The Committee considered a report on the initiatives being implemented across the department to increase direct payment take up by residents who used the Council’s social care services.

The Assistant Director for Integrated Commissioning advised that direct payments were social care payments from a Council for residents who had been assessed as needing help and would like to exercise more choice and control over arranging and paying for their care and support services. Some people decided to use direct payments to employ their own personal assistant staff, whilst others bought support from a care agency, or used them to access other services and activities that met their needs and outcomes. Without a direct payment, the Council would arrange a service user’s care and support on their behalf through the use of more traditional commissioned services. A direct payment was designed and provided to be used flexibly and innovatively and was often referred to as self-directed support. Most users of social care services would have an entitlement to choose to have their care and support provided through a direct payment. It was noted that the choice of taking up a direct payment rested with the service user, and Councils could not make direct payments take up compulsory.

The Assistant Director for Integrated Commissioning highlighted that national and local evidence indicated that direct payments encourage those who used them to achieve their social care goals in a way which gave a better quality of life, with greater resilience, and more independence. It also showed that direct payments represented good value for money and a sustainable way of using public resources now and in the future. For these reasons the Council had sought to increase the availability and take up of direct payments by those who used social care services and their carers. Four changes would be introduced:

-  Direct payments as the ‘first choice’;

-  Implementation of a Direct Payment Support Service;

-  Implementation of a Temporary Direct Payment Advisory Service; and,

-  A marketing and learning campaign.

It was noted that as part of the pilot arrangements, it was proposed that the CCG was supported in its direct payment arrangements through the Council’s infrastructure. The Direct Payment Support Service would manage direct payments for both the Council and CCG, with the CCG being charged for the Council’s support. A service level agreement, which carefully set out the terms of this arrangement, would be drawn up with CCG.

A Member said that they would like to see a support structure in place for people who did not want to use direct payments and highlighted the need for centres to be used proactively, for multiple purposes. The Assistant Director for Integrated Commissioning noted that at a previous meeting, a report had been presented to the Committee regarding proposals to increase day opportunities for older people. The growth of direct payment had some impact on the way in which people accessed services that were provided through block grants in the past. The  ...  view the full minutes text for item 61.

Report ACH22-002

The Committee considered an extract from the November 2021 Contracts Register which was presented to Members for detailed scrutiny. The Contracts Register contained in Part 2 of the agenda included a commentary on each contract to inform Members of any issues or developments. It was highlighted that no contracts had been flagged as a concern during this quarter.

The Assistant Director for Integrated Commissioning advised that the five Learning Disabilities – Supported Living contracts that were flagged as ‘amber’ had all been let and had started earlier that week. It was anticipated that the contract for the Learning Disability Employment Support would be awarded within the next two weeks and the two Public Health contracts were also making good progress – all three would be implemented prior to the 1^st April 2022.

RESOLVED that the report 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.

The following summaries

Refer to matters involving exempt information

The Committee noted the Part 2 information within the report.