Agenda and draft minutes

Adult Care and Health Policy Development and Scrutiny Committee - Wednesday 7 September 2022 7.00 pm

Venue: Bromley Civic Centre

Contact: Jo Partridge  020 8461 7694

Items
No. Item

24.

APOLOGIES FOR ABSENCE AND NOTIFICATION OF SUBSTITUTE MEMBERS

Minutes:

Apologies for absence were received from Councillors David Jefferys and Jessica Arnold, and Councillors Kira Gabbert and Tony McPartlan attended as their respective substitutes.

25.

DECLARATIONS OF INTEREST

Minutes:

Councillor McPartlan declared a non-pecuniary interest in relation to items 9a and 15a (Part 2 exempt).

26.

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 onThursday 1st September 2022.

Minutes:

No questions had been received.

27.

MINUTES OF ADULT CARE AND HEALTH PDS COMMITTEE MEETING HELD ON 28TH JUNE 2022 pdf icon PDF 442 KB

Minutes:

The minutes of the meeting held on 28th June 2022 were agreed, and signed as a correct record.

28.

WORK PROGRAMME AND MATTERS OUTSTANDING pdf icon PDF 121 KB

Additional documents:

Minutes:

Report CSD22097

 

The Committee considered a report setting out matters outstanding from previous meetings and the proposed work programme for 2022/23.

 

The Chairman requested an update in relation to Minute 68 22ndMarch 2022 – Bromley Healthcare Commissioner Assurance. The Assistant Director for Integrated Commissioning advised that Bromley Healthcare’s most recent engagement meeting with the CQC had taken place at the end of August 2022, from which positive feedback had been received in relation to the progress being made. If was further noted by the Assistant Director for Integrated Commissioning that he chaired a monthly meeting which received an oversight of the assurance arrangements – good feedback was being received, and Bromley Healthcare needed to continue to sustain the energy they were putting into this work.

 

With regards to the matter outstanding for the appointment of Co-opted Members, as the work in relation to wider representation was ongoing, it was proposed that the existing Co-opted Members be reappointed for the 2022-23 municipal year. Members confirmed that they were happy to agree to this proposal.

 

RESOLVED that the following Adult Care and Health PDS Committee Co-opted Membership appointments for 2022/23 be agreed:

 

Co-opted Member

Organisation

Rona Topaz

Experts by Experience (X by X)

Roger Chant

Carers Forum

Vicki Pryde

Bromley Mental Health Forum

Charlotte Bradford (Health Scrutiny Sub-Committee)

Healthwatch Bromley

 

29.

TACKLING LONELINESS STRATEGY - ACTION PLAN UPDATE pdf icon PDF 140 KB

Additional documents:

Minutes:

Report ACH22-026

 

The Committee considered a report providing an update in delivering the Tackling Loneliness Strategy Action Plan. The Tackling Loneliness Strategy was approved by Adult Care and Health Policy Development and Scrutiny Committee in November 2021 and was launched later that year. At the time, Members were advised that an updated Action Plan would be brought to the Committee with evidence of progress throughout the lifetime of the Strategy.

 

Councillor Mike Botting, Executive Assistant for Adult Care and Health  informed Members that he had recently taken on the role of Loneliness Champion, which he considered it to be a great privilege. Thanks were extended to Councillor Cuthbert, who had previously been the lead Member on this project, the Assistant Director for Strategy, Performance and Corporate Transformation and the Strategy Officer, for the work they had undertaken to date. The Chairman welcomed the Principal Loneliness Champion to the meeting, and led Members in congratulating her on the appointment to this role.

 

The Strategy Officer informed Members that key success in recent months had included:

-  the recruitment and appointment of the Principal Loneliness Champion, whose role would be responsible for delivering the Action Plan;

-  the expansion of Simply Connect Bromley through the input of volunteers working on the project;

-  running social media communications programmes promoting emotional wellbeing and Loneliness Awareness Week;

-  work by statutory partners, the community sector and faith groups to support Ukrainian refugees to connect with other Ukrainian families and their local communities whilst settling in the borough;

-  work by partners in the libraries, leisure and community sectors to support groups at risk of and experiencing loneliness by participating in targeted activities;

-  the development of a service offer to reduce isolation and loneliness and enhance the befriending offer across all pathways in the re-commissioned Bromley Well contract;

-  the launch of the Platinum Jubilee Parks Fund in July 2022 including initiatives to tackle loneliness and reduce isolation; and,

-  updating the Accessible Guide to Transport;

 

The Chairman echoed the comments made by the Executive Assistant for Adult Care and Health, and commended officers on an excellent report which demonstrated the fantastic progress being made against the Action Plan. It was noted that the next update was scheduled to be presented to the Adult Care and Health Policy Development and Scrutiny Committee at its meeting in January 2023.

 

A Member highlighted the importance of not relying too heavily on the voluntary sector and the need to be proactive. It was considered that the Simply Connect Bromley e-directory was a fantastic resource, but needed some tweaking to ensure it was user-friendly. The Strategy Officer said that this would be passed on to partners and they would look to address the gaps highlighted.

 

In response to questions, the Strategy Officer said that an issue raised during the engagement process was that those experiencing isolation may not have access to, or may be unfamiliar with, accessing the internet and/or social media. Part of the Principal Loneliness Champion’s  ...  view the full minutes text for item 29.

30.

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 informed Members that over the summer period, demand had remained high, with continuing pressures to discharge people from hospital in a timely way. Levels of COVID-19 had peaked a few weeks ago, with a large number of care homes experiencing staff sickness, although the level of infection in residents remained fairly low. The government guidance changed the previous week, and care settings were no longer required to routinely test, as had been the case for the last two years. This did not mean that the infection had gone away, but it would make it potentially more difficult for those in residential care settings to monitor and keep residents safe from the risk of infection. The Directorate would continue to work with care providers to support them.

 

Members were advised that major work had now been completed to support care providers to identify the cost of care, in preparation for delivering a return to central government in October. An update on the progress of this work would be provided later in the meeting, but the Director of Adult Social Care said she would like to take the opportunity to put on public record her thanks to the Programme Manager – Adult Social Care Reform, and her team, for the work undertaken so far. Thanks were also extended to the care providers that took the time to return information, which would help the Local Authority to complete the piece of work to estimate the financial impact of the changes as they reached a realistic cost for care.

 

The Director of Adult Social Care shared a note from the Manager of Antokol Care Home, which provided a better understanding of the work that care providers undertook, and set in context the largely unnoticed challenge that providers faced day in, day out. The Executive Assistant for Adult Care and Health said that in this role he had the privilege of visiting Antokol as part of an inspection of care homes – it was a fantastic place, with unbelievable staff, and Members were encouraged to visit if they were given the opportunity to do so. The Chairman asked that the Director of Adult Social Care pass on thanks, on behalf of the Committee, to the Manager for allowing her letter to be shared, and for all the work undertaken by her, and her staff.

 

RESOLVED that the update be noted.

31.

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.

31a

CAPITAL PROGRAMME MONITORING - QUARTER 1 2022-23 pdf icon PDF 307 KB

To follow

Additional documents:

Minutes:

Report CSD22103

 

On 21st September 2022, the Executive would receive a report summarising the current position on capital expenditure and receipts following the 1st quarter of 2022/23 and be asked to agree a revised capital programme for the four-year period 2022/23 to 2025/26. The Committee considered a report summarising changes to be put to the Executive and the 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 changes within the Adult Care and Health Portfolio Capital Programme related to the re-phasing of the PCT Learning Disability reprovision programme - Walpole Road. It was anticipated that the spend, in in relation to Astley Day Centre and the short breaks service at 118 Widmore Road, would occur during 2023/24.

 

Members agreed that in future, if there were no changes to the Capital Schemes, the updates could be provided to the Committee as an information item.

 

RESOLVED that the Portfolio Holder be recommended to note the changes to be put to the Executive on 21st September 2022.

31b

BUDGET MONITORING - QUARTER 1 2022-23 pdf icon PDF 227 KB

Additional documents:

Minutes:

Report FSD22064

 

The Committee considered a report providing the budget monitoring position for 2022/23 for the Adult Care and Health Portfolio, based on activity up to the end of July 2022.

 

The Head of Finance for Adults, Health and Housing advised that there was a projected overspend of £594k on the controllable budget. To provide some context, it was noted that at the Final Outturn report, presented to the Committee in June 2022, had reported full year effect cost pressures of £6.6m and growth of £4.5m had been included. Coming into the financial year, a greater overspend had been expected, which had been aided by the funding from the South East London Integrated Care Board (£3.3m). The main pressure related to hospital discharge packages, and one-off funding had been drawn down and set aside for Discharge to Assess (D2A).

 

A Member noted the latest full year effects, particularly in relation to Assessment and Care Management and Mental Health Care Placements, and enquired how sustainable the current position was considered to be. The Head of Finance for Adults, Health and Housing said that this was difficult to answer as this issue was likely to be overtaken by the Fair Cost of Care work.

In response to a question regarding the proportion of Assessment and Care Management - Care Placements spend for the 18-64 (£564k) and 65+ (£257k) age groups, the Head of Finance for Adults, Health and Housing said that a lot of the pressures related to the 65+ cohort were connected to hospital discharges, and a lesser full year effect was anticipated the following year. For those in the 18-64 cohort, if more service users entered into the service now, it would have a greater effect the following year. It was agreed that these figures would be checked following the meeting. Members were advised that the Community Deprivation of Liberty Safeguards (CDoLS) budget had been set a few years previously – a growth element had been included, and to date had recorded an underspend. The Director of Adult Social Care highlighted that the projected spend could not be predicted as the service was demand led. Delivery was within budget, and there may be further referrals into the service during the year ahead.

 

RESOLVED that the Portfolio Holder be recommend to:

i.)  Note the projected overspend of £594k on controllable expenditure based on information as at July 2022;

 

ii.)  Agree the release of amounts carried forward from 2021/22 as set out in section 3.5 of the report; and,

 

iii.)  Recommend that Executive agree the release of funds from the Central Contingency as set out in section 3.6 of the report.

32.

PRE-DECISION SCRUTINY OF EXECUTIVE REPORTS

32a

INTEGRATED SEXUAL HEALTH TENDER (PART 1) pdf icon PDF 233 KB

Minutes:

Report ACH22-031

 

The Committee considered a report detailing the outcome of the tender process and recommended contract award for the Bromley Integrated Sexual Health Service.

 

The London Brough of Bromley had a statutory duty to improve the health of the population and to provide local public health services. The specific responsibilities were set out in the Health and Social Care Act 2012 and associated regulations and included a mandated requirement for local authorities to provide or make arrangements to secure the provision of comprehensive open access sexual health services.

 

On 24th November 2021, the Executive agreed to proceed to a competitive tender process (Report ACH21-051) to commission an Integrated Sexual Health Service (according to the national specification), bringing together sexual health and contraception services previously provided by two providers. The new integrated service would provide sexual and reproductive health services in clinic to address both the sexually transmitted infections (STI) and contraception requirements of service users. Pre-booked appointments would be available as well as walk-in appointments and a dedicated young people’s clinic. Testing and treatment for all STIs, including HIV, would be provided as well as partner notification. Work around blood borne viruses would include vaccination for hepatitis. The full range of contraception would be available as well as pregnancy testing and referral for abortion services and antenatal care. The HIV Specialist Nursing Service would support complex patients and work with partners to support the early detection of infection.

 

A community programme will also be delivered, which would include targeted outreach interventions for specific groups in the community at risk of STIs and pregnancy. The service would help to improve access to clinics and raise awareness of sexual health. A campaigns programme would raise awareness to the wider community and bite size education sessions would be delivered at regular intervals to specific groups throughout the year. There was a specific offer for young people, which would be delivered through pharmacies (to increase access) which would address preventing unplanned pregnancy as well as sexually transmitted infections. This would be delivered in addition to the National Chlamydia Screening Programme (NCSP) and the London C- Card condom scheme. The service would be underpinned by digital innovation to enhance service delivery, including an electronic patient management system and a focus on self-managed care. The recommended Service Provider had a proven track record, especially in innovation.

 

RESOLVED that the Executive be recommended to:

 

i.)  Approve the award of contract for the Bromley Integrated Sexual Health Service to the Service Provider named in the Part 2 Report, commencing 1st April 2023 for 5 years with an option to extend for up to a further two years at an estimated contract value as detailed in the Part Two report.

 

ii.)  Delegate authority to the Chief Officer in consultation with the Portfolio Holder following agreement from the Assistant Director Governance & Contracts, the Director of Finance and Director of Corporate Services to the extension period and to authorise any variation to the scope of the contract.

 

32b

SOCIAL CARE REFORMS pdf icon PDF 300 KB

Additional documents:

Minutes:

Report ACH22-030

 

The Committee considered a report providing a summary of the changes embedded within the Adult Social Care Reform White Paper – ‘People at the Heart of Care’, and an update on the work undertaken by the Council to prepare and implement the changes.

 

The Programme Manager – Adult Social Care Reforms advised Members that in September 2021, in the Build Better plan, the government announced £5.4bn of investment in the adult social care system in England over 3 years to transform the sector – £3.6bn was allocated for the charging reform (including paying a Fair Cost of Care) and £1.7bn for the systems reforms. The government was committed to the introduction of charging reforms by October 2023 including a new £86k cap on personal care costs; changes to the means test thresholds, further bringing into effect section 18(3) and a move towards paying a fairer rate of care. A decision was also requested to drawdown the grants totalling £908k to support the work detailed in the report.

 

A Co-opted Member commended the decision made to charge higher earners for care. In response to questions, the Director of Adult Social Care advised that the budget for Adult Social Care was determined as part of the Council’s annual budget setting process. It was noted that the changes were part of the national agenda, allowing those who funded their own care to purchase it at the same price as pad by the Council. The movement of money from one budget to another would be subject to political decision – the Council was doing all it could to mitigate the risk, whether care was paid for privately or by the Local Authority,

 

A Member noted that the Association of Directors of Adult Social Services in England (ADASS), had stated that a sustainable care home market sat at circa 85%. As Mental Health and Physical Disabilities homes were at 98%, it was questioned whether there was a risk of reaching maximum capacity. The Director of Adult Social Care advised that Bromley was well placed in terms of the number of care homes and a large private market. It was not a struggle to find places, however they may not be at a price the Council could afford. In terms of the Mental Health homes market, Bromley’s perspective was mirrored on a national level, but alternative methods of support could be considered for those with mental health needs. It was noted that the borough had an older population and therefore had more capacity which could be drawn upon. In response to further questions, the Director of Adult Social Care advised that if another local authority placed someone in a residential care home, they would retain financial responsibility for the duration of the placement. However if a resident moved into a care home on their own accord, they would become the responsibility of the Council in which it was located if they reached the point of requiring funding. It was noted that a house was  ...  view the full minutes text for item 32b

33.

CONTRACT MONITORING - EXTRA CARE HOUSING SCHEMES pdf icon PDF 324 KB

Minutes:

Report ACH22-027

 

The Committee considered a report detailing the annual performance of the Extra Care Housing schemes.

 

The Commissioning Officer advised that Creative Support and Mears Extra Care Ltd provided care and support services into the six Extra Care Housing (ECH) schemes within Bromley. Creative Support were responsible for Apsley Court, Sutherland Court and Regency Court whilst Mears provided services into Norton Court, Crown Meadow Court and Durham House. The report was being presented in line with LBB Contract Procedure Rules and provided an analysis of ECH provider performance during the current contract term.

 

The contracts commenced on 1st August 2017 for an initial period of five years, ending 31st July 2022. A formal 2+2 year extension option was available and approval to extend the contracts for two years under delegated authority was given from 1st August 2022 to 31st July 2024 whilst a strategic review of extra care housing is undertaken. The contracts were currently due to expire on 31 July 2024. The current annual value of the Creative Support contract was £1.73m, with a whole life contract value of £12m (2017-2024), assuming the second extension option was not used. The current annual value of the Mears contract was £1.96m, with a whole life contract value of £13.1m (2017-2024), assuming the second extension option was not used.

 

It was highlighted that the ECH schemes were subject to inspection by the Care Quality Commission (CQC), and all six had been rated as ‘Good’ at their most recent inspections. Both providers were delivering a high quality and responsive service.

 

In response to questions, the Commissioning Officer confirmed that all residents received a questionnaire from the provider to complete in relation to customer satisfaction, and there had been a good response rate. With regards to the step-down units, the Commissioning Officer advised that these flats were leased, and the Council had an agreement with the landlord. They did not impact on discharges from hospital, and for a certain period the residents would not need to contribute – however the was dependent on the reason for their stay. The length of stay varied dramatically, but the target was up to six weeks – ideally an exit strategy would be in place, but there was not a definitive end point.

 

The Chairman led Members in thanking officers for an excellent report.

 

RESOLVED that:

 

i)  the contents of the report be noted; and,

 

ii)  the proposal for an update on performance and progress made by the Creative Support and Mears contracts to be presented in 12 months’ time be noted.

34.

CONTRACT MONITORING - COMPLEX NEEDS DAY SERVICE pdf icon PDF 300 KB

Minutes:

Report ACH22-028

 

The Committee considered a report detailing the annual performance of the Learning Disability Complex Needs Day Service.

 

The Strategic Commissioner advised Members that Eleanor Care was the current provider of the Learning Disability Complex Needs Day Service based at Astley Day Centre. The annual monitoring report was being presented in line with the Council’s Contract Procedure Rules where the contract value exceeds £0.5m and provided an analysis of Eleanor’s performance during the initial contract mobilisation period and the current contract term. The contract commenced on 16th August 2021 and the initial term was scheduled to terminate on 15th August 2024. A formal 2-year extension option was available to 15th August 2026. The annual value of this contract was £859k with a whole life contract value of £4,295k if the 2-year extension option was taken.

 

It was highlighted that the initial contract mobilisation period was particularly challenging for Eleanor Care, as they were required to restart the service after a long period of closure during the pandemic and managing the anxieties of staff, service users and their carers who were returning to day services. The Strategic Commissioner informed Members that they quality of the service was improving, and the feedback received was extremely positive.

 

In response to questions, the Strategic Commissioner advised that discussions had taken place with the Transport Team regarding a potential proposal in relation to service user transport. These were still at an early stage, and would depend on the feasibility of the proposals. The Director of Adult Social Care clarified that the report had been brought to the Committee as part of the contractual relationship for the provider to deliver regular updates, which had coincided with their latest inspection. It was noted that a further update would be provided to the Committee if any issues were raised during the inspection.

 

RESOLVED that:

 

i)  the contents of the report be noted; and,

 

ii)  the proposal for an update on performance and progress made by the provider to be presented in 12 months’ time be noted.

35.

QUESTIONS ON THE ADULT CARE AND HEALTH PDS INFORMATION BRIEFING

The briefing comprises:

 

  • Bromley Healthcare Update - CQC Improvement Plan – Health Scrutiny Sub-Committee - July 2022
  • Minutes from the Informal Health Scrutiny Sub-Committee meeting held on 5th July 2022

 

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 2 reports:

 

  • Bromley Healthcare Update - CQC Improvement Plan – Health Scrutiny Sub-Committee - July 2022
  • Minutes from the Informal Health Scrutiny Sub-Committee meeting held on 5th July 2022

 

RESOLVED that the Information Briefing be noted.

36.

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

37.

EXEMPT MINUTES OF ADULT CARE AND HEALTH PDS COMMITTEE MEETING HELD ON 28TH JUNE 2022

Minutes:

RESOLVED that the exempt minutes of the Adult Care and Health PDS Committee meeting held on 28th June 2022 be agreed.

38.

PRE-DECISION SCRUTINY OF EXEMPT EXECUTIVE REPORTS

38a

INTEGRATED SEXUAL HEALTH TENDER (PART 2)

Minutes:

The Committee noted the Part 2 information within the report.