Agenda and minutes

There were no apologies for absence.

Report CSD23080

The Committee considered a report which sought confirmation of the appointment of Co-opted Members to the Adult Care and Health PDS Committee; Member appointments to the Health Scrutiny Sub-Committee; and membership of the South East London Joint Health Overview and Scrutiny Committee for 2023/24.

RESOLVED that:

i.)  The following Adult Care and Health PDS Committee Co-opted Membership appointments for 2023/24, to be re-appointed annually until the end of the current four-year term of the Council, be agreed:

ii.)  Councillor Charles Joel be appointed to the Health Scrutiny Sub-Committee for 2023/24, so that the final membership be agreed as:

iii.)  Councillors Mark Brock and Felicity Bainbridge be appointed as Members of the South East London Joint Health Overview and Scrutiny Committee for 2023/24.

There were no declarations of interest.

In accordance with the Council’s Constitution, members of the public may submit one question each on matters relating to the work of the Committee. Questions must have been received in writing 10 working days before the date of the meeting – by 5pm on Tuesday 13^th June 2023. 

Questions seeking clarification of the details of a report on the agenda may be accepted within two working days of the normal publication date of the agenda – by 5pm on Wednesday 21^st June 2023.

No questions had been received.

The minutes of the meetings held on 15^th March 2023 and 10^th May 2023 were agreed and signed as a correct record.

Report CSD23082

The Committee considered a report setting out matters outstanding from previous meetings and the proposed work plan for 2023/24.

The Chairman advised that there was one matter outstanding, which was still in progress. This related to re-establishing the programme of Member visits to care homes and it was intended that these would resume during the municipal year.

Members were asked to notify the Chairman and clerk if they wished to have any further items added to the work programme for 2023/24.

RESOLVED that the update be noted.

Including an update on Adult Social Care Reforms

The Director of Adult Social Care welcomed the new Co-opted Members to the Adult Care and Health Policy Development and Scrutiny Committee, and noted that she looked forward to working with them and using their knowledge and experience to develop the services in Bromley. Co-opted Members were thanked for agreeing to give up some of their very valuable time to work with the Committee.

The Director of Adult Social Care gave an update to Members on work being undertaken across the Adult Social Care department. It was highlighted that progress continued to be made in several areas as they prepared for the assurance process. The department was now six weeks into the programme of work with the Social Care Institute of Excellence(SCIE). The SCIE were working with them to review the way the department worked and to test how they could better use assistive technology and artificial intelligence (AI) to respond to the public and speed up responses to people who needed either assessment or information and advice. This was really exciting work, with good staff engagement, and permission had been given for the SCIE to share what they were doing with the Department of Health and Social Care (DHSC).

The Director of Adult Social Care noted that a report had been provided in the agenda pack which described the work underway to better engage with the public and those that may need their services. This was an area in which they were aware that more work needed to be undertaken, but good progress was being made. A report would also be presented later in the meeting regarding the corporate approach to engagement.

The Director of Adult Social Care said she was pleased to report that the Housing directorate had now employed a new officer who would be leading the work on the Disabled Facilities Grant (DFG). This would be an important piece of work to ensure that better use of the grant was made, which was intended to help people remain in their own homes where they needed work done to improve the property.

As mentioned by the Chairman, the department was also working on the new programme of Member visits to care providers. A number of care homes had been identified who would welcome visits and they would shortly be providing dates for consideration.

Members were advised that, last Thursday evening, an event had been held to celebrate the excellent work that staff working in the care sector in Bromley had, and continued to, deliver. It had been a very successful evening, full of great stories and celebration, and thanks were extended to Members for attending. The feedback from those attending was very positive, and it was hoped that this could become a regular event, funding permitting.

The Director of Adult Social Care said she was very pleased with the budget outturn position which had come in underspent for a further year. This was partly due to a late grant being awarded, but it also reflected the hard  ...  view the full minutes text for item 7.

Report ACH23-023

The Committee considered a report providing an update for the second half of the 2022-23 Portfolio Plan and a refresh of the Adult Care and Health Portfolio Plan for 2023-24.

The Adult Care and Health Portfolio Plan was refreshed each year in line with the Council’s Transformation Programme and the Corporate Strategy ‘Making Bromley Even Better’. Within each priority were a number of statements which were underpinned by actions and measures of success within the work of Adult Care and Health Services. In the second half of 2022-23, steady progress had been made on the majority of the actions within the Portfolio Plan.

The Strategy Officer advised that there had been some changes made in the refresh of the Plan for 2023-24. Any actions completed throughout the year had been removed and replaced with new workstreams, where appropriate. The document had also been streamlined to remove any actions that reported into other Policy Development and Scrutiny Committees. It was noted that the document also aligned with the new Adult Social Care Strategy 2023-2028 which would be reported through the Portfolio Plan.

In response to a question regarding LD services, the Director of Adult Social Care advised that the directorate had been looking at alternative ways to support adults with learning disabilities, moving away from the traditional large day centres and instead looking to assist people with day time activities.

A Member noted the reference made to the implementation of the Innovation Fund to pilot and/or support the development of new community-based services, and asked for further information particularly in relation to digital access for older people. The Director of Adult Social Care said that the management of the fund had recently been transferred back to the Council and advised that information regarding what the fund had been used for could be circulated to Members following the meeting.

In response to questions, the Director of Adult Social Care said that the support in relation to courses for Ukrainian refugees had been provided by the Children, Education and Families directorate. There had been the ability to carry forward the Homes for Ukraine grant and there was some general flexibility to support refugees from other countries. With regards to the pilot of wearable GPS tracking devices, which alerted the next of kin when a resident left a designated area around their property, the Portfolio Holder for Adult Care and Health considered that the devices were very useful in providing reassurance for the family, with the consent of the person being tracked. There would also be governance arrangements in place if the person did not have the capacity to give their agreement. The Director of Adult Social Care advised that the kit used was very discreet, such as a watch, disc that fitted in a pocket or a credit card shape, which people found much more acceptable. The technology could also be used for things such as monitoring how often a person got up during the night and would allow care to  ...  view the full minutes text for item 8.

Report ACH23-021

The Committee considered a report providing an update on the delivery of the Tackling Loneliness Strategy Action Plan. The Tackling Loneliness Strategy was approved by the 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.

The Principal Loneliness Champion informed Members that a bespoke London Borough of Bromley (LBB) Tackling Loneliness Workshops had commenced in March 2023. The workshop was aimed at professionals and volunteers working with residents of all ages, stages of life and backgrounds who may be experiencing loneliness. Over 100 people, from various areas, had already attended the workshop, and Councillors were encouraged to attend future sessions which they would look to hold in the evening. The workshops had received fantastic feedback with 95% of participants having found it to be ‘useful’ or ‘extremely useful’. In response to questions, the Principal Loneliness Champion advised that the remaining 5% had said it was useful to have an understanding about loneliness, however they could not put anything into practice within their role. It was also confirmed that the Tackling Loneliness Workshop was a recommended training session for LBB officers. The Chairman advised that he had attended one of the workshops and recommended that Members attend future sessions. It was agreed that holding them in the evening was a good suggestion, which could increase the number of attendees.

The Principal Loneliness Champion advised that she had been connecting with other local and national organisations, including local authorities across the UK, to share ideas and good practice via the Tackling Loneliness HUB. The HUB was a free online platform, managed by the Department of Culture, Media, and Sport (DCMS), for professionals, policy makers and those helping people experiencing loneliness. The Principal Loneliness Champion advised that this had been extremely insightful, and she was now an ambassador for the HUB.

Members were informed that Loneliness Awareness Week had taken place from the 12^th–16^th June. A Tackling Loneliness Summit had been held at Bromley Civic Centre on Friday 16^th June which had been attended by over 100 people. Discussions had been held regarding loneliness and the work being undertaken both nationally and locally. A video had been received from the Minister for Sport, Tourism, Heritage and Civil Society and there had been speakers from various organisations. There had also been a marketplace of 10 stalls to showcase and promote local activities and projects – such as Bromley Football Club, Shared Lives and the Platinum Jubilee Parks Fund. Members extended their thanks and congratulations to all those involved in organising and participating in the Tackling Loneliness Summit. A copy of the press release, which contained a video of the event, can be accessed via the following link: Bromley - Tackling Loneliness Summit 2023

The Principal Loneliness Champion informed Members that a number  ...  view the full minutes text for item 9.

Portfolio Holder decisions for pre-decision scrutiny.

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

Report FSD23045

The Committee considered a report which provided details of the final outturn position for the Adult Care and Health Portfolio for 2022/23.

The final outturn for the “controllable” element of the Adult Care and Health budget in 2022/23 was a net underspend of £156k compared to the last reported figure of a net underspend of £57k which was based on activity at the end of December 2022. The Head of Finance for Adults, Health and Housing advised that there had been pressures on the budget throughout the year, however these had been managed by utilising available grant monies and keeping controls on expenditure.

A Member noted that there was a Public Health in-year underspend of £910k in 2022/23. The balance of the Public Health reserve now stood at £2,874k, which remained ring-fenced forPublic Health activities, and this should not keep accumulating. The Director of Public Health said this had been impacted by two different elements. The first of these related to non-essential services that had been stopped during the COVID-19 pandemic, which accounted for around half of this underspend. This included the Health Checks undertaken by GPs which only resumed last year and had created a knock-on effect to other services. The was a similar situation with sexual health services, which was a national issue. The Director of Public Health noted that additional funding had been received this year, but could not be used immediately and therefore the full year effect would not have been seen. The other issue had related to the Public Health grant being announced in April/May of the current year – by this time the budget had already been set and they could not predict what the uplift would be. Members were informed that there were plans to reduce the underspend and a number of services had been commissioned late last year.

The Director of Adult Social Care expressed her thanks to the Head of Finance for Adults, Health and Housing for the report provided.

RESOLVED that:

i.)  the net underspend of £156k on controllable expenditure at the end of 2022/23 be noted; and,

ii.)  the Portfolio Holder for Adult Care and Health be recommended to endorse the 2022/23 final outturn position for the Adult Care and Health Portfolio.

Report ACH23-026

The Committee considered a report setting out the background behind what would form a 10-year ‘Bromley Housing with Care Strategy’ and an associated action plan. This strategy would create a roadmap taking Bromley’s housing with care arrangements from where they currently were to where the Council wanted them to be over the next 10 years in order to meet resident demand. The Assistant Director for Integrated Commissioning and Associate Director – Discharge Commissioning, Urgent Care and Transfer of Care Bureau (“Associate Director”) delivered the presentation provided on pages 159-176 of the agenda pack.

A demand and needs analysis had predicted an increased demand from vulnerable adults who would need to be supported to live at home and/or accommodated in special housing. The developing strategy was looking to mitigate the financial risk to the Council in meeting this demand and offer residents who needed extra help desirable housing and support in the community rather than in residential care homes. The vision was for older people and vulnerable adults to have a home that would be safe, promote independence, and support good health and wellbeing, as well as quality of life. This in turn would be supported by a vibrant housing with care market that would keep pace with changes in the population. The Housing with Care Strategy would also address the current issues relating to the quality of provision in some of the older units to ensure they were meeting the needs of residents through the fit-for-purpose built environment.

A Member noted that a new single Mental Health ‘support@home’ service contract was planned to commence in 2024 and asked for an update on how this was progressing. The Assistant Director for Integrated Commissioning advised that this contract would shortly being going out to tender and it was anticipated that the service would commence from October 2024.

In response to questions, the Associate Director said that within the current arrangements they had very close links with landlords and there were strict requirements with their contracts regarding responding to repairs. They also used elements such as void payments hold to them account which they found to work very well. With regards to ensuring that residents in extra care housing received the right support, the Associate Director advised that there was a care and support offer in place, managed by social work colleagues. Assessments were undertaken on those entering extra care housing to ensure their needs were safely met. A benefit of extra care housing was that a single provider worked on site and therefore any change of needs could be flagged, and reviews undertaken in a timely manner. This was the normal process offered to everyone and it work well having a dedicated team as they knew the residents and providers.

A Member stated that they strongly supported the reference made in the need analysis that best practice for developing future proof housing with care would be ensuring an integrated approach to supporting health and care needs of clients. It was  ...  view the full minutes text for item 11a

Report ACH23-025

The Committee considered a report outlining the proposed Carers Plan 2023-2025.

The Council had developed a Carers Plan with the South-East London Integrated Care Board (Bromley) that set out what advice, guidance and support was available to unpaid carers in the borough and how this offer to carers would be developed further over the next two years. The Assistant Director for Integrated Commissioning highlighted the importance of carers – they held families and communities together, enabled those they cared for to get the most out of life, and made an enormous contribution to community life in Bromley. Alongside the Council’s social care and SEND services and local NHS services carers played a vital role in supporting vulnerable residents.

The proposed plan had been developed across the Council and SEL ICB (Bromley) and with Bromley Well who delivered a Carers Support Service on their behalf. The plan and its priorities had been informed through a series of engagement and co-production events with carers.

David Walker, Chief Executive Officer – Bromley Third Sector Enterprise (“CEO – BTSE”) informed Members that the Carers Plan had been a collaborative piece of work with a significant amount of consultation undertaken with carers. One recommendation was the development of an all-age Carers’ Charter for Bromley, which had been agreed by the One Bromley Executive. There was a whole system approach as to how they integrated the engagement with carers. It was noted that Bromley Well was a member of the Carers Trust, which was a national organisation, and had direct access to national best practice. Informal consultation had already taken place with a number of carers and the carers teams within Bromley Well and other organisations. Other organisations provided specialist support within the borough, and they had wanted to engage with them. It was clear from the conversations held that both partners and carers wanted identification of carers, information, support and a voice for carers in the borough. A number of stakeholder meetings had already taken place, including with social prescribers to raise awareness and refer carers to appropriate services. The aim was to launch the Carers Plan in the autumn.

A Member highlighted the importance of Priority 5: supporting young carers and young adult carers. It was noted that a survey of young people had been presented at the Health and Wellbeing Board in March and this had been raised as an issue. It was questioned how young carers who were outside of the system would be identified. The CEO – BTSE advised that this was an integral part of the work undertaken by Bromley Well, and they had identified over 600 young carers in the borough. Members were informed that identifying young carers was a national issue. For the first time this year, the school census had required schools to identify young carers – however, 79% of schools had responded to say that they had not identified any young carers, and therefore this was “work in progress”. Within Bromley Well, outreach with  ...  view the full minutes text for item 11b

Report ACH23-030

The Committee considered a report outlining an Engagement Framework which informed the way in which the department sought to hear the experiences of residents and service users to inform service design and improvement.

The Engagement Strategy Manager advised Members that the Engagement Framework had also been presented at the Children, Education and Families Policy Development and Scrutiny Committee. The purpose of the framework was to provide a tool for staff in terms of how they should engage with both residents and visitors. The existing user voice framework had been updated to make it wider and clearer.

RESOLVED that the updated Engagement Framework (Curiosity and Influence) be endorsed.

Report ACH23-020

The Committee considered a report providing an overview of the Resident Voice Project and Working Group, both established in October 2022.

The Resident Voice Project aimed to focus on engagement with residents and service users of Adult Social Care, as well as providers of care services in Bromley, with the objective of strengthening commissioning and co-production. Various methods of capturing the service user voice would be explored, these included using digital platforms to capture feedback, along with face-to-face engagement with residents, consulting on different areas of the Adult Social Care business. The project had established a Resident Voice Group that met every six weeks to consider new resident engagement activities and to share lessons learned to strengthen business development in Adult Social Care. Current group members included officers and team leaders across the department, with an aim of establishing wide representation across the Service.

The Bromley Safeguarding Adults Board Manager advised that some of the achievements so far included a Roadshow Event at The Glades shopping centre. Working with the Bromley Safeguarding Adults Board, Trading Standards and Public Protection, a two-day event was held at the centre to meet directly with members of the community. The objective was to raise the profile of the key support and safeguarding services available to the wider public, as well as capture feedback via surveys and/or direct conversations, and trends had been recorded. There had been requests to raise awareness of support services for people who were blind or hard of hearing. As a result, an engagement session had been held with members of the DeafPlus community and a similar session would be arranged with the Kent Association for the Blind. Another area identified was support and information for carers – consultation on the Carers Plan had been given a dedicated space on one of their platforms and subsequently there had been a significant increase in the responses to this survey.

The Bromley Safeguarding Adults Board Manager advised that other areas identified had included raising awareness around homelessness and the support available – this would be brought forward for discussion with the Safer Bromley Partnership. Further areas identified included tackling loneliness and safeguarding awareness sessions for professionals. With regards to the issue of self-neglect, an awareness campaign had just been published and an animation would also be produced outlining what self-neglect was and how early trends could be identified. There had also been engagement with faith-based communities groups, following which information had been requested on transitional safeguarding services. Other areas highlighted included the great work being undertaken by Quality Checkers and the outreach work completed by the Trading Standards team.

The Assistant Director for Safeguarding, Practice and Provider Relations stated that this was a good news story – talking to residents, listening to how they wanted to be engaged with and reacting to their suggestions. This all contributed towards making Bromley even better – swift progress had been made and lots of examples of responses had been provided.

The Chairman highlighted the  ...  view the full minutes text for item 13.

Report ACH23-024

The Committee considered a contract monitoring report for the Direct Payments Support and Payroll Service.

The Commissioning Officer informed Members that Vibrance was the Council’s Direct Payments Support and Payroll Service provider. The annual monitoring report was being presented in line with the Council’s Contract Procedure Rules which specified the requirement to provide updates for the Policy Development and Scrutiny Committee on how the service performed in the previous financial year from April 2022 to March 2023. The current contract was awarded to Vibrance in November 2020. It started in April 2021 for a five-year period with the option to extend for up to two years to April 2028.

It was noted that the provider had either met or exceeded the vast majority of their key performance indicators (KPIs). There were a couple of occasions where they had fallen slightly short, however this was related to the individual’s circumstances or the shortage of Personal Assistants (PAs). The Commissioning Officer advised that the Local Authority and Vibrance had agreed a business plan to try and increase the number of PAs in Bromley. It was noted that this was a national issue, but it was exacerbated due to the demographics of the borough. The business plan had included billboard advertising; promotion at job centres; leaflet distribution to promote the role; and social media advertisements including a promotion detailing “A Day in the life of a PA”. Vibrance had also attended a number of recruitment events and had approached PAs in neighbouring boroughs.

In response to a question, the Head of Service for Community Living Commissioning said that they were committed to having a wide-ranging and holistic offer to support residents. They were commissioning domiciliary care, providing access to day opportunities and a range of services that could be accessed were listed on the Simply Connect Bromley database.

The Commissioning Officer said that the Local Authority had a good working relationship with Vibrance, which had been built over the duration of the contract, and they were working together to made improvements for residents.

In response to a question from the Chairman regarding the response rate to the customer satisfaction survey, the Commissioning Officer noted that this had been in line with the response rate achieved in previous years. It was also similar to the average response rates for similar providers. They had tried to encourage responses by offering an Amazon voucher, and it was highlighted that this was a general issue that was not specific to Vibrance. One recommendation was to amend the surveys to gather more information. The  Head of Service for Community Living Commissioning advised that work was also being undertaken to consider how technology could be used to increase interaction with the survey. It was noted that very few complaints had been received in relation to this contract and highlighted that feedback tended not to be provided if service users were happy.

RESOLVED that the content of the contract monitoring report on the performance of Vibrance in delivering  ...  view the full minutes text for item 14.

Report ACH23-027

The Committee considered an extract from the May 2023 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.

RESOLVED that the report be noted.

The briefing comprises:

• ACH Risk Register Q4 update
• Minutes from the Health Scrutiny Sub-Committee meeting held on 20^th April 2023

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 Adult Care and Health PDS Information Briefing comprised 2 reports:

·  ACH Risk Register Q4 update

·  Minutes from the Health Scrutiny Sub-Committee meeting held on 20^th April 2023

RESOLVED that the Information Briefing be noted.

RESOLVED that the Press and public be excluded during consideration of the items of business listed below as it was likely in view of the nature of the business to be transacted or the nature of the proceedings that if members of the Press and public were present there would be disclosure to them of exempt information.

The following summaries

Refer to matters involving exempt information

The Committee noted the Part 2 information within the report.