Agenda and minutes

Apologies for absence were received from Councillor David Jefferys and Councillor Jonathan Andrews attended as substitute.

Apologies for absence were received from Co-opted Member, Michelle Harvie.

Apologies for lateness were received from Councillor Kevin Kennedy-Brooks.

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 16^th January 2024. 

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 24^th January 2024.

No questions had been received.

The minutes of the meeting held on 21^st November 2023 were agreed, and signed as a correct record.

Report CSD24010

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

The Chairman noted that verbal updates would be provided during the meeting in relation to minute 36 (work being undertaken with the Social Care Institute of Excellence) and minute 50 (Integrated Community Equipment Service).

The Chairman said he was pleased to see that the programme of Member visits had been restarted. In response to questions, the Assistant Director Strategy for Performance and Corporate Transformation advised that visits had been arranged in January and February – future visits would be arranged, and invites would be sent out in a timely manner to provide as much notice as possible. Following feedback from Members they would also look to schedule some evening sessions for the visits.

RESOLVED that the update 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 advised that winter planning had stood up well to the usual pressures experienced over the holiday break, and immediately afterwards, and that any unnecessary delays in discharging people from hospital as planned had been avoided. Thanks were extended to staff who worked over the holiday period to keep services running.

With regards to the Community Equipment service, Members were advised that negotiations had continued to enable the new provider to get up to speed. There had been no additional payments made to the provider, as was requested at the last meeting, due to a change in the legal advice being given. The service continued to deliver, but also continued to experience some challenges. Members were encouraged to contact either the Assistant Director for Integrated Commissioning or Assistant Director of Operations if they became aware of any problems encountered by local residents as this feedback would be useful. It was noted that updates would continue to be provided at future meetings.

The Director of Adult Social Care noted that Members had requested a further update on the Adult Social Care Transformation Plan – it was highlighted that a report providing a summary of the digital work being planned would be considered later in the meeting. Members agreed that they would find it helpful to have a one-off information session to explore further the opportunities for extending the use of Assistive Technology. The Director of Adult Social Care advised that the Project Manager for Assistive Technology could run an interactive session at a time convenient for Members. It was noted that Bromley Healthcare also provided an Assistive Technology offer in relation to people’s healthcare needs and could be invited to attend the session.

Members were advised that the department continued to prepare for the assurance visit from the Care Quality Commission and were currently in the middle of reviewing the latest self-assessment, exploring four themes in four weeks. This involved taking a robust look at the work completed by team members and sense checking the assessment of their readiness and performance against the key requirements of the assurance process. The Director of Adult Social Care said she had attended the first of these sessions the previous week and was impressed with the rigour and honesty shown by all the team in preparing and challenging the assessments completed. In preparing for the assurance process they were clear that not everything would be 100% perfect, but that a large part of the process would be self-awareness and having a plan in place to address those areas that still needed further work.

The Director of Adult Social Care said she was pleased to inform Members know that a new Principal Social Worker, Alecia Ivers, had been appointed and would be leading on the preparation for assurance alongside a number of other things. Alecia brought a great deal  ...  view the full minutes text for item 56.

Report FSD24007

The Committee considered a report setting out the draft Adult Care and Health Portfolio Budget for 2024/25, 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 17^th January 2024. Members were requested to consider the initial draft budget being proposed and also identify any further action that might be taken to reduce cost pressures facing the Council over the next four years. It was noted that there were still outstanding issues and areas of uncertainty remaining further updates would be included in the 2024/25 Council Tax report to the next meeting of the Executive.

The Head of Finance for Adults, Health and Housing advised Members that the 2024/25 budget included significant growth to reflect the full year effect of the budget pressures during 2023/24, less some significant savings and mitigation to offset these pressures. Overall the draft 2024/25 budget totalled just under £95m which was a net increase of £6.7m compared to the previous year’s budget.

A Member considered that it would be beneficial for the table provided in Appendix 1 to include a column with projected costs for 2023/24. The Head of Finance for Adults, Health and Housing said that the Q2 2023/24 Budget Monitoring report had a projected overspend of £1.5m. The 2024/25 budget looked to address the previous in-year pressures and included growth. The Director of Adult Social Care advised that the planning of the 2024/25 budget was based on the position at the end of Q2, which was reported at the last meeting. It was hoped that going forward there would be reduced pressure in the budget for this year.

In response to further questions, the Director of Adult Social Care advised that pressures on the Learning Disabilities service were in three areas: growth in the numbers using the service as people were living longer; the higher cost of purchasing services; and a significant increase in the number of young people transitioning from Children’s to Adult Services. It was noted that the transition figures were based on Q2, however there was often an increase in demand at the end of the school year. With regards to the reference made that ‘there may need to be a reduction in the scope and level of services’, the Director of Adult Social Care said that the department would not stop providing any statutory services but would look at how they could be delivered more efficiently. The change of approach was outlined in the Adult Social Care Transformation Programme report provided to the meeting. The Director of Adult Social Care confirmed that work to identify any working age adults/older people whose care and support was currently being paid for by Bromley, but were the responsibility of another local authority, was undertaken on a regular basis. However it had been recognised that some were slipping through, particularly when people left hospital and those with mental health needs. These pressure points had been identified  ...  view the full minutes text for item 57.

Report ACH24-005

The Committee considered a report setting out what the Council planned to do over the next 10 years through its Adult Social Care Transformation programme – to develop a more sustainable and efficient future operating model that offered a new way of working, provided service quality improvements and better outcomes for Bromley residents and our workforce, whilst delivering good quality and safe care and support.

The Council had developed the Adult Social Care Strategy for the period 2023 to 2028 to take account of developments across the social care market, changing government policy and wider technological, demographic, and economic changes. It considered the key changes of increased service demand and rising costs pressures in relation to supporting vulnerable older residents, carers, and working age adults with a disability and/or long-term health condition. The new strategy, Adult Social Care Digital Transformation Strategy 2024 to 2034 had been developed to enable achieving the Making Bromley Even Better ambitions.

The Programme Manager – Adult Social Care Transformation noted that the strategy was a refresh of the document provided to the September 2023  meeting of the Committee. It considered the improvements in digital capabilities, connectivity, and infrastructure, in relation to the care solutions offered and delivered for residents – providing more engagement choice, but also supporting efficient ways of working. The strategy has been developed in collaboration with the Social Care Institute of Excellence (SCIE), officers in Adult Social Care, and across the Council, Voluntary, Community and Social Enterprise (VCSE), and local system partners. It introduced a series of interventions and projects that would transform the ‘Resident Journey’. The proposed interventions and projects looked to introduce a range of digital tools that changed the ways in which the Adult Social Care engaged and worked with residents, carers and partners.

In response to a question, the Programme Manager – Adult Social Care Transformation advised that a business case, looking at the resources needed, would be presented to a future meeting of the Committee.

RESOLVED that the report and refreshed strategy be noted.

Report ACH24-002

The Committee considered a contract monitoring report in relation to the Extra Care Housing Schemes.

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. Mears managed Norton Court, Crown Meadow Court and Durham House. This annual service review was being presented in line with LBB Contract Procedure Rules and provided an analysis of provider performance during the current contract term.

The Commissioning Officer informed Members that Creative Support and Mears Extra Care Ltd provided care and support services into six Extra Care Housing (ECH) schemes within Bromley (271 flats). The two providers were each responsible for three schemes. The majority of the flats were allocated to long-term tenants, however there were 16 allocated for short-term step down provision.

The Council’s Quality & Provider Relations Team monitored all ECH schemes using the Quality Assessment Framework (QAF). The QAF reports provided Creative Support, Mears and the LBB contract manager with feedback and were discussed at quarterly contract management meetings. The Commissioning Officer noted that all six schemes were currently rated as ‘good’ by the Care Quality Commission (CQC). Both providers were always willing to engage with new Council priorities/projects and had been heavily involved in the Tackling Loneliness initiatives. The commitment of staff, particularly the Scheme Managers and Area Managers, was highlighted.

The Chairman said the report was extremely positive. With regards to the most recent customer satisfaction survey results, 100% of residents had said they were satisfied with the quality of the care and support services provided by Mears and Creative Support. It was noted that the response rate of those surveyed had been circulated – Mears – 80% and Creative Support – 68%.

In response to a question, the Commissioning Officer advised that a 2-year extension of the contract had been agreed, and would be recommissioned in 2026. The Assistant Director for Integrated Commissioning confirmed that this had been via delegated authority.

RESOLVED that:

i)  the information contained within the report in relation to the provider performance of these two contracts, and that both providers were consistently meeting the Council’s standards under the contract, be noted; and,

ii)  Creative Support and Mears to be reviewed again in 12 months to provide an update on performance and progress made, be noted.

The briefing comprises:

• Minutes from the Health Scrutiny Sub-Committee meeting held on 21^st November 2023
• Contract Register

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:

·  Minutes from the Health Scrutiny Sub-Committee meeting held on 21^st November 2023

·  Contract Register

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

RESOLVED that the exempt minutes of the Adult Care and Health PDS Committee meeting held on 21^st November 2023 be agreed.