Agenda and draft minutes

Apologies for absence were received from Councillor Kim Botting and Councillor Gemma Turrell, and Councillor Harry Stranger and Councillor Dr Sunil Gupta attended as their respective substitutes.

Report CSD24062

The Committee considered a report which sought confirmation of the appointment of Co-opted Members to the Adult Care and Health PDS Committee and membership of the South East London Joint Health Overview and Scrutiny Committee for 2024/25.

RESOLVED that:

i.)  The following Adult Care and Health PDS Committee Co-opted Membership appointments for 2024/25 (to be re-appointed annually until the end of the current four-year term of the Council) be agreed:

ii.)  Councillors Mark Brock and Felicity Bainbridge be reappointed as Members of the South East London Joint Health Overview and Scrutiny Committee for 2024/25.

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 4^th June 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 12^th June 2024.

No questions had been received.

The minutes of the meetings held on 12^th March 2024 and 15^th May 2024 were agreed and signed as a correct record.

Report CSD24068

The Committee considered a report setting out matters outstanding from previous meetings and the proposed work plan for 2024/25.

The Chairman noted that confirmation of the Children and Young People’s element of the domiciliary care budget had been provided to Members (minute 70a).

In response to a question from the Chairman, the Director of Adult Services advised that a ‘Briefing on Member Visits’ paper had been included in the Information Briefing pack for the meeting. Work was continuing to progress the programme of Member visits, providing sufficient notice and clarity regarding timings. The Chairman highlighted that Members had been unaware of a proposed visit scheduled to take place on the 18^th July until being issued with the Information Briefing. The importance of providing Members with as much notice as possible was emphasised.

In relation to the Assistive Technology session (minute 56), the Director of Adult Services informed Members that this would now be arranged early in the autumn, as the timing of the session had to be reconsidered due to room availability.

In response to a question regarding the work programme, the Director of Adult Services advised that the Adult Social Care Transformation – Workforce Strategy 2023-28 was still being finalised, and would be presented to the Adult Care and Health PDS Committee later in the year.

RESOLVED that the update be noted.

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

The Director of Adult Services informed Members that Donna Glover, the new Director of Adult Services would start in post on the 9^th September, taking over as the Statutory Director on the 23^rd September 2024. Support would be provided to the new Director of Adult Services for a few weeks after she took over the role, and they would both be attending the next Adult Care and Health Policy Development and Scrutiny Committee on the 10^th September.

The Director of Adult Services said she was pleased to note the year-end budget position, which was a slightly improved position on that predicted at the end of Quarter 3. This left the Directorate better placed to manage within the available resources this year, but this would by no means be an easy task. The team had started to identify potential efficiencies for future years to reduce the overall corporate budget gap.

Members were informed that a report would be presented later in the meeting regarding the Digital Strategy. This formalised plans to work with a partner to deliver an improved digital offer to the population that encouraged less reliance on formal services, improved the information and advice offer and assisted with reducing demand on staff to deliver assessment of both need and finances. In the next few weeks the Council would formally go out to tender to attract the strategic partner to deliver the Transformation Programme over the next two years. The Director of Adult Services noted that this was an officer decision, but she would ensure that Members were provided with the detail of this process at the next meeting.

Members were advised that, building on the relationship with the Social Care Institute for Excellence (SCIE), the department had been directly approached to take part in some national work they were leading on with the Department of Health and Social Care (DHSC) to increase the transformation of a number of service areas. They had reflected that for two of the workstreams, Digital and Co-Production, Bromley was well ahead, but it was intended to bid to work with them to review opportunities around Safeguarding and the delivery of Housing options for Older People. Both of these were areas identified as a priority, so they were hopeful of success with one of the bids. There was no financial commitment for the Council for this work, but potential for kudos as work would be shared with others across the country.

The Director of Adult Services noted that the department had recently reported on three further internal audits: Safeguarding of Adults, Learning Disability and the Quality of Residential Care. The Safeguarding Audit provided Limited Assurance and had a robust action plan in place to address the areas highlighted. The work with SCIE would assist with delivering the action plan hence the interest in bidding for this programme. The Learning Disability Audit was given  ...  view the full minutes text for item 7.

Report ACH24-030

The Committee considered a report providing an update for the second half of the 2023-24 Portfolio Plan and a refresh of the Adult Care and Health Portfolio Plan for 2024-25.

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 2023-24, progress had been made on all of the actions within the Portfolio Plan.

The Portfolio Plan 2024-25 focused on two of the ambitions from Making Bromley Even Better:

-  Ambition 2 - for adults and older people to enjoy fulfilled and successful lives in Bromley, ageing well, retaining independence and making choices; and,

-  Ambition 5 - to manage our resources well, providing value for money, and efficient and effective services for Bromley’s residents.

It was noted that the Plan also aligned with the Adult Social Care Strategy.

In response to questions, the Director of Adult Services noted that, as agreed earlier in the meeting, a report on the Safeguarding of Adults Audit would be provided to the Committee. Concerns had been raised in the audit however opportunities to identify the positive work undertaken had been missed – this had been challenged, and there had been a shift in the response from the external auditor. A robust plan was being developed to ensure responses could be quality checked – they were looking to work with SCIE to receive further external scrutiny and provide reassurance that practice was matching policy and expectations. In response to a question from a Co-opted Member regarding any learning/practices that could be taken from Children’s Services, the Director of Adult Services said that this was often discussed, particularly in terms of  transition. It was noted that safeguarding of adults had less of a legal framework around it. The main difference was that people were encouraged to take risks in order to maintain their independence, but there was some learning that could be taken.

With regards to the review of the hospital social work team to better support the pathway, the Director of Adult Services said that this would not involve additional resource. The review would ensure that work being undertaken by the hospital social work team was aligned to reflect the changed pathways that had been put in place – this included undertaking assessments in an individual’s own home, rather than in a hospital setting. The hospital social work team were linking with the award-winning single point of assessment (SPA) to move individuals through the pathway as quickly as possible and in to long-term support.

A Member noted that some of the services were currently held in venues that were facing closure. In response to questions, the Assistant Director for Integrated Commissioning advised that meetings/discussions were taking place with organisations and ongoing support would be provided.  ...  view the full minutes text for item 8.

Report ACH24-031

The Committee considered a report providing the current Adult Care and Health Services’ Risk Register – Quarter 4 2023/24 and the existing controls in place to mitigate the risks.

Since November 2023, when the ACH PDS last saw the Risk Register, Risk 10 – Data Collections, had been removed and the following change had been made to the gross and net (current) risks – Risk 1 – Financial Strategy – change of net risk from 12 to 16.

In response to a question regarding Risk 14 (Community Equipment), the Assistant Director for Integrated Commissioning advised that the red rating was scored after the credits due had been received, and confirmed that the risk rating of 16 still applied.

RESOLVED that the current Adult Care and Health Services’ Risk Register and the existing controls in place to mitigate the risks be noted.

Report ACH24-032

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 advised that key highlights included:

-  The London Borough of Bromley Tackling Loneliness Workshop started in March 2023 – 349 people had attended the workshop so far, and it had been delivered within Bromley as well as globally.

-  Bromley Well continued to offer a service to reduce isolation and loneliness and enhance the befriending offer across all pathways in the service. From January–March 2024, 66 people have received 1 to 1 befriending support from a dedicated volunteer, with 867 befriending phone calls made to those waiting for 1 to 1 support.

-  Six ‘Big Lunches’ had been planned across the borough in June 2024 to bring residents together in locations highlighted through London’s Festival of Architecture. Community initiatives would be promoted to increase social connection at these events.

-  The London Borough of Bromley was carrying out research in the form of a survey to understand what impact local groups were having on residents regarding their experience of loneliness and isolation. So far 249 responses had been received to date. The data suggested that from joining a local group, users were more likely to feel more connected to their community – the current results showed a 23% increase in connectivity and a reduction in loneliness.

-  Simply Connect Bromley, a service e-directory for residents, had received over 72,000 page views over the last 12 months.

Members noted that the Tackling Loneliness Strategy had won the Gold iESE Transformation Public Sector award, in the Community & Customer Focus category in March 2024, and congratulations were extended to all involved in this work. A Member highlighted that it was positive to see some of Bromley’s policies being implemented around the world.

Councillor Botting noted that, as Members’ Champion, he had sent a number of requests to encourage uptake of the Tackling Loneliness Workshop – however, only 18 Members had currently completed it. It was emphasised that Members regularly met with residents and this training provided an insight into what some may be experiencing. A Member agreed that the Workshop was enjoyable and informative, and asked if there was anything that could be done to encourage uptake. The Principal Loneliness Champion said that she was extremely flexible in terms of offering dates, and could attend Group meetings. It was agreed that Members would take this proposal back to their Groups.

A Member advised that she had contacted the Principal Loneliness Champion on behalf of a resident – they had been able to pinpoint nearby activities on the Simply Connect Bromley database, and it was considered that  ...  view the full minutes text for item 10.

Portfolio Holder decisions for pre-decision scrutiny.

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

Report FSD24038

The Committee considered a report which provided details of the final outturn position for the Adult Care and Health Portfolio for 2023/24.

The final outturn for the “controllable” element of the Adult Care and Health budget in 2023/24 is a net overspend of £1,311k, compared to the last reported figure of a net forecast overspend of £1,925k which was based on activity at the end of December 2023. The Head of Finance for Adults, Health and Housing advised that there had been particular pressures on packages and placement budgets, including hospital discharge packages and the Community Equipment contract. However, the use of available grant monies had reduced the overspend.

In response to a question regarding the underspend in Extra Care Housing as a result of the net impact of voids, the Assistant Director for Integrated Commissioning advised that there were 271 units available, however some were considered not to be fit for purpose. Work was being undertaken with the landlord of one scheme to change its use to sheltered housing, which was felt to be more appropriate.

In response to questions, the Head of Finance for Adults, Health and Housing advised that the underspend in quality assurance and safeguarding was primarily related to Deprivation of Liberty Safeguards (DoLS) – this was regarding volume, rather than issues with the service provision. With regards to the deficit in the mental health budget, the Head of Finance for Adults, Health and Housing noted that the full year effect was a snapshot of a moment in time, and did not take into account any packages that were not continuing.

RESOLVED that the Portfolio Holder for Adult Care and Health be recommended to endorse the 2023/24 final outturn position for the Adult Care and Health Portfolio.

Report ACH24-029

The Committee considered a report seeking approval for a variation to the scope and price of the Digital Strategy contract.

The Council had a contract with the Social Care Institute of Excellence (SCIE) to complete an independent review and produce a forward plan outlining the key findings, improvement recommendations and a roadmap for delivery, to make better use of digital solutions in Adult Social Care service delivery. The contract commenced on 1^st May 2023 for an initial eleven month period with the option to extend for a further year at an estimated annual value of £40k (whole life value of £80k inclusive of extension option).

The extension option had been applied with a revised contract end date of 30^th September 2024 due to early completion of the initial review work, with work in the extension period focusing on completion of an Adult Social Care Digital Transformation Strategy and Mobilisation Plan.

The Head of Service – Adult Services Transformation and Improvement advised Members that the proposed variation to accommodate the additional work was at an estimated value of £60k, rather than £40k as stated in the report, revising the whole life value of the contract to £140k.

RESOLVED that the Portfolio Holder for Adult Care and Health be recommended to approve the variation to the Digital Strategy contract with the Social Care Institute of Excellence (SCIE) Partnership, as detailed in paragraphs 3.11 to 3.12 of the report, to increase the contract value by £60,000 with a revised whole life value of £140,000 inclusive of the variation.

Report ACH24-013

The Chairman welcomed Members of the Children, Education and Families Policy Development and Scrutiny Committee, and the Portfolio Holder for Children, Education and Families, to the meeting for consideration of this item.

Members considered a report seeking Executive approval to procure a framework for domiciliary care services 2025-2029.

The Care Act 2014 provided the context of the council’s statutory duty to provide Adult Social Care services. Domiciliary Care was a provision under this Act, that described a range of services put into place to support an individual to remain within their own home. The Council discharged this duty through the provision of awarding contracts to Domiciliary Care providers upon the completion of a competitive tendering process under the correct Procurement Regulations and Contract Procedure Rules.

Since, 28^th August 2021, the Council had embedded its Domiciliary Care strategy, set out in an earlier Gateway report (CS18147). This Patch model, supported by a call-off Framework of Domiciliary Care providers, had resulted in 31 call-off Framework providers being awarded a four-year contract in 2021. These would expire on 27^th August 2025, with no option to extend. The call-off Framework contract was designed to allocate 30-40% of the Domiciliary Care demand to these multiple providers. The Council’s total Domiciliary Care spend was £16.4m per annum, with a commensurate spend the call-off Framework providers projected spend was £4.9 to £6.7million per annum.

RESOLVED that the recommendations in the report be supported.

Report ACH24-034

The Chairman welcomed Members of the Children, Education and Families Policy Development and Scrutiny Committee, and the Portfolio Holder for Children, Education and Families, to the meeting for consideration of this item.

Members considered a report seeking Executive approval to award a substantive Patch contract together with award of contracts to four providers for the Reserve Patch framework.

Under its statutory responsibilities for adult social care, the Council provided domiciliary care services to eligible adult residents at approximately 15,000 hours of standard care per week at an estimated cost of £16m per annum. The Head of Service – Community Living Commissioning advised Members that eligible children and young people also accessed domiciliary care services at an estimated cost of £1.5m per annum, rather than £1m as stated in the report. Members were advised that domiciliary care was delivered through a network of providers. The main provider contracts were based on geographical locations or patches (East, West, Central and South). Each patch was supported by one to three provider contracts, depending on size, known as Patch Providers. Patch Providers were expected to support up to an estimated 70% of domiciliary care packages within their patch, with the remainder of packages supported by a wider Domiciliary Care Framework of providers.

The Patch contracts commenced in August 2021 for a five year period with the option to extend for a further three years with delegated authority to the Chief Officer to apply the extension options. In June 2023, the contract with a Central Patch Provider was terminated early and Executive approval was received to proceed to procurement to replenish the portfolio of Patch contracts. The procurement was also designed to identify further providers to be awarded to a Reserve Patch framework from which future contracts may be awarded, as appropriate, in the event of a further need to replace a Patch contract (Report ACH24-006).

The report, together with the accompanying Part 2 report, set out the outcome of the tendering process and sought Executive approval to award a substantive Patch contract together with award of contracts to four providers for the Reserve Patch framework.

RESOLVED that the recommendations in the report be supported.

Report ACH24-035

The Committee considered a report seeking Executive approval of the Adult Social Care Digital Strategy 2024-2024.

The Council had developed the Adult Social Care Strategy for the period 2024 to 2034 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 report set 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, providing service quality improvements and better outcomes for Bromley residents and our workforce, whilst delivering good quality and safe care and support. It was noted that ‘invest to save’ proposals were outlined in the accompanying Part 2 report.

The new Adult Social Care Digital Transformation Strategy 2024 to 2034 had been developed to achieve the Making Bromley Even Better ambitions. It was an ambitious programme that would significantly change the way Adult Services operated in the future, interacted with residents receiving care and support, and with partners across the local system.

In response to a question from the Chairman regarding AI technology, the Head of Service – Adult Services Transformation and Improvement advised that its use would be explored through a number of projects in order to support staff and improve processes. Later in the year they hoped to demonstrate some of different technology available.

In response to questions, the Head of Service – Adult Services Transformation and Improvement confirmed that the co-production would include engagement with both staff and Members, and they would look to set up a series of workshops. With regards to digital exclusion, they were working with Community Links Bromley. Early conversations were taking place in relation to digital inclusion to ensure that assisted support was in place, in line with national guidelines, and key locations identified across the borough for those that needed to access IT and Wi-Fi.

RESOLVED that the recommendations in the report be supported.

Report ACH24-033

The Committee considered an extract from the May 2024 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:

• Briefing on Member Visits
• Minutes from the Health Scrutiny Sub-Committee meeting held on 12^th March 2024
• Bromley Well Contract Monitoring Report
• 0-19 Years Public Health Nursing Service Performance Report

This briefing is circulated for information only, but issues can be debated at the meeting at the request of any member of the Committee. Such requests should be made to the Democratic Services Officer at least 24 hours before the meeting and should set out which aspects of the information briefing need to be discussed.

Members have been provided with advance copies of the briefing via e-mail.  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 4 reports:

• Briefing on Member Visits
• Minutes from the Health Scrutiny Sub-Committee meeting held on 12^th March 2024
• Bromley Well Contract Monitoring Report
• 0-19 Years Public Health Nursing Service Performance Report

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 12^th March 2024 be agreed.

The Committee noted the Part 2 information within the report.

The Committee noted the Part 2 information within the report.

The Committee noted the Part 2 information within the report.