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APOLOGIES FOR ABSENCE AND ANNOUNCEMENT OF SUBSTITUTE MEMBERS
(if any) – received.
Apologies were received from Councillor Ray Best. Members of the Committee sent their best wishes to Councillor Best who is experiencing ill health at present. Councillor Best was substituted by Councillor Michael Deon Burton.
DISCLOSURE OF INTERESTS
Members are invited to disclose any interest in any items on the agenda at this point in the meeting.
Members may still disclose any interest in an item at any time prior to the consideration of the matter.
There were no declarations of interest.
To approve as a correct record the Minutes of the meeting of the Committee held on 17 July 2018 and authorise the Chairman to sign them.
The minutes of the meeting held on 17 July, 2018, were agreed and signed by the Chair as a correct record.
The Quarter 1 Performance Report was presented to the Committee by Lucy Goodfellow, Policy and Performance Business Partner. This covers the period between 1April and 30 June, 2018.
It was noted at the outset that following a trial without the amber rag rating, this had been reinstated for 2018 and 2019 performance reporting.
Two performance indicators are reported to the Individuals Overview & Scrutiny Sub-Committee:
· % of service users receiving Direct Payments; and
· Rate of permanent admissions to residential and nursing care homes per 100,000 population (aged 65+).
The % of services users receiving Direct Payments has an amber rating. This is a target of 35% with a Q1 performance level of 33.6%.
It was noted however, that a bank of Personal Assistants is now in place and it is envisaged that this will improve the outturn for Direct Payments. The Personal Assistants will give support to service users to access the care they need and encourage others to receive self-directed support.
The rate of permanent admissions to residential and nursing care homes was at a green rating and well within target. The Q1 Performance Target is 145 with 2018/19 performance at 106, where smaller is better.
The Individuals OSSC:
Noted the contents of the report and the actions identified to improve services.
Members also noted the positive feedback to services by way of compliments received and highlighting good practice.
The Director of Adult Services presented the Adult Social Care Complaints Annual Report to the Committee. This detailed the complaints enquiries and compliments received during the period April 2017 to March 2018.
There is a statutory requirement to publish the report annually.
Adult Social Care complaints have decreased slightly. Ombudsman enquiries however, have increased slightly. Out of the nine received in the relevant period two were found to be maladministration injustice.
The highest number of complaints received related to external home care. These ranged from time keeping to not staying for the required period or at all. These have been recurring themes.
The number of complaints upheld in 2017-18 was 51 with 52 not being upheld and 5 being withdrawn. A new Social Care system was introduced in February 2018 and this will allow for improved management of information and it should help to ensure consistency across the service.
It was noted that there are still complaints involving financial information as a result of a change in provision and also in relation to frustrated visit charges. The Charging Policy has been revised and is on Havering’s website. Service users need to give notice that services will not be required within an appropriate time frame to ensure there are no charges.
Overall response times to complaints need to improve although there has been some improvement. Complaints relating to multiple agencies will have a single response.
Monitoring information has been an issue though the main equalities characteristics are being captured. Marital status and sexual orientation have been factors which have not been routinely recorded and so efforts are in place to improve on that aspect.
Compliments have decreased by 21% though this is believed to correlate with a reduction in satisfaction surveys. It has been believed that too many surveys would become burdensome. Feedback is required but this needs to be captured in an unobtrusive way.
Member enquiries have declined from 98 in 2016/17 to 68 in 2017/18. However, only 88% were replied to within timeframes and this needs to be improved to 100%.
Learning from complaints is very important. Evidencing improvements in the service is crucial. Actions have been reviewed and implemented and further improvements are being driven. Better integrated working on complaints is needed and being explored.
The Individuals OSSC:
Members of the Committee agreed to accept the supplementary agenda detailing The Adult Social Care (SC) Precept, Funding ASC and Green Paper.
The Director of Adult Services delivered a presentation to the Committee. This gave an overview of the Adult Social Care Precept and options for funding in the future.
In 2018/19, revenue from the 2% Council Tax Precept is estimated at £2.3m and is being used to safeguard the Adult Social Care provision within the Borough. This Precept helped to mitigate pressures from demographic growth and the increased complexity of needs from both an ageing population as well as the younger adult’s cohort.
To date approximately £6.7 million has been raised from the ASC Precept, of which £4.6 million has been under the extended powers granted in 2016.
The last year for Council’s to take up the precept is in 2019/20. Thereafter the ASC Green Paper is expected to set out the options and mechanisms for funding in the future.
Other funding for ASC comes from:
· The Better Care Fund
· The Improved Better Care Fund
The Committee considered the financial analysis and noted there had been some good news in the fact that there have been short-term injections of funding from Government, a balanced budget and improved performance.
However, this is against other issues such as:
· the fact that there are more older and disabled people with more complex needs
· Market failures in some parts of the country and fragility elsewhere.
· Further savings are still required to close the funding gap; and
· Due to projections in demographic growth and complexity of need further funding will be needed.
Further events on the horizon will have to be featured in such as
· Green Paper for Adult Social Care
· Green Paper on Supported Housing
· Fair Funding Review
· National Programmes
· £20 billion Health monies
· The Comprehensive Spending Review and
· The CQC Inspection Regime – System Reviews,
Sustainable social care needs to take a long term approach to funding reform and must recognise the needs of working age as well as older people. It must address the costs of a sustainable and valued workforce and seek to achieve a stable and responsive provider market.
A fair balance between individuals and families as to how care is funded is needed and members of the public should be made fully aware of the value of social care.
Government has decided to delay the Green Paper and as a result The Local Government Association has taken action to publish its own Green Paper and public consultation. The consultation closes at the end of September 2018 and the results will be published thereafter.
The Individuals OSSC:
Noted the contents of the presentation.
The Individuals Overview and Scrutiny Sub Committee welcomed Ian Buckmaster, Executive Director and Company Secretary of Healthwatch Havering who attended to give an introduction to the organisation.
Members watched two short videos:
"We are the Borough's Independent health and care champion”, and “Share Your Story", which are both available on the website through the following link
Healthwatch is a national initiative created in 2012 following the Public Enquiry into the failings at the Mid Staffordshire Hospital by Sir Robert Francis QC. The report resulted in the government making it law that people should be at the centre of care. Healthwatch’s role is to consider and understand the needs of different people ensuring that these views are heard by decision makers in health and social care. Healthwatch have the power to Enter and View organisations that receive public sector funding and the resultant reports are available in the public domain.
Mr Buckmaster presented the Healthwatch Havering Annual Report as detailed in the agenda pack. Healthwatch help to make sure views are heard and encourage services to work hard for everyone. Members of the public have a greater say in their own care and everyone working together is helping to drive improvement through informed feedback and recommendations.
Over the past year Healthwatch has made over 60 recommendations to improve services following the Enter and View Programme which included visits to 10 GP’s, 3 hospital visits and 13 Nursing and Care Home visits, the reports of which are all available on the website. Healthwatch have been listening to residents, voluntary organisations and other partners who have repeatedly raised concerns about sight services. None of this work would have been possible without the Healthwatch team and the volunteer members that work very hard to produce really valuable work and reports.
Partnership working is key to the work that is done and invaluable to ensure that Healthwatch make a difference. There are a number of examples of this work including:
· Partnership with the CCG seeking the views of people about urgent and emergency care services – Right Care, Right Place, First Time
· Healthwatch have reported on Sight Services responding to the concerns of local people and voluntary organisations
· Raising concerns about the withdrawal of out of hours pharmacy services at Harold Wood Poly Clinic
· Working with the Overview and Scrutiny Committee on the delays experienced by patients referred for treatment at BHRUT
· Being part of the wider network of organisations involved with Learning Disabilities and Autism helping to improve health and social care services for individuals, their families and carers.
Healthwatch need input from local people to shape the health care needed now and in the future. This helps to produce strong evidence for decision makers to act upon.
There is a strategic plan for 2018/19 ensuring that strategic objectives are met to ensure people are supported to have their say in order to make a difference together. Relationships to develop relationships with policy makers will also continue.
The Individuals OSSC:
Thanked Mr ... view the full minutes text for item 11.
Members of the Individuals OSSC gave consideration to the report of Healthwatch Havering entitled, Services in Havering for People who have a visual Impairment: a review. The report was finalised in June 2018.
Members had heard from the previous presentation that a significant role of the Healthwatch organisation is to support and empower the most vulnerable members of the community to have a voice and influence services which have a substantial impact on day to day lives.
The report looked at concerns from residents, professional staff and voluntary organisations and looked at the journey taken by patients using services.
The report started from the view of patients and carers which is contained within the UK vision Strategy:
“Seeing it my way”
? That I have someone to talk to
? That I understand my eye condition and the registration process
? That I can access information
? That I have help to move around the house and to travel outside
? That I can look after myself, my health, my home and my family
? That I can make the best use of the sight I have
? That I am able to communicate and to develop skills for reading and writing
? That I have equal access to education and lifelong learning
? That I can work and volunteer
? That I can access and receive support when I need it
The report made a total of 18 recommendations
The Individuals OSSC:
Noted the contents of the report
Noted all 18 recommendations made in respect of all agencies and partners.
To consider any other items in respect of which the Chairman is of the opinion, by reason of special circumstances which shall be specified in the minutes, that the item should be considered at the meeting as a matter of urgency.
There was no urgent business before the Committee.