Agenda and minutes

(A)  SAFEGUARDING ADULTS TRAINING

The Chair announced that a half day training session had been arranged to give a basic awareness of issues around safeguarding adults.  It was suitable for Elected Members and co-optees undertaking visits to residential and nursing care providers.  A flyer had been emailed round separately but hard copies were circulated to all attendees.

(B)  SOCIAL SERVICES VISITS

The Chair announced that the Social Services Visits would now be opened up to all ASH Panel co-optees.  These were generally held on the 3^rd Monday of each month at 9.30 am, and all co-optees were asked to confirm their attendance for each as transport needed to be arranged.

(C)  PANEL WORK PROGRAMME

The Chair announced that the panel would be considering the detail of this year’s work programme at the next meeting.  She highlighted some of the key areas:

Adult Services

• Review of the number of people in Rotherham on incapacity benefit and what actions were being taken to support those who want to go back to work
• Ensure service quality is maintained with the increasing provision of social care by the Independent Sector
• Examine Continuing Care and how it was funded
• Look at how new individual budgets system would be implemented
• Assess how the Council was supporting Independent Living

Health

• Focus on the key public health issues for Rotherham, identified in Rotherham’s 2008 Health Profile
• Look at Adult access to Dentistry
• Undertaken a scrutiny review to look at how breastfeeding rates could be improved in Rotherham
• As part of a cross-panel piece of work, scrutinise the health service implications of EU migration into the Borough
• Other health issues, including the availability and effectiveness of well women and well man clinics, the issue of female incontinence after childbirth and stroke services provision in Rotherham.

Councillor Hilda Jack declared a personal interest in item 143 (Co-option onto the Adult Services and Health Scrutiny Panel) and item 148 (Performance Assessment Excellence Plan).  Janet Mullins declared a personal interest in item 149 (Adult Services 3^rd Quarter (April to December) Performance Report 2007/08)

There were no members of the public and press present.

Councillor Jack presented the submitted report for members to consider co-optee representation for the two municipal years beginning May 2008.

RESOLVED:- (1) that the following individuals be co-opted onto the panel for two commencing May 2008:-

(2) That REMA’s standing invitation to attend meetings in an advisory capacity, when appropriate, be noted.

(3) That a request be made to the host organisation, for a representative of the Rotherham Local Involvement Network (LINk) to attend Panel meetings once the LINk was established.

(Councillor Hilda Jack declared a personal interest in the above item, as her husband, Kingsley Jack was a proposed co-optee)

Steve Turnbull, Head of Public Health presented the submitted report, which looked at the next steps for tobacco control in two key areas:-

• The development of a refreshed comprehensive tobacco control strategy, and
• The continued development of the Rotherham Stop Smoking Service

The existing tobacco control strategy looked at the implementation of the Smokefree law and therefore needed to be refreshed.  This started with a local multi-agency tobacco control event in November and also included a visit by a Department of Health – Tobacco Control National Support Team (TCNST).

There were a range of targets which the tobacco control and the local stop smoking service would work towards.  These were:

The broad strategy was intended to look at the two key themes of:

-          Making it harder to start smoking, and

-          Making it easier to stop smoking

The TCNST gave positive feedback on Rotherham’s progress and highlighted the following:

-          Active, enthusiastic and effective Partnership working and commitment

-          Strong leadership on tobacco control

-          Well resourced, committed and motivated Stop Smoking Service

-          New stop smoking support within Rotherham General Hospital

-          RMBC commitment to operational elements of tobacco control agenda

The NST supported much of the intended direction and asked for some specific developments to be looked at which included:

-          undertaking a market needs assessment at community level

-          developing and expanding a series of Key Performance Indicators to evaluate progress

-          development of a shared policy on smoking and home visits across the partnership

-          supporting RDASH to secure good compliance with Smokefree legislation on 1 July 2008

-          developing further ways to protect children and families from second hand smoke

-          further development of the Stop Smoking Service

-          further enhancement of the role of Trading Standards, particularly around under age sales and illicit and counterfeit tobacco

The report gave an overview of the Stop Smoking Services, which included how the service was made up, what it offered and the potential developments and priorities over 2008/09.

The National Support Team (Tobacco Control) made some specific recommendations on the Stop Smoking Service, which included:

·        Reviewing the effectiveness of stop smoking interventions

·        Using social marketing techniques to target routine and manual occupational groups

·        Evaluation of the Locally Enhanced Scheme (LES) for effectiveness and value for money

·        Further development of the ‘Stop before the Op’ scheme

·        Provision of training and support for stop smoking interventions in partner organisations

·        Ensuring that midwifery services can access and use brief awareness training

These developments and potential areas for discussion would be progressed through the Tobacco Control alliance and the PCT.

A  ...  view the full minutes text for item 144.

Councillor Doyle presented the submitted report in relation to the update on the Water Fluoridation Review.

He reported that the water supply in Rotherham was not currently artificially fluoridated, although Rotherham Primary Care Trust (PCT) were in favour of it as a measure to reduce dental decay, particularly in children aged five years or below.

In February 2007, members of the Adult Services and Health and Children and Young People’s Scrutiny Panels set up a review group, which undertook a review looking at the issue of fluoridation.  The terms of reference of the group were:

• To determine whether adding fluoride to water was an effective means of reducing dental decay in children
• To identify the benefits and risks associated with adding fluoride to water
• To consider the ethics of fluoridating water supplies
• To clarify the current legal position and route for making changes to the water supply

The report gave updated positions of the Strategic Health Authority and the PCT in respect of the recommendations made.  Feema Francis, Locum Consultant, presented the recommendations of the PCT.

A question and answer session ensued and the following issues were discussed:

• Whether the women on the ante natal pilot were being given £200 or just health eating advice.  It was confirmed that the reasoning behind this was to encourage the mother to think about herself and her unborn child.  It was felt that week 39 in pregnancy was too late to begin thinking about a healthy diet and that this should be done at the beginning of the pregnancy
• It was felt that a more effective way of tackling damage to teeth was to reduce the sugar intake of a child.  The PH in the mouth alters when consuming sugar which then turns to acid and attacks the coating on the teeth
• A suggestion was made to encourage the use of fluoride toothpaste rather than fluoridation of water. 
• Whether funding had been secured for the health eating initiatives and if not what the implications would be for the continuation of the work.  It was confirmed that a reduction in funding would result in a decline in dental health in those areas
• The effect Jamie Oliver’s initiative to encourage more people to cook would complement the work already being done.

Members of the panel expressed their disappointment at the lack of detail contained within the responses provided by the PCT and asked for this to be reflected in the resolution.

Resolved:- (1) That the current position on consultation on water fluoridation by the NHS Yorkshire and the Humber be noted

(2) That the PCT’s response to the report’s recommendations be noted.

Further to minute 121 of the Cabinet Member for Adult Social Care and Health meeting held on 21 April 2008, the panel considered a report on Adult Services Commissioning Strategy.

The report set out the radical change to the way the Council would spend their money to meet the social care needs and improve the health, well-being and quality of life for people in Rotherham over the next 15 years.

A discussion ensued and the following issues were raised:

• The introduction of direct payments which enabled people to purchase services to suit their needs.  Members were advised that people were moving away from purchasing the more traditional services.
• Concerns about whether the introduction of direct payments would cause closure of specialised services.  These concerns were dispelled as the Director of Commissioning and Partnership confirmed that they would be working closely with providers to ensure the required services were maintained
• Whether patient dignity would be included within the strategy.  This was confirmed to be a key outcome.
• Whether members of the public had been involved in the decision making process
• Concerns about the privatisation of homes as there was an issue in relation to continuity of care.  It was confirmed that consistency of care had been included as a condition in the tender process
• Whether the Commissioning Strategy addressed learning disabilities
• The requirement for an additional £18.4 million per year by 2023 and whether the council would be able to meet this

Resolved:- That the progress that has been achieved in the continued development of the Commissioning Strategy be noted.

Shona McFarlane, Director of Health and Wellbeing presented the submitted report about the progress made on the implementation of the intermediate care review.

She advised the panel that progress had been made in respect of:

• Establishment of pooled budget arrangements
• Joint Commissioning Arrangements
• Service reconfiguration

A question and answer session ensued and the following issues were discussed:

• The post of Service Manager for intermediate care had now been filled on a temporary basis
• Whether the commissioning arrangements would be successful and what the hardest challenges might be.  It was envisaged that there would be little or no challenges as all those involved were committed to providing this service
• How the joint commissioning arrangements would be review to ensure they were fit for purpose.  It was confirmed that the Joint Commissioning Team act as Commissioner and would hold monthly performance meetings to monitor progress.

Resolved:- That the progress made on implementation of the intermediate care review be noted.

John Mansergh, Service Performance Manager presented the submitted report, which outlined the progress being made to improve on areas of weakness identified by the Commission for Social Care Inspectorate (CSCI) in the 2007 Annual Performance Assessment of registered Adult Services.

The 2007 social care Annual Performance Assessment identified Rotherham as a ‘2 Star’ (Good) Authority with promising prospects for improvement.  The report identified 60 areas of strength and 29 areas of weakness.

The areas of weakness identified were captured in the Neighbourhoods and Adult Services Performance Assessment Excellence Plan and each weakness was given to a Director with clear timescales for completion.  Progress was managed by the Directorate Management Team and reported to members on a quarterly basis.

The first progress report was presented to Cabinet in December 2007 and the Adult Services and Health Scrutiny panel in January 2008, and of the 29 actions within the plan, 26 had been rated ‘complete’ or ‘on target’ and 3 ‘off target’.

The 3 ‘off target’ actions were:

• Progress recommendations of the review of the intermediate care service
• Raise awareness of services, the help available for older people from black and minority ethnic groups, and to improve access to services from BME post assessment, achieving targets for E47 and E48
• Implement electronic social care records

The plan also highlighted recent improvements to services.  Key achievements to date were:

• Health and Wellbeing – level of reviews had increased from 45% to 75%
• Improved Quality of Life
  • Backlog of assessments had been reduced from 300 to 0
  • 374 more older people had been helped to live at home
  • Waiting times for major adaptations had been reduced from 183 days to 52 days

·                                                        Making a positive contribution – RMBC had become Standard Bearers fro Cabinet Office Customer Service Excellence Standard

·                                                        Increased Choice and Control

• Economic Wellbeing – 246 more carers had been supported

A question and answer session ensued and the following issues were discussed:

• Why the review of intermediate care had taken so long to do.  This had been due to problems experienced recruiting a Service Manager as it was a specialised post.
• Whether the development of the Single Assessment Process would mean that the service user would be responsible for looking after it.  It was confirmed that records would be kept in a persons home, and would be most beneficial for those who had a joint package
• How many residents had the council managed to help quit smoking.  Smoking in residential care homes had decreased, but there were still smoking rooms available.
• Whether there were any particular problems raised by the Maltby Pilot relating to the implementation of electronic social care records.  The delays had been due to problems with the IT interfaces which were being addressed.

Resolved:- That the report be received and the progress made against the excellence plan be noted.

(Councillor Jack declared an interest in this item  ...  view the full minutes text for item 148.

John Mansergh, Service Performance Manager presented the submitted report which outlined the 2007/08 key performance indicator 3^rd quarter results for the Adult Services elements of the Directorate.

At the end of the quarter, 17 key performance indicators were on track to achieve their year end targets and 7 were rated ‘off target’.  These were both improvements from the previous quarter.

It was anticipated that 4 areas of service would have delivered ‘step change’ improvements by the end of the year.  These related to doubling the number of reviews that had been done (D40), increasing the number of carers (C62), improving the number of people that were given a statement of how their needs would be met (D39) and the reduction in the time people had to wait for an assessment from 12 weeks to 1 week (D55)

The exceptions were outlined as detailed below:

• D40 – Reviews completed of those on service
• C28 – Intensive Home Care
• C62 – Services for Carers
• C32/C29 – Older people and those with physical disabilities helped to live at home
• D54 – Equipment delivered in 7 days
• C72 – Permanent admissions of older people to residential/nursing care
• E82 – Adults (over 18’s) assessments leading to a provision of service
• E47 Ethnicity of older people receiving an assessment
• LPI 102 – Number of protection plans in place

A question and answer session ensued and the following issues were discussed:

• Had more people been employed to help double the number of reviews being undertaken?  It was confirmed that 16 posts which had previously been frozen had been filled and there were changes in working practices. 
• In relation to C32/C29, what methods were being used to turn these numbers around. Social Workers were being set more challenging targets and prioritising their workloads and more discussion was taking place with service users.
• With more emphasis being placed on keeping older people at home, would people still be able to go into care homes if they preferred.  As part of choice and control assessment, choice would be taken into account.
• The CSCI had advised that Adult Social Care must improve performance on 6 specific indicators by December 2008 in order to achieve the aims for 3 star Adult Social Care service.  These were:

Members queried whether these indicators were achievable.

Resolved:- That the results and the remedial actions in place to improve performance be noted.

(Janet Mullins declared a personal interest as members of her family used the Homecare and Equipment Services)

- to consider representation for 2008/09

Resolved:- That representation by Members on outside bodies for 2008/9 be as follows:

Domestic Violence Forum – Councillor Colin Barron

Rotherham Women’s Refuge – Councillor Beryl Billington and Janet Mullins

Resolved:-  That the following appointments and nominations be made to the Panels, bodies etc. listed below, for the 2008/2009 Municipal Year:-

(a)               Members Consultation Advisory Group

            Chairman (Councillor Doyle) and Councillor Turner (substitute)

(b)               Member Development Panel

Councillor Peter Wootton

(c)               Members Sustainable Development Action Group

(Deferred to next meeting)

(d)               Looked After Children Scrutiny Sub-Panel

                  Chairman (Councillor Hilda Jack) and Janet Mullins

(e)               Health, Welfare and Safety Panel

Jonathan Evans and Councillor Wootton (substitute)

(f)                 Review of the Community use of School Buildings

Councillor John Doyle

Resolved:- That the minutes of the meeting of this Panel held on 10 April 2008 be approved as a correct record for signature by the Chair.

Resolved:- That the minutes of the meetings of the Cabinet Member and Advisors for Adult Social Care and Health held on 7 April and 21 April 2008 be received and their content noted.