Agenda and minutes

The following issues were reported:-

(1)               Consultation on Care Quality Commission (CQC)

The Scrutiny Adviser reported that this was a new organisation which would bring together the work of the Commission of Social Care Inspection, the Healthcare Commission, and the Mental Health Act Commission.  Places were available for members to attend an event in Leeds on Monday, 16^th January, 2009, to give their view on consulting on how the CQC intended to use its enforcement powers, which would include the Care Standards Act (CSA) 2000 powers and three new powers under the Health and Social Care Act 2008.

Attendance allowances and expenses would be paid by the Commission.

Registration was on-line (the Scrutiny Adviser would send the link to those interested)

(2)               Personalisation – training

The Scrutiny Adviser reported that a dedicated session explaining the personalisation agenda within Adult Services and the Council’s approach was being provided for the Panel by Tom Sweetman in Adult Services.  This session had been arranged to take place at Talbot Lane Church on Thursday, 19^th February, 2009 from 2 p.m. to 4 p.m, with refreshments provided.  Members of the Panel were requested to submit any questions regarding the personalisation of services to the Scrutiny Adviser before hand so that these could be covered in the presentation.

No declarations of interest were made at the meeting.

There were no members of the public, or the press, present.

Tom Cray, Strategic Director for Neighbourhoods and Adult Services, presented the submitted report which summarised the results and findings of the 2008 social care Annual Performance Assessment (APA) process for Rotherham conducted by CSCI (Commission for Social Care Inspectorate) which was published on 27 November 2008.

The performance judgement for Rotherham was as follows:

• Delivering outcomes: Good
• Capacity for improvement: Promising
• Rotherham Adult Social Care services performance rating was 2 Stars

The result recognised that the Council had improved the quality of outcomes in six areas, achieving an excellent standard in four overall.  The performance rating received in 2006 and 2007 had been maintained.  The Panel was informed that a full copy of the assessment report, in various formats, could be provided on request.

Dave Roddis, Service Quality Manager, provided details of the delivery of outcomes and capacity for improvements, together with the progress which had been made in relation to each of them.  These were:

Judgement Areas               2007 Rating              2008 Rating

Delivering Outcomes        Good                          Good

1. Improved health and         Good                          Excellent

well-being

2. Quality of Life                    Adequate                   Good

3. Making a positive             Excellent                     Excellent

contribution                           

4. Increased choice and       Adequate                   Good

control

5. Freedom from                   Good                          Excellent

discrimination and               

harassment

6. Economic well-being        Good                          Good

7. Maintaining personal        Adequate                   Good

dignity and respect

Capacity to Improve          Promising                 Promising

(Combined judgment)

8. Leadership                        Promising                  Excellent

9. Commissioning and         Promising                  Promising

use of resources

Performance Rating          2 Stars                       2 Stars

Members of the Panel congratulated the staff of the Directorate in achieving this excellent standard given the challenging circumstances during 2007-2008.

Members of the Panel raised the following issues, and responses were given by the Strategic Director and the Director of Commissioning and Partnerships:-

-                      Demographics

-                      budget pressures

-                      economic downturn

-                      delivery of promised expectations

-                      resourcing of the direct payments system

-                      Rotherham’s national profile re:  direct payments

-                      Information sharing with other local authorities

-                      The personalisation agenda

-                      Lack of progress with the electronic single assessment process

-                      Finance for the new safeguarding team

-                      Impact of efficiency savings on the maintenance of a two star rating

-                      Ensuring that service users have increased choice now that many services would be provided by the private sector

-                      Areas where the Directorate was under performing in terms of safeguarding people against abuse

-                      Development of commissioning

-                      Clarification of outcomes in terms of commissioning

-                      Aims of the new senior citizens’ network

-                      The 2009-2010 budget pressures and anticipated revenue allocation

-                      The Older People’s Network and sources of information available from Age Concern

Resolved:-  (1)  That the outcome of the assessment be noted.

(2)  That the ‘Excellence Plan’ put in place to improve the areas of weakness identified in the report be noted.

(3)  That it be noted that the Cabinet Member for Adult Social Care and Health approved the investment to develop a safeguarding adults team which consists of 10 social workers, a manager and administration support to manage the increase in referral rates.  ...  view the full minutes text for item 216.

Steve Turnbull, Head of Public Health, presented the submitted report, together with a PowerPoint presentation, which outlined the progress made to date and informed the Panel of the interim findings in relation to BME Health Needs.

It was explained that research was conducted on all BME communities to gather a comprehensive picture of health needs.  This research was backed up by in-depth community consultations with five specific communities which were chosen for a variety of reasons to give a broad picture of needs in different communities.  The initial focus had been on the more established communities and new economic migrants were not included in the detailed consultation.  The five communities were:

• Pakistani/Kashmiri
• Chinese
• Yemeni
• Black African, and
• Irish

The community consultation exercises involved in-depth family interview conducted in homes, gender specific focus by ethnic minority and a general event open to all communities.

Further sources of data were also explained, together with the demography, population number predictions to 2030 and age profile.

The findings were focussed around four themes:

-                      Demography/changes and nature of population

-                      Health conditions and access to services

-                      Lifestyles and behaviours

-                      Wider determinants of health

Specific slides within the presentation detailed:-

-                      Practice based (2 GP practices based in areas with a high proportion of BME patients) Qualitative Health Needs Assessment 2008 – Selected measures by z scores;  with particular reference to increased prevalence of coronary heart disease and diabetes in BME communities

-                      CHD in South Asians Equity Audit – Deaths from All Causes - % by Age Group:  South Asian residents compared to Rotherham Residents

-                      Infant Mortality by Ethnicity and Low Birth weight by ethnicity

-                      Practices % ethnics v Mental Health admissions

-                      Smoking and Cancers

-                      Accidents

-                      Broader issues

-                      Ethnicity monitoring:  the cycle of invisibility

Taiba Yasseen, REMA, provide further explanation about the assessment process and range of events and tools used to gather this information.

A question and answer session ensured covering the follow:-

-                      The need to add an additional category for Eastern Europeans

-                      Further work to increase knowledge and raise awareness about access to a wider range of services

-                      The widening gap between the more affluent and the deprived population groups

-                      Access to leisure services, particular for women, with reference to the Women’s Strategy

-                      Accuracy and validity of the data, together with the difficulties in collecting data

-                      Human rights issues and methods used to obtain information

-                      Genetic issues:- diabetes and obesity

-                      Accidents in the home

-                      Increased incidences of tuberculosis

-                      BME representation on the Scrutiny Panel

-                      Were there any plans to include the new economic migrant communities in future health needs assessments?

-                      How many individuals/families were interviewed and how confident was the service that they represent their communities in terms of their health needs?

-                      What was meant by ‘South Asian’?  Did this mean both the Yemeni and Pakistani/Kashmiri communities?

-                      How would the next stage of assessing health priorities for action be carried  ...  view the full minutes text for item 217.

To nominate 2 Elected Members and 1 Co-opted Member to represent the Adult Services and Health Scrutiny Panel on the Annual Health Check Working Group.

The Scrutiny Adviser reported that the Annual Health Check measured health trusts’ performance using a framework of national standards and targets set by Government.

In April 2009 each health trust needed to provide a declaration of its compliance (or otherwise) against the Department of Health’s 24 core standards.

Overview and Scrutiny Panels, along with patient and public involvement forums/LINks and SHA’s, were invited to make evidence based comments on the performance of their local health trusts, which would be submitted unedited with the trusts’ declarations.

The Care Quality Commission (which replaces the Healthcare Commission on 1^st April, 2009) would take these comments into account when assessing the trusts and awarding them an overall rating for ‘quality of services’ and ’use of resources’.

The approach was to set up an Annual Health Check Working Group and 3 members for this Scrutiny Panel, together with 3 members from the Children and Young People’s Scrutiny Panel, were invited to take part.  The Working Group would hear presentations by local health trusts (a maximum of 3 meetings) and would produce draft comments for consideration by the Scrutiny Panels for eventual submission to the Care Quality Commission.

Resolved:- That the following members be appointed to the Annual Health Check Working Group

• Councillor Jack, Chair, Adult Services and Health Scrutiny Panel
• Councillor McMahon
• George Hewitt, Co-optee

Consideration was given to the minutes of the meeting of the of the Adult Services and Health Scrutiny Panel held on 4^th December, 2008.

Ann Clough, Co-optee, declared a retrospective personal interest in Minute No. 205 – Carers Strategy.

Resolved:- That the above declaration be noted and the minutes of the meeting of the Panel held on 4 December 2008 be approved as a correct record for signature by the Chair.

Consideration was given to the minutes of meetings of the Cabinet Member for Adult Social Care and Health held on 1^st and 15^th December 2008.

Reference was made to Minute No. 73 Carers Forum – Verbal Update and it was reported that the name of the Assistant Manager from RAIN was Linda Haynes (not Hayne).

Resolved:- That the minutes of the meetings of the Cabinet Member for Adult Social Care and Health held on 1^st and 15^th December 2008, with the above clerical correction, be received and noted.

The following item is likely to be considered in the absence of the press and public as being exempt under paragraph 3 of Part 1 of Schedule 12A to the Local Government Act 1972.

Resolved:-  That, under Section 100A(4) of the Local Government Act 1972, the press and public be excluded from the meeting for the following item of business on the grounds that it involves the likely disclosure of exempt information as defined in Paragraph 3 of Part 1 of Schedule 12A to the Local Government Act 1972, as amended.

Tom Cray, Strategic Director, gave a PowerPoint presentation, explaining the corporate overview of the 2008/2009 budget, together with the current position of Directorate.  Details of the aims of the 2009/2010 budget setting process, and the Directorate’s approach, were also explained.

The budget pressures being experienced in the current financial year were detailed along with measures taken, and being taken, by the Directorate to manage individual service budgets.  The reasons for the variances in budget heads and the current overspend were fully explained.

An indication of the target budget for 2009/2010 was given as well as the savings target with had been set both corporately and for the Directorate.

Shona Mcfarlane, Director of Health and Wellbeing, presented the Directorate’s Savings Proposals, and Kim Curry, Director of Commissioning and Partnerships presented the Directorate’s Investment Proposals.

A question and answer session ensued in which the following issues were highlighted:-

-                      Impact on service users

-                      Staff affected

-                      Risks

-                      Demographic pressures

-                      Increasing complexity of physical disabilities

-                      Rotherham as the pioneer of the Personalisation agenda

-                      Impact on CSCI Assessment 2009/2010

-                      Maintaining quality provision of services

-                      The current economic downturn and impact on service providers

-                      Additional pressures over and above the medium term financial strategy

-                      Continued management initiatives, and possible supplementary budget estimate for 2008/2009

-                      Explanation of “Preserved Rights”

-                      Where the extra savings were to come from, as a budget gap was evident

Resolved:-  That the officers be thanked for their presentations and the contents of the presentation be noted.