Agenda and minutes

The Chair introduced Chrissy Wright and welcomed her to the meeting.  Chrissy had recently taken up the position of Director of Commissioning and Partnerships following the departure of Kim Curry.

The Vice Chair reported that a Professor from the Cambridge Research Unit would be visiting Rotherham on 11^th July, 2009 to give a talk on stem cell research and all panel members were invited to attend.

Janet Mullins declared an interest in item 9 in relation to Rothercare as she had a relative who was in receipt of the service provided by Rothercare.

Councillor Jack declared an interest in item 9 in relation to Rothercare as her husband was in receipt of the services provided by Rothercare.

There were no members of the public and press present.

Resolved:-  That the following appointments and nominations be made to the Panels, bodies etc. listed below, for the 2009/2010 Municipal Year:-

(a)               Members Consultation Advisory Group

Councillor Barron and Councillor Turner (substitute)

(b)               Member Development Panel

Councillor Wootton

(c)               Members Sustainable Development Action Group

Councillor Barron

(d)               Looked After Children Scrutiny Sub-Panel

                  Chairman (Councillor Hilda Jack) and Councillor Barron

(e)               Health, Welfare and Safety Panel

Councillor Wootton and Councillor Turner

Kirsty Everson, Director of Independent Living and Shona McFarlane, Director of Health and Wellbeing gave a powerpoint presentation in respect of the Review of Physical Disability and Sensory Impairment and Safeguarding Services.

The presentation drew specific attention to:-

• The Inspection Process
• CSCI Annual Performance Assessment Score
• Aims of the 2009/10 budget
• Summary of Investments from 2009/10 budget
• Physical Disability Self Assessment
  • Summary of Strengths
  • Summary of Weaknesses
  • Improvement Plan
• Safeguarding Self Assessment
  • Background
  • Improving Customer Access and Service Standards
  • Improving the way cases are managed
  • Improvement Performance and Quality
  • Putting in place a trained and skilled workforce at all levels
  • Service users are kept safe and in control
  • Improvement Plan

A report was also presented which detailed the proposed joint inspection by the Care Quality Commission of safeguarding adults (all ages) and physical disability services.

There are six themes to the inspection:

• Universal services – CQC will assess access to and quality of transport, leisure, shopping, employment, nightlife etc
• Promoting independence – CQC will assess social care and health services and how well they promote independent living within communities
• Preventative services – CQC will assess social care, health, information and the role of the VCS
• Specialist Provision – in relation to social care and health services
• Care management styles – in relation again to social care
• Range of services provided – in relation to social care and health

A self assessment of the service was carried out by NAS and the following key strengths were identified:

• LAA targets were in place to measure the level of independent living, employment and training
• Joint commissioning priorities had been agreed with NHS Rotherham on the management of long term conditions and intermediate care within the community
• There had been MTFS investment to recognise developments required
• There was a Joint Disability Equality Scheme in place with NHS Rotherham
• Residential care costs were lower than average
• There had been corporate investment into leisure facilities and improving access at public buildings to comply with the DDA
• There was a dedicated team to support people with head injuries
• There was top quartile performance for reviews and intensive home care for people with physical disabilities and an emergency carers scheme was in place
• Customer surveys revealed 94% satisfaction ratings for home adaptations
• There had been an increase in the resources made available for home adaptations and the number of people assisted had also increased over the past 5 years
• Occupational therapists were employed alongside 2010s Decent Homes programme to ensure that people with mobility issues get their needs met when their homes were refurbished.  81% of tenants, in a recent survey said their health had improved as a result of this service.
• Rotherham was considered a Centre of Excellence for the blue badge system
• High profile events had taken place to raise awareness of disability issues such as the Fair’s Fayre multi agency stakeholder event which was attended by over 4000 people
• Level 5 of the Equality Standard had been achieved across the Council

The following areas were  ...  view the full minutes text for item 5.

Shona McFarlane, Director of Health and Wellbeing presented the submitted report which informed Members of progress made in increasing awareness and take up of Adult Social Care services for older people from Black and Minority Ethnic (BME) communities resulting from a 6 month pilot undertaken at Rotherham GeneralHospital.

It also highlighted the need to extend the pilot for a further 6 months in order to endeavour and achieve top banding performance for the relevant Performance Assessment Framework Ethnicity Indicators for older people E47 and E48.

The methodology for this was by interview/questionnaire which were undertaken by staff with the relevant communication skills who attended the hospital 2 mornings each week, working with the Hospital Assessment & Care Management team to identify older people from BME communities who had been admitted into hospital.

The aim was to focus on the Pakistani community who were identified in the Rotherham 2001 census as the largest BME group with specific focus upon the older people from that community.  The Older People group were chosen as performance management information systems identified that there was a disproportionate under representation of this population in proportion to older people in Rotherham who accessed assessments and subsequent service provision.

The hospital setting was chosen as the preferred way of identifying and engaging vulnerable BME customers who from past initiatives had been/were difficult to engage with, and because of their current circumstances be more likely to require support. A total of 59 interviews were undertaken and enquiries were made by customers for information on health and social care services which included services for Carers, Direct Payments, BME Day Care, Memory Clinic, Intermediate Care, Meals on Wheels and community based service provision by the Voluntary/community sector.

The outcomes had been grouped by emerging themes as follows:

• Knowledge/awareness of Adult Social Care Services
• Access to services
• Assessment of care management
• Social care needs
• Carers issues

Outcomes

• Four care packages were currently in place and clients receiving services (approx 10% of patient sample)
• Identification of the need for service to be extended for a further 6 months phase commencing April 2009

The action plan would address both how services would be changed and evaluate the success in improving access to information and services for BME older people and what hospital needs to address as a result of the research project.

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

• How were those people interviewed identified and was it felt that they were representative of the BME community.  Contact teams within Neighbourhoods and Adult Services identified those people to be interviewed, which initially were mainly Pakistani.
• How many different languages are used?  Confirmation was given that information was provided in the main 5 key languages used in Rotherham, but for other languages interpreters and language line were available.
• It was queried whether the interviews had changed the way in which Adult Services would provide and target their services in the future.  It was felt that a better service would  ...  view the full minutes text for item 6.

Shona McFarlane, Director of Health and Wellbeing presented the submitted report which outlined proposed improvements for customer access at Customer Service Centres and District Offices. This would require a temporary change to Assessment Direct’s current deployment of staff in order to provide an improved responsive service.  It would be an interim change until Rothercare and Assessment Direct were merged.

The current service delivered at Customer Service Centres and District Offices was provided by Assessment Direct Assistants and Assessment Direct Officers.  The role of an Assessment Direct Assistant was to process and provide Blue Badge applications, to give general advice and information pertaining to Neighbourhood and Adults Services, and the redirection/signposting of customers to other appropriate services.  Assessment Direct Officers provide additional services, but these have been required less since the inception of Assessment Direct.  The deployment of Assessment Direct Officers at Customer Service Centres had been variable recently dependent upon the number of staff available due to sickness, holidays and vacancies.  The vacancies had not been appointed to and were being temporarily withheld, to be utilised as required in the newly merged ‘Rothercare Direct Service’.

Most people wishing to access services now do this through Assessment Direct through the single telephone number, which has proven to be a more direct and easy access route for many people.

The proposal was to withdraw the Assessment Direct Officers from the Customer Service Centres and District Offices and maintain the physical Assessment Direct Assistant presence only.  Customers wishing to make contact with the Assessment Direct Officers would be directed to make contact by telephone, or contact could be made on their behalf by an Assessment Direct Assistant.

Should a customer require a face to face meeting with an Assessment Direct Officer, then the Assessment Direct Assistant would contact the Mobile Duty Assessment Direct Officer to arrange a meeting.

This would enable the service to be more personalised and responsive to the customer’s individual needs and requirements.  It would also be more efficient, providing increased resources to target directly at the front line provision of services to the customer in a more targeted way and increase from a part-time response to a full-time response.

The report also detailed the progress which had been made in relation to implementation of the new Rothercare Direct service which would provide a single customer access point for a range of services across NAS as well as continuing to provide an emergency community alarm service.

To date, progress towards the new service was as follows:-

·                    New access criteria for aged person and sheltered housing that clarify the position in relation to Rothercare was published as part of the Housing Allocation Policy with effect from 1st December 2008.

·                    The Rothercare charging arrangements have been reviewed and now the service is taking control of the invoicing and collection methods. This includes notifying all current customers about a 2.5% charge increase for 2009/10.

·                    Assistance from Finance has been provided in relation to merging the budget for Rothercare and Assessment Direct  ...  view the full minutes text for item 7.

Consideration was given to the draft Work Programme for 2009/10.

Councillor Jack added that the Rotherham LINK’s work programme this year would include: Care for the elderly, Substance abuse and the subsequent social issues, Obesity, GPs (attitude of front line staff), Accessing services for the profoundly deaf and Finding out about what support services are available and issues around accessing them.

Resolved:- That the following items be prioritised in work programme for 2009/10

Ken Wragg, Consultant in Dental Public Health from NHS Rotherham gave a presentation in relation to Primary Care Dentistry in Rotherham.  The presentation drew specific attention to:

• New Dental Contract introduced in 2006
• Location of all dental practices in Rotherham
• Oral Health in Rotherham Children
• Dental Access
• Dental Commissioning
• Commissioning Target
• Orthodontics
• Special Care Dentistry
• Domiciliary Dental Care
• Recommendations
• Oral Health Context
  • Health Needs Assessment
  • Prevention
  • Dental Services
  • Workforce

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

• What was the policy in respect of ancillary staff undertaking work on behalf of dentists?  It was confirmed that skill mixing was taking place, which included dentists delegating tasks, where necessary following on from the initial check up.
• How we overcome the problem of children being frightened of the dentist?  It was felt that the biggest influence came from within the home, so it was important for prejudice to be tackled here.
• Reference was made to the Specialist Orthodontic Practitioner and a query was raised as to whether they had the capacity to absorb the orthodontic work from the 3 practices.  It was confirmed that a needs assessment had been done and a shortfall had been identified.  An advert had been placed to recruit a further Specialist Orthodontic Practitioner.
• The report suggested fluoridation of water supplies, but made no mention of negative side effects.  A query was raised as to whether these had been considered.  It was suggested that as a lot of children didn’t brush their teeth as regularly as they should that water fluoridation was a good way of helping them.  This was a decision which was taken by the PCT following consultation with the public.
• Whether adults with special needs had their dental care met by the current system?  Confirmation of this could not be given but it was suspected that there were gaps in the system which would need to be addressed in the future.
• Reference was made to the location of dental practices in Rotherham and it was queried as to why practices could be more widely spread.  It was confirmed that traditionally it had been down to the individual dentist to choose their premises and set up practice.  However they were now looking at encouraging more practices to open up in areas with poor dental health.

Resolved:- (1) That, in line with current Council policy, the Panel does not support  the fluoridation of Rotherham water supplies

(2)  Support be given for increased spending on Dentistry in Rotherham to help improve dental access for patients, and help with oral health inequalities that exist in Rotherham

(3)  That the increased expenditure on orthodontic treatment in Primary Care for Rotherham children be supported

(4)  That the succession planning of dental workforce by the retention of dentists who have completed the Vocational Training Scheme be supported

(5)  That the increase in provision of domiciliary dental care for older adults in residential care be supported.

Pursuant to Minute 236 of the meeting of the Panel held on 5^th March 2009, Members considered the answers to questions raised in relation to MH 1^st Aid and Suicide Prevention.

Resolved:- That the information be noted and received.

Resolved:- That the minutes of the meeting of the Panel held on 2^nd April, 2009 be approved as a correct record for signature by the Chair.

Resolved:- That the minutes of the meetings of the Cabinet Member for Adult Social Care and Health held on 23^rd March 2009 and 6^th April 2009 be received and noted.

Resolved:-  That, under Section 100A(4) of the Local Government Act 1972, the press and public be excluded from the meeting for the following items of business on the grounds that it involves the likely disclosure of exempt information as defined in Paragraph 3 of Part I of Schedule 12A to the Local Government Act 1972 (information relating to the financial or business affairs of any person (including the Council)).

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.

Tim Gollins, Strategic Commissioning Manager presented the submitted report in relation to Home from Home.

Home from Home is a new and innovative way of raising standards and rewarding better standards in contracted residential and nursing care homes in Rotherham. The framework increases the quantity of the assessments on any single home from one a year to three.  In addition the quality of the assessments has been increased by separating out three quality elements: contractual compliance, customer experience, and health care interventions

A major strength of the Home from Home quality scheme is that it delivers co-operation between the local authority, the voluntary sector through Age Concern, and NHS Rotherham.

Two pilot Home from Home assessments have been completed, and this report documents the learning from these (Melton Court and Layden Court)

Following the success of the pilots the main Home from Home programme has started with services prioritised on the basis of risk. (see the risk section for details) and the following homes have had assessments completed in addition to the two pilot homes:

• Cherry Trees
• The Abbeys
• Athorpe Lodge
• Laureate Court
• Moorgate Croft

A web page has been produced with a list of homes in the Home from Home scheme and the reports once completed will be posted for customers and potential customers as well as professionals to read.

The website will become more interactive over the next year as it becomes more sophisticated in providing a window for customers onto the quality of residential and nursing care homes in the borough.

Resolved:-  (1)  That the learning from the pilot be noted

(2)  That the Home from Home programme is delivered in 2009 on each contracted residential and nursing care home in Rotherham

(3)  That the quality premium is paid from October 2009 following completion of assessments of each home

(4)  That the website is developed to become a dynamic and interactive site for customers to make informed judgements about their care.