Agenda and minutes

Janet Mullins declared an interest in item 12, “Single Line Management Structure for Intermediate Care Services” as she had family who were receiving treatment at the Millennium Rehabilitation Day Care Centre.

There were no press or public present at the meeting.

10.05 am

Councillor John Doyle, Cabinet Member for Health and Social Care gave a verbal update on the priorities for the coming year.

He outlined the successes of the previous year which included:-

• 15 year Commissioning Strategy now in place
• 3 year working progress with NHS Rotherham
• Safeguarding Adults
• Increased support for carers
• Opening of two new residential care homes
• Waiting times for care packages had improved

He informed members of the panel that there had been a recent inspection undertaken by the Care Quality Commission (CQC) which had been very positive. The results had been presented to Cabinet and would be presented to a future meeting of the Panel.

Areas to be prioritised for the forthcoming year were:-

·         Working with NHS Rotherham to promote public health

·         Personalisation agenda

·         Reducing obesity in Rotherham

·         Safeguarding adults and vulnerable people

·         Reducing use of tobacco.

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

• Whether training was available to carers and if so what did this entail?  Confirmation was given that there were various training courses available for carers and information could be made available for those people interested.
• It was felt by some members of the Panel that improvements were necessary in relation to consultation with the public, as decisions appeared to be being made prior to this taking place.  This concern was not shared by all members, with some being strongly opposed to it.  The Strategic Director for Neighbourhoods and Adult Services commented that extensive consultation was always undertaken, but that sometimes it was not apparent to members of the public.  Lessons had been learned in the past 12 months and more effort would be made in the future to communicate better with the public and service users.

Resolved:- That the Cabinet Member’s notes be circulated to Panel Members.

10.20 am

Mark Scarrott, Finance Manager (Adult Services) presented the submitted report which provided information to members in respect of the 2008/09 outturn position plus the latest performance and monitoring against the 2009/10 revenue budget as part of the first stage of the budget setting process for 2010/11.

The 2008/09 approved cash limited budget of £69,738,124 included an additional one-off budget allocation approved by Cabinet, of which £997,000 was to address service pressures reported earlier in the financial year.

The net Outturn for the service for 2008/09 was £69,697, 361, an overall net underspend of £40,763 or -0.06%.

The main variations from budget were:-

• Overall overspend within Home care services due to delays in the implementation of shifting the balance of provision to the independent sector to 65%.  As at 31^st March the market share in the independent sector was 58%.
• Overspend on Direct Payments within Physical and Sensory Disabilities and Mental Health
• Underspend within Extra Care Housing including a review of existing resources
• Underspend on Intermediate Care pooled budget.
• Additional income from continuing health care income and delays in the start up of supported living schemes within Learning Disability Services.

The latest budget monitoring report for Adult Services showed some underlying pressures of £1.1m, however assuming the achievement of management actions it was currently forecast that there would be an overspend of £128k by the end of the financial year.  The Directorate Management Team were still seeking additional efficiency measures to bring the year end position into balance.

The latest year end forecast showed there were underlying  budget pressures on Home Care due to delays in shifting the balance of provision to the independent sector.  There had been a significant increase in clients receiving a Direct Payment within Physical and Sensory Disabilities and Older Peoples Services.

Additional one-off expenditure was being incurred in respect of the costs of boarding up, removal of utilities and security costs at the former residential care homes prior to them transferring to the Council’s property bank.  Other budget pressures were due to delays in the implementation of budget savings agreed as part of the budget setting process for 2009/10 in respect of meals on wheels and laundry and the bathing service.

There were a number of underlying demographic and existing budget pressures within the service including delays in achieving a number of savings options approved as part of the 2009/10 budget setting process.  These continue to be monitored and reviewed on a monthly basis including the development of management actions in order to reduce the projected overspend with the aim of containing expenditure within approved budget.

There were currently a number of cross cutting Value for Money Service Reviews as part of the budget setting process which may also impact on Adult Services.

The Council had an overall funding gap of £11.5m for 2010/11 in its Medium Term Financial Strategy, which included a number of investments and demographic pressures totalling £2.9m and savings of £680k for Adult Services.  In addition further investments had been  ...  view the full minutes text for item 42.

11.20 am

John Mansergh, Service Performance Manager presented the submitted report which outlined the 2008/09 key performance indicator year end results for the Adult Social Care elements of the Directorate.  He also gave a presentation which drew specific attention to the overview for 2008/09 and the outcomes.

At the end of the year 55% of our Key Performance Indicators (KPIs) achieved their targets compared to 58% last year.  82% of the indicators had improved upon their position from last year which compared to 56% in the previous year.

Two significant issues led to changes in forecasted outcomes.  The success of our safeguarding champions and the raised profile of this issue nationally had led to an unprecedented increase in the number of incidents reported and investigated, from 251 referrals in 2007/08 to 526 in 2008/09.  Response to this trend was positive with significant resources being deployed (£400k) into adult protection.  Additional resources of £4.3m committed for 2009/10 and beyond would enable pace of improvement to pick up once again.

Measures taken by the Council to extend the range of services available and provide new ways of delivery led to improved outcomes and VFM but resulted in lower scores on some performance indicators because of the national definitions.

The following performance measures did not achieve their targets:-

• Reviews of care packages (reference D40)
• Achieving independence for older people through rehabilitation and intermediate care (reference NI 125)
• People supported to live independently through social services (reference to indicators NI 136, C29 and C32)
• Percentage of vulnerable people who are supported to maintain independent  living (reference NI142)
• Services for carers (reference C62)
• Equipment delivered within 7 working days (reference D54)
• Timeliness of social care assessments (reference NI132 and D55)
• Adults aged 18-64 admitted to permanent residential or nursing care (reference C72)
• Percentage of people receiving a statement of needs (reference D39)
• Ethnicity of older people receiving assessment (reference E47)
• Safeguarding cases completed (reference LPI 4)

The following Indicators were able to demonstrate significant step change improvement from last year:-

• Carers receiving needs assessment or review and a specific carers service, or advice and information (reference (NI 135)
• Percentage of vulnerable people achieving independent living (reference NI 141)
• Adult with mental health problems helped to live at home (reference C31)
• Acceptable waiting times for care packages (reference NI 133)
• Direct Payments (reference C51)
• Older people admitted to permanent residential or nursing care (reference C72)
• Number of safeguarding reports (reference LPI 3)

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

11.40 am

John Mansergh, Service Performance Manager presented the submitted report which outlined the 2009/10 Quarter 1 Key Performance Indicator results for the Adult Social Care elements of the Directorate.  He also gave a presentation which drew specific attention to:-

• Reviews of care packages
• Review performance – so far this year
• Waiting times for assessments
• Waiting times for assessments – so far this year
• Management actions

At the end of the quarter, 57% of the Key Performance Indicators (KPIs) were on target compared with 55% at the end of 2008/09.

The following performance measures did not achieve their quarter 1 targets:-

• Reviews of care packages (D40)
• Timeliness of social care assessments (NI 132)
• Acceptable waiting times for care packages (NI 133)
• People supported to live independently through social services (NI 136)
• Adults with learning disabilities in settled accommodation (NI 145)
• Adults with learning disabilities in employment (NI 146)

There was one indicator in the suite which could not be reported at the first quarter which was:-

• Percentage of staff trained in safeguarding across all partner agencies (NAS 26)

This was a new indicator set up for the Safeguarding Adults Board and the baseline for the calculation had not yet been established.  Work was underway to develop and report this indicator.

There were two other safeguarding performance indicators that were reported as part of the new Safeguarding Joint Performance Management Framework which had been agreed by the Safeguarding Adults Board.  The information to support these indictors was currently subject to recent guidance being introduced by the National Adult Social Care Intelligence Services (NASCIS) and, due to changes to technical definitions, were therefore likely to change in subsequent reports.

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

Delia Watts, Scrutiny Adviser presented the submitted report in relation to the National Networking Event for Health, Care and Wellbeing Scrutineers.

The Centre for Public Scrutiny was running a series of networking events for those involved in scrutinising health, care and wellbeing.  The event for Yorkshire and Humber authorities was to be held at the Thackray Museum in Leeds in Tuesday 24^th November and was aimed at all members of Health, Care and Wellbeing Overview and Scrutiny Committees for sharing learning and development.

The event would run from 11.00 am until was intended to complement new member induction, and keep health care and wellbeing scrutineers up to date with the latest developments.

The programme for the day was as follows:-

·        “A new regulator for health and social care – what every health and social care OSC needs to know.” 

The Care Quality Commission (CQC) will share early thoughts on the relationship between OSCs and CQC and how scrutiny can contribute to the new registration and assessment processes for health and social care organisations.

·        High impact scrutiny – knowing what matters.

Looking at the Joint Strategic Needs Assessment to ensure a focus on high priority health and wellbeing issues in a time of ever-tightening resources.

·        Closing the gap – how can scrutiny make a difference?

Su Turner, CfPS on a major new project which will support scrutiny committees to make a real impact in narrowing health inequalities.

·        The health inequalities scrutiny challenge.

A highly interactive session challenging you to devise an approach to scrutinising health inequalities in the fictional county of Enneyshire.

·        Eating the elephant – making scrutiny of commissioning manageable.

Examples of approaches to effectively scrutinising the way services are  planned at local level.

Approval has been given for 3 members and 1 officer to attend this event.  Members were asked to indicate whether they would like to be considered for one of the places available.

Resolved:- That the following members be authorised to attend

·        Councillor Jack

·        Councillor Barron

·        Mr R Wells (Co-optee) – to be confirmed.

A report was submitted which outlined details of the consultation and proposed options relating to the transfer of services from Park Lea. 

The plan was to integrate the existing Park Lea services, service users and staff into Oaks and Addison services.  This would be achieved by:-

• Developing the existing outreaches for older people at Oak Trees and developing a new outreach service for older people at St Johns Church Centre in Swinton, at Swinton Potteries in Swinton and at Bakersfield Court in Herringthorpe;

• Increasing the number of places and days at existing outreaches currently provided by Oaks at St James Church Centre in Wath and Addison services at Durlston House;

• By increasing the number of places provided each day at the Elliott Centre and using the Elliott Centre as a Borough-wide service.

Consultation took place with a range of stakeholders including people who currently used day services, their carers/families, providers, community team workers, staff from across day services, Unions and the senior management team.  Methods included individual meetings, individual letters, open day events at Addison, Oaks and the proposed new outreach service.  Taster sessions at the proposed new venues were also set up.  Two open meetings were held at each venue as well as individually arranged meetings which were well attended.  Carers were very positive and wanted to know how soon the proposed move would happen.

People directly affected by the proposed changes were consulted on an individual basis and provided with the options available to them.  The proposed options were:-

• To attend the proposed new outreach service for older people
• To transfer to Addison/Oaks
• To transfer to the Elliott Centre

Resolved:- That the report be noted.

A report was submitted in relation to Single Line Management for Intermediate Care Services.

The Intermediate Care Review and Joint Commissioning Strategy recognised that the development of a single line management structure for intermediate care services would ensure that there were clear lines of professional and operational accountability and service integration between health and social care professionals.  This would also ensure that there were clear lines of communication between both organisations in order to provide an effective intermediate care service.

The Enabling Care Manager (ECM) employed by Neighbourhoods and Adult Services (NAS) and the Strategic Therapy Lead (STLA) within Rotherham Community Health Service (RCHS) had recently agreed to a single line management structure.  This had also been endorsed by NHS Rotherham’s Human Resources and Priority 2 Intermediate Care group on 12^th February, 2009. 

The Enabling Care Manager would become the single line manager for the single line management structure for intermediate care services.  The ECM and STLA would work in partnership to deliver the objectives set out in the Joint Commissioning Strategy.

Resolved:- That the report be noted.

The National Burncare Network newsletter was submitted for information.

Resolved:- That the content of the newsletter be noted.

Resolved:- That the minutes of the meeting of the Panel held on 10^th September, 2009 be approved as a correct record for signature by the Chair.

Resolved:- That the minutes of the meeting of the Cabinet Member for Health and Social Care held on 14^th September, 2009 be received and noted.