Agenda and minutes

The following Declaration of Interest was made at the meeting:-

Councillor Andrews (non-pecuniary) – Mental Health Nurse working in the private sector.

There were no members of the public and press present at the meeting.

Janet Spurling, Scrutiny Advisor, reported that 8 Elected Members had participated in the recent work programme prioritisation session to shortlist potential items.  It was agreed that an underlying theme would be to ask questions addressing health inequalities.

Key issues were the big transformational projects some of which would follow on from last year’s work:-

-          Sustainability and Transformation Plan including Rotherham Place Plan

-          Housing and Social Care integration

-          Adult Social Care development programme

-          Mental Health transformation

Within the above major projects, specific issues/services were identified including Learning Disability/Carers/Older People’s Housing. 

There would also be the Quality Accounts, the final monitoring of previous reviews and monitoring the Children’s Commissioner’s Takeover Challenge review plus the regional work on the Commissioners Working Together Programme.

A more detailed programme would be circulated in due course.

The minutes of the previous meeting of the Health Select Commission held on 16^th June, 2016, were noted.

Arising from Minute No. 5 (Director of Public Health Annual Report), there was an outstanding question regarding Making Every Contact Count (MECC) which had been included in the first version of the Health and Wellbeing Strategy but had proved difficult to progress.  The issues raised were:-

-          How would we achieve the balance between the worker carrying out the core purpose of their visit or interaction with the customer (which might be a very short appointment time) and finding time to ask the wider questions?

-          If someone does disclose something that needs to be acted upon, how would this be dealt with when there may be waiting lists already?

Terri Roche, Director of Public Health, reported that there had been a couple of unsuccessful attempts in Rotherham to get MECC off the ground but now seemed to be the right time due to the Health and Social Care integration and the Sustainability and Transformation Plan having a big focus on the need for prevention, self-care and early help.  It was a challenge when people were incredibly busy but the important message about MECC was that you developed it with the front line staff.

It was about helping people to make healthier choices but starting where they were at and helping them to achieve small sustained long term health changes. 

The organisation that was buying into it needed to consider the whole culture in which their staff worked. It was about getting senior management buy-in so they understood that their staff needed time, training and consideration to the environment in which they were working so there was more health information, posters around etc. to get the person to start thinking about healthier lifestyles before they saw a health or social care professional. 

As well as the change in the individual it was important to get organisational change, including your own staff’s health and wellbeing. It was easier to have these conversations with others if you were making these changes yourself.

It was not about being an expert but about having the basic information that was available to the public and being able to ask that question which checked if they were ready to change and if so to give them a small amount of information and/or signpost to specialists.

That way it was believed it would happen.  There were already some positive responses from the Rotherham Foundation Trust who definitely wanted to take it forward.  It was hoped that proceeding in this measured way would not overburden staff.

Arising from Minute No. 7 (Quality Account Sub-Groups), it was noted that the sub-groups had now been determined with Members having been circulated with all the relevant information for the sub-group they were involved with.  Meetings would take place in November and December, dates to be notified.

Alison Lancaster and Kerri Booker, RDaSH, to present

Alison Lancaster and Kerri Booker, RDaSH, together with Kate Tuffnell, Rotherham Clinical Commissioning Group, presented the recommendations for the future RDaSH service based on the work that had been carried out in Phases 1 and 2.

The Clinical Commissioning Group and RDaSH were working closely with the Authority and health professionals to explore the potential for shared services such as a Rotherham Hub as an initial single point of contact and co-location of services.

A number of public engagement events had been held during 2015-16 to discuss the proposals as they had evolved and been informed by consultation and feedback.  This had culminated in the recommendations for the future Service set out in the attached report.

At the Select Commission meeting on 17^th December, 2015 (Minute No. 60), option 3, the needs-led community based approach, had been supported.  However, since then the model had developed further (Minute No. 9 of 16^th June, 2016 refers).

Positive progress from Phase 1 of the transformation was highlighted and then details of the new model were outlined, including recognising the differing needs of young adults aged 18 compared with for example adults aged 70+.

Discussion ensued on the report with the following issues raised/highlighted:-

-          How local would the services feel to the Service user?  Would they be accessing the services at their GP or would there be 2 central buildings, north and south?

The In-Patient Services would stay where they were i.e. Woodlands (for Older Persons Services) and Swallownest Court (for Adult Services).  The organisation was looking at what resources building wise it had in the north as it was recognised that was a real area for requirement.  A number of patients had home visits and they would continue.  Staff did have agile working but staff bases were required and whatever community assets there were would be used in order to link in with making the services as accessible as possible

-          Have you considered whether whoever did the ‘signposting’ actually made the first contact on behalf of the client?

Work was taking place with a couple of Council Officers who had done a huge amount of work looking at what agencies were out there, what was offered, what had changed etc. and were putting together a directory.  The mapping of all the assets would also include the way the services were accessed some of which were by the client only.  However, all staff were being encouraged to make the first point of contact dependent upon the patient’s wishes.  It was also about signposting more accurately to the appropriate service, what they were being signposted for and how it would happen

-          Would there be time frameworks for the transformational change especially for CAMHS?

There was an absolute commitment to complete the transformation with the Trust stating their intention of October for having all the management structure in place which was where most of the savings were coming from.  Some of the Service users would not necessarily notice a difference  ...  view the full minutes text for item 18.

Nathan Atkinson, Assistant Director Strategic Commissioning, and Scott Clayton, Performance Officer, to present

In accordance with Minute No. 6 of 16^th June, 2016, Nathan Atkinson, Assistant Director, Strategic Commissioning, submitted the additional information requested by the Select Commission.

Scott Clayton, Interim Performance and Quality Team Manager, and Stuart Purcell, Performance Officer, were in attendance to answer any issues raised.

Discussion ensued on the report with the following issues raised:-

-          Reassurance was needed that the improvement in data was leading to changes/changes of approach

There was a challenge with the benchmarking of Yorkshire and Humber data due to the availability of data to benchmark as it tended to be on an annual basis.  There were other mechanisms available via the real time data from the Authority’s Social Care records and day-to-day activity

The mechanisms by which the Mental Health Employment Indicator were calculated had changed very recently in terms of their platform for informing the Authority how they had calculated and therefore produced the current rate of performance.  The performance for the year end as per their publication was close to 6% whereas it had dropped in the first cycle of the new published figure nearer to 2%.  There was no current 2016/17 handbook of definitions but it would be unpicked when released later in the year and followed up with RDaSH regarding their performance if this had deteriorated once there was clarity on the measure. Supporting people into employment was a priority and required co-ordination with partners and a more corporate approach to employment and skills as at present there were a number of initiatives

-          Given that it was about how the data trends actually improved the service, who do we ask about that to make sure they actually were doing something with the data that you collected?

You can only run an effective organisation by using your data wisely to inform whether you were on the right track.  The data was used and aligned to the budgetary position as well.  It was the key to good performance

The data was fed into the Senior Management and Directorate Leadership Teams and into the Corporate reporting mechanisms.  Issues would also be discussed with Service Managers to see if the performance data reflected how they felt about what was actually happening within their Services.

An update was submitted to Cabinet but there was no reason why progress reports could not be submitted to the Select Commission

-          What was the decision making process for accepting an expression of dissatisfaction as an actual complaint

Customers filled in a complaints form or contacted the Complaints Team through a number of channels.  There was no decision making process as such - if a customer had filled in a complaint form it was a complaint.  In the majority of cases if someone wanted to make a complaint there was no barrier

-          There had been 75 complaints which were a slight increase to last year. Did that relate to those forms filled in or complaints accepted at Stage 1?

These were formal complaints where someone had  ...  view the full minutes text for item 19.

Nathan Atkinson, Assistant Director Strategic Commissioning, and Scott Clayton, Performance Officer, to present

Further to Minute No. 6(3) of the meeting held on 16^th June, 2016, Nathan Atkinson, Assistant Director for Strategic Commissioning, presented a report on the local measures that had been priorities to ensure that they reflected areas of Adult Social Care Service activity.  They also linked to the Council’s overarching strategic policies and strategies.

The Directorate Management Teams received regular updates of the current performance of the Local measures alongside the National ASCOF measures reporting.  Local measure in-year performance would be included in future Cabinet Member reporting arrangements.  This would align and run parallel to the agreed Corporate Plan and Improvement Plan reporting schedules.

It should also be noted that, in addition to the Local measures, a range of other measures of activity were also performance managed and reported via alternative reporting streams.  Service level management information measures were also regularly reported internally to Senior Management Teams.

The report set out the current performance challenges as at 31^st May, 2016, which included:-

LM01 – Reviews

LM02 – Support plans % issued

LM03 – Waiting times assessments

LM04 – Waiting times care packages

LM05-07 – commissioning KLOE’s

Discussion ensued with the following issues raised/highlighted:-

-          Was commissioning a problem for the Directorate or across the whole of the Authority?  Who decided if it was across the board and so who should look at commissioning or whether it was just in this particular Directorate and the Select Commission would look at it?

The Directorate had self-assessed itself as red in most of the category areas.  The way that Rotherham approached commissioning was a little behind its peers especially in relation to Adult Services.  In terms of the development plan commitments were around co-production for outcomes that we should be doing.  There was evidence of recent activity starting to move in that direction and engagement and involvement of officers working with communities and members of the voluntary sector was helping that.  The Directorate was very much at the start of the journey and a lot of work to do. The staffing structures had to be considered and the skills within the existing team which was doing very effective work but very much focussed on contract monitoring especially for care homes/statutory services, and the strategic side had been somewhat lacking.  There was much work to be done with Autism an absolute area that needed to be prioritised together with Mental Health and Learning Disabilities

Nathan had been asked by the Chief Executive to oversee the Corporate Commissioning Review which was part of the Improvement Plan and a fundamental part of the Authority’s journey to regain powers and within that would be looking at Children and Young People’s Services, Public Health and perhaps other areas where there was some commissioning.  That work was in its infancy but had a deadline of January, 2017 to conclude the review and publish the outcome.  Within that there were a number of gateways which were specified within the Improvement Plan

-          Where was the appropriate place for  ...  view the full minutes text for item 20.

Elizabeth Bent, Crossroads Care, and Jayne Price, Carers Forum, presented the updated draft Strategy which emphasised the need to identify and support all carers, including hidden carers and young carers.

The following powerpoint presentation set the context for the Carers Strategy:-

Why do we need a Carers Strategy

-          Approximately 31,000 carers in Rotherham

-          Last Rotherham Carers Strategy expired in 2011

-          Introduction of the Care Act 2014 – new rights for Carers

-          Funding cuts throughout Health and Social Care

Co-production

-          Multi-agency Development Group comprising representatives from:-

Carers Groups i.e. Forum

RMBC Adult and Children

Rotherham CCG

RDaSH

Voluntary Sector

Rotherham Foundation Trust

Job Centre Plus

Carers Corner

Consultation/Community Engagement

-          Crossroads AGM

-          Magna Event

-          Carers Forum

-          Adult Services Consortium

-          Carers Resilience Service

-          Barnardos

Outcomes

-          Carers in Rotherham are more resilient and empowers

-          The caring role is manageable and sustainable

-          Carers in Rotherham have their needs understood and their wellbeing promoted

Where are we today

-     A step in the right direction for Carers

-     Draft document

-     Not complete

-     Not perfect

-     Open to suggestions

The Future

-          Aiming to present to Health and Wellbeing Board September meeting

-          Strategy shared widely

-          Development group – Delivery Group

-          Rollout of actions – monitored by delivery group

-          Annual review and update

Discussion ensued with the following issues raised/highlighted:-

·           Can you explain the Pledge?  How you can influence the Pledge that carers in Rotherham were not financially disadvantaged as a result of their caring role?

Part of that was to ensure that carers had access to benefits advice and support.  The work taking place with the Carers Resilience Service was funding that support and had been successful in carers getting Carers Allowance and obtaining Attendance Allowance for the people they cared for.  It was not all about money but a little bit of finance could make a big difference to carers

·           There was felt to be a difference in the language used in the Pledge and in the Outcomes

We can take that back and change it.  The Pledge was picked up from the National Carers Strategy as it was at present.  There were plans for a new National strategy for which the consultation finished on 31^st July and was another reason why Rotherham’s publication had been delayed until September to ensure it was not out of line

·           There were a lot of carers in Rotherham. How do you think this will help reach more carers and support them?

There were a lot of groups in Rotherham and the information would be cascaded as widely as possible.  Once the Carers Strategy was approved it would be rolled out, promoted and shared out to as many people and in as many ways possible

·           Were Directorates playing ball with the new initiative?  How were they linking in with you at all?

The development group was multi-agency and working along with the Directorates.  Within the Forum, the Carers Forum  ...  view the full minutes text for item 21.

Minutes of meetings held on 20th April and 1st June, 2016

The minutes of the Health and Wellbeing Board held on 20^th April and 1^st June, 2016, were noted.

Councillor Cusworth reported that it was still work in progress but the Improving Lives Select Commission work programme shortlist included:-

Domestic abuse

Safeguarding

CSE post-abuse support

Early Help

Special Educational Needs and Disability

The Select commission had been careful to ensure there was no duplication with the work of this Select Commission.

It was noted that the next meeting would be held on 8^th August, 2016.

Papers were published on the website at the link below.

http://modgovapp/ieListDocuments.aspx?CId=1045&MId=13847&Ver=4

No issues had been raised.

Thursday, 22^nd September at 9.30 a.m.

Resolved:- That the next meeting of the Health Select Commission be held on Thursday, 22nd September, 2016, commencing at 9.30 a.m.