Agenda and minutes

Members and officers must declare any pecuniary or personalinterest in any business on the agenda. They should also make declarations at any stage such an interest becomes apparent during the meeting. Consideration should be given to leaving the meeting if the nature of the interest warrants it.  If in doubt please contact Democratic Services before the meeting.

35.1     In accordance with the code of conduct, the following personal interests were declared: -

·         Cllr A Cooper in respect of item 5, Proposal to Change Neonatal Services in West Sussex, as a governor of University Hospitals Sussex NHS Foundation Trust

·         Cllr Pudaloff in respect of item 6, Adults’ Services Quality Assurance Update, as a former user of Adults’ Services

The Committee is asked to agree the minutes of the meeting held on 21 January 2022 (cream paper).

36.1     The Committee agreed to change the word ‘co-produced’ to ‘co-designed’ in minute 35, recommendation v.

36.2     Resolved – that with the change above, the minutes of the meeting held on 21 January 2022 are approved as a correct record and are signed by the Chairman.

The Committee is asked to note the responses to recommendations made at the 21 January 2022 meeting.

37.1     Resolved – that the Committee notes the responses to recommendations made at its 21 January 2022 meeting.

Report by NHS England.

The report details the proposal to change neonatal services at
St. Richard’s Hospital Chichester.

38.1     The Committee scrutinised a report by NHS England Specialised Commissioning Southeast (copy appended to the signed minutes).

38.2     Summary of responses to committee members’ questions and comments: -

·         Only the Chichester neonatal unit at St Richard’s hospital was shown on the map of Thames Valley & Wessex Neonatal Units as this is the only one affected by the proposed change

·         NHS England would work with the maternity partnership and the charity for premature and sick babies (Bliss) to ensure all users of maternity services are included in the consultation to get an understanding of their views of the impact of change on them

·         Staff have been aware of the proposal for some time and had been engaged with extensively

·         A service level agreement between staff at St Richard’ and Queen Alexandra hospitals would be developed to maintain key skills in life support and resuscitation amongst staff

·         The proposal was about improving safety and quality, not savings

·         There is a well-established link with babies born below 27 weeks at Chichester being transferred to Queen Alexandra hospital, Cosham where there are facilities for parents that need to stay over

·         There are care co-ordinators at neonatal centres and clinical psychologists to offer emotional/mental health support to parents

·         There are good public transport links between Chichester and Portsmouth

·         Moving premature/sick babies can be detrimental to them, so it is better that they be delivered at a special unit with 24/7 cover

·         People will know their pathways early

·         The neonatal unit at St Richard’s hospital does not meet national standards so has to go through this process as do all others that do not meet the standards

38.3     Resolved – that: -

                     i.        The engagement strategy includes engagement with current and past service users

                    ii.        The Committee is provided with further information on any cost savings this proposal will bring, and where any identified savings will be reattributed to

                   iii.        The Business Planning Group to consider if neonatal services in the rest of West Sussex need to be added to the Work Programme, including relevant data and any impact on hospital sustainability when services are changed

                  iv.        The Committee concludes that this is not a substantial variation, and supports the proposals in the report

Report by the Executive Director of Adults and Health.

The report provides an update with respect to Quality Assurance activities since the report to the Committee in November 2021.

39.1     The Committee scrutinised a report by the Executive Director of Adults and Health (copy appended to the signed minutes).

39.2     Summary of responses to committee members’ questions and comments: -

·         A range of approaches was used to get customer feedback including ‘Making Safeguarding Personal’ surveys, complaints, learning from reviews, safeguarding adults reviews and the customer and carers group

·         The six-monthly Quality Assurance update reports to the Committee will include themes from audits

·         The Mental Health Quality Assurance Framework reflects ongoing learning

·         Implementing the Quality Assurance Framework (QAF) will be done within current resources, as it is part of the Council’s core business

·         Summaries and podcasts of bulletins are produced

·         Audits were co-designed with staff who are on board with them

·         The QAF is focussed on the Council’s practice, not external organisations. The only link to primary care is through referrals either way

·         Over time the QAF will contain more detail of e.g., audits and key themes/trends

·         The collection of quantitative data was paused during covid, so it is hard to compare with pre-pandemic data

·         At year end, national data should be available against which the Council can measure its performance and benchmark against other authorities. Early data should appear in Summer with full data published in Autumn

·         Trends in self-neglect had been identified and training introduced as a result

·         Team meetings discussed trends

·         The new complex case forum is a senior management group that oversees the most complex cases. This is supported by a multi-agency risk management group that discusses cases across West Sussex

·         One of the themes identified is professional curiosity, looking wider than the individual e.g., their rooms and communal areas when visiting them in care homes

·         The Ethical Decision-Making Audit Tool supported audits of practice. It is not the only tool used to understand the quality of practice, performance of the Council, or how the Council engages with partners in terms of understanding what it is currently doing and will be doing in future and can be adjusted

·         The QAF is how the Council supports people, carries out assessments and develops care plans to meet their needs in line with its statutory duty

·         Case file records should show if people think their needs are not being met

·         Learning from the Ombudsman and complaints are considered and can be part of future reports

39.3     Resolved – that the Committee: -

             i.        Agrees to the running of a separate workshop on the audit process

            ii.        Requests that future quality assurance updates to the Committee include further detail on how feedback from service users is captured, learning from Local Government Ombudsman complaints and trends and learning being identified from audit data when appropriate

          iii.        Requests that future performance and resources reports to the Committee include benchmarking data

A report by the Director of Law and Assurance, setting out the finance and performance position as at the end of December 2021.

The Committee is asked to examine the data and supporting commentary for the performance and resources report and make any recommendations for action to the relevant Cabinet Member.

40.1     The Committee scrutinised a report by the Director of Law and Assurance (copy appended to the signed minutes).

40.2     Summary of responses to committee members’ questions and comments: -

·         The full report on local activity around Stoptober will be shared with the Committee

·         The Government has set a target of smokers being 5% or less of the population by 2030 – it is currently about 12%

·         Health inequalities are exacerbated by smoking

·         The Council will promote non-smoking day on 9 March

·         Recruitment of social workers and occupational therapists was a challenge with vacancy rates around 15% and 12% respectively

·         The coming year’s budget includes £2m to match social worker pay with other local authorities – this will be reflected in recruitment campaigns

·         There have been a lot of care assessments of increasing need lately, but the number of people in residential care was expected to go down against the Council’s three year target

·         The Cabinet Member for Public Health & Wellbeing was willing to consider the addition or amendment of key performance indicators to include one about people’s activity

·         The Cabinet Member for Public Health & Wellbeing would consider the best way for members of the Committee and the Health and Wellbeing Board to work together to address performance measures in health and wellbeing

·         Sustainability in the care market is a local and national issue

·         It is difficult to meet the needs within resources of the growing number of older people and those with disabilities and mental health issues

·         The Council is developing a market sustainability plan with providers regarding recruitment and retention, including overseas recruitment, and to develop community-based services and dementia nursing care

·         The Council had agreed to invest significantly in services next year to meet challenges

·         The Council was a low performer in learning disability employment before Covid and will still be below average even if it meets its target – proposals to address this will be a focus of the Adults Strategy and can be scrutinised at a future date

·         The Department of Health and Social Care requires care packages to be reviewed each year if performance on learning disability performance is to be counted

·         Although the Council has invested in reablement, this service has been affected by recruitment difficulties and large numbers of people discharged from hospital needing care – it was hoped that this would improve in the near future

·         The average gross weekly cost of older people’s care since April 2018 has increased despite the number of people being cared for at home going up, and the number in residential care going down – this is due to more expensive care package costs

40.3     Resolved – that the Committee asks: -

             i.        For the full report on the results of the smoking cessation programme to be shared with the Committee when available, and for the Business Planning Group to consider if any aspects of this is required for future scrutiny

            ii.        The Cabinet Member for Health and Wellbeing and the Business Planning Group to  ...  view the full minutes text for item 40.

The Committee is asked to review its current draft work programme taking into account the Forward Plan of Key Decisions and any suggestions from its members for possible items for future scrutiny.

41.1     The Committee considered its work programme taking into account the Forward Plan of Key Decisions and suggestions from members.

41.2     Resolved – that the: -

             i.        Committee receives an update, as per the Work programme on the provision of services or older people with mental health issues in the west of the county

            ii.        The Committee to be provided with an update on the Integrated Care System at its June meeting

          iii.        The Business Planning Group considers whether an item on discharge pathways should be added to the Work Programme

The next meeting of the Committee will be held on 15 June 2022 at 10.30 am at County Hall, Chichester.  Probable agenda items include:

·         Care Quality Commission Inspection of University Hospitals Sussex NHS Foundation Trust

·         Shaw Homes Contract

Any member wishing to place an item on the agenda for the meeting must notify the Director of Law and Assurance by 27 May 2022.

42.1     The next meeting of the Committee will take place on 15 June 2022.