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.

22.1     There were no declarations of interest.

The Committee is asked to agree the minutes of the meeting held on 15 September 2023.

23.1     Resolved – that the minutes of the meeting held on 14 June 2023 are approved as a correct record and are signed by the Chairman.

The Committee is asked to note the responses to recommendations made at previous meetings of the Committee.

24.1     The Committee considered the responses to recommendations (copy appended to the signed minutes) and felt that its request to receive further information on how long people are waiting in hospital for an assessment had not been adequately answered.

24.2     Resolved – the Committee requests

                i.    That a response be provided ahead of the next meeting to this question which covers the range, shortest, longest and average figures

               ii.    That the other responses are noted

A report by the Chief Executive and Director of Finance and Support Services setting out the corporate performance, finance, workforce, risk and capital programme positions as at the end of September 2023.

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.

25.1     The Committee considered a report by the Chief Executive and Director of Finance and Support Services (copy appended to the signed minutes).

25.2     Summary of responses to members’ questions and comments: -

Adults

·             Although the Prevention Assessment Team is important in supporting people it is not the only method of early support in place

·             Reviews of individuals’ care needs are carried out on a priority basis due to finite resources available and if requested by individuals as their needs change

·             Specific teams do strength-based reviews which are longer in duration – strength-based reviews concentrate on community-based support with a focus on individuals, putting their strengths/interests first and looking at what is available in the community e.g. lunch clubs, community centres –
Action: - Adults’ Services to work on a definitive definition of strength-based reviews

·             Family members may provide support in some cases reducing the amount of support required

·             The Service is looking at reviewing people in high-cost residential placements to see if they can move to supported living

·             A lot of reviews are carried out where people may have left hospital or have had short term packages for a reablement service for up to 12 weeks and these reviews are not included in the current definition of reviews to be counted

·             Some people have multiple reviews which makes data less accurate

·             The Council is not far off the south-east average for reviews in 12 months (64%)

·             A new indicator is required and will be developed that shows how the Council meets people’s needs with reviews being one element

·             The Council regularly lobbies government and local MPs over funding for social care

·             Some savings have rolled over from prior years, mainly in lifelong services and will be reprofiled for future years

·             The Service has recently got a better understanding of the rationale behind the proposed savings - what is deliverable and what is not – and is committed to deliver the overall savings target, but maybe not in the exact way in the report as the savings are reprofiled - this will be shared with the committee when completed

·             There is an opportunity to develop a range of services that will improve outcomes for people by helping them live independently rather than institutional care and at better value for money

·             The Service is also looking at alternatives if there are further savings gaps

·             The Council does a lot of work supporting providers in the recruitment and retention of their staff e.g. by giving them inflationary uplifts so they can pay staff reasonable wages

·             There is no intention to reduce the external workforce, but there will be a small reduction over two years of the internal workforce

·             More people are being recruited now to deliver the improvement programme which will determine what level of staffing is needed going forward

·             The Council has difficulty in recruiting social workers and staff in mental health services so is developing a workforce strategy to support staff to enable them to do their jobs better,  ...  view the full minutes text for item 25.

The Report by the Director of Adults and Health and Assistant Director – Improvement and Assurance updates the Committee on progress on the two-year improvement programme.

The Committee is asked to consider and comment on the update on the delivery of the two-year improvement programme.

26.1     The Committee considered a report by the Director of Adults and Health and Assistant Director – Improvement and Assurance (copy appended to the signed minutes).

26.2     Summary of responses to members’ questions and comments: -

·             The Council takes on apprentices in a number of roles including administration, management, social workers and occupational therapists, but needs the right number of supervisors to oversee their work

·             The Council is exploring using people from the voluntary sector with the right skills and training as part of the West Sussex Partners in Care Trusted Assessors for Care Homes model

·             When the Council outsourced services to Carers’ Support West Sussex, it retained responsibility for assessments meeting required standards

·             Independent contractors/care providers are monitored by the Care Quality Commission – domiciliary care is covered this way with all the Council’s contractors rated as either good or outstanding

·             If the Council hears of any concerns it feeds these back to the provider

·             The Council has a statement of works to co-produce work with Roretti consultants which is monitored by weekly informal meetings and monthly formal meetings to mitigate any identified risks and delays – this is fed through to the Improvement Assurance Board

·             The Council is working with partners on a programme to let the public know where they can go for support at the earliest opportunity rather than coming to adult social care at a later date

·             The Council is also developing a provider portal for quality concerns for partners, so they understand the difference between quality concerns and safeguarding issues so only the right concerns are reported to the safeguarding hub

·             Routes for care assessments will be made clearer through the early support strand of the improvement programme

26.3     Resolved – that the Committee requests: -

                i.    An updated report to be provided to the Committee at its meeting in March 2024

               ii.    Adults’ Services to advise if there are diagrams or flow charts available to demonstrate how Strength-based Oversight Group works with the smaller working groups as detailed in Paragraphs 1.6-1.8 of the report

Report by Director of Finance and Support Services.

The Committee is asked to review the County Council’s budget pressures, proposed budget reductions and Capital Programme for 2024/25 within the remit of this Committee.

Feedback from the Committee will be considered by Cabinet in preparing the final draft budget and Capital Programme 2024/25 that will be presented to County Council for approval in February 2024.

27.1     The Committee considered a report by the Director of Finance and Support Services and Director of Law and Assurance (copy appended to the signed minutes).

27.2     Summary of responses to members’ questions and comments: -

·         The Council has been working on a project called ‘The Great Care Employers Scheme’ which has released £170k in the budget by changing the way the Council supports care providers in the recruitment and retention of staff

·         The carers’ information, advice, assessment and support contract is ending – providers will now have more flexibility over how they deliver carer support and this may lead to a new provider working with the Council

·         Providers are responsible for their own staff, including recruitment and retention

·         There will be key performance indicators that measure the outcomes the Council is seeking in the new contract – the same level of support as before is expected meaning a 10% efficiency saving

·         The review of the Quality Practice and Development Team to refocus and prioritise assurance work around practice related to the improvement programme will be met by not filling vacancies

·         The saving for 2025-26 in the Commissioning Team is based on a need to increase its budget due to the amount of new work it will do over the next couple of years to support the delivery of the improvement programme. Once that is delivered, the amount of funding needed for the Commissioning Team can be reduced

·         The Council is reviewing its section 75 agreement with the NHS, this is commercially sensitive at the moment, so further information will come to the Committee in the future

·         The ‘Accelerated Reform Fund’ will give a one-off sum of money (£300k - £1m) to each integrated care area, one element of bidding for this money is around unpaid carers

·         There is no legislation to allow the Adult Social Care precept on Council Tax to continue beyond 2024-25 and the Council can only plan its budget around known factors

·         Information given to Members at the informal session on the budget will be made available to local MPs so that they see what pressures the Council will be under

27.3     Resolved – that the Committee requests: -

         i.        Advice on whether scrutiny ahead of the procurement award could be undertaken in relation to the decision on the care information, advice, assessment and support contract

        ii.        For further information to be provided on the review of commissioning contracts at an appropriate time to the Committee

This report sets out NHS Sussex’s plans relating to West Sussex residents highlighting any specific challenges and risks and how these are being addressed.

28.1     The Committee considered a report by NHS Sussex (copy appended to the signed minutes).

28.2     Summary of responses to members’ questions and comments: -

·           Sussex Partnership NHS Foundation Trust has an aim that no patient should wait more than three days for a bed, at the moment it is between seven and eight days

·           The current average length of stay in a mental health bed is 57 days, it is hoped to bring this down to 46 by maximising the use of havens, changing how crisis resolution teams operate, working with the local authority to implement discharge to assess beds and establishing community integrated teams

·           The High Intensity Users Programme has been successful in Brighton and a pilot is planned for West Sussex, but may not be the same as the two populations differ

·           Guidance for this year’s vaccination programme was delayed and more complicated than previous rounds

·           There have also been challenges at GP level which meant the flu vaccination couldn’t always be offered

·           365,000 vaccines have been delivered with flu take-up at 51% compared to 46% nationally

·           Mobile vaccination units will be used in Worthing and Chichester until 15 December

·           To increase uptake, translation services, community champions and free travel to vaccination centres in rural areas will be used

·           It is not known why the 111 services is used less in West Sussex than in other areas as it is encouraged

·           There is a coordinated communications plan for winter between health and care partners that includes signposting to the right services, encourages positive use of services and has information about supporting people to stay healthy and well

·           The communications plan also shares information about what the NHS is doing with a weekly focus on different themes - November focused on prevention, including vaccination, in December the focus will be operational plans

·           The plan uses mainstream media, social media, websites, partner newsletters and is working with the community and voluntary sector

·           NHS Sussex has received money from NHS England for a project in Arun to understand people's digital exclusion from health services and the barriers to health literacy by engaging with communities

·           The project has identified around 75 people who are being helped to develop proactive, personalised care plans. If successful, this programme could be rolled out across Sussex

·           There is an Access Recovery Plan to address primary care issues such as access, capacity and disparity by offering more appointments and triaging by a clinician using the modern GP model

·           Key themes for primary care are access, safe working in general practice, sufficient staff to meet demand and patients being empowered to self-help using technology where possible (e.g. cloud telephony) and self-referral pathways looking at utilising community services

·           Some GP practices are receiving support through an improvement programme to help them function more effectively

·           There are additional roles coming into practices and primary care networks, including training hub retentions, recruiting GPs and GP trainees

·           NHS Sussex is investing in estates in some current GP practices and will  ...  view the full minutes text for item 28.

Extract from the Forward Plan dated 7 November 2023 – attached.

An extract from any Forward Plan relevant to the Committee’s portfolio published between the date of despatch of the agenda and the date of the meeting will be tabled at the meeting.

The Committee is asked to consider whether it wishes to enquire into any of the forthcoming decisions within its portfolio.

29.1     Resolved – that the Committee notes the Forward Plan of Key Decisions.

The Committee to review its draft work programme taking into consideration the checklist at Appendix A.

30.1     Resolved – that the Committee asks for Primary Care to be considered at the next Business Planning Group meeting for possible inclusion in the Committee’s Work Programme.

The next meeting of the Committee will be held on 10 January 2024 at 10.30 am at County Hall, Chichester.  Probable agenda items include:

·         Sussex Health and Care People Plan

Any member wishing to place an item on the agenda for the meeting must notify the Director of Law and Assurance by 21 December 2023.

31.1    The next meeting of the Committee will be held on 10 January 2024 at 10.30 am at County Hall, Chichester.