Agenda and minutes

The Committee is asked to approve the co-opted membership of the Committee as set out below

Mr Boram (Adur District Council)

Mr Belsey (Mid Sussex District Council) To be confirmed.

Mr Bickers (Worthing Borough Council)

Mr Blampied (Arun District Council)

Mr Coldwell (Horsham District Council)

Mrs Neville (Chichester District Council)

Mrs Belben (Crawley Borough Council)

N.B. The Healthwatch West Sussex representative, Miss Russell, is an ongoing appointment.

1.1     Resolved – that the Committee approves the co-opted membership.

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.

2.1     The following interests were declared: -

·        Cllr Belsey declared a personal interest in respect of item 6 (Adults In-House Social Care Services ‘Choices for the Future’) as his wife is a Trustee of Age UK East Grinstead & District

·        Mr Turner declared a personal interest in respect of items 8 (Outturn Total Performance Monitor 2017/18) and 9 (Business Planning Group Report) as a pharmacist

The Committee is asked to agree the minutes of the meeting held on 8 March 2018 (cream paper).

3.1     Resolved - that the minutes of the meeting of the Health & Adult Social Care Select Committee held on 8 March 2018 be approved as a correct record and that they be signed by the Chairman.

An extract from the Forward Plan of Key Decisions dated 1 June 2018.

An updated extract will be tabled at the meeting and made available on the Internet if a subsequent edition of the Forward Plan affecting the Adults & Health portfolio is published between the date of despatch of the agenda and the date of the meeting.

The Committee is asked to identify any decisions to be previewed by it considering new entries from the latest extract of the Forward Plan of Key Decisions published since the its last meeting.

4.1     The Committee had questions over the decision for procurement of housing support services and learned that this was an extension to two existing contracts to help mental health patients find accommodation. The Council was working with the clinical commissioning groups to ensure people were discharged from hospital as soon as possible and aimed to meet targets by the end of the year.

4.2     Resolved - that the Business Planning Group look at this in more detail at its July meeting and that the Committee notes the Forward Plan of Key Decisions. (Post meeting note: The July meeting of the Business Planning Group was subsequently cancelled so this will be go to the October meeting).

A report by Executive Director for Children’s, Adults, Families, Health and Education (CAFHE) and Director of Adults Services.

The report outlines proposals by the County Council to deliver In-House Services to better meet the needs of people in West Sussex.

The Committee is asked to determine whether it wishes to support the proposals for the future model and configuration of Adults In House social care provision in West Sussex, taking into account the results of the engagement exercise, and provide any comment to the Cabinet Member for Adults and Health for consideration prior to a planned formal decision in July 2018.

5.1     The Committee considered a report by the Executive Director for Children, Adults, Families, Health and Education (copy appended to the signed minutes) which was introduced by Jana Burton, who highlighted the following: -

•    The Care Act stipulated that services needed to be modernised, be    more preventative and help people maintain their independence

•    West Sussex County Council still allocated a significant amount of      funding to in-house services compared to many other local authorities

•    Work had taken place over the last two years involving 800 people to       develop the proposals which were intended to be adaptable to           future needs

•    Not all feedback had been received as yet so the analysis which had been included in the report was incomplete, however all information      would be shared with members when available

5.2     Barry Poland, Operations Manager Provider Services, highlighted the following: -

•    There had been 11 reviews of in-house services over 10 years, but    none had considered bringing customer groups together to share       resources

•    Engagement had taken place with service users, families, carers and       organisations (including district/borough councils) over the past two years – from this, success factors had been developed that formed service principles and ‘Choices for the Future’ had been published in 2018

•    The aim was to maintain levels of service at the heart of local       communities whilst rationalising use of buildings as 55% of capacity was currently not used

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

•    The three service managers responsible for daily operations and       development were already in post so there would only be three new       posts

•    It would cost £15m to maintain services, but in five years residential       stock would be unfit for purpose, already there were eight vacancies           in learning disability accommodation due to inaccessible upper floor bedrooms

•    Services would still be offered to the same number of people (900)   but in fewer buildings with more community-based services which          would be tailored to need and could cope with increased demand

•    Service uptake often increased when there were good community       opportunities available

•    When the consultation was complete there would be a better idea of what people wanted

•    The use of personal budgets could also affect people’s choice of         service

•    Members had concerns over: -

Ø  evidenced support for the proposals by users and volunteers

Ø  the lack of consultation on specific proposals

Ø  a seemingly rushed implementation

Ø  mixing different user groups

Ø  the potential break-up of relationships between groups of service users and service users and staff

Ø  the proposals being buildings/finance-based not people-based

Ø  difficulties for people getting transport to different centres, especially in rural areas

Ø  closing centres leading to less choice of service

Ø  community services not being developed now in readiness for the changes

Ø  no consideration of a mix of out and in-house services

Ø  some services leaving large buildings for smaller ones with less customer transport available – Maidenbower to Deerswood/Burley’s Wood  ...  view the full minutes text for item 5.

A report by Executive Director Children, Adults, Families, Health and Education.

The report informs the Committee of how the improved Better Care Fund has been spent in the 2017/18 financial year.

The Health and Adult Social Care Select Committee is asked to:

i.            Review how the iBCF has been spent in the financial year 2017/18 and whether the outcomes achieved meet the intended use of the funding as set out in the grant conditions;

ii.           Agree that the Committee should reviewiBCF investment for the financial year 2018/19 in terms of outcomes achieved, scheme suitability and priority at a future meeting.

6.1     The Committee considered a report by the Executive Director, Children, Adults, Families, Health and Education (copy appended to the signed minutes) which was introduced by Martin Parker, Head of Integrated Adult Care Commissioning, who told the Committee the iBCF had three grant conditions: -

1.   Pool the grant funding into the local Better Care Fund (BCF) so it       comes within the Section 75 agreement that governs arrangements         of BCF spend

2.   Work with relevant clinical commissioning groups and providers to    meet the Integration and Better Care Fund National Condition 4         (Managing Transfers of Care), and

3.   Provide quarterly reports

•       There was a possibility that iBCF funding would be withdrawn, but this did not happen due to the good performance of the Council regarding Delayed Transfers of Care (DTOCs)

•       The iBCF has been used to: -

Ø  Support the Council to fulfil its Care Act duties to meet eligible assessed needs

Ø  Mitigate the risk of overspending in the Adult Social Care budget due to increased demand and complexity

Ø  Reduce the number of days people remain in hospital

Ø  Ensure that people have the appropriate care and support to meet their longer-term needs and remain independent in their own home

Ø  Support providers in the care market so as to prevent disruption to people receiving care

•       There is an uncommitted budget of £1.3m that the Council could have used to meet the adult social care overspend, however it has been agreed that the funding be taken forward to fund one-off adult social care costs that deliver system-wide benefits

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

•       A small amount of iBCF money had been used to create a small team responsible for working with providers to develop recruitment, retention and capacity plans and to identify and support providers with workforce training.

•       DTOC figures come out six weeks after the end of each month, the latest were for April which showed a slight increase – the Council was working with the clinical commissioning groups on year round resilience planning

•       Shortfalls in 2017/18 spending were as follows: -

Ø  Workforce development – £16k was spent on four recruitment campaigns, the balance was designated to create a small team that was not recruited until after the 17/18 financial year end.

Ø  Investment in occupational therapists – this was due to problems in recruitment (a campaign to recruit more occupational therapist had recently been launched)

Ø  Transfers from community health services – this was a two year plan for which costs were expected to be higher

Ø  Implementation of the High Impact Change Model – work is still ongoing with the three accident & emergency boards across the county to establish this

Ø  Lifelong conditions – work to review packages of care had started but would need  to continue into 2018/19 as will work to source appropriate services and managing underspends in the joint health and social care budget

•     The  ...  view the full minutes text for item 6.

Report by Director of Finance, Performance and Procurement.

This report concerns the end of year Total Performance Monitor outturn position for 2017/18 for the Adults & Health portfolio.

The Committee is invited to:

         i.        Examine the data and supporting commentary for the Outturn 2017-18 and make any relevant recommendations for action to the Cabinet Member

        ii.        Identify any issues for further scrutiny by this Committee

       iii.        Identify any strategic issues for referral to Performance and Finance Select Committee

7.1     The Committee considered a report by the Director Finance, Performance and Procurement (copy appended to the signed minutes) which was introduced by Chris Salt, Strategic Finance Business Partner, who told the Committee: -

•       The budget overspend of £0.5m was due to: -

Ø  Delays in delivering savings in disability-related expenditure

Ø  Lifelong Services

•     The overspend was managed corporately and it was expected that the savings will be delivered in future years

•     £2.5m from the improved Better Care Fund was used to support pressures on the budget

•     Of the seven performance targets, four were green, two amber and one, appropriate admissions to residential care, was red

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

•       There was disappointment at the level of detail provided in the Total Performance Monitor

•       Members queried whether the final early dementia diagnosis figures were available – ACTION: Chris Salt to check

•       Innovation sites had shown the direction of travel to reduce admissions to residential care homes and the Local Government Association peer review was leading to plans for stronger foundations

•       Residential/nursing care home figures had gone down due to less people presenting early, but with complex needs, meaning stays were shorter – numbers were less than in 2016

•       Information was available for those looking to arrange their own care

•       The figures attending memory assessments clinics in the Coastal West Sussex Clinical Commissioning Group area were lower than in the rest of the county and an action plan was in place to improve the situation

•       The Child and Adolescent Mental Health Service (CAMHS) was struggling capacity-wise, but the new Youth Emotional Support service was helping with only 3% of those who used it being referred on to CAMHS

7.3     Resolved - that the Committee: -

     i.        Asks the Cabinet Member to provide the Committee with the latest data regarding the dementia diagnosis rate

    ii.        Asks Coastal West Sussex Clinical Commissioning Group to provide detail regarding its Memory Assessment Service performance and action plan

  iii.        Asks the Performance & Finance Select Committee to  review the level of detail provided to individual select committees when reviewing the outturn Total Performance Monitor in future years

  iv.        Reviews investment and referrals into Children’s Mental Health Services at a future meeting

The report informs the Committee of the Business Planning Group meeting held on 21 May, setting out the key issues discussed.

The Committee is asked to endorse the contents of this report, and particularly the Committee’s Work Programme revised to reflect the Business Planning Group’s discussions (attached at Appendix A).

8.1     The Committee considered a report by the Chairman of the Business Planning Group (copy appended to the signed minutes) which was introduced by the Chairman who highlighted the following: -

·        A Home Office Select Committee report on the welfare of detainees in detention centres was due to be published in July – the Business Planning Group would await the outcome of this report before deciding if any further action was needed

·        South East Coast Ambulance Service NHS Foundation Trust would attend a future Committee meeting where its performance would be discussed

8.2     Resolved - that the Committee endorses the Business Planning Group’s report.

The Committee is asked to appoint five of its members to its Business Planning Group, to include the Chairman of the Committee and two minority party members.

9.1     Resolved – that the Committee agrees the appointment of the following members to its Business Planning Group, Mr Turner (Chairman), Dr Walsh (Vice Chairman), Mrs Arculus, Mr Petts and Mrs Smith.

Report by Director of Law and Assurance.

The report updates the Committee on meetings of the working groups since the Committee last met.

The Committee is asked to:

i.   Consider the detail of the notes attached to this report from the recent meetings of the BSUH and SECAmb regional working groups;

ii.  Note that the SECAmb Regional Working Group will cease to meet in future and the SECAmb representatives will attend future HASC meetings, when invited

ii. Highlight any particular issues that members wish the HASC representatives to raise at the next meeting of the BSUH regional working group.

10.1   The Chairman updated the Committee on the most recent meetings pointing out that BSUH had a plan to improve the culture of the organisation and that the Care Quality Commission was regularly checking its progress.

10.2 Resolved – that the Committee notes that the South East Coast Ambulance Service NHS Foundation Trust Working Group will cease to meet and that representatives from the Trust will attend future Committee meetings when invited.

The next meeting of the Committee is scheduled to take place on 27 September 2018 at 10.30 a.m. at County Hall, Chichester.

Any Member wishing to place an item on the agenda for this must notify the Director of Law and Assurance by 12 September 2018.

11.1   The next scheduled meeting is on 27 September County Hall, Chichester at 10.30.