Agenda and minutes

To note any apologies for absence.

Apologies were received from Cllr Lisa Spivey (Vice-Chair).

To advise of any declarations of interest relating to matters for discussion at the meeting.

No declarations of interest were made at the meeting.

To confirm and agree the minutes of the meeting held on 6 September 2022

The minutes of the meeting held on 6 September 2022 were confirmed and agreed as a correct record of that meeting.

The Director of Public Health to present the Public Health Annual Report 2022/23.

The title of the report is ‘No Person is an Island: Social Connections in Gloucestershire’.

Siobhan Farmer, Director of Public Health for Gloucestershire, presented the Director of Public Health Annual Report 2022/23. The theme of the report for this year is ‘No Person is an Island: Social Connections in Gloucestershire’.

In her first annual report, the Director of Public Health, referred to the attached power-point presentation and highlighted the importance of social connections for good health and wellbeing. She explained that the report relayed some of the challenges that had been experienced to maintain social connections during the pandemic, and how this led to an increase in social isolation and loneliness. The report also provided an opportunity to showcase examples of work and activities to bring people together in Gloucestershire and made recommendations of proposed actions for individuals, communities and organisations to take forward to ensure Gloucestershire was a place which enabled connections.

Referring to the challenges experienced during the past three years, and specifically during the pandemic, it was estimated that over a million more adults throughout the UK had become chronically lonely during this time, impacting on young people, people living alone, people on low incomes or unemployed and people with mental health conditions. Despite the beginnings of recovery from the pandemic, the past year, (2022), had presented further challenges for many people. The war in Ukraine, the rising cost of living and the subsequent pressures on services that provide help to people, has emphasised the importance of the need to support one another other and to maintain social links and networks to keep everyone healthy and resilient.

It was reported that the impact on connecting had been witnessed across all ages and within all socioeconomic groups, although some groups had been more disproportionally affected than others, including children and younger people. It was suggested that, reduced opportunities to socialise with their peers had significantly contributed to feelings of loneliness amongst children and young people in Gloucestershire. Roughly a third of the students who had completed the Gloucestershire Pupil Wellbeing Survey during 2021-22 had indicated that the pandemic had adversely affected their wellbeing. Whilst impacting on the lives of every child in the country, the pandemic was likely to have had a particularly harmful impact on the estimated four million children and young people already living in poverty in the UK. On a more positive note, the pandemic had also brought new and innovative methods of communication, and had rallied communities into taking action to build on the benefits and values of increased social interaction.

Expanding on the differences between isolation and loneliness, it was explained that a lack of meaningful social connections can often lead to social isolation and loneliness. The words “social isolation” and “loneliness” are often used interchangeably, but are not the same thing. Social isolation is defined as ‘an objective state determined by the quantity of social relationships and contacts between individuals, across groups and communities.’ Loneliness can be defined as ‘a subjective state, based on a person’s emotional perception of the number and/or quality of social connections they  ...  view the full minutes text for item 4.

Paul Yeatman, Independent Chair of the Gloucestershire Safeguarding Adults Board, and Sarah Jasper, Head of Safeguarding (Adults) at Gloucestershire County Council to present the Gloucestershire Safeguarding Adults Board GSAB Annual Report 2021/2022.

Paul Yeatman, Independent Chair of the Gloucestershire Safeguarding Adults Board, and Sarah Jasper, Head of Safeguarding (Adults) at Gloucestershire County Council, introduced the Gloucestershire Safeguarding Adults Board GSAB Annual Report 2021/2022.

The report is produced as a statutory requirement of the Care Act 2014 and covers the period April 2021 to March 2022.

Referring to the challenges the Gloucestershire safeguarding partnership had experienced during the past year, members were informed that work to ensure the safety and well-being of adults with care and support needs continued. Although circumstances were far from normal and the partnership continued to operate in a pressured environment during the recovery period from the COVID-19 pandemic, efforts were being made to establish a “new” normal approach to the work.

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In line with the current national position, the Gloucestershire Health and Social Care Systems has experienced unprecedented demand during the past year, and at the same time, had to cope with the challenge of staff isolating due to COVID, and current difficulties in the retention and recruitment of staff.

It was explained that, owing to a number of factors, the Gloucestershire systems have experienced an ever-increasing volume and complexity of safeguarding issues, many of which related to individuals experiencing severe and multiple disadvantages, including homelessness, contact with the criminal justice system, substance misuse, sex working and mental health. This was evidenced in a number of Safeguarding Adults Reviews (SARs).

In spite of the challenges of the past year, the Gloucestershire Safeguarding Adults Board has continued to maintain focus from a virtual system based approach, striving to deliver the objectives of the extended 3-year Strategic Plan 2018-2021: Improving Effectiveness of the Board, Improving Safeguarding Practice, Preventative Strategies and Making Safeguarding Personal. The Board has recently launched a new 3-year Strategic plan 2022-2025, with new and clear priorities for the next few years.

Another statutory requirement of the Gloucestershire Safeguarding Board is to commission Safeguarding Adults Reviews (SAR’s), set against certain criteria. During 2020/2021, the Board received 6 referrals from undertaking SAR’s, of which one was proceeding to further review and another as a learning event. Three completed SARs were published during the past year.

The Safeguarding Board Sub Group continued to oversee implementation work on the recommendations of the three published SARs in order to ensure service improvements are embedded and maintained. The Sub Group also continued to respond to the findings and recommendations of the first National Analysis of Safeguarding Adults Reviews in England, undertaken to consider all published reviews during the period April 2017- March 2019, including those submitted by the Gloucestershire Safeguarding Adults Board.

Throughout the past year, the Workforce Development Group has continued to respond to ongoing challenges to recruitment and retention, with 12,478 Gloucestershire staff, (including volunteers), undertaking GSAB approved Safeguarding and Mental Capacity Act (MCA) courses. Some of the training was able to be delivered on a face-to-face basis during the final few months. It was noted that, moving forward, training would be delivered from a ‘blended’ approach due to  ...  view the full minutes text for item 5.

A report from the Director of Public Health (Gloucestershire County Council)

The committee received an update from the Director of Public Health.

To view the information report circulated with the agenda, please refer to the link here.

Members recalled that, at the Full Council meeting on 9 November 2022, the council had considered a motion relating to concerns about the quality and cost of dentistry in Gloucestershire and on the principle that every Gloucestershire resident had the right to ‘good oral hygiene’ at affordable NHS rates. As part of the motion, the Council had asked the Gloucestershire Health and Wellbeing Board and the Director of Public Health to give an update on activities to promote oral health hygiene to the Gloucestershire Health Overview and Scrutiny Committee (HOSC).

The committee was informed that a report would be presented at the HOSC meeting on 31 January 2023, with specific focus on what was being done to promote good oral hygiene amongst children and young people. The report would be presented alongside a report from NHS England colleagues on access to dental treatment services. The oral health promotion report and the NHS dentistry report can be viewed here.

Detailed updates on Childhood Obesity Levels in Gloucestershire and on the National Child Measurement Programme were provided. The National Child Measurement Programme (NCMP) measures the height and weight of children in reception class, (children aged 4 to 5), and in year 6, (children aged 10 to 11), in state schools across England every year. Trained nurses take the measurements, which are used to calculate a child-specific BMI score based on the child’s age and gender.

Data from the programme details the proportion of children who are an unhealthy weight in England and within each region and county. The data is used to plan and develop services for children and families.

Data relating to obesity levels during the 2021/22 academic school year was published in December 2022, (the first full year of data collection since the start of the Covid-19 pandemic), with reports identifying a significant increase in levels of obesity and severe obesity during this period, in comparison to pre-pandemic levels. Recent data indicated a decrease in obesity levels in comparison to this time last year, but, nevertheless, rates remain significantly higher than pre-pandemic levels for Year 6 children, (aged 10 to 11 years).

Data for Gloucestershire is in line with national trends, with early signs of increasing obesity prevalence across the county. Such trends are often associated with poverty and health inequality.It was noted that Year 6 obesity levels for the county are significantly lower than the English averages, but remain a concern.

Later in the meeting, a member reiterated concerns about obesity levels in young children and proposed that the committee monitor the situation. It was agreed more work was required, including work to commission a specialist service following a cabinet decision in September 2022 to tender for a provider to deliver a countywide healthier lifestyles, (healthy weight), service for children and young people aged 4-17 years old, (up to 25  ...  view the full minutes text for item 6.

A report from the Executive Director of Adult Social Care, Wellbeing and Communities.

The committee received an update from the Executive Director of Adult Social Care, Wellbeing and Communities, on matters relating to the delivery of Adult Social Care in Gloucestershire. To view the information report presented at the meeting, please refer to the link here

Members attention was drawn to the Government’s Autumn Statement and to the two year delay to progress the Care Act Reform. In spite of the delay, work to prepare for the Care Quality Commission (CQC) assessment of local authorities and Integrated Care Systems, (effective from 1 April 2023), and to ensure the government’s adult social care reform linked with the council’s Transformation Programme continued. The Transformation Programme, at this date in the programme, was directed at improving efficiencies, productivity and performance from the refining of existing operating models and from the implementation of advanced digital solutions. A report on the actions being taken to prepare for CQC Assessment would be presented to the committee at its meeting on 7 March 2023.

It was confirmed that the ‘fair cost of care exercise’ the council had been required to undertake had been submitted on 14 October 2022. The Market Sustainability Plan, detailing activities on how the council intended to progress the outcomes of the exercise and ensure a fair cost of care, (if not already paid), had been produced. The results of the cost of care exercise had been submitted within the given timescales and in accordance with the prescribed format. It was anticipated that the outcomes and analysis of data from the exercise, (analysed within a local context), would be released in early February 2023.

Members received an update on the cabinet decision taken in July 2022, relating to the decommissioning of four care homes within the Gloucestershire Care Partnership. All residents had vacated the care homes in August 2022. The care homes were now in the ownership of the council and being considered for future use. 

Details of the move to initiate a hyper localised model of commissioning domiciliary care were noted. Members supported the move and agreed the new approach was a positive one. Members acknowledged the demands on the care system and supported the work being applied to provide more quality care for those in need, including people with dementia.

The report was noted.

An update on matters relating to the portfolio of services delivered by the Chief Fire Officer, (Gloucestershire Fire and Rescue Service), and within the remit of the Gloucestershire County Council’s Adult Social Care and Communities Scrutiny Committee, (Trading Standards, Civil Protection and Coroners Services).

The committee received a detailed overview of matters relating to the delivery of services within the portfolio of services covered by the Chief Fire Officer, (Gloucestershire Fire and Rescue Service), and within the remit of the Gloucestershire County Council Adult Social Care and Communities Scrutiny Committee, (Trading Standards, Civil Protection and Coroners Services).

To view the full report, please open the link here

A member enquired into what actions were being taken to address cultural differences in people taking refuge in the county and the impact this might have on the work of the Trading Standards Team. The member asked that a briefing be included in a report to the committee at a future meeting and the request was noted.

The member also requested more detailed information on the Gloucestershire County Council Critical Incident Plan, (guidance on coordinating the County Councils’ response to a critical incident/impact on service delivery).

Cllr Terry Hale reiterated strong concerns about the welfare and risks associated with free roaming sheep in the Forest of Dean District and of the lack of progress in arranging a meeting with representatives from each of the statutory organisations responsible for the welfare and safety of the sheep. Expressing his continued frustration, Cllr Hale asked that the Chief Fire Officer consider what action might be undertaken by the Trading Standards Team to address the situation. The Chief Fire Officer agreed to investigate the matter and report back to Cllr Hale. 

The report was noted.

To note the Adult Social Care Quarter 2 (2021/22) Performance Scorecard Report.

The committee considered a detailed analysis of performance relating to the delivery of services within the remit of the Adult Social Care and Communities Scrutiny Committee. The analysis was produced by the County Council’s Performance & Improvement Team, based on data to the end of September 2022.

Healthwatch Gloucestershire questioned the lack of matrix data recorded in the performance report and enquired whether the data would be available in the future? It was explained that, during the Pandemic, it had been necessary to take a different approach to the collection and reporting of data. It was agreed that this may now be an opportunity to re-evaluate the position.

A member questioned some of the target symbols referred to in the report, including those recorded against child obesity targets. It was agreed to review, and where necessary, amend the symbols.

The information was noted.

To suggest items for consideration at future meetings.

The committee work plan was noted.

At the Corporate Overview and Scrutiny Committee meeting on 7 December 2022, the committee agreed to make a recommendation to the Adult Social Care and Communities Scrutiny Committee (ASCC) asking that it ‘consider the possibility of establishing a scrutiny task group to look at social care staff shortages and retention, (subject to whether the issue was already being considered as part of the committee work plan)’.

As a member of the Corporate Overview and Scrutiny Committee and as Chair of the Adult Social Care and Communities Scrutiny Committee, Cllr Stephan Fifield, requested that officers produce a briefing note for consideration at this meeting regarding the Recruitment and Retention of Staff in the Independent Sector. The briefing note circulated prior to the meeting can be viewed here.

Members noted the information and agreed to continue to receive periodical updates regarding the ‘recruitment and retention of staff in the independent sector’ as part of the regular committee information reporting process. Chair of the Committee, Cllr Stephan Fifield, suggested that the issue be the subject of a twice yearly review by the committee, and this was agreed. The reviews to be supplemented by relevant updates, as and when required, including the reporting of specific data by the Executive Director of Adult Social Care, Wellbeing and Communities.

The suggestion was supported by the committee, with a request that Cllr Fifield report the outcome of the committee’s decision to the Corporate Overview and Scrutiny Committee at its meeting on 28 February 2023, (in addition to any future updates that might be appropriate to report to the Corporate Scrutiny Committee).

The dates of meetings pre possible changes in the membership of the committee were confirmed as: -

7 March 2023

16 May 2023

The dates of meetings for the rest of the year were confirmed as:

18 July 2023

12 September 2023

14 November 2023