Venue: Cabinet Suite - Shire Hall, Gloucester. View directions
Declaration of Interests
No additional declarations made.
Future meetings will provide an item for members to identify items for the work plan. A work-planning meeting has been arranged for 28 June 2019.
3.1 Members noted the terms of reference for the Committee as agreed by Constitution Committee. The committee had been established as a result of the Scrutiny Review undertaken by members.
3.2 The Committee had a work planning meeting scheduled for 28 June 2019 where members would have the opportunity to plan future agendas and identify the areas within their remit they would like to focus on. In addition to the regular Committee meetings, there would be joint meetings with the Health Overview and Scrutiny Committee for items that were cross cutting. It was suggested that a meeting be held in July with Health Scrutiny members to look at workforce planning.
3.3 At future Committee meetings, there would be a work plan item which would allow members to see the items that were coming up and to identify any additional work required.
Also attached for Member’ information is the Scrutiny Task Group report on examining the culture of the Fire and Rescue Service
4.1 Wayne Bowcock the Chief Fire Officer had been unable to attend the meeting so Mark Astle presented the report in his absence. This report had been considered in the past by Environment and Communities Scrutiny Committee and the same format was being presented to the Adult Social Care and Communities Scrutiny Committee. At work planning, members could discuss any revisions to the format and this would also be reviewed as part of the Chief Fire Officer’s consideration of the audit findings.
4.2 Members were informed that the HMICFRS Inspection team had visited the Fire and Rescue Service on the week commencing 8 April 2019 looking closely at systems and processes and speaking to teams and members of staff. There was a strategic briefing where the service had some positive feedback, as well as outlining some of the areas of improvement. The full inspection was undertaken on the week commencing 3 June 2019 which included focus groups and speaking to a large amount of frontline staff. The next step would be a report being published by the HMIC by the end of the year with a debrief prior to that on 13 June 2019. There would also be a wider report on ‘State of the Nation’ reflecting on other services and trends across the country.
4.3 One member asked for a
copy of the self-assessment that had been provided and asked who
was invited to the debrief on 13 June 2019 and whether this might
be a wider invite. In response it was stated that a copy of the
assessment would be provided to members. With regards to HMIC
briefing it was a small number of individuals to receive
‘bullet points’ without context. Once the document was
produced it would come back to the service so there was an
opportunity to challenge any inaccuracies. A response would be
provided as to whether it could be a wider invite.
4.4 The report also provided details of the Safer Firefighter programme, as well as a joint review of the civil protection team and an update on the work of the Community Safety Team.
4.5 In terms of the performance of the service, accidental dwelling fires continued to be a current concern with the 3rd quarter having seen an increase of 15 above target. Many of these fires were cooking and electrical related, staff continued to undertake Safe and Well visits highlighting safety in these areas. 77% of those visits were carried out to high risk groups. Quarter 4 showed an end of year total of 8058 visits, short of the aspirational target of 10,000. Nevertheless 78% of those visits were carried out to high risk groups.Prevention work around white goods was also important to help tackle the issue and in the fourth quarter there had been a decrease from 94 to 64 accidental dwelling fires.
4.6 In response to a question, it was explained that medical emergency was currently outside of the fire fighter role, but staff ... view the full minutes text for item 4.
Adult Single Programme
Members will receive a presentation at the meeting providing an overview of the programme.
5.1 Mark Branton, provided members with an overview of the Adult Single Programme. The strategic direction was outlined for members, which focussed on supporting people to live independently. This had been reinforced by the Care Act.
5.2 Local Authority responsibility was outlined which included broader community services as well as lower level intermediate care and long term bed based and home care.
5.3 The Committee was advised that greater emphasis was being placed on targeted interventions based in part on research carried out by the University of Newcastle into patterns of decline due to frailty. Although for some this might be a slow process with little support required until late in life for some the research showed more rapid early decline reducing independence and impacting on quality of life. It was important to be able to identify where on the decline curve an individual was in order to put together the right level of support and there was close working with both the public health team to identify this and with Health colleagues on delivering such interventions.
5.4 This work was part of the wider programme which consisted of over 80 projects aimed at delivering a modern adult social care fit for at least the next ten years, moving from a service model subject to meeting criteria thresholds to a model that prevents people entering care unnecessarily, reducing dependency and delaying people entering social care sooner than necessary. The aim was to manage demand for better outcomes within budget.
5.5 Members understood the components of ‘the offer’ which reflected the variety included and recognised the value of community as well as integration with health and adult social care.
5.6 The programme was built into clusters in order to structure the work. This included:
· Population health management
· Information and advice
· Enhance independence offer
· Practice development
· Contract and market management
5.7 It was explained that this was based on a three tier approach. At tier one it was about having ‘something for everyone’, tier two was about providing help when it was needed and tier three was about ongoing support for those who needed it. This included conversations about helping individuals to help themselves by listening and connecting with them. At a later stage the conversation would be about working intensively with people who were in crisis and then about building a good life.
5.8 It was explained that the next step was turning the conversations into better ones to enable greater connection and impact. This was a change in mind set and behaviours not merely about processes and forms and working with people not doing things ‘to’ people. The emphasis was on ‘lives’ becoming what matters, less about ‘services. There were a new set of expectations which were clear and uncompromising with a focus on well-being.
5.9 The Cabinet Member, Cllr Roger Wilson, emphasised the importance of culture change outlining that the Adult Social Care team had worked hard over the previous two years with a focus ... view the full minutes text for item 5.
6.1 Margaret Willcox, Director of Adult Social Care, introduced the report which provided an update of the relevant services including key activity and challenges. Members noted the update of the implementation of Liquid Logic Adults System with the proposed date for going live July 2020. In addition, the Committee were informed of the new criteria relating to Blue Badge Eligibility which would be implemented in August. The report contained further information regarding eligibility and how that would be assessed. The County Council was in the process of finalising the local authority guidance.
6.2 The Committee understood that the new provider of the Adults element of the carers support contract was now operational. The service was called the Gloucestershire Carers Hub provided by People Plus, with the main hub based in Gloucester City Centre. The transition to the new provider had gone well with many staff TUPE’d across so their skills and experience was not lost. There had been no complaints during the transition. A sample was being carried out on satisfaction around the new service.
6.3 It was explained that Proud to Care Gloucestershire worked closely with local Providers and the Local Workforce Action Board on long term recruitment and retention strategies for the care sector. The focus was on recruiting into Domiciliary Care.
7.1 The Committee noted the performance report which reflected performance at quarter 4 for 2018/19. This report had been produced for the Health and Care Overview and Scrutiny Committee which had previously had responsibility for it and was coming to the Adult Social Care and Communities Scrutiny Committee to close the financial year.
7.2 One member had a query
around the indicator for permanent admissions aged 65+ to
residential and nursing care homes per 100,000, it was suggested
that the total figures were inconsistent with the client group
breakdown. Clarity would be sought around this area.
7.3 Members stated that they would welcome a performance workshop to help the committee to understand the performance indicators detailed and improve their understanding of the reports.
ACTION Lead Members
7.4 In response to a concern about performance on reablement and enablement care, it was explained that the service was working with a view to develop the reablement service with a paper going to Cabinet looking at community and bed based reablement. A lot of staff in the community area had been lost and so investment would be diverted across to this area to build up the service.
7.5 Members noted that the
number of nursing care clients had reduced. The plan had been to
reduce the amount of placements that were made and offer
alternatives to stay in the community. Although improvement had
been achieved this was not to the level indicated in the report so
the detail would need to be checked. It was suggested there was
also an inconsistency in the use of symbols. One member suggested
that numbers should be provided alongside percentages so the
committee could understand the number of peoples being affected. An
alternative report would be shown at work planning.
8.1 Sarah Scott, Director of Public Health introduced the report explaining that there was a commissioning role for services such as sexual health, healthy lifestyles as well as a role in supporting people in vulnerable circumstances. A lot of work was carried around with the Health and Wellbeing Board and working with partners particularly on the integrated care service.
8.2 Members noted the publication of the 2018 Gloucestershire Online Pupil Survey. The report provided a summary of the main findings and over the next two years the service would be taking an in-depth look at the results, including publication of ‘deep dives’.
8.3 The Health and Care
Overview and Scrutiny Committee had previously queried attendances
of sexual health services in Gloucestershire by over 60s. The
response had been included in the report outlining that only 3% of
attendances in 2017 were among the over 60s. Overall diagnosis of
STIs remained relatively low in older age groups and attendances at
the service in Gloucestershire was highest among the 15-24 year
olds age group. One member requested a list of where those services
were being offered.
8.4 Members noted that following a successful bid for central government funding, two Somewhere Safe to Stay hubs had been set up to help people sleeping rough move away from a life on the streets for good. The hubs had been operating since March and had already supported a number of rough sleepers access accommodation.
8.5 The new Gloucestershire Joint Health and Wellbeing Strategy had been presented in draft form to the Health and Wellbeing Board on 14 May. This had been developed through community and wider stakeholder engagement.
8.6 Members understood that work had been carried out by the Public Health team to develop support for local planning authorities to maximise health benefits and minimise or avoid the negative impacts of development. A draft framework had been developed setting out consistent guidelines.
8.7 Members were informed that the staff influenza vaccination programme in Gloucestershire County Council had continued to grow. Work was being carried out with the CCG around three key programmes to improve care home resilience. Details were included in the report. In addition, this season 1,700 employees had been vaccinated, more than three times the number who accepted the vaccine 2 years previously.
8.8 One member commented on
the somewhere safe to stay hub stating that he would be interested
in a report being received by the Committee going into more detail
as to what had been done in Cheltenham and Gloucester. One member
stated that the hub provided a good example of the issue of
homelessness being taken seriously and suggested that a visit be
set up so that members could visit the hub.
8.9 There was a detailed discussion around the ‘capacity’ of individuals who chose to live on the streets and the framework that was in place to help support them and assess their capacity to make that decision.
8.10 One member suggested that ... view the full minutes text for item 8.
9.1 The Committee received the 4th quarter performance report for public health 2018/19 which had originally been produced for Health and Care Overview and Scrutiny Committee. This included a proportion of the services provided linked to the priorities of the service and integrated care model.
9.2 With regards to a question on vaping this was a live debate and there were studies being released regularly. The current position was that vaping was better than smoking where there were established links to ill health. If an individual wanted to quit smoking using vaping they would be supported in that.
9.3 It was explained that the latest data around sexually transmitted infections would be provided in the next performance report. There was a debate as to whether there was an increase in occurrences or whether there were now better services in place to help detect it. Members were provided with the details of the success of self-testing kits particularly with regards to chlamydia
9.4 One member suggested that
it would be helpful to see that services were targeting areas of
deprivation and those who were most vulnerable and that a breakdown
of the figures by district would be helpful. It was explained that
the data was not routinely captured on that basis. All services had
been redesigned to tackle inequalities with the example around the
targeted work relating to sexual health. The Director would come
back to the committee as to the best way to demonstrate that
9.5 One member stated the importance of scrutiny being involved in policy development and that the scrutiny committee should not be seen as being ‘backward looking’. He quoted from the LGA that:
‘In many councils, scrutiny has built up a reputation as a strong voice in the policy development process as a place where ideas for improvement can be debated and evaluated…it can act as a constructive critical friend and can have significant influence over policy’