Agenda and minutes

No apologies.

To agree the minutes of the meeting held on 7 July 2020.

The minutes of the meeting held on 7 July 2020 were confirmed as a correct record of that meeting.

The minutes will be signed as confirmation of their approval at a later date.

No declarations of interest were made at the meeting.

To consider a joint report on COVID-19 testing in care homes, including amongst domiciliary care workers.

The committee received an update from the Executive Director of Adult Social Care at Gloucestershire County Council and the Director of Public Health outlining the county’s response to the Covid-19 pandemic in care homes and in relation to domiciliary care in Gloucestershire. 

The update included information on the Adult Social Care Infection Control Fund, NHS discharges to care homes, the care home ‘lookback exercise’ agreed at the previous scrutiny committee meeting, care home visiting arrangements, day trip and day centre guidance and Covid-19 testing in care homes and domiciliary care settings. The Gloucestershire Weekly COVID-19 Summary report, based on data reported between 24 and 30 August 2020 and available daily data up to 1 September 2020 was also considered at the meeting.

4.1 The Adult Social Care Infection Control Fund constituted £600 million funding nationally. The primary purpose of the fund was to support adult social care providers, (including those not contracted to the local authority), to reduce the rate of COVID-19 transmission in and between care homes and support wider workforce resilience.

4.2 Whilst most care providers would have preferred to have allocated the funding towards the purchase of PPE, this was not permitted. Grant condition specifications regulated that at least 75% of the funding would be required to be spent on COVID-19 infection control measures in Care Homes, but not for the purchase of PPE. The remaining 25% to be used on other infection control measures, including the purchase of PPE, and for the wider care market.

4.3 Care homes were obliged to sign up to the requirements of a National Capacity Tracking System and submit data in order to qualify/receive funds during the second tranche of funding.

4.4 A small percentage of the funding could be used to support domiciliary care providers and support wider workforce resilience to deal with COVID-19 infections.

4.5 In Gloucestershire, funding was allocated to care providers under the auspices of a grant agreement. Once completed, the grant agreement apportioned the 75% portion of funding to care providers based on the number of beds stipulated by the Care Quality Commission (CQC) list received from Central Government.

4.6 During the first tranche of funding, 188 care home providers received funding. The 25% portion of funding was allocated to domiciliary care providers, comprising 68 care providers.

4.7 During the second tranche of funding, 191 care home providers received a share of the 75% funding proportion. At the time of the meeting, the 25% portion of funding was being dispensed to 68 domiciliary care providers and 52 supported living providers.

4.8 Two pots of funding remained unallocated. Approximately £400,000 of funding not dispensed during the first tranche of funding, (the 25% allocation), had been identified to fund the Gloucestershire flu vaccination programme for care workers. The Executive Director: Adult Social Care explained that, to deliver the flu vaccination programme in all settings, (including administering the vaccine to staff at the care home work place), was anticipated to achieve a better response than care  ...  view the full minutes text for item 4.

The Executive Director of Adult Social Care gave an update on the delivery of Adult Social Care, including the work of the Gloucestershire Partnership Board during the early months of the COVID-19 crisis.

The following points were raised at the meeting.

5.1 Good attendance at a Zoom held Partnership Board meeting had produced positive outcomes. Common issues had been identified in relation to the support and need required in response to COVID-19. Many of the voluntary organisations involved in the partnership arrangement had worked tirelessly to provide support to the various partnership boards, enabling them to feed into the county’s emergency command structure rapidly and effectively.

5.2 Inequalities for people with disabilities and mental health conditions had heightened during the pandemic, the impacts of which could not be underestimated. People living alone and people with disabilities, who, until the lockdown, had coped with living independently supplemented from the support of external support services, were now experiencing feelings of isolation and finding it difficult to cope.

5.3 Care would need to be taken to protect the mental health of care workers and to prevent exhaustion from the new work regimes.

5.4 All of the council’s day care/respite centres had re-opened but were experiencing a notable reduction, (about a third), in the number of visitors. It was suggested that former visitors to day centres were now seeking alternative routes to how they received care.

5.5 It was ‘business as usual’ for the Deprivation of Liberty Safeguards Service, with practitioners having to carry out assessments remotely due to not being able to visit care homes. The Department of Health and Social Care had confirmed April 2022 as the new date for the implementation of the Liberty Protection Safeguards Service, (replacing the DoLS system). Originally due to commence in October 2020, this was considered no longer  realistic pending the demands being placed on the service by the pandemic.

5.6 During the early stages of the pandemic, the Safeguarding Team had experienced a significant increase in the number of referrals received from residential homes, from Gloucestershire Police, the South West Ambulance Service and concerns raised by friends and family. This was now beginning to settle. In terms of the types of abuse that had been reported, domestic abuse concerns had increased to104, (compared to 77 for the same period last year), as had reports of self-neglect, (82 compared to 38). The safeguarding team intended to review the referral process for adult referrals to gain a better understanding of the reasons for the increase.

5.7 Responding to questions about the impact of the pandemic on decisions to place relatives in care homes, it was confirmed that there had been a notable reduction in the number of beds occupied in care homes and a steady increase in the need for domiciliary care. This reflected both local and national trends. Conscious that the care being provided by care homes is different to that provided by hospitals, it was reported that the demands placed on staff during the pandemic  ...  view the full minutes text for item 5.

To include an update on Homelessness.

Director of Public Health, Sarah Scott, gave an update on the information presented to the committee on 7 July 2020. The information presented at that meeting can be viewed here

6.1 The report presented at today’s meeting provided further information on the work of the multi-agency Rough Sleeper and Homelessness COVID-19 Cell and Strategic Housing Partnership (SHP). It was explained that the work undertaken under this arrangement would ensure a county wide response to the pandemic, the sharing of resources and the ability to deliver the right options to individual clients, irrespective of administrative boundaries.  It also aimed to ensure rough sleepers, and those at imminent risk of rough sleeping, would be given the opportunity to self-isolate and mitigate the risk of infection as a result of COVID-19.

6.2 The report explained that Leadership Gloucestershire, specifically Chief Executive Officers and the Managing Directors of the 7 District/Borough Councils and Gloucestershire County Council, had tasked Strategic Directors to oversight this work. The report included the following statement to outline the strategic intent from which the Directors would be guided:

‘We will focus on and prioritise those individuals we have housed through the Covid-19 pandemic who are vulnerable and those with entrenched homelessness, and ensure they have access to suitable move-on accommodation. We will not lose sight of the broader context of our housing needs across the County and will seek to provide options for the current cohort which will serve the housing system in the longer term’.

6.3 Referring to the services commissioned to provide community and accommodation-based support (Appendix A) and the homeless pathway developed for Gloucestershire (Appendix B), the Director of Public Health confirmed that, with the extra services in place and the easing of lockdown restrictions in recent weeks, the number of people verified as rough sleeping had further reduced from that stated in the report, (from 34 to 22). It was explained that the number was liable to fluctuate periodically.

.

6.4 Concerns were raised about the impact of the pandemic on the numbers of mental health referrals and people self harming. Acknowledging the concerns, the Director of Public Health agreed to include a specific section on mental wellbeing and an update on suicide rates in her next report to the committee. Action by - Sarah Scott

The Director of Public Health’s report was noted

Chief Fire Officer, Wayne Bowcock, gave an update on matters relating to the delivery of key service provision within his portfolio of services, (Gloucestershire Fire and Rescue Service, Trading Standards, Civil Protection and Coroners Services). The update included an overview of issues emerging from the recent COVID-19 emergency.

The Chief Fire Officer highlighted the following points: -

Gloucestershire Fire and Rescue

7.1HMICFRS (Inspectorate of Constabulary and Fire and Rescue Services)

Following publication of the Gloucestershire Fire and Rescue Service (GFRS) HMICFRS report on 17 December 2019, HMICFRS had published the National State of Fire & Rescue 2019, along with the Public Perceptions of Fire and Rescue Services 2019 report.

Delayed due to the COVID-19 emergency, it is hoped the inspection process would resume as quickly as possible. A virtual re-inspection assessment, (COVID-19 related), was anticipated in the Autumn, (anticipated to last two weeks).

A Local Government Association (LGA) Peer Review of the GFRS scheduled in June 2020 had been postponed until later in the year. It is hoped a revised date for the review would be re-arranged in early October.

Earlier in the year, HMICFRS had commissioned a material assessment of GFRS’s response to the pandemic. The assessment had considered the work of the GFRS in maintaining fire safety, plus work undertaken to assist and provide community support to the county during the COVID-19 emergency. It was felt the outcomes of the assessment in assessing the use of resources when applied to supporting other blue light services and in collaboration with GCC’s response to the pandemic would be useful.

A COVID-19 staff survey had been circulated to all GFRS staff.

Significant progress had been made to increasing the size of the GFRS team, including the appointment of two Grade 7 qualification posts. The development/recruitment of officers with Grade 1 to 4 qualifications would continue in 2021.  

7.2Improvement Board

To ensure robust monitoring of the actions culminating from the HMI inspection report, an Improvement Board (IB) had been established in December 2019. Once ratified, are then forwarded to the GCC Audit, Risk and Assurance Team. Updating the information within the report, the Chief Fire Officer confirmed that a total of 36 of the 124 audit actions remained outstanding. The 36 outstanding actions were currently awaiting further input or work from other departments within GCC. A full update will be presented to the committee at the January meeting. Action by – Wayne Bowcock

7.3Business Planning

A one-year extension to the current Integrated Risk Management Plan (IRMP) was approved in July 2020. The decision authorised the extension of the current IRMP 2018 - 2021 for a further year, supported by a one year IRMP Action Plan for 2021 - 22. A three year IRMP from 2022 – 25 will be produced to run concurrent with the GCC Council Strategy. It was felt this was the most practical, sensible approach given the current circumstances.

A workshop on 7 September 2020 had been held to consider/develop the  ...  view the full minutes text for item 7.

The Adult Social Care Performance Report (Quarter 1) was taken as read and noted at the meeting. Following on from the updates that had been presented earlier in the meeting, it was suggested performance reports at future meetings be considered alongside further updates to the committee, incorporating the council’s response to the COVID-19 emergency.

No questions were put to Cabinet Members, Cllr Carole Allaway Martin, Tim Harman and Dave Norman.

In response to concerns about the impact of the COVID-19 pandemic on the county’s suicide rates, it was agreed the Director of Public Health would provide an update at the next meeting, to incorporate as part of the Director of Public Health’s report to the committee. Action by – Sarah Scott

To review the Committee work plan for 2020/21 (work plan attached).

The work plan circulated with the agenda was noted.

10 November 2020

In addition to the standard directorate reports, the items included on the work plan for consideration at the committee meeting on 10 November 2020, included: -

a)    Public Health Annual Report - Domestic Abuse (Director of Public Health)

b)    Long term viability of care homes and domiciliary care providers (Executive Director of Adult Social Care)

c)    Quarter 2 2020/21 Performance Report

The Director of Public Health, Sarah Scott, informed the committee that the Public Health Annual Report Domestic Abuse item would be updated to include the impact of the COVID-19 Pandemic.

At the meeting itself, it was suggested the following items be added to the work plan for the November 2020 meeting:

d)    Mental Health Services Update – to include the impact of the COVID-19 pandemic on the county’s suicide rates

e)    COVID-19 Public Data – Update

The following items were suggested as items for consideration at future meetings:

28 January 2021

GFRS Business Continuity Management Plan Update

16 March 2021

Cabinet Member for Public Protection, Cllr Dave Norman, advised the committee that the Road Safety Cabinet Panel report scheduled for consideration at the committee meeting on 16 March 2021 had been delayed due the panel not meeting during the recent COVID-19 pandemic. The first meeting of the panel would not be held until late September/October 2020. It was therefore agreed that the panel report would be considered at a later meeting.

Notes:

1)    Scrutiny budget planning meetings (budget 2021/22) would be subject to national updates/government announcements;

2)    The impact of recent changes to Public Health England to be considered pending further announcements/updates. If current functions continued to perform successfully under the current arrangement, it was not anticipated that this would be a matter for concern.

3)    It was suggested that the committee work plan should be re-visited by members and officers to consider the relevance of some of the more historic items and this was agreed.