Agenda and minutes

To receive any apologies for absence

Apologies for absence were submitted from Graham Ebers, Councillor Charles Margetts and Susan Parsonage.

To confirm the Minutes of the Meeting held on 14 December 2023.

The Minutes of the meeting of the Board held on 14 December 2023 were confirmed as a correct record and signed by the Chair.

To receive any declarations of interest

There were no declarations of interest.

To answer any public questions

A period of 30 minutes will be allowed for members of the public to ask questions submitted under notice.

The Council welcomes questions from members of the public about the work of this Board.

Subject to meeting certain timescales, questions can relate to general issues concerned with the work of the Board or an item which is on the Agenda for this meeting.  For full details of the procedure for submitting questions please contact the Democratic Services Section on the numbers given below or go to www.wokingham.gov.uk/publicquestions

There were no public questions.

To answer any member questions

There were no Member questions.

To receive the West of Berkshire Safeguarding Adults Board Annual Report 2022-23.

The Board received the West of Berkshire Safeguarding Adults Board Annual Report 2022-23.

·       During the discussion of this item the following points were made:

·       Professor Brown, Chair of the Board, stated that the Board was working well with the voluntary sector.  There was a desire to work more closely with other partnership boards such as Health and Wellbeing Boards, and Community Safety Partnerships, on the safeguarding agenda.

·       Professor Brown asked the Health and Wellbeing Board how the Mental Health Capacity Act impacted on its work.  The Act and sometimes the lack of understanding of it and lack of application of it, was one of the major issues that the Safeguarding Adults Board heard about in its work.  Councillor Hare asked if often people were said to have sufficient capacity when they did not, or vice versa.  Professor Brown responded that it was often that staff did not always know what the Act meant and made assumptions about capacity or lack of or did not understand the nuances e.g. around lasting power of attorney.

·       Councillor Bray questioned what training was given to staff about understanding the Mental Health Capacity Act.  Lorna Pearce, Assistant Director of Safeguarding, Quality and Governance, responded that mental capacity was one of the most challenging areas for the system.  The Council had invested heavily in training its staff in the Mental Capacity Act.  Over the last 3 years consideration had been given to digging down to understand what the barriers to implementation were, and then adjusting training accordingly.  The content and the lens in which the training was being delivered had been changed to focus more on the application of the Act.  A Mental Capacity forum had been set up where staff could bring cases and explore different ways of working.  Lorna Pearce emphasised that the focus for next year was mental capacity and executive functions, which would be delivered via a bitesize learning programme. 

·       Councillor Bray also asked about the learning coming out of the Safeguarding Adults reviews.  Lorna Pearce commented that nationally people expressed concerns about the same lessons coming through safeguarding adults reviews.  However, the West of Berkshire panel was good at looking at how deeper learning could be gained from a review.

·       Professor Brown commented that a lot of care was provided by the private and voluntary sectors.  He was of the view that the Council did a good job in training its staff.  Professor Brown wanted assurance that students on three year professional Health and Social Care education programmes, were trained and assessed in the Act, prior to finishing their course.  He had sought assurance from the university sector.

·       Councillor Conway welcomed the close working with the voluntary sector and the ambition to work closer with Partnership Boards.  He added that the Council was strongly committed to pursuing the partnership agenda.

·       Dr Milligan stated that the voluntary sector was now dealing with more complex case of care, which previously would have been seen by GPs or other care teams.  She questioned how  ...  view the full minutes text for item 90.

To receive the Berkshire West Safeguarding Children Partnership Annual Report 2022-23.

David Goosey, Independent Chair of the Berkshire West Safeguarding Children Partnership, presented the Berkshire West Safeguarding Children Partnership Annual Report 2022-23.

During the discussion of this item the following points were made:

·       He advised that the Partnership was the only one in England that had three local authorities in it.  Whilst this increased complexity it also presented a range of possibilities for wider working.

·       One of the key issues which the Partnership considered was harm done to children outside of the home.  Child exploitation and youth violence did not recognise geographical boundaries. 

·       Collaboration was key and early steps had been set out in 2022/23 to look at how this should be carried out.  David Goosey hoped to be able to update further on progress made against this in the next annual report.

·       The three Chief Executives of the local authorities were working collaboratively with the ICB and Local Police Commander.

·       Work around the thresholds for statutory intervention had been carried out.  Common partners of health and the Police had the same set of standards applied.

·       David Goosey advised that learning had emerged out of a series of local safeguarding practice reviews, with some common themes.  This included the assessment of risk to children, the use of chronologies, and stepping down cases from the statutory level to a lower level of intervention.  Information sharing could be improved.

·       Councillor Bray thanked David for the difference that he had made since being in post.

·       Andrew Statham asked what the Board could do to help improve matters even further.  David Goosey emphasised that barriers to alignment across the partnership should be kept as small as possible. 

·       Councillor Conway gave assurance that there were good relations across the political and professional leadership in Berkshire West.

·       Dr Milligan asked if adults who had gone through the process as children were asked whether any improvements could be made.  David Goosey commented that he would like to hear the voice of the child and from those with lived in experience at all stages of the process. 

·       Councillor Bray commented that interaction with the Children in Care Council had much improved.

·       Helen Watson assured the Board that when file audits were undertaken the children and young people and families and carers were spoken to.  She drew the Board’s attention to the new policy documents from the Department for Education, including Working Together to Safeguard Children 2023.  The Partnership Board would be looking at the implications of these.

RESOLVED:  That the Berkshire West Safeguarding Children Partnership Annual Report 2022-23 be noted, and David Goosey be thanked for his presentation.

To receive a presentation on the Wokingham Inequalities Project.

Anna Richards, Consultant in Public Health, provided an update on the Inequalities Project.

During the discussion of this item, the following points were made:

·       Whilst there was a perception that Wokingham Borough was very healthy and wealthy in comparison to other parts of the country.  However, there was variation and on average, in the most deprived neighbourhoods people were dying approximately 5 years earlier than those in the least deprived neighbourhoods.  The project sought to understand the variation and what would make a difference to reduce it.

·       The underlying factors which determined how healthy someone was, their life expectancy and quality of life was complex.  Factors influenced an individual's wellbeing, including environment and opportunities.

·       Anna Richards highlighted the building blocks of health and wellbeing.

·       The project would be running from August 2023 to August 2024 and would have 5 worksteams.  Some aspects of the work had been completed – looking at data and intelligence and literature and research review. 

·       At the last Full Council meeting Members had resolved that the Council would take a Marmot approach, looking at developing the building blocks to ascertain how residents’ health and wellbeing could be supported. 

·       Discussions would be held with residents and key line workers to gain direct insight into their lived experiences of inequality.  The Steering Group had identified two key existing Wokingham strategies which highlighted those residents who were at greater risk of experiencing inequalities - the Wokingham Tackling Poverty Strategy 2022-2026, and the Health and Wellbeing Strategy.  These included people in persistent hardship, people with learning difficulties, unpaid carers, and people with lived experience of substance abuse.  The Steering Group hoped to invite residents from these groups to participate in discussion groups.  Anna Richards highlighted key workers that would be asked to participate.

·       With regards to the Council’s commitment to the Marmot principles, Councillor Conway commented that the housing element was vital to promoting health and wellbeing.  The quality of housing was important.  He indicated that a desire for greater equality was one of the emerging themes of the Community Vision work.

·       Sarah Webster welcomed the approach being taken and commented that it highlighted the importance of working in partnership.  In terms of insights from frontline workers, Sarah referred to the Community Outreach Workers, and suggested that good feedback could be received from them.

·       Alice Kunjappy-Clifton asked why the ethnically diverse community was not referenced as a group of residents whose views would be sought.  Anna Richards commented that it had been difficult to define some cohorts and that work was building on discussions already held with identified groups.

·       Councillor Bray stated that recently the Government had announced extra money for councils in response to the Local Government Settlement.  In a letter from Michael Gove regarding this, was a reference to expecting councils to do performance reporting in the summer and to discredited equality and diversity strategies.  Councillor Bray asked that clarification be sought as to what this referred to specifically.

·       Councillor Hare emphasised the importance of the Marmot principles.  ...  view the full minutes text for item 92.

To receive a presentation on the Wokingham SEND Partnership - Strategy Development.

Jonathan Wilding, Programme Manager – SEND, provided an update on the Wokingham SEND Partnership - Strategy Development.

During the discussion of this item, the following points were made:

·       Helen Watson indicated that the SEND Partnership comprised of representatives from the local authority, health, schools and the Parent Carer Forum, amongst others.

·       Jonathan Wilding indicated that the current Strategy ran from 2021-2024 and had been written in the context of a poor SEND local area inspection.  Whilst much progress had been made, many of the priorities previously identified remained relevant.

·       There had been a light touch refresh of the existing priorities in the changing context of SEND, such as the new area inspection framework.

·       Jonathan Wilding reminded Board members that the Council was in the Safety Valve programme because the financial situation had deteriorated since the last strategy period.

·       An early version of the document had been produced last year, and a lot of dialogue had been held with schools, parents, and carers.  Health colleagues had wanted to have a further opportunity to coproduce and input into the strategy.

·       Work around action planning was ongoing.  Workshops were being held with partners on this.

·       Sufficiency of provision was a key challenge facing the area.  Wokingham Borough did not have as much specialist provision as many of its comparators, although work was being carried out to address this.  Oak Tree had recently opened, and two new specialist schools were due to open in September 2026.  Nevertheless, there was currently a shortage of specialist provision, and consequently a lot of pupils were in mainstream schools with increasing numbers then moving to high-cost independent specialist provision.

·       Board members were advised that even with the new provision, which was coming on board, unless there were fundamental changes around early intervention and prevention, this provision would still prove insufficient.

·       Jonathan Wilding highlighted the importance of joint commissioning and working in partnership between social care, health, education, and the voluntary sector.

·       There was a need for closer alignment with health.  One of the challenges was the small footprint of the area so there was a need for effective partnership working with neighbours to ensure the right level of local specialist provision.  Jonathan Wilding commented that there was more work to be done on low instance, high-cost placements.

·       Another priority was ensuring effective transitions. 

·       Co-production and communication were key.  Parent anxiety around changes being made was ongoing.  Investment was being made to improve communication.

·       The Board was informed of a recent Local Government Association Peer Review.  One of the emerging headlines from this was developing a sense of togetherness using language consistently between the local authority and health.  This would also help improve the level of confidence from the community.

·       Councillor Hare asked whether work was being undertaken with the children as well as parents.  He was informed of work carried out by the Me2 Club who had spoken to around 50 children with Special Educational Needs to understand their views on the Strategy.  Many of the themes that  ...  view the full minutes text for item 93.

To receive the Royal Berkshire NHS Foundation Trust Integrated Performance Report December 2023.

The Board received the Royal Berkshire NHS Foundation Trust Integrated Performance Report December 2023.

During the discussion of this item, the following points were made:

·       Andrew Statham commented that the report contained a similar macro picture to the report presented at the previous meeting, including a sustained performance regarding staff turnover and engagement.

·       There had been sustained work on quality. 

·       There was a possibility of meeting the stretching financial budget. 

·       Board members were advised the Trust was in a difficult position on some of its operational matrix around cancer diagnostics, A&E and elective.  The teams were taking a range of action to address this.   There were also some asks being made of partners to help ease the emergency flow element.

·       Andrew Statham referred to the impact of the sustained industrial action on performance, services provided and staff.

·       Senior leaders had expressed concern that there was a chance of meeting the financial budget, but that performance did not fully match this.  Consideration would be given to whether there were people who could provide more time to help improve performance.

·       There was uncertainty around the level of the financial settlement for next year which had an impact on planning services.

·       With regards to the New Hospital Programme, the Trust had been asked to produce, by Spring, a detailed, conclusive report as to whether it would be viable to remain on the existing RBH site.  Should it be concluded that this would not be possible, further engagement would be carried out.

·       Councillor Conway questioned whether a potential change in national government had been factored into plans.  Andrew Statham commented that the NHS featured highly in different campaigns.

·       In response to a question from Councillor Conway about the New Hospital Programme, Andrew Statham commented that the Trust had been asked if it could build the hospital for the future on the current footprint.  Various issues needed to be taken into account, such as geological conditions, access, connectivity of what was already there and restrictions on surroundings.

·       Councillor Bray asked about maternity services.  Andrew Statham indicated that the maternity services had recently been through a CQC inspection, and the Trust was proud of its service.  A lot of work had been undertaken on recruitment and learning from other inspections.

RESOLVED:  That the Royal Berkshire NHS Foundation Trust Integrated Performance Report December 2023 be noted, and Andrew Statham be thanked for his presentation.

To consider the Board’s work programme for the remainder of the municipal year.

The Committee discussed the forward programme for the remainder of the municipal year.

During the discussion of this item the following points were made:

·       Sarah Webster asked if the Board would like to rotate performance reports from the Berkshire NHS Foundation Trust and the Royal Berkshire NHS Foundation Trust, in future.  She would take this action forward.

·       Councillor Conway commented that the Board would be receiving a report on Marmot at the March meeting.  He highlighted that he was keen that these principles be embedded across the Council.  He wanted the different Overview and Scrutiny Committees be to be engaged at an early stage and look at what the Council could do as an organisation on Marmot, and had suggested this to the Chair of the Overview and Scrutiny Management Committee.  Ingrid Slade would take this away as an action.

RESOLVED:  That the forward programme be noted.