Agenda and minutes

To receive any apologies for absence

There were no apologies for absence.

To confirm the Minutes of the Meeting held on 28 July 2015 (5 mins)

The Minutes of the meeting of the Committee held on 28 July 2015 were confirmed as a correct record and signed by the Chairman.

To receive any declarations of interest

There were no declarations of interest made.

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 committee.

Subject to meeting certain timescales, questions can relate to general issues concerned with the work of the Committee 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 an update on the work of the Health and Wellbeing Board

(20 mins).

Councillor McGhee-Sumner, Chairman of the Health and Wellbeing Board provided an update on the work of the Health and Wellbeing Board.

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

·         Members were informed that the Health and Wellbeing Board was likely to undergo a Local Government Association (LGA) Peer Challenge early next year.  It was intended for the review to comprise three Health and Wellbeing Boards:  Wokingham, Reading and West Berkshire.

·         Individual reports and recommendations would be produced for the three Boards and also recommendations for common areas for improvements and possible opportunities for collective working.

·         The review would enable the Board to reflect on and improve the way it worked and made an impact by identifying areas for improvement.

·         Councillor McGhee-Sumner commented that he wanted the Board to be benchmarked against the three best performing Boards in the country.  Councillor Clark asked which were the best Health and Wellbeing Boards.  The Director of Health and Wellbeing indicated that the LGA reviews gave some indication of performance but that  Plymouth and North Lincolnshire Boards had been identified as examples of good practice. Councillor Clark questioned whether less well performing Boards should also be looked at to ensure that the Health and Wellbeing Board avoided pitfalls.

·         Councillor Houldsworth asked Councillor McGhee-Sumner what he felt was the biggest single problem in health and social care and was informed that integration of health and social care was a challenge. In addition some areas such as Hospital @ Home had not had the take up that had been hoped for.

·         The Committee discussed admissions and residential care.  Councillor McGhee-Sumner commented that the Council had a good record of keeping people in their homes when appropriate. 

·         The Committee was informed of the Frail Elderly Pathway which looked to track individuals through the health and social care system. The Director of Health and Wellbeing offered to bring the data sets for the Frail Elderly Pathway to the Committee’s November meeting.

·         Councillor Richards commented that NICE guidelines stated that home care visits should last at least half an hour.  However, sometimes visits did not require that amount of time, for example if the individual simply required help taking medication.  Nicola Strudley emphasised that there were 15 minute med calls for those who needed assistance with their medication but that these were not considered care calls.  The Director of Health and Wellbeing commented that some areas allocated 15 minute visits for intimate tasks such as bathing, potentially leading to issues of dignity in care.  He assured the Committee that it was the Council’s policy not to do this.  The policy took a more personalised approach.

·         Councillor Shepherd-DuBey queried how the Council could be sure that carers’ visits lasted as long as recorded and whether carers were paid for travelling between appointments and was informed that discussions regarding telecare systems were taking place.  Staff were paid for travel.

·         Councillor Haines asked whether language barriers between carers and customers were an issue.  The Director of Health and Wellbeing  ...  view the full minutes text for item 26.

To question Councillor McGhee-Sumner, Executive Member for Health and Wellbeing on Council activities within his portfolio and upcoming issues. 

A list of the Executive Member for Health and Wellbeing’s specific portfolio responsibilities is attached. (20 mins)

The Committee received an update on the Health and Wellbeing portfolio from the Executive Member for Health and Wellbeing.

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

·         Members were updated on the Berkshire West Joint Commissioning Function.  The Chief Executive Officers would be meeting to discuss if a review was needed.

·         In response to a question regarding if there was sufficient variety of residential care providers to give people the best choice, Councillor McGhee-Sumner emphasised that there was at least 20 providers in the Borough, not including extra care providers.  The Council had contracts in place with various providers for extra care housing.

·         Members questioned if the Council aimed to develop a market that delivered a wide range of sustainable high quality care and support services which were available to residents and were advised that the Council endeavoured to drive down prices without undermining the market.

·         Councillor Houldsworth asked about needs assessments to determine the type of support required and waiting times.  The Director of Health and Wellbeing commented that waiting time performance was not as good as was hoped for.  However, those in urgent need received an urgent response and there was no one who required urgent care currently on the waiting list. 

·         It was confirmed that internal procedures and policies reflected the requirements of the Care Act 2014.

·         Written information was provided about charging for residential placements before people began to look for placements.  Leaflets were available on charging and financial assessments and people were signposted to advice and guidance.  Councillor Miall questioned whether the independent people providing advice were truly independent and was advised that they were.

·         Councillor Haines queried whether there had been any resistance from those looking for residential placements when the Council identified homes which it considered to be affordable and appropriate for the individual.  Councillor McGhee-Sumner indicated that Officers tried to make clear the issue of affordability at an early stage.  If a person had been resident in a home for some time and the placement began to become unaffordable the Council tried to come to an agreement with the provider.  People were only moved to another home as a last resort.  The Independent Care Brokerage Service helped people to understand what the most appropriate solutions would be for their personal circumstances and advised people to plan ahead in case their placement should became unaffordable.  If people preferred a more expensive care home to the one the Council had offered they could still move there, if a relative paid the difference.

RESOLVED: That Councillor McGhee-Sumner be thanked for his presentation.

To receive an update on the impact of the closure of the Independent Living Fund (20 mins).

The Director of Health and Wellbeing provided an update on the impact of the closure of the Independent Living Fund (ILF).

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

·         The Independent Living Fund was established in 1988 to make direct payments to enable disabled people and (where appropriate) their carers to purchase support that could not be obtained from local authorities. 

·         Following changes to the way in which care was delivered by local authorities, the ILF was closed to new claimants from December 2010.  In 2012 the closure of the fund for existing beneficiaries from 31 March 2015 was announced.  Judicial Review meant this was delayed until 30 June 2015.  Since 1 July 2015 the Council had had full responsibility to fund eligible care needs (defined in accordance with the Care Act 2014) for current ILF beneficiaries in its area.

·         Regular information updates were provided to the Council by ILF and these had initially confirmed that 19 cases were likely to transfer to the Council upon the fund’s closure. 

·         All affected customers had been advised in writing in April of the transfer date, that the Council intended to carry out a full re-assessment of their needs and that, in the meantime, funding at the appropriate ILF level would be paid by the Council for July and August where appropriate.  They had also been advised that should the re-assessment process not be completed by the end of August, further funding at the ILF level would be made available for September.

·         18 cases were transferred on 1 July.  The Council had been informed that it would receive £230,456 in ILF grant funding for the remainder of the financial year.

·         The Committee was advised of progress on the transferred cases as at 8 September.  2 recipients had moved outside of the Borough and ongoing care arrangements had been passed to their new local authority.  The ILF grant did not move with the recipients; in another case a customer was now fully funded under S117 arrangements with Health partners; in another instance the review process had been completed and the customer now jointly funded by the Council and the CCG on a 50/50 basis; the re-assessment and Personal Budget review process had been completed in 7 cases; in 5 cases, the re-assessment process had been completed and reviews of the outcomes and possible impact on the Council defined Personal Budgets were ongoing; the re-assessment process was still ongoing in one case; and the Council had been unable to gain access to undertake the reassessment in another case.

·         Councillor Swaddle asked what the situation was of the 19^th individual of the cases identified pre transfer.  The Director of Health and Wellbeing agreed to look into this and to feed back to the Principal Democratic Services Officer.

·         The Director of Health and Wellbeing commented that it was difficult to understand the implications of the ILF transfer next year as it would no longer be separate ring fenced money.

·         In response to a  ...  view the full minutes text for item 28.

To receive an update on the work of Healthwatch Wokingham Borough

(15 mins).

Nicola Strudley presented an update on the work of Healthwatch Wokingham Borough.

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

·         It was noted that as a result of a deaf blind champion walkabout at Wokingham Medical Centre a number of changes had been made to make it more accessible.  A video would be put up on You Tube and the Healthwatch website.

·         Healthwatch Wokingham Borough had helped to keep the spotlight on CAMHS and had influenced the joint strategy produced by the Council and CCG.  They were pleased that the 18 month action plan included named individuals and dates against actions.  The Healthwatch Board would be meeting with Berkshire Healthcare Foundation Trust to discuss the government document ‘Future in Mind’ and the implications of this.  Healthwatch Wokingham Borough had produced a FAQ about CAMHS. 

·         Healthwatch Wokingham Borough had introduced Twyford Village Partnership to the CCG Better Care Fund “Neighbourhood Cluster” Project Manager and they were willing to be a pilot site.

·         With regards to Healthwatch Wokingham Borough’s report ‘Totes Emosh’, Nicola Strudley informed the Committee that as a result of the work undertaken, St Crispin’s School had changed its curriculum.  Personal Health and Social Education now took place during registration period. Work was being undertaken with several students to develop an app on pathways and coping strategies in particular.  The Council’s Young Carer Project had been reinvigorated. Councillor Swaddle asked if Healthwatch Wokingham Borough would be working with others schools.  Nicola Strudley indicated that whilst other schools had expressed an interest, Healthwatch was staffed by 1.5FTE so capacity was limited.  Nevertheless, discussions about how Healthwatch’s funding could be best utilised, would be taking place.  She would be putting forward a proposal for a Young Person Worker. 

·         Healthwatch Wokingham Borough had been attending flu clinics at the Wokingham Medical Centre, which had been a good means of engaging with more people.  Councillor Haines questioned whether they would be attending flu clinics at other surgeries and was informed that arrangements had been made to attend a forthcoming flu clinic in Woodley.

·         Councillor Blumenthal commented that there had been stories in the media recently regarding NHS 111 and asked whether Healthwatch Wokingham Borough had received many comments on the service.  Nicola Strudley indicated that the service was being recommissioned at present and that the Thames Valley Healthwatches were pulling together data to contribute to the recommissioning process.  However, this was not a high volume topic.

·         In response to a Member question, Nicola Strudley explained how Healthwatch Wokingham Borough handled calls from those outside the area.

RESOLVED:  That Healthwatch Wokingham Borough be thanked for their report. 

To discuss the Work Programme for 2015/16 (10 mins).

The Committee considered the Work Programme 2015/16.

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

·         It was noted that the November meeting had a heavy agenda.  It was therefore proposed that the items on the Report of the Possible Implications for Scrutiny of the Francis Report Working Group – follow up of recommendations and Update from Council’s representative on Berkshire Healthcare NHS Foundation Trust and Royal Berkshire Foundation Trust – Board of Governors, be deferred to the Committee’s January meeting to ensure a more manageable agenda.

·         Members were requested to email the Principal Democratic Services Officer with any questions they had or areas that they wished to focus on regarding the Joint Strategic Needs Assessment and the South Central Ambulance Service.

·         Councillor Haines raised an issue regarding community responders and the provision of defibrillator equipment.  The Principal Democratic Services Officer agreed to follow this up.

·         A member of the public informed the Committee of NHS Wokingham CCG’s consultation on its vision for the future of GP and primary care services and the public event on 20 October.  It was suggested that Committee members may wish to attend.

RESOLVED: That the Work Programme 2015/16 be noted.