Agenda and minutes

To receive any apologies for absence

Apologies for absence were submitted from Councillors Tahir Maher and Adrian Mather.

Councillor Michael Firmager attended the meeting virtually.

To confirm the Minutes of the Meeting held on 19 January 2022 and the Minutes of the Extraordinary Meeting held on 21 February 2022.

The Minutes of the meeting of the Committee held on 19 January 2022 and the Minutes of the Extraordinary meeting held on 21 February 2022 were confirmed as a correct record and signed by the Chairman.

Councillor Bishop Firth clarified that whilst the Committee had been informed that the Peach Place toilets were a Wokingham Town Council facility, they were a Borough Council facility.

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 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 South Central Ambulance Service.

The Committee received an update on South Central Ambulance Service from Kirsten Willis-Drewett, Head of Operations (Berkshire West) & Interim Head of Operations (Oxfordshire), South Central Ambulance Service, and Mark Ainsworth, Director of Operations.

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

·       Mark Ainsworth referred to graphs which highlighted the demand for 999 calls and 999 responses.  With regards to 999 calls, the blue line was where the Trust anticipated demand would be using historical data from the last 12 months to set the budget.  This was recalculated every 5 weeks to see how demand was progressing. This was represented by the red line.  The green line represented the volume of calls actually received.  In the middle two weeks of February 15,000 calls per week had been expected but approximately 17,500 had been received.  Mark Ainsworth explained that this would not all relate to separate incidents and that people often phoned back to check on the progress of the ambulance.   The second graph highlighted the 999 responses.  The number of actual responses was below predictions and approximately 10,500 were responded to a week by sending an ambulance or car.  Some of the other calls would be dealt with by Emergency Clinicians in the Emergency Operations Centre or who would advise of different routes to access their medical care.

·       With regards to performance, there were nationally set standards for all ambulances.  For Category 1 calls there was a mean target of a 7 minutes, and the Trust was performing at around 9 minutes.  There was also a target of 15 minutes for being on scene for the 90^th percentile.  Through December to early January this was being met but this was starting to slip.  For Category 2 calls the National Target was an 18 minute mean.  This was not being met with an upward trajectory of decline, at around 33 minutes.  The target for being on scene was 40 minutes for 90^th percentile.  Performance against this target had also started to deteriorate.  For Category 3 calls the National Target was 2 hours for the 90^th percentile.  This was being exceeded by just over an hour currently

·       Performance on all measures was challenged.

·       In response to a question from Members Mark Ainsworth explained that:

Ø  Category 1 calls were patients in cardiac arrest, or who were unconscious, or who were not breathing, or who were fitting uncontrollably or had noisy breathing (e.g., were unconscious and were swallowing their tongue)

Ø  Category 2 calls were patients who had chest pains, breathing difficulties, or strokes.  This represented the biggest category of call.

Ø  Category 3 calls were patients who had a lower grade medical emergency such as an isolated fracture.

Ø  Category 4 calls were patients who required a face-to-face assessment and were non emergencies.

·       SCAS also transported GP admissions as requested and there were time targets related to this that the Trust was required to meet.

·       There were challenges in meeting operational hours required to meet the demand  ...  view the full minutes text for item 65.

To consider the Adult Social Care Key Performance Indicators.

Councillor Margetts, Executive Member for Health, Wellbeing and Adult Services and Simon Broad, Assistant Director Adult Services provided an update on the Key Performance Indicators for Quarters 2 and 3.

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

·       AS1: Social work assessments allocated to commence within 7 days of the requests (counted at point of allocation) – there had been a drop off in performance over the last few quarters.  There had been an increase in complexity in cases.  Steps being taken to rectify this included increased recruitment and improved retention.  Members were reminded that it was a stretch target and Wokingham was performing well above national average.

·       AS3: People aged 65+ who received reablement from the START team following discharge from hospital, and remained at home 91 days later, was on an upward trajectory.

·       AS4: safeguarding timeliness – concerns completed within 2 days.  This target continued to improve.

·       AS7: Proportion of people receiving long term care who were subject to a review in the last 12 months – this was another stretch target and Wokingham was third in the South East.  A small improvement had been made.

·       AS9: Permanent admissions to residential and nursing care homes per 100k population and AS10: Information and Advice at the front door - % of contact referrals closed with ‘NFA – Advice & Information only’ were both performing well.

·       AS11: Proportion of people who use services who receive direct payments – snapshot at end of quarter, was slightly under target.

·       A Member sought an update on action being taken to improve AS7.  Councillor Margetts commented that they were trying to raise the department to the top 25% for all measures.  Simon Broad added that the Council had a statutory responsibility to review all those who received care support.  However, it also needed to be able to respond to care quality concerns which meant that the reviewing team sometimes had to undertake unplanned reviews.  The stretch target for the number of planned reviews needed to be balanced against any unplanned reviews.

·       Members asked if there were any issues around recruitment and retention.  Simon Broad indicated that there was a shortage of Occupational Therapists and Social Workers nationally.  A number of mitigating actions were being taken including the production of a Workforce Development Strategy, reviewing the recruitment website and including videos from different practitioners and advertising on radio.  The Council was trying to be more competitive.

·       Members asked whether the Council had looked beyond the UK for recruitment.  Simon Broad indicated that it was supporting the provider market, which was looking to widen recruitment to overseas.  Lewis Willing, Head of Health & Social Care Integration, added that work was being undertaken on a Workforce Strategy, which included the provider network, and various schemes were in place to ensure appropriate levels of Occupational Therapists and Social Workers.  Nationally it was Social Worker Week and the Council’s social media referred to this.

·       Councillor Margetts commented that KPIs needed to be meaningful.

·       Simon Broad referred to the  ...  view the full minutes text for item 66.

To receive an update on Healthwatch report regarding Carers in Wokingham Borough

The Committee received an update on the response to the report from Healthwatch Wokingham Borough regarding carers.

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

·       In 2020/21 Healthwatch Wokingham surveyed unpaid carers about their experiences of caring during the pandemic.  89 carers had completed the survey.  As of the last census there were approximately 14,000 carers within the Borough.

·       Top concerns raised included –

Ø  Decline of person being cared for either physically or mentally, during lockdown.  Some had reported those with dementia had found it difficult to understand the restrictions.

Ø  Workload and lack of time out: 78% said the hours of care they provided had increased, 70% hadn’t been able to get regular breaks.

Ø  Carer wellbeing, notably a negative impact on their: mental health (84%) physical health (62%), family wellbeing (73%)

·       One positive was that many carers had found it easier to get access to food and medication as result of the Wokingham community response, coordinated by the One Front Door.

·       Direct payment recipients had reported delays and Council inflexibility, which was being addressed by a Direct Payments review.

·       2 out of 3 respondents were not aware of their rights as a carer, 30% did not know what a carer’s assessment was and 40% were not registered as being a carer with their GP.

·       The Council had reviewed the report’s recommendations –

Ø  Identify hidden carers – this aligned with Priority 1 of the Council’s Carer’s Strategy ‘Identifying and recognising carers’ and it was important thatseldom heard and hidden carers were included in that.  A Keeping in Touch project had been commissioned and would run for 12 months.  In addition, a data validity exercise would be undertaken to make sure the Council was aware of who all the carers were and to update if the person being cared for had sadly passed away.

Ø  Improve GP surgery support – this was being undertaken through integration work with the Primary Care Networks, including ensuring that there was a link of GP websites which linked to uptodate information for carers.

Ø  Increase information and support to known carers – A co-production customer engagement toolkit was being developed which would enable greater engagement of carers.  Current and former carers had given their input on the service during the retendering process.  In addition, the Community Directory was being reviewed and Project Joy, an online platform allowing service users to connect with services, was being recommissioned.  TuVida would be undertaking Care Act training and service improvement plan.

Ø  Continue what worked well during the Covid period – this linked with all 4 priorities in the Carers Strategy.  A review was being undertaken of the Council’s community response.  The Council had been engaging in welfare calls to carers (approximately 1000 in January) and this would continue

Ø  WBC to publish written guidance for direct payment recipients who cannot spend their payments normally - A review would be undertaken on Direct Payments arrangements within Adult Social Care, to strengthen current  ...  view the full minutes text for item 67.

To receive an update on the work of Healthwatch Wokingham Borough.

Members received an update from Healthwatch.

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

·       The team was working towards the transition to a new provider which would take effect at the end of the month.

·       The annual report would be published in June.

·       The GP access report would be published by the end of March.

·       Access to NHS dentistry continued to be a challenge.  The Committee was informed of one resident who had been offered an urgent appointment elsewhere but had not been able to afford to travel there, and of another who had been hospitalised as a result of an untreated tooth problem.

·       The Committee thanked Jim Stockley for his hard work and support during his time with Healthwatch.

·       Members were reminded that the Overview and Scrutiny Management Committee would be considering suggestions for the work programme for the next municipal year at its next meeting.  The Chairman encouraged Members to send any suggestions that they might have to Democratic Services.

·       The Chairman thanked Councillors Patman and Cheng for their contribution to the Committee as it was their final meeting.

RESOLVED:  That

1)    the update from Healthwatch be noted.

2)    Jim Stockley be thanked for his hard work during his time with Healthwatch.