Agenda and draft minutes

Health Overview and Scrutiny Committee - Tuesday, 19th July, 2022 7.00 pm

Venue: David Hicks 1 - Civic Offices, Shute End, Wokingham RG40 1BN

Contact: Madeleine Shopland  Democratic & Electoral Services Specialist

Media

Items
No. Item

1.

Election of Chair 2022/23

To elect a Chair for 2022/23.

Minutes:

RESOLVED:  That Adrian Mather be elected Chairman for 2022-23.

2.

Appointment of Vice Chair 2022/23

To appoint a Vice Chair for 2022/23.

Minutes:

RESOLVED:  That Beth Rowland be appointed Vice Chairman for 2022/23.

3.

Apologies

To receive any apologies for absence

Minutes:

There were no apologies for absence.

4.

Minutes of Previous Meeting pdf icon PDF 257 KB

To confirm the Minutes of the Meeting held on 16 March 2022.

 

Minutes:

The Minutes of the meeting of the Committee held on 16 March 2022 were confirmed as a correct record and signed by the Chairman.

5.

Declaration of Interest

To receive any declarations of interest

Minutes:

Andy Croy declared a general personal interest on the grounds that he worked for an Adult Social Care company.

6.

Public Question Time

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

Minutes:

There were no public questions.

 

7.

Member Question Time

To answer any member questions

Minutes:

There were no Member questions.

8.

Optalis Update pdf icon PDF 3 MB

To receive an update on Optalis.

Minutes:

The Committee received an update on Optalis from David Birch, Chief Executive of Optalis.

 

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

 

·       Optalis was the Council’s own Adult Social Care company.  It worked closely with the Council’s Adult Social Care Team.

·       Matt Pope and Councillor David Hare were Directors of Optalis.

·       Optalis was jointly owned by Wokingham Borough Council and the Royal Borough of Windsor and Maidenhead Council.

·       The contract had recently been renewed for a further 5 years which gave continuity in provision.

·       Optalis’ formal aims were to:

Ø  Transform and improve the delivery of adult services

Ø  Secure the stability of the workforce

Ø  Identify and deliver opportunities for joint commissioning

·       David Birch highlighted the range of services provided to residents including day services for residents with learning disabilities and with physical disabilities, extra care services, residential care, and supported employment services.

·       Members were informed that services continued to run well.  However, a current spike in Covid was creating some pressure on service delivery.

·       In terms of the last 3 years, efficiency savings had been consistently delivered.  In 2021/22 the budget had been met and additional savings of £184,000 had been delivered to the Council. 

·       With the support of the Council, staff were paid at the rate of the National Living Wage or above in 2022/23.

·       David Birch stated that it was anticipated that the next few years would be increasingly challenging from a financial perspective, primarily because of the impact of the rising cost of living on the recruitment and retention of care staff.  Use of agency staff was expensive, and work was being undertaken to minimise this in a very difficult employment market.

·       Optalis was supporting the Council by taking on at least 10 new and existing services across the Borough, covering a wide variety of different care needs.  This expansion had been made possible by the Council’s investment in a new Peripatetic Team which had given capacity to expand, and initiative new service as required.

·       Members were informed of the new Learning Disability and Mental Health services at Hatch Farm in Winnersh.  Feedback from customers and their social workers had been very positive.

·       The respite service at Loddon Court in Earley had recently transferred from the previous provider Dimensions to Optalis. 

·       David Birch provided an update on how existing services were being improved.

·       Capacity and productivity enhancements were planned for the START team, to support residents where reablement would give them a higher quality of life than they would receive through traditional care packages.

·       Optalis had relaunched its Day Services for those with physical and learning disabilities, under the Community Lives brand.  The pandemic had shown how much residents and their families had valued the services and the difficulties that they had experienced when they had been unavailable.  There had been increasing demand for a wider range of more innovative activities taking place across and within the local community, instead of traditional buildings-based services.  Optalis was therefore working with the Council to  ...  view the full minutes text for item 8.

9.

Health and Wellbeing Strategy

To receive an update on the Health and Wellbeing Strategy.

Additional documents:

Minutes:

Tracy Daszkiewicz, Director Public Health Berkshire West and Lyndon Mead, Public Health, provided an update on the Health and Wellbeing Strategy.

 

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

 

·       Matt Pope commented that the agenda items were to provide the committee with a high-level overview of some of the important areas of work in Adult Social Care and Health and Wellbeing.

·       Members were advised that the Health and Wellbeing Strategy had been adopted jointly across Berkshire West.  Wokingham had developed a Strategy into Action delivering the Wellbeing outcomes specifically for the Borough.

·       The Health and Wellbeing Strategy aimed to incorporate all aspects of local authority input into residents’ health and wellbeing and across the whole life course.

·       Health inequalities and equity were important topics. 

·       Resident’s health and wellbeing sat within a broad context:

Ø  Wider determinants of health – e.g., housing, jobs, school readiness, schools, and economic prosperity;

Ø  Health behaviours and lifestyles – e.g., green open spaces and active travel;

Ø  Integrated health and care system – planning future services and joined up thinking;

Ø  Places and communities we live in, and with – ensuring safe and thriving communities.

·       The Committee considered a diagram representing the Social Determinants of Health.  Consideration was given to how services were accessed throughout the life course.

·       The development of the Integrated Care System gained Royal Assent on 1 July.  The Health and Wellbeing Strategy sat within the Health and Wellbeing Board and was the springboard from which the Integrated Care Partnership strategy was being derived.  Having a clear and needs driven Health and Wellbeing Strategy was essential for meaningful representation of the health and wellbeing of residents within the Integrated Care System.

·       Guided by the overarching principles of the Berkshire West Health & Wellbeing Strategy, the Wokingham Strategy into Action (SiA) determined the priorities for focus within the Borough to improve resident health and wellbeing.

·       Five Berkshire West wide priorities had been adopted as well as a Wokingham specific priority of ‘Creating physically active communities.’  The priorities had been mapped to a range of relevant action or partnership groups.  They were developing action plans on delivering against their particular area.  Each action/partnership group was responsible for delivery of their action plan and for reporting progress to the newly established SiA Steering Group, who provided operational oversight of SiA delivery on behalf of the Wellbeing Board.

·       The Committee noted the governance and reporting structure.  Some areas were further along in terms of action.

·       A Member was of the view that the Committee should monitor the work on making the Borough dementia friendly and particularly how this was filtered out to the parishes, which could be more isolated.

·       A Member commented that a lot of the action identified for improving physical activity already appeared to be underway.  Matt Pope commented that the action plans had a good focus on the priorities and were making a difference.

·       Members felt that it was important to highlight action that would otherwise not have taken place had  ...  view the full minutes text for item 9.

10.

Adult Social Care Priorities - Adult Social Care Reforms pdf icon PDF 865 KB

To receive a presentation on the Adult Social Care Priorities - Adult Social Care Reforms.

Minutes:

Matt Pope updated the Committee on one of the main Adult Social Care priorities, the forthcoming Adult Social Care Reforms.

 

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

 

·       The proposals in the ‘People at the heart of care’ White Paper represented an enormous change for Adult Social Care.  Matt Pope suggested that the Committee may wish to focus on the matter as it developed.

·       Adult Social Care had been chronically underfunded and needed reform. 

·       Matt Pope believed in order to reform Adult Social Care, funding, how it was funded and how it was paid for, should be considered.  Other areas of Adult Social Care also needed improvement and reform including quality and workforce, control of care and tailored support.

·       Matt Pope felt that there should be a National Social Care Minimum Wage which was on par with the NHS.

·       The amount and variety of support available needed to be addressed.

·       Members were reminded that the Government had put a health and social care levy on National Insurance which raised approximately £12billion a year of which £1.8 billion in the first 3 years was planned to go to Social Care.

·       The Charging reform would have a massive impact on the Borough giving a huge funding gap.  From October 2023 more private funders would be able to come to the Council, either for the Council to set up care accounts to monitor against a capped amount or, be able to access local authority rates where they had been unable to do so previously.

·       Wokingham had a high level of private funders.  At present approximately 1,800 people received formal social care support.  This could increase by in the region of a further 3,000 people, which would require additional staff, services, and IT systems, to support.  Without central government funding, the delivery of services to an additional 3,000 residents would be extremely challenging.

·       Members were advised that it was proposed that the proposals come into effect at the same time, which was very difficult from an operational stand point.  Matt Pope highlighted the timetable for the reforms.

·       The principles and the content of the White Paper had been well received by the social care world, but the funding and detail needed to be correct.

·       Key themes of the White Paper were highlighted.

·       A Member questioned how the shortfall would be manifested – would the Borough have insufficient revenue to pay, and would the Council receive insufficient funding from the Government to address the shortfall?  Matt Pope advised that over 3 years the funding gap would be significant, possibly £20million.

·       In response to a question regarding IT systems, Matt Pope advised that guidance stated that it if an individual wanted to start metering their spend against their care cap, the local authority had to undertake an assessment and decide what the needs for the individual were and an appropriate amount.  The local authority had to set up a care account on an IT system as the individual paid for their care, which  ...  view the full minutes text for item 10.

11.

Adult Services Key Performance Indicators pdf icon PDF 554 KB

To consider the Key Performance Indicators for Adult Services.

Minutes:

Matt Pope presented the Adult Social Care Key Performance Indicators for Q4.

 

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

 

·       A Member referred to the KPI ‘% of safeguarding concerns leading to an enquiry completed within 2 working days.’  She felt that 2 days was a long time for a very urgent issues and sought clarification about the triage arrangements.  Matt Pope indicated that all referrals were triaged and something which appeared to be very urgent would be dealt with very quickly.  There had been some issues regarding staffing that were being ironed out.   There has been a large increase in safeguarding reporting.  Certain agencies such as the Ambulance Service had been over reporting and not undertaking their own triaging.  The Council was working with them to improve this.  Whilst performance against the indicator had decreased because of increased demand, Matt Pope anticipated that it would improve.

·       A decision had been taken in several areas to work with stretch targets.  A Member questioned if there were any indicators where a lot of money would need to be spent to make minimal improvement.  Matt Pope commented that this varied according to the indicators.  Some targets were deliberately set to push services in a particular direction or to have a high standard.  Matt Pope also commented that some of the KPIs and stretch targets would be reviewed and potentially amended over the next 12 months.  Given the backdrop of the forthcoming Adult Social Care reform maintaining a performance level was a likely future target. 

·       Members were encouraged with the KPI performance.

 

RESOLVED:  That the Adult Social Care Key Performance Indicators for Q4, be noted.

12.

Forward Programme pdf icon PDF 29 KB

To consider the forward programme for the remainder of the municipal year.

Minutes:

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

 

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

 

·       It was noted that mental health post Covid, and also the Autism Strategy had been delayed several times.  Members felt that these topics should be brought forward.

·       The Chairman commented that regular updates from Healthwatch were useful.

·       Members felt that it would be useful to look at work regarding dementia and how this was being disseminated around the Borough.

·       A Member was of the view that the Committee had traditionally had a smaller workload than some of the other Overview and Scrutiny Committees.

 

RESOLVED:  That the forward programme be noted.