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Adult Social Services Review Panel
Thursday, 13th July, 2017

Adult Social Services Review Panel Minutes

Date:
Thursday 13th July 2017
Time:
5:00pm
Place:
Room F10, the Town Hall, Katharine Street, Croydon CR0 1NX
 

Attendance Details

Present:

Councillor Louisa Woodley (Chair)
Councillors Margaret Bird, Pat Clouder, Yvette Hopley, and Callton Young.

Also present:
Councillor Bernadette Khan
Apologies for absence:
None

Item Item/Resolution
MINUTES - PART A
A18/17 MINUTES

The minutes were agreed.

A19/17 DISCLOSURE OF INTEREST

Disclosures are up to date.

A20/17 URGENT BUSINESS (IF ANY)

There was none.

A21/17 EXEMPT ITEMS
A22/17 ADULT SOCIAL CARE AND ALL AGE DISABILITY CARE UPDATE REGARDING MENTAL HEALTH SERVICES AND THE 3RD SECTOR

Officers introduced the agenda item. They explained that in February 2017, the CCG governing body took the decision to serve six months' notice on a number of initiatives (marked in yellow in the report), advising them that their services would be decommissioned. They also served six months' notice on a number of other services (marked in blue in the report), which were to be reviewed by the CCG before a re-commissioning decision was made. Officers added that an urgent meeting was subsequently held between council and CCG officers, and that it was agreed that meetings would be held with the affected providers to try and ascertain the impact of the CCG's funding reductions.

 

The Council have proposed to produce a scoping paper on proposed measures to limit the impact of the cuts. Members were advised that the Council's Gateway service would be involved in mitigation work to reduce the impact of these cuts on affected service users.

 

Officers highlighted the services which the CCG governing body have decided to continue funding in 2017-18, which are set out in paragraph 4.5 of the report. They also listed the services which the CCG have now decided to decommission:
- Imagine Drop-In service
- Rethink Carer Support Service

 

The Cruse initiative is also being decommissioned by the CCG but the Council have agreed to accept responsibility for the CCG's element of the funding.

Members were advised that the CCG governing body had now accepted the Council's recommendations. They expressed disappointment at the cuts brought about by the CCG, after expectation had been raised following increases in funding from central government.

 

It was observed that some of the services which have been cut had not been reviewed for a number of years, and that there had been no analysis of outcomes from these initiatives, or of potential service duplication. This was a particular issue with joint contracts. Members stressed the need to do this systematically in future and expressed the need for a clear strategic plan for mental health service provision, with its various elements fitting in with objectives in a logical fashion. They expressed concerns regarding the adhoc nature of proposals for efficiencies, and feared that ill-thought through cuts could end up bringing about higher service costs.

 

Officers remarked that the Outcome Based Commissioning initiative should bring about greater clarity in terms of outcomes and effective use of funding.

Members expressed concerns regarding the decommissioning of the MIND welfare benefits advice service. They highlighted the fact that the Woodley review had acknowledged the fact that financial problems could cause or exacerbate mental breakdowns. They were advised that the Gateway initiative could cover some elements of this service but could not replace it in its entirety, and that officers were exploring the possibility of identifying sources of council funding which could cover this service.

 

Members also discussed service reviews initiated by the South London and Maudsley NHS Foundation Trust, including that of services for dementia sufferers. They expressed the wish to find out the outcome of the consultation process on this specific review.

 

The Panel RESOLVED to note the contents of the report.
 

A23/17 OUTCOMES BASED COMMISSIONING UPDATE

This item was postponed till the next meeting of the panel.

A24/17 SHARED LIVES UPDATE

Officers described this scheme, whereby an adult in need of support and accommodation moves in with a registered Shared Lives carer and shares in the carer's home and community life. The scheme is funded from housing benefit.

 

Members were advised that in the summer of 2016, NHS England had made available a sum of money for CCGs and partner authorities to bid for match funding to expand Shared Lives into other innovative areas. Croydon had put forward a case for using Shared Lives with mental health sufferers during periods of crisis with support from SLaM to prevent hospital stays. Unfortunately, the bid was unsuccessful. However, Croydon CCG and the council recognised the fact that the business case was strong and that a reviewed proposal should be considered for funding through the Better Care Fund. This new bid has been successful.

 

Members were advised that a steering group was to be set up to implement the scheme, which lines up well with the outcomes of the Woodley Review.

Officers informed Members that housing staff in the council had good networks for publicising the scheme and recruiting Shared Lives carers into the scheme, and that the Shared Lives coordinator gave high level support to carers and service users. They added that it was in all partners' interest to make the service work well, including during periods of crisis, in order to reduce demand for psychiatric beds.

 

Members welcomed these positive news and asked to be provided with a small number of case studies to illustrate the effectiveness of this scheme. They also suggested that summaries of these might be published in the council's magazine.

 

It was suggested that an update on this scheme be presented at a future meeting of the review panel.

 

The Panel RESOLVED to note the contents of the report.
 

A25/17 ADULT SOCIAL CARE & ALL - AGE DISABILITY IN 2017/18 - FINANCE UPDATE

The Director of Adult Social Care and All-Age Disability introduced this report.

 

She highlighted the vigilance of the division in identifying what social care budgets should fund and what the CCG should cover, particularly in relation to costs incurred when a patient is discharged from hospital.

 

Members were reminded that the divisional budget for 2017-18 was £108.150m, which includes growth of £4.9m to address the additional costs from 2016-17 and emerging new pressures. This has been funded largely through the 2017-18 Adult Social Care Precept of 3%.

 

The Director outlined the various elements of the Better Care Funding allocated to the council for 2016-17 and 2017-18. Members heard that new IBCF funding would be paid out in two tranches per year.

 

The objectives of the second tranche will be to:
- Meet adult social care needs
- Support hospital discharge, including the Out of Hospital Programme (OoH)
- Stabilise the social care provider market

 

Members were advised that £1.232m would be allocated in 2017-18 to the Out of Hospital business case, including the enablement service, thus helping patient to stabilise more swiftly on their return home. The following year, the sum of £2m (50% of the IBCF funding) is due to be allocated to this service, and another £2m in 2019-20 (100% of the IBCF funding for that year). However, challenges remain on identifying ways of supporting carers after hospital discharge.

 

Members discussed work to stabilise the social care provider market. Officers explained that they were working with the CCG and other healthcare agencies to set fair prices and observed that the care market was no longer financially profitable for some companies. Members heard that the London Borough of Sutton was working with the CCG, pharmacies and care support teams and visiting care homes to provide support at a sustainable cost, and that part of shaping the market would involve exploring new models of care and the possibility of offering a range of provision for different needs. Officers stated that this stabilisation work would be implemented through Outcome Based Commissioning, and that work would also be carried out with service users to help them make the right choices with their personalised budgets. All this work would be carried out as part of the Transforming Adult Social Care (TRASC) strategy.

 

The Panel RESOLVED to note the contents of the report.

A26/17 [THE FOLLOWING MOTION IS TO BE MOVED AND SECONDED AS THE "CAMERA RESOLUTION" WHERE IT IS PROPOSED TO MOVE INTO PART B OF A MEETING]

The motion was moved by Councillor Yvette Hopley and seconded by Councillor pat Clouder.

MINUTES - PART B
B27/17 MINUTES
  • Minutes 26.04.2017 (114K/bytes)

The Panel RESOLVED that the Part B minutes of the meeting held on 26 April 2017 be signed as an accurate record of the meeting.
 

B28/17 ADULT SAFEGUARDING IN CROYDON
  • Safeguarding report (410K/bytes)
  • |
    Appendix 1 (5M/bytes)
  • |
    Appendix 2 (308K/bytes)
  • |
    Appendix 3 (767K/bytes)

The Director gave a brief introduction to the report and stated that the council was very active in safeguarding its vulnerable residents receiving support either at home or in residential care. She added that 167 providers had been graded as "good" and 2 as "outstanding", and that 7 were on the Provider Concerns List.

 

Members asked whether all relevant stakeholders were informed when a care home was placed on the Provider Concern list. Officers replied that the council tried not to use such an establishment when an embargo was placed on it or when the CQC notified the council regarding concerns emerging during an inspection. However, this approach needs to be balanced because of the shortage of places available in the borough. Nevertheless, officers gave assurances that these concerns were shared with individuals concerned. Self-funding individuals, however, might not have access to this information.

In answer to a question on safeguarding in sheltered accommodation, the Director explained that the safeguarding function covers all residents regardless of tenure.

 

However, members were advised that important operational changes to safeguarding were due to come into effect, embedding it into all relevant services, with support from a few safeguarding specialists. Officers explained that the mainstreaming of safeguarding was already in place for 0-65 year olds, but that it would take another year to extend this to over 65 year olds.

 

The Panel RESOLVED to note the contents of the report.