To:All Members of the Adult Care and Health Cabinet Panel, Leader of the Council, ACSMB, Executive Assistant to the Director of Adult Care Services, all officers noted for ‘action’ / From:Legal and Member Services
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ADULT CARE AND HEALTH CABINET PANEL

10 JANUARY 2011

M I N U T E S

ATTENDANCE

MEMBERS OF THE PANEL

J R Barfoot, R H Beeching (for S L C Johnston), M Cowan, T L F Douris, C M Hayward (Vice-Chairman), D J Hewitt, N A Hollinghurst,S Markiewicz, C A Mitchell (for T J Price),

S O’Brien, R H Smith (Chairman, Executive Member for Adult Care and Health),

A S M Witherick

Other Members:

A M R Searing, Chairman of the Overview & Scrutiny Committee

Upon consideration of the agenda for the Adult Care and HealthCabinet Panel meeting on 10 January 2011as circulated, copy annexed, conclusions were reached and are recorded below:

Note: No conflicts of interest were declared by any member of the Panel in relation to the matters on which conclusions were reached at this meeting.

PART 1

ACTION
1. / CHAIRMAN’S ANNOUNCEMENTS
1.1 / The Chairman informed the Panel that following the dissolution of the Joint Commissioning Partnership Boardin October 2010 it was proposed that two representatives from the Hertfordshire Alliance be invited to attendfuture meetings of the Panel as observers - the same capacity under which a representative of the Hertfordshire Local Involvement Network (LINks) representative currently attends meetings.
1.2 / The Panel heard that a letter had been sent to the Hertfordshire Alliance containing this offer, and their response was expected after their meeting on 14 January.
2. / MINUTES
2.1 / The minutes of the meeting held on 11 November 2010 were confirmed as a correct record and signed by the Chairman.
3. / PUBLIC PETITIONS
3.1 / There were no public petitions.
4. / INTEGRATED PLANNING PROCESS 2011/12 – 2014/15 PART B: FINANCIAL AND HUMAN REOURCE PLANS INCLUDING KEY SERVICES ISSUES AND VALUE FOR MONEY ANALYSIS
4.1 / The Panel considered a report which presented information on the government’s grant settlement and the emerging financial and human resource plans for 2011/12 – 2014/15, together with the key issues for each of the Council’s services. The Panel was invited to consider the information in relation to Adult Care Services, and to comment and make recommendations in relation to the Adult Care Services budget.
4.2 / Iain MacBeath, Assistant Director Performance and Business Support, informed Members of the key areas of note or change relating to the Adult Care Services budget, which were summarised around the following themes: pressures; savings and efficiencies; capital projects; and value-for-money. In debate Members sought further information around a number of areas described in the budget, and these were responded to.
4.3
4.4
4.5 / The Panel heard that pressures on the budget centred around demography, with meals-on-wheels and safeguarding being other areas of pressure. Members heard how demography pressures are calculated, and the Assistant Director Performance and Business Support undertook to supply a paper entitled ‘Demography Pressures in ACS’, which provides further information.
It was noted that demography had led to a £10.188m pressure within the budget, of which £6.450m related to Learning Disability services. In response to a Member question as to whether this pressure would be likely to ease in future years the Panel heard that whilst there may be a point where a plateau would be reached, it was not considered that this would take place within the next few years (and may take up to 10 or 15 years). It was also noted that £37.078m had been transferred from the NHS to fund the care of approximately 300 people with severe learning disabilities, following a government decision that this funding should be transferred from PCTs to councils with effect from 1 April 2011.
In relation to Safeguarding, the Panel heard that there had been a significant increase in safeguarding referrals - particularly in Learning Disability services - which had led to the pressure identified in the budget. The Panel heard that the majority of these had involved incidents between service users, rather than between staff and service users. / Assistant Director Performance & Business Support
4.6 / The Panel heard thatsavings and efficiencieshad been identified in a number of areas, which were shown on pages 37 – 39 of the report and had been grouped around the workstreams of the ‘Council for the Future’ transformation programme. It was noted that these included: Supporting People efficiencies; a review of the Money Advice Unit; a review of the ACS charging policy; a Value for Money review of working age mental health; supporting older people to remain in their own homes; increased enablement and enhanced intermediate care arrangements; an OLM costing and negotiation project; and improvements to Customer Services Centre scripting and online self-service capability. The Assistant Director Performance and Business Support informed Members of the detail of each of the areas where savings had been identified, and responded to Members’ questions both on how the level of expected savings had been calculated, and how they would be achieved in practice.
4.7 / The Panel also heard about thecapital projects provided for within the budget and how these are being funded: it was noted that a number of the projects (e.g. reprovision of Scarborough and Manor House Hostels and Learning Disability Supported Living) were self-financing, whilst the day centre modernisation programme had been funded through a capital receipt achieved through the sale of Balmoral Day Service in Watford. New arrangements with Quantum Care for the County Council to borrow (at a cheaper loan rate) and fund older people’s residential care homes reprovision were also noted.
4.8 / In relation to value-for-moneyit was noted that performance against indicators for the new Vision for Social Care (e.g. enablement, homecare and self-directed support) is good, although it remains at relatively high cost. It was noted that performance for adults under 65 with learning difficulties 2009/10 appears low and Members were informed of the reasons for this, which include a legacy of long-stay hospitals located in the county (e.g. service users with more profound and complex needs than other authorities) and a number of placements being made outside Hertfordshire. It was noted that only two performance indicators are used to benchmark with other councils for learning disability services and these are not representative of Hertfordshire’s good quality assessment and care services for people, as recognised by the Care Quality Commission in their service inspection.
Conclusions:
The Panel:
4.9 / endorsed the draft Integrated Plan;
4.10 / commended Adult Care Services for the significant amount of work which had been undertaken across a number of initiatives to achieve improvements in service and efficiencies with the budget.
5. / A VISION FOR ADULT SOCIAL CARE
[Officer Contact: Sarah Pickup, Director Health and Community Services]
5.1 / The Panel received a report which presented the key components of the government’s new Vision for Adult Social Care. Members were informed that the full document was available at the Department of Health’s website:

5.2 / The Panel heard that the Vision is based on seven principles, and the report explained each of these in detail, together with details of the work undertaken to date in Hertfordshire in relation to each principle.
5.3 / In debate it was agreed that the Vision in many ways builds on work already being done, and Adult Care Services’ achievements to date were welcomed. The importance of an apprenticeship scheme for Personal Assistants, and the importance of the Joint Strategic Needs Assessment to provide a framework for joint strategies, were particularly highlighted.
Conclusions:
The Panel:
5.4 / noted and welcomed the expectations set out in the government’s Vision for Adult Social Care and the proposed sector-wide commitment to moving forward with personalisation and community based support;
5.5 / noted the work already underway in line with the seven principles as described in the report; and commended Adult Care Services for its achievements to date which are in line with, or exceeding, government requirements.
6. / DATE OF NEXT MEETING
[Officer Contact: Emma Lund, Democratic Services Officer]
6.1 / Thursday 3 February 2011 at 10.00 am in Committee Room B. / All to note

Kathryn Pettitt

Chief Legal Officer

110110 Minutes

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