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ADULT CARE AND HEALTH CABINET PANEL
3 FEBRUARY 2011
M I N U T E S
ATTENDANCE
MEMBERS OF THE PANEL
D Andrews (for D J Hewitt), J R Barfoot, R F Cheswright, M Cowan, T L F Douris,
S L C Johnston,D E Lloyd (for B J Lamb), S Markiewicz, C A Mitchell (for T J Price),
S O’Brien,P A Ruffles (for C M Hayward), R H Smith (Chairman, Executive Member for Adult Care and Health), A S M Witherick
Also present:
H Goldberg (Hertfordshire LINk)
Upon consideration of the agenda for the Adult Care and HealthCabinet Panel meeting on 3 February 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, except for the declarations made by S Markiewicz and M Cowan (minutes 6.1 and 6.2 refer).
PART 1
ACTION1. / CHAIRMAN’S ANNOUNCEMENTS
1.1 / The Panel expressed condolences to B J Lamb following the recent death of her husband.
1.2 / The Panel heard that a response had now been received from the Hertfordshire Alliance, which wishes to accept the Chairman’s offer to permit representatives of the Alliance to attend future meetings of the Panel as non-voting observers. The identities of the Alliance’s observers will be advised in due course.
1.3 / It was noted that Peter Sell House in Hitchin will become a flexi-care housing scheme comprising 39 units in April 2011.
1.4 / The Chairman advised that he would be attending the East of England Social Care Network meeting in early February and would report on matters of interest to the Panel.
2. / MINUTES
2.1 / The minutes of the meeting held on 10 January 2011 were confirmed as a correct record.
3. / PUBLIC PETITIONS
3.1 / There were no public petitions.
4. / INTEGRATED PLANNING PROCESS 2011/12 – 2014/15
[Officer Contact: Iain MacBeath, Assistant Director, Performance and Business Support]
4.1 / The Panel received an update on one change which had been made to Part B of the Integrated Plan since the Panel’s meeting in January. The Panel was invited to endorse Part B of the Plan (containing the service’s financial plans), and to note Parts A (Corporate Priorities and Performance Targets) and C (Treasury Management Strategy) as background, these documents having been circulated prior to the meeting.
4.2 / The Assistant Director Performance and Business Support, advised the Panel that there had been just one change to the service’s budget since the January meeting, which was to correct the amount of additional income from the review of the Fairer Charging Policy from the £2m shown in the draft Plan to £2.745m (the correct figure, as reported to the Panel in November 2010). It was also noted that the headcount reduction shown on page 63 of Part B did not accurately reflect Health and Community Services’s plans: the headcount reduction would therefore be revised before approval of the Plan by County Council is sought.
4.3 / It was also noted that the Assistant Director had provided a response to a number of queries which had arisen during consideration of the Plan at the January meeting, and that this had been circulated to all Members of the Panel.
Conclusions:
The Panel:
4.4 / noted thechange to Part B of the Integrated Plan since the January meeting of the Panel;
4.5 / accepted the Integrated Plan proposals in relation to Health and Community Services.
5. / THE MEALS ON WHEELS SERVICE
[Officer Contact: Peter Ruane, Senior Commissioning Manager]
5.1 / The Panel received a report which provided Members with a comprehensive update on the Meals on Wheels service following the last report to the Panel on the service in May 2010. Peter Ruane, Senior Commissioning Manager; Sarah Wren, Chief Executive of Hertfordshire Community Meals; and Shazia Butt, Commissioning Manager, attended the Panel to present the report and respond to Members’ questions. Members also heard about the establishment, development, and future plans of Hertfordshire Community Meals (HCM) - the social enterprise organisation which provides the service on behalf of the County Council.
5.2 / In debate a number of points were raised, and the following was particularly noted:
- Hertfordshire’s innovative approach to the delivery of the Meals on Wheels service through a social enterprise model has prompted interest from other authorities;
- HCM has undergone rapid growth, but recognises that there is a continuing need to challenge the business model to ensure that efficiencies are maximised. £80,000 has been saved through operational changes to date, and a further £100,000 efficiency is being sought. HCM is conscious of the need to reduce the subsidy of the service (currently £1m is provided by the County Council) and to bring unit costs down;
- It is recognised that the Apetito vans are a relatively expensive means of delivery, though beneficial when large areas need to be covered. Potential for savings through using leased cars equipped with a hot box for deliveries are being investigated, and could be implemented when the current van lease contract expires;
- Feedback indicates that most people consider the £3.80 charge to represent value for money;
- Additional services are being piloted, such as the introduction of a tea-time meal, grocery delivery, and ‘home from hospital’ boxes. Economies of scale may be able to be achieved through these new initiatives;
- Although subsidised by the County Council, the service enables savings to be achieved elsewhere in the Council’s budgets by enabling older people to remain independently in their own homes, and by ensuring that clients receive a nutritionally-balanced meal and sufficient hydration for the day, thus reducing malnutrition and dehydration. The service also plays a valuable role in providing an early alert should clients become unwell;
- Further work will be undertaken on marketing the service, as economies would be achieved if more people signed up for the service. There is a also need to change the perception of the service: many people are unaware of the quality, choice and flexibility now offered. Events such a food tastings are helping to change opinions;
- 95% of referrals for the service come through the Customer Services Centre, where an eligibility check is carried out over the phone. Other referrals can come from sheltered housing schemes or via GPs. The referrals process is being looked at to see whether more organisations could undertake referrals, given that the need / benefit of the service may not be recognised by the client themselves. A ‘light touch’ eligibility criteria is now in place;
- Food hygiene legislation means that trays cannot be recovered by HCM for recycling, and responsibility for recycling would rest with the client. However, the trays used by Apetito are made from recycled aluminium, and are among the most carbon-friendly available.
Conclusions:
The Panel:
5.3 / thanked officers for an interesting and informative report and thanked Sarah Wren for attending the Panel;
5.4 / requested that a further update be brought to the Panel in February 2012; / Peter Ruane / Barbara Freestone
5.5 / noted an offer for Members to accompany staff on a meal delivery round. Members wishing to take-up the offer are invited to contact Peter Ruane. / All to note
6. / PROPOSED RESTRUCTURE OF THE MONEY ADVICE UNIT
[Officer Contact: Sue Darker, Assistant Director, Learning Disability and Mental Health]
6.1 / S Markiewicz declared a personal, non-prejudicial interest in this item as a member of the Board of Trustees of Welwyn Hatfield Citizens’ Advice Bureau. He remained in the meeting and participated in the debate.
6.2 / M Cowan declared a personal, non-prejudicial interest in this item as the spouse of a worker for the Citizens’ Advice Bureau. He remained in the meeting and participated in the debate.
6.3 / The Panel received a report which presented proposals for a restructure of the Money Advice Unit. Members heard that the objective is to make an efficiency of £202,000 from the Money Advice Unit base budget of £814,000 through a reduction in current staffing levels. The report also sought support for moniesto be made available to offer to the voluntary sector in order to undertake some activities currently carried out by the Money Advice Unit; it was noted that it is proposed that a tender process be undertaken in the future to appoint the most appropriate organisation(s) to undertake the work.
6.4 / In debate Members supported the proposal, and endorsed the vision for the Unit as undertaking an enhanced ‘monitoring’ role in future. However, it was noted that at this early stage some of the detail around the proposal remains unclear, until the outcome of a number of proposed welfare reforms is known. Members also stressed the need for the suitability and preparedness of the voluntary sector to undertake the additional casework to be determined:the risk that the voluntary sector will not wish to recruit or train staff for the specialist work, if this is only offered for a short period of time, was also stressed.
Conclusions:
The Panel:
6.5 / recommended to Cabinet that changes to the structure and service delivery of the Money Advice Unit as set out in the report be approved;
6.6 / recommended to Cabinet that the County Council enters into arrangements with the voluntary sector to provide complementary casework support: the nature of these arrangements to be determined by the Director Health and Community Services, in consultation with the Executive Member for Adult Care and Health;
6.7 / requested that a further report be brought to the Panel once the tender process had been completed. / Sue Darker / Barbara Freestone
7. / IMPLEMENTATION GUIDANCE FOR THE COMMISSIONING STRATEGY FOR LEARNING DISABILITY SERVICES FOR ADULTS IN HERTFORDSHIRE 2012 – 2013
[Officer Contact: Judith Jackson, Senior Commissioning Manager]
7.1 / The Panel received a report which provided information on the work to produce the implementation guidance for the finalised Commissioning Strategy for Learning Disability Services for Adults in Hertfordshire 2010 – 2013. Members were invited to comment on the process and guidance, and the Senior Commissioning Manager Learning Disabilities responded to Members’ questions.
7.2 / In debate Members welcomed the strategy and implementation guidance. It was noted that the strategy does not specifically cover those with high functioning autism and Asperger’s syndrome (where there is no learning disability): the Assistant Director Learning Disability and Mental Health advised that work is underway at the moment on the Hertfordshire Autism Strategy which it is anticipated will be implemented by the end of the year; the Panel requested that further information on this be brought to a future meeting of the Panel.
7.3 / In relation to employment, the Panel heard that restructuring of the Work Solutions Team had been undertaken last year, and no further changes are expected. The Assistant Director Learning Disability and Mental Health outlined the work of the ‘Pathways to Employment’ Board, and the Panel was pleased to hear that a significant number of adults with a learning disability had been able to find job opportunities.
Conclusions:
The Panel:
7.4 / noted the implementation guidance for the Commissioning Strategy for Learning Disability Services for Adults in Hertfordshire 2010 – 2013;
7.5 / requested that a report on the Hertfordshire Autism Strategy be brought to a future meeting of the Panel. / Sue Darker / Barbara Freestone
8. / UPDATE ON SAFEGUARDING VULNERABLE ADULTS
[Officer Contact: Sue Darker, Assistant Director, Learning Disability and Mental Health]
8.1 / The Panel received a report which provided an update on key developments in safeguarding adults work. Members heard that there had been a significant amount of activity since the last report to the Panel in November 2009, and that much work has now been completed to address the recommendations arising from the Commission for Social Care Inspection’s service inspection in November 2008 which had included a focus on safeguarding issues.
8.2 / The Panel also heard that a scrutiny of Adult Safeguarding had taken place in March 2010, and that the recommendations identified by the Topic Group had now been fulfilled.
8.3 / The key achievements of 2009/10, as described in the report, were noted: Members also received a factsheet which has been produced to provide assistance when advising constituents on how to proceed with making a safeguarding referral. The Panel heard that the profile of safeguarding adults has improved significantly, and examples of leaflets and posters which have been issued to care providers, driver-attended vehicles and hospitals in order to promote awareness were shown.
8.4 / In response to Member questions the Panel heard of the processes followed when a safeguarding referral is made, and were informed about how cases are recorded and monitored. In relation to questions on the figures for the number of cases reported over the year, the Assistant Director Learning Disability and Mental Health advised that the change to the new Adult Care Services Information System (ACSIS) meant that there has been some difficulty in obtaining accurate data this year. It was noted that the reported 39% increase in safeguarding alerts over quarters 1 and 2 could be explained by a number of factors, including the way in which the alert process is managed on ACSIS. The Assistant Director advised that this was being investigated, to ensure that the data obtained is helpful and accurately reflects the scale of safeguarding issues in the county.
Conclusions:
The Panel:
8.5 / noted the work undertaken in the last year to improve safeguarding practice and raise the profile of safeguarding adults;
8.6 / requested that officers consider ways of providing statistical information for the Panel(possibly in collaboration with foundation trusts) on the number of safeguarding alerts issued over the year and the number of people involved. / Sue Darker
9. / DATE OF NEXT MEETING
[Officer Contact: Emma Lund, Democratic Services Officer]
9.1 / Thursday 10 March 2011 at 10.00 am in Committee Room B. / All to note
Kathryn Pettitt
Chief Legal Officer
110203 Minutes
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