To receive apologies for absence.

Apologies were received from Councillors BA Durkin, H Davies and GA Powell.

To receive details of any Member nominated to attend the meeting in place of a Member of the Committee

There were no named substitutes.

To receive any declarations of interest by Members in respect of items on the Agenda.

Councillor AE Gray declared a personal interest as a provider of provisions for people with learning disabilities.

To approve and sign the Minutes of the meeting held on 21 June 2010.

RESOLVED: That the Minutes of the meeting held on 21 June 2010 be confirmed as a correct record and signed by the Chairman.

To consider suggestions from members of the public on issues the Committee could scrutinise in the future.

There were no suggestions from members of the public.

To receive a presentation by the Cabinet Member for Adult Social Care, Health and Wellbeing reviewing past performance, identifying key issues and commenting on future plans in relation to the her portfolio.

The Committee received a presentation from the Cabinet Member, Adult Social Care, Health and Wellbeing on past performance, key issues and future plans in relation to her portfolio.  In her report

The Cabinet Member report that the Integrated Commissioning Directorate has continued to develop joint health and social care solutions, including our practice led solutions in ‘Transforming Community Services’. The ‘World Class Commissioning strategy was a key driver in the provision of new services and the Council and PCT was successfully delivering a highly complex ‘competitive dialogue’ procurement of mental health services to target, with the active support of staff, service users and carers, clinicians and partners.

She went on to say that the delivery of the Putting People First programme had continued to be effectively managed, and Herefordshire had moved forward on all 4 domains (Choice and Control, Social Capital, Universal Services and Early Intervention).  The Council had declared at amber/green because (like other Local Authorities) there was a delay in the delivery of a Remote Access System, and consequent poor performance on NI 130 (number of personal budgets in place). This had been in part caused by problems in developing the ICT.  Rather than allow this to delay delivery of outcomes, personal budgets had continued to be offered, and this would accelerate once the tools became available.

The Chairman thanked her for her report, and in the ensuing discussion the following points were made:

• That the comment on the County’s stroke service was no noted, and it should be appreciated that this service was poor, and was a major source of handicap in the County.

• That there were concerns over the delay of the Agresso Finance System, which should be in place by October.  There were a number of projects that depended upon this being put in place.  The Service had bought an EMS package for Home Care, but was unable to use it until the appropriate ICT system was in place.

• In reply to a Member, the Principal Accountant said that migration of data onto the Frameworki system in order to enhance the finance module was in hand, and payments were being done on both the new and the old system.  The biggest issues were around residential and home care.  A test would be run in the next few weeks.  AN integration of the PCT and Council finance packages was on track to be in place for 1 April 2011.

• That the withdrawal of the Independent Living Fund would have a detrimental effect on the Service.  Local Authorities were already considering some independent living packages to be too expensive, and it was possible that Herefordshire might have to come to the same conclusion.

• That Homelessness did not sit comfortably in the present Cabinet Portfolio structure. It was an important issue, and consideration might be given to either including it into the Adult Social Care, Health and Wellbeing portfolio, or making it part of the wider corporate management structure.

• That the Council’s Special Energy Efficiency Scheme, which  ...  view the full minutes text for item 18.

To advise the Committee of the financial position for the Adult Social Care budget within the Joint Commissioning Directorate, and the Strategic Housing budget within the Regeneration Directorate for the period to 31 May 2010. The report provides the variations against budget and a projected outturn for the year.

The Committee received a report on the financial position for Adult Social Care and Strategic Housing revenue budgets for the period to 31^st May 2010.

The Principal Accountant reported that the outturn position had benefited from the use of central budget, contingencies and reserves of £2.2m and the additional funding was shown as a reduction in spend.  The next report would show the budget allocated over the areas once it had been signed off by the Chief Executive to ensure virement rules had been complied with.  A budget deficit of £1.5m remained which would need to be recovered by 31^st March 2011.  The outturn position included a number of measures within the recovery plan and further work would be required in order to balance the budget.

The position for 2011/12 would also need to be addressed and further savings would have to be found to achieve the required 5% reductions and potential further budgetary cuts of up to 25%.  The Associate Director, Joint Commissioning was in the process of drawing up plans on spending reductions which would need to be implemented within this financial year in order to have a significant impact in future years and achieve the targets set.

The Supporting People Grant had a deficit of £1,290k between the current year grant and contract commitments, was being supported by the brought forward underspend and was currently under review by a new Transitions Board chaired by the Director of Resources.  It would be merged into the Herefordshire Partnership. 

In the ensuing discussion the following points were made:

That a percentage cut in the budget of 25% would decimate the Service, and make it impossible to deliver services to the County.

The Associate Director, Joint Commissioning reported that it was not clear as to whether the budgetary cuts would be as high as 25%, and it was to be hoped that they would only be in the region of 15%.  Reductions in funding at these levels would, however, mean cuts to services.

That there would be a formal consultation with staff before a decision was taken regarding the Meals on Wheels service.  Alternative ways of delivering the service would be considered as a preference

In reply to a question from a Member, the Associate Director said that domiciliary care costs were higher in the County than the national average, but this was largely as a result of the rural nature of Herefordshire.  A great deal of work had been undertaken over the previous year to produce a fair price policy for care provision, something that was not done for home care in other authorities.

In reply to a further question, she went on to say that negotiations were underway regarding the block contracts with Shaw Care, and would be finalised by September. 

That the increase in the number of safeguarding referrals over the past 12 months was as a result of an increased awareness of the team.  This had lead to an increase in activity of 50% for  ...  view the full minutes text for item 19.

To update the Committee on progress made since the action plan that was

produced on the Review of Transition from Leaving Care to Adult life on 19

December 2008.

The Committee received a report on progress made on the action plan for the Scrutiny Review of Transition from Leaving Care to Adult Life.

The Chairman of the Review Group went through the report and made the following comments:

• That the review of the Children’s and Young People’s Directorate would successfully incorporate the Education Liaison Support Service for Looked After Children (LAC).

• That she was concerned that an IT solution to link the Council’s system with the Health System had not yet been produced.

• She welcomed the news that there was a proposal to employ a dedicated health worker for Care leavers and that despite lack of funding, that this remained a key issue for transition to adult care.

• That the issue of measuring the number of LAC’s from other authorities who were placed in the County had to be solved. 

• She was outraged that black bin liners were still being used three years after this report had been published.

The Chairman of the Children’s Services Scrutiny Committee concurred with her comments and said that he was deeply disappointed by the years of obfuscation and delay that had greeted this review.  He said that this was a poor report, and he would raise the matter with the Interim Director of Children’s Services.

In reply to a question from a Member, the Head of Safeguarding, LADO (Local Authority Designated Officer) reported that the recent judgement made in Southwark, which found that homeless 16 and 17 year olds should be treated as Looked After if provided with accommodation, would have a profound effect on Aftercare services in Herefordshire as these individuals would become entitled to these services if Looked After for more than 12 weeks. They would also be entitled to advice and support until aged 21 years. Having to find suitable accommodation for 40 young people who had previously been dealt with by the Housing Service had put pressure on the accommodation available to Care leavers.  A funded agreement had been reach with the Supporting Herefordshire Young People Project (SHYPP) in order to recruit and support an additional eight supported lodgings to meet the needs of this group

The Head of Safeguarding went on to say that there were currently 89 LAC children in the County, placed here by other Authorities.  The provider organisations were obliged to provide the Council with information regarding these children, and the Council was working in partnership with the Police.  The placing authorities were not obliged to provide the information, and he did not understand why OFSTED would not provide information regarding these placements.

The Head of Safeguarding undertook to provide Members with a briefing note regarding the status of LAC in the County.

RESOLVED: 

That:

a)      That the Committee expressed concern that it was still not clear that any of the areas of concern raised by the Review had been adequately dealt with, and the Action Plan was not fit for purpose;

b)     The report should be brought back to the next meeting  ...  view the full minutes text for item 20.

To receive a report on progress against Putting People First, the Governments agenda for transforming Adult             Social Care Services.

The Committee received a report on progress against Putting People First, the Government’s agenda for transforming the Adult Social Care Service.

The Associate Director, Joint Commissioning reported that, through the Transforming Adult Social Care Reform Grant, the Government had provided ring fenced funding specifically to enable councils to make the changes.  In September 2009 a set of milestones was agreed with the Department of Health which focused on five areas to help councils prioritise their use of the final year of the reform grant. These were laid out in the report.

At present the Council was reporting achievement at amber/green, largely because it had not been able to deliver the changes in IT and operating systems to support industrial scale adoption of personal budgets.  A robust project was managing progress and it was anticipated that target would be achieved by April 2011.  Significant achievements, which  included piloting external agencies delivering care brokerage for the region, working with young people with complex needs reaching adulthood to assist them into employment and an ‘e’ catalogue of services for all including self funders to have easy access to information.

RESOLVED:

THAT:

a)      Progress in managing performance towards achieving targets should be noted;     and;

b)     Concern was expressed that the progress and improvement of the Service had been obstructed by the lack of the appropriate IT package.

To provide an updated report on the progress towards the achievement of national performance indicator targets and other local performance indicators for Adult Social Care within the Joint Commissioning Directorate.

The Committee received a report on the progress toward the achievement of national performance indicator targets and other local performance indicators for Adult Social Care within the Joint Commissioning Directorate.

The Associate Director, Joint Commissioning reported that she was pleased that NI 135 (Carers receiving a needs assessment or review) continued to be above target.

In reply to a question, the Associate Director said that there was a wide range of equipment associated with telecare that allowed the Service to monitor people.  These ranged from pendant alarms to pressure pads to ensure that people had actually got out of bed, and sensors to check whether taps had been left running or whether gas hobs had been left on.

RESOLVED

That:

a)            The report be noted; and;

b)           Areas of concern should continue to be monitored.

To consider the Committee’s Work Programme.

The Committee noted its Work Programme.

RESOLVED: That the work programme be approved and reported to the Overview and Scrutiny Committee.