Apologies were received from Cllr PE Crockett and Cllr RL Mayo.  

To receive details of any members nominated to attend the meeting in place of a member of the committee.

There were no substitutes.

To receive any declarations of interest by members in respect of items on the agenda.

There were no declarations of interest.

To approve and sign the minutes of the meeting held on 23 August 2017.

RESOLVED:

That the minutes of the meeting held on 23 August 2017 be confirmed as a correct record and signed by the chairman.

To receive questions from members of the public.

Deadline for receipt of questions is 5pm on Monday 18 September 2017.

Accepted questions will be published as a supplement prior the meeting.

Please submit questions to councillorservices@herefordshire.gov.uk

There were no questions from members of the public.

To receive questions from councillors.

Deadline for receipt of questions is 5pm on Monday 18 September 2017.

Accepted questions will be published as a supplement prior the meeting.

Please submit questions to councillorservices@herefordshire.gov.uk

There were no questions from councillors.

To review the quality and performance of the substance misuse service commissioned by Herefordshire Council and delivered by Addaction.

A presentation was given by officers of Addaction.

In his introduction, the chief officer of Addaction thanked council officers for their frank feedback and noted concerns raised about service delivery which he had taken up with Addaction’s trustees.  An action plan had been discussed with the public health team and it was recognised that the service had not started-off well and that the resulting concerns were understood. It was accepted that the level of cultural change was underestimated, and with support, the service had now identified what was required to make the transition from a medical model of care to one that was more peer and community focused.  Much had been learned from this and there was confidence that the team was in place to take the service forward.  The motivation was to ensure the best possible service for Herefordshire, regardless of who provided the service. 

In answer to a member’s question about what the challenge was in taking on the Herefordshire service compared with other areas that Addaction covered, the chief officer explained that there were demographic challenges in Herefordshire with implications for an available workforce.  A possible comparative area was Norfolk but in Addaction’s experience there were very few close comparators to draw upon. Other factors were that the shift in service model was greater than had been seen with other services whilst ensuring continuity for service users.  There had been much learning taken from this area and a different approach was being taken to recruitment and training.

Members welcomed the invitation to visit Addaction again and for the opportunity to hear from a service user about their experience of the service.

A member asked about cultural changes, staff transfers and recruitment in terms of how long it would now be expected to take, with the benefit of lessons learned, to make the transitions required and embed the new model of provision.  In response, it was estimated that this would take 6 to 9 months.   In terms of preparation for re-tendering within a 3 year contract, it was believed that the best approach was to ensure the service continued to evolve right up to point of re-tendering and that the next transition for the new contract would be smoother as the most challenging aspects of service development had been overcome.  Contracts tended to be of 3 years’ duration typically although longer terms were emerging nationally, and recent research had shown how contracting could affect service delivery.  It was noted by the Director of public health that the new drugs strategy recommended longer contracts although this could be a challenge for funding with the public health grant ending in 2019 and arrangements thereafter remaining unclear.

A member asked about patterns of substance use. Officers suggested that patterns were linked to changes in the drugs market and how the supply chain operated within rural areas compared with urban areas. The impact of police intervention was known to interrupt supply which then resulted in a down turn in use of particular  ...  view the full minutes text for item 15.

To report on the annual report of the Herefordshire Safeguarding Adults Board (HSAB), which addresses the work of multi-agency partners in Herefordshire in safeguarding and promoting the welfare of adults at risk within the county, including achievements and areas for improvement, and priorities identified for 2017/18.

The chair of the Herefordshire Safeguarding Adults Board (HSAB) presented his annual report for 2016 - 2017. In his opening comments he reminded members that the HSAB was focused on a defined cohort of the most vulnerable people in the county, with 3 strategic priorities of partnership working, prevention and protection, and communications and engagement. Within these priorities it was key to ensure that partners were contributing to the work of the board to ensure a whole system approach to safeguarding.

The HSAB chair highlighted a number of points regarding the work of HSAB:

There was a national network of independent chairs which had looked at a number of common issues including an emerging theme of closer working between child and adult safeguarding boards. In Herefordshire the two boards were innovative in the establishment of a joint business unit role, which supported closer working on shared issues and which boards in other areas were considering to replicate.  Consideration had also been given to cross-cutting issues that other agencies such as the community safety partnership were sighted on and there was assurance that the dynamics of such issues were understood and managed effectively within the Herefordshire system.

Other agencies contributed to safeguarding activity and the broader prevention strategy, examples of which included the fire and rescue authority extending their home safety check for those homes at more risk of fire to include assessments such as regarding risk of falls, and ‘flu jabs, on behalf of partners.

The promotion of ‘making safeguarding personal’ (MSP) was fundamental to resolving a safeguarding episode by enabling the system to understand the risks and mitigations around the choices people made.  Following an audit by the local authority, there was a mature understanding of the current position on MSP within the system.

A range of approaches had been attempted to increase engagement and this activity was to be referred to Healthwatch for additional support in seeking the views of people who have been through a safeguarding episode, in order for the system to learn from that experience.  The local authority had a role in actively engaging with providers to support them to make improvements in safeguarding where needed. 

Responding to the report, the chair asked for more explanation of the figures provided to understand the numbers behind the percentages.  

It was clarified that the figures were based on representative samples or a significant proportion of people across county and although there was potential to provide deeper analysis of specific cohorts, the resulting figures would be less reliable as meaningful statistics due to the smaller size of the samples.

A member commented on a reference to HSAB publicity in parish magazines, observing that this had not been apparent in the 5 parishes within her ward. Attention was drawn to the need for everyone to develop a better understanding of safeguarding issues and to be more aware within their communities.

A member made a number of comments regarding the data contained in the report and asked what the figures  ...  view the full minutes text for item 16.