To receive apologies for absence.

Apologies were received from Councillor R.B.A. Burke, J.W. Hope MBE, R. Mills and P.G. Turpin.

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

Councillor H. Bramer substituted for Councillor R.B.A. Burke, Brigadier P.Jones CBE for Councillor J.W. Hope MBE and Councillor J.G.S. Guthrie for Councillor R. Mills.

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

There were no declarations of interest.

To approve and sign the Minutes of the meeting held on 17th March, 2006.

RESOLVED: That the minutes of the meeting held on 17th March, 2006 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.

No suggestions were received.

To receive a presentation by the Cabinet Member (Social Care Adults and Health) informing the Committee of progress in 2005/06 and the challenges in 2006/07 and future years.

The Cabinet Member (Social Care Adults and Health) reported to the Committee on progress on matters within her remit in 2005/06 and the challenges in future years.

A report by the Cabinet Member had been circulated separately to Members of the Committee.  She referred Members to the detail on the achievements in 2005/06 and future challenges and developments in both Adult Social Care and Strategic Housing as set out in her report. 

Commenting briefly on her report she noted that pressures on the adult social care budget were well documented but as a result of considerable efforts the budget for older people’s services for 2005/6 had been contained within the 1% overspend limit despite the overall overspend across Adult Social Care. 

The pressure on Strategic Housing had to date received less recognition but was also significant and she paid particular tribute to the work of the Head of Strategic Housing.

She welcomed the Committee’s work on Learning Disability Services and looked forward to receiving recommendations following its review.

In conclusion she paid tribute to all members of staff working in adult social care and strategic housing noting the challenges they faced.

In the ensuing discussion the following principal points were made:

·          The Cabinet Member was questioned upon the section in her report on the development of a stroke rehabilitation unit at Hillside.  She informed the Committee that, as referred to in her report, she welcomed the proposal but was mindful that there would be a need to work closely with the Primary Care Trust on the matter and monitor the proposal’s implementation.

·          It was suggested that the Village Warden Scheme, referred to in the Cabinet Member’s report, might usefully draw on the knowledge of local clergy in identifying vulnerable people.  The Cabinet Member commented that she understood consideration was being given by the Members Development Working Group to a seminar on the Scheme.

·          A question was asked about the Council’s targets for the number of service users receiving direct payments to enable them to purchase their own care.  In reply the Head of Adult Social Care said that the Government wanted all service users to have a personalised care package but this did not necessarily mean that every service user would receive a direct payment.   She confirmed that a pilot study had shown that personalised care did lead to budgetary savings.

·          It was noted in relation to affordable housing that the Hereford City Extra Care Site had been expected to be completed by the Summer of 2007 but it was a complex project and it was now likely the completion date would slip to 2008.

·          The Cabinet Member drew the Committee’s attention to difficulties associated with the process for providing minor adaptations to properties for social care purposes.  The Committee agreed to call for a report on the matter.

RESOLVED: That a report on the process for providing minor adaptations to properties for social care purposes be submitted to a future meeting.

To consider the interim report on the Scrutiny exercise into services for people with a learning disability.

The Committee considered an interim report on the scrutiny review of services for people with a learning disability.

It was proposed that a final meeting of the review groups be held to consider the emerging themes and formulate recommendations to the Cabinet Member (Social Care Adults and Health).

The following principal points were made:

·          The high quality of staff working in very difficult situations needed to be recorded.

·          The operation of day centres needed to change and improve, responding to the choice offered to service users with personalised budgets.

·          That far too much of the Council’s resources were invested in buildings which were no longer appropriate.

·          That there was a need for more experienced staff to meet demands for extra care.

·          That Members’ visits had been appreciated by staff.

·          It was requested that in the final report the summary of expenditure set out on page 28 of the agenda papers should be presented in the Council’s standard format for accounts.

·          The implications of the fact that Herefordshire has a high level of learning disability residential care beds per head of population.

·          The need to ensure that day opportunities budgets reflected true costs and levels of service.

·          The importance of Central Government using demographic projections to plan future funding.

·          That services should be planned over a much longer timeframe.

RESOLVED:

That    (a)             the interim report be noted;

                        and

            (b)       a further meeting of the Review Group be convened to convert the emerging themes into recommendations for the Cabinet Member (Social Care Adults and Health).

To consider the Phase 1 needs analysis report assessing future social care needs and the services to meet them for older people and adults with learning disabilities. 

The Committee considered the Phase 1 needs analysis reports assessing future social care needs and the services to meet them for older people and adults with learning disabilities. 

The report noted that the Council had commissioned a group of Council and Primary Care Trust Officers to undertake a needs analysis of these key areas to inform future service development and financial planning.  The phase 2 report to be completed in August 2006 would set out costed options for the future development of services.

The Head of Adult Social Care noted that a national report, the Wanless Review, had recently examined the factors driving demand for social care and this was being used to inform the Council’s work.  She highlighted the following points in the needs analysis:

·          The disproportionate number of people in Herefordshire aged over 65 and the forecast percentage growth in this number by 2011 and 2020. 

·          The ability to pay for social care and the effect that higher home ownership rates and high house prices in Herefordshire had on the self funding of social care is not known.

·          Whilst in the 2001 Census 69% of Herefordshire’s population had said they were in good health the proportion stating their health was not good increased with age.

·          In terms of mental health dementia affected one quarter of people aged 85.

In the course of discussion the following principal points were made.

·          It was noted that, as described on page 93 of the agenda papers, in the majority of authorities 75% of those with a learning disability would be living with family carers.  In Herefordshire the figure was 29%.  This meant that a much higher proportion were living in registered care homes.  Herefordshire had the highest number of care beds as a percentage of the population in the West Midlands.  The availability of residential care beds made it appear a safe and easy option to choose.  Registered care was not, however, the most cost effective type of care nor in many cases the most appropriate form of care.  Work was underway to examine how the Council might be able to assist in providing appropriate supported accommodation.

·          The availability of residential beds had a further implication in that additional demands were placed on the Council’s community team for health and adult protection services from non-Herefordshire people taking advantage of the availability of beds.

RESOLVED: That the interim reports be noted.

To report progress with the adult social care improvement plan.

The Committee received a report on  progress with the Adult Social Care Improvement Plan.

The Director of Adult and Community Services presented the report.  He explained the background to the development of the Adult Social Care Improvement Plan in response to the Commission for Social Care Inspection’s assessment of Adult Social Care Services.  He noted that some elements of the Plan were being managed within the Council.  Other areas, as described in the report, were being managed as a project with additional capacity and support being provided by an external project manager appointed by the Department of Health. 

He commented on each of the five workstreams that would form part of the project and the composition of the Project Board which would oversee the project.  He emphasised the extent to which the Council wished to demonstrate its willingness to respond to the issues which had been raised in the inspection and its commitment to achieving improvement.

RESOLVED: That the report on Adult Social Care Improvement planning be noted.

To report on the performance indicators position and performance management initiatives for the Adult Social Care and Strategic Housing Divisions within the Adult and Community Services Directorate.

The Committee considered a report on the performance indicators position and performance management initiatives. 

The report stated that the outturn figures for 2005/06 represented a positive step forwards. 

The Performance Improvement Manager reported a number of amendments to the planned targets for 2006/07 set out in the appendix to the report. 

RESOLVED:

THAT     (a) the report on Adult Social Care and Strategic Housing performance be noted;

            and

   (b) areas of concern continue to be monitored.

To consider the Stage 4 Report and outcomes of the Best Value Review of the Private Sector Housing team.

The Committee considered the Stage 4 Report and outcomes of the Best Value Review of the Private Sector Housing team.

The report noted that the Stage 3 report had been considered by the Committee on 10th June, 2005 and endorsed by the Strategic Monitoring Committee on 1st July, 2005.  In addition to the improvements identified at that Stage, the Improvement Plan, as appended to the report, included a number of other improvements designed to ensure a more efficient and effective range of Services.

The Private Sector Housing Manager presented the Plan and reported on progress which had already been made.

The Committee expressed some surprise at the actions required in relation to the Decent Homes Strategy and some apparent anomalies, but noted that there was a national target to be met.

RESOLVED: That the draft Improvement Plan be  referred to the Cabinet Member (Social Care Adults and Health) to be finalised.

To review representation on the Committee from the Voluntary Sector.

The Committee reviewed representation on the Committee from the Voluntary Sector.

The report noted that the Committee had last formally reviewed its approach to co-option and user and care involvement in April 2002.  It was proposed that the Committee should strengthen its formal links with the Alliance by seeking a co-opted representative who could speak on behalf of the Alliance of Voluntary Sector Organisations in Health and Social Care in Herefordshire (the Alliance).  It was noted that the Alliance had said that it would like to nominate someone who could speak on behalf of the Alliance as a whole.

The Committee was also asked to consider whether it wished to seek any additional representation on the Committee or adhere to its practice of inviting participation in its work as the nature of its enquiries required.

RESOLVED:

That    (a) a formal representative of the Alliance as a whole be co-opted;

            and

            (b) participation in the Committee’s work otherwise be invited as the nature of its enquiries required.