To receive apologies for absence.

Apologies were received from Councillors J.G. Jarvis, R. Mills, R. Preece and P.G. Turpin.

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

Councillor J.P. Thomas substituted for Councillor R. Preece.

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 2nd October, 2006

RESOLVED: That the Minutes of the meeting held on 2nd October, 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.

There were no suggestions from members of the Public.

To report on the revenue budget’s financial position for Adult Social Care and Strategic Housing as at the end of October 2006 and to provide projections to the end of the financial year.

The Committee considered the position on the revenue budget for Adult Social Care and Strategic Housing as at the end of October 2006 and projections to the end of the financial year.

The Interim Finance Manager presented the report updating some of the figures in the report.  The projected outturn as at the end of October for Adult Social Care was an overspend of £1.437m against a budget of £31.1m. This compared with a  projected outturn in the Integrated Performance Report as at the end of September, as reported to Cabinet on 16 November of £2.743m.

The Director of Adult and Community Services commented that the financial position was significantly better than it had been but there was still a major challenge to face.  The recent work on analysis of future social care needs for older people had highlighted the demographic pressures facing the Council. 

In response to a question the Head of Strategic Housing Services explained action being taken in respect of homelessness.

RESOLVED:  That the projected 2006/07 financial outturn for Adult Social Care and Strategic Housing 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 the performance indicators position and performance management initiatives for the Adult Social Care and Strategic Housing Divisions within the Adult and Community Services Directorate.

It was reported that the Commission for Social Care Inspection had given the Council’s adult services a one star rating judging that the Council was serving some adults well and that the capacity to improve services was uncertain. Work on  the Adult Social Care Improvement Plan was progressing and it was hoped that this would lead to an improved judgment in 2007.

·          Best Value Performance Indicator 183b (the average length of stay of Families with Children in hostel accommodation) was discussed.  The Head of Strategic Housing Services noted that the figure for the second quarter was high but related to one family.  He assured the Committee that officers did seek to encourage people to apply for accommodation but on occasions it was difficult to house some families.

·          It was acknowledged that the way in which the Council’s one star rating had been reported on the local radio station had not been helpful and ignored the work which had been carried out to improve on the previous rating.

·          It was requested that an update be provided on how the In Control pilot project under which individuals with a learning disability were provided with indicative individual budgets was going.

RESOLVED: 

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

                        and

         (b)           areas of concern continue to be monitored.  

To consider Cabinet’s response to the recommendations made to it in the Scrutiny Review of services for people with a learning disability.

The Committee considered Cabinet’s response to the recommendations made to it in the Scrutiny Review of services for people with a learning disability.

It was noted that the majority of the recommendations had been accepted.  An action plan was appended to the report.

A question had been received from a Member of the Public relating to recommendation h: that models of provision should be developed which maximise funding streams, and the comment in the report that moving away from registered residential to more independent living would promote access to other funding streams.  The correspondent had asked, “in the enthusiasm to move away from registered residential provision to more independent living is there not a danger that the care package for some individuals in the Community may in fact cost more than if they were in residential care.  For example an individual could receive up to 5 visits a day and this might cost more than if they were in a residential set up?”

The reply to the question was as follows:

“National and local consultation has shown that older and disabled people want to have services that enable them to live as independently as possible in their own homes.  The development and provision of services that support people to remain independent within their local community is a key priority for the Council.

All services users have a Community Care Assessment to determine their needs, and a care package drawn up to meet these needs.  There are some cases where the assessment process identifies needs which are capable of being met by two or more alternative packages, for example an intensive home care package or a residential placement and the cost of the home care package is greater than the residential placement.  In such cases the Council will take account of the service users and family’s wishes, whether the care package would preserve the person’s independence in their own home and the relative cost of alternative care packages.  The Local Authority will seek to secure the most cost effective package of care services that meet the individual care needs, taking account of the users and carers own preferences.”

RESOLVED:   That Cabinet’s response to the findings of the review of the services for people with a learning disability be noted and an update provided to the Committee in March.

To consider the findings and recommendations of the review of future social care needs of older people and people with learning disabilities and the services needed to meet them. 

The Committee considered the findings and recommendations of the review of future social care needs of older people and people with learning disabilities and the services needed to meet them. 

The context for undertaking the review had been that Herefordshire’s adult social care services had been facing increasing financial pressures, against a background of continuously increasing user demand.  Substantial additional investment and improvements had been made but the Council’s performance continued to lag behind high-performing comparable local authorities.

In order to understand the demographic pressures facing the County and the way the pressures might translate into service needs to vulnerable adults the Council, jointly with the Primary Care Trust (PCT) had agreed to commission a detailed needs analysis looking at the demographic pressures and how these might translate into service needs.  This work had been independently validated and benchmarked with high-performing authorities elsewhere in the country and was regarded as representing best practice. The costings in the report were also considered robust.

The report and appendices set out the analysis undertaken and summarised the conclusions both in terms of the demography and the way in which that demography would translate into increased service needs and budget pressures. 

The reports also set out a strategy for the future based on a significant shift to a more preventative model of services, which would require a much greater contribution from the voluntary sector. 

It was stated that this new model of service would require some additional investment but not as much as would the current model of service.  It would also enable the Council to improve significantly the quality of services available to the residents of Herefordshire. 

The Corporate Policy and Research Manager gave a presentation highlighting key aspects of the report.  This summarised the assessment of the needs of older people and people with learning disabilities, how the Authority’s performance and approach compared with comparator authorities and the proposed way ahead.

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

·          The issue of housing needs and provision of affordable housing was discussed.  It was noted that it was hoped that the new Unitary Development Plan would help deliver more affordable houses. 

·          The report noted the importance of the voluntary sector contribution to the proposed better services, particularly so as to enable people to continue to live independent lives in their own communities.  The Committee was informed that from the Voluntary Sector’s perspective the report was impressive.  The Herefordshire Alliance of Voluntary Sector Organisations was undertaking a considerable amount of work to improve service delivery capability and accredit suppliers.  Nevertheless a huge task was faced.

·          Attention was drawn by Members to the references in the report to the fundamental importance of good ICT systems including systems for data collection and analysis.  It was proposed that the importance of developing appropriate, effective and compatible systems with the Council’s partner organisations should be emphasised to Cabinet.

·          A question was asked about changes to the thresholds governing eligibility for care.  In reply it was  ...  view the full minutes text for item 39.

To provide information on the Local Authorities (LA) responsibilities in relation to the provision of care in registered care home settings and to explain the associated financial commitments.

The Committee was informed of the Local Authority’s responsibilities in relation to the provision of care in registered care home settings and the associated financial commitments.

The report noted the requirement on Local Authorities to provide care homes and the desire of most older and disabled people to have services provided which enabled them to live as independently as possible in their own homes.  Local authorities were expected to seek a financial contribution from individuals towards the costs of the care.  The processes for assessing that contribution for care at home and care in a registered care home were set out in appendices to the report.

It was noted that whereas charges for care in a care home were prescribed by Government the Council had more discretion in setting charges for care at home.  Recommendations on this point were being made in the Adult Social Care Improvement Plan and arising from the review of future social care needs, the subject of a separate report to the meeting.

The Committee noted also the requirements governing the contribution of the Primary Care Trust in relation to the provision of nursing care in a care home and the importance of a co-ordinated and consistent approach to care assessment with the Council.

RESOLVED:   That the report be noted.

To inform the Committee about the provision of minor adaptations to homes within Herefordshire and to outline the ways in which these can be accessed.

The Committee was informed of arrangements for the provision of minor adaptations to homes within Herefordshire.

It was reported that processes were examined to seek to generate efficiencies.  Attention was drawn in particular to the increase in the scope for  self-referral to the Occupational Therapy service whereas traditionally this had been through a GP and the success this had had in enabling simple needs to be met more quickly and allowing more Occupational Therapy staff time then to be focused on more complex assessments.

The preventative benefits of the you@home repairs service providing assistance to vulnerable people in their homes by carrying out essential or urgent works up to the value of £1,000 was also highlighted. 

RESOLVED: That the arrangements for accessing minor adaptations in Herefordshire be noted.

To consider the Committee’s work programme.

The Committee considered its work programme.

The intention to include a report summarising recommendations made by the Committee and corresponding outcomes was noted.

RESOLVED:  That the work programme as amended be approved and reported to the Strategic Monitoring Committee.