To receive apologies for absence.

Apologies were received from Councillors MJ Fishley and GA Powell.

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

Councillor PL Bettington substituted for Councillor MJ Fishley.

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 services for people with learning disabilities.

To approve and sign the Minutes of the meeting held on 13 December 2010.

RESOLVED: That the minutes of the meeting held on 13th December, 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 an updated report for the Committee on Adult Safeguarding within Herefordshire.

The Committee received a report on the latest position on adult safeguarding within Herefordshire.

The Head of Safeguarding reported that the Department of Health had published a report entitled A Vision for Adult Social Care Capable Communities and active Citizens which set out the overarching principals for adult social care and provided a context for future reforms. The document reinforced the commitment to the local community being part of the safeguarding framework, and the importance of the personalisation agenda whereby people make informed choices regarding the care they received. However, the there will be an even greater need in future to balance safeguarding against a person’s rights to make decisions about how they live their lives

The Safeguarding Adult Board provided the multi agency strategic leadership for safeguarding adults.  Whilst it had not been in existence for as long the Safeguarding Children Board, their work increasingly dovetailed in order to ensure that robust safeguarding processes were in place across the County.  The Board would be chaired by the Interim Director of Adult Social Services and would have representatives from the agencies involved in the safeguarding of adults, ranging from the Police to the Third Sector.  The joint working between the Boards would ensure that there were improved linkages between Adult Social Care and Children’s Services.

The Head of Safeguarding went on to say that a Quality Concerns Process was being developed whereby early intervention could take place to support care homes when quality issues were identified in order to lessen the risk of safeguarding issues.  In addition, a MARAC (Multi Agency Risk Assessment Conference) had been set up.  This was a meeting where information was shared between different agencies on the highest risk cases of domestic abuse including: police, criminal justice, health, child protection, adult social care, housing, Independent Domestic Violence Advisers and other specialists from the statutory and voluntary sectors. Herefordshire MARAC reviewed approximately 50 cases per quarter and had recently received a quality assurance visit from CAADA (Co-ordinated Action Against Domestic Abuse).

In the ensuing discussion, the following points were made:

• In reply to a question from a Member, the Interim director of Adult Social Services said that it may not be appropriate that the Safeguarding Board should include elected Members, as it was primarily an operational Board that would be considering procedural matters and confidential cases.  The Board would be accountable to Members through this Committee and the NHS Herefordshire PCT Board, in line with the practice of the Children’s Safeguarding Board.  She undertook to review the Membership of the Board in the light of comments made. She added that the Council’s responsibilities under Section 75 of the National Health Service Act 2006 would also be reviewed. 

• In reply to a further question, the Head of Safeguarding said that in order to ensure that the agencies involved were working together, there were regular monthly meetings between all the parties concerned at which frank discussions were held.

• In reply to a question from a Member as to  ...  view the full minutes text for item 53.

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 Sustainable Communities Directorate for the period to 30 November 2010. The report provides the variations against budget and a projected outturn for the year.

The Committee noted a report on the financial position for the Adult Social Care and Strategic Housing revenue budgets for the period to 30^th November 2010.

The Principal Accountant reported that the current forecast outturn for November 2010 had predicted an overspend of £3.81m for Adult Social Care, while Strategic Housing would come in on budget.  A detailed Recovery Plan was appended, which outlined the targeted savings of within Adult Social Care of £2m.

The Principal Accountant went on to say that following saving that had already been made, there was a balance of £876k to be achieved by the end of the year.  She outlined the areas where the budget was under pressure and remarked that one of the main areas was that of the projection for residential, nursing, and domiciliary care, which amounted to a total of £248k.  As fewer personal budgets had been approved than had been budgeted for, there had been a saving of £139k.  As a result of reassessments of clients, the Shaw contract for residential care had decreased and the anticipated increase in client contributions was £70k for the year.

The Principal Accountant said that the Interim Director was now attending monthly budget clinics and was actively involved in cost improvement plans that were outlined in the report before the Committee.

The Interim Director of Adult Social Services said that there was a need to look more strategically at the services that were being delivered, and how they could be more efficiently managed.  A complete rethink of service provision was required in order to ensure that services were affordable to those on individualised budgets.  There was also a need to give consideration as to how the people who were self funding could be supported to help them remain living independently. 

In the ensuing discussion, the following points were made:

·          That the Council would be in a position to shoulder some of the basic administrative work for those on individual budgets. 

·          In reply to a question from a Member about the number of long term carers over the age of eighty in the County, the Interim Director said that there were a number of adults with a learning disability between 40-55 years of age who were being cared for in the County whose needs had not yet been addressed in order to allow them to live more independently.  Discussions were in hand with providers to offer shared tenancies to these people, as a large number of them still lived with their families.  The carers concerned after would still be in a position to shape and plan the care, but would be able to retire from undertaking care on a daily basis.

·          In reply to a question regarding the Shaw Healthcare contract, the Interim Director said that this was a long term contract.  The Council is working actively with the company to diversify to address the needs that the Service had.

·          In reply to a Member, she went on to say that Supporting  ...  view the full minutes text for item 54.

To provide an updated report on progress in achieving national performance indicator targets and other local performance indicators in Adult Social Care within the Integrated Commissioning Directorate and to update the Committee on proposed changes to the national performance and outcome framework.

The Committee received an updated report on progress in achieving national performance indicator targets and other local performance indicators in Adult Social Care within the Integrated Commissioning Directorate and to update the Committee on proposed changes to the national performance and outcome framework.

The Interim Director of Adult Social Services reported that there were changes taking place in the way that the Service would be performance managed in the future as part of the Government’s Vision for Social Care consultation.  There would be no more Annual Performance Assessments of Councils, and the last one had been published on the 25^th November 2010.  The consultation document set out the need to ensure the best outcomes for those needing social care, their families, carers and the wider local community. There were a number of key themes within the paper, which included the provision of a single Quality and Outcomes Data Set (QODS) to replace existing reporting requirements. Appendix 2 outlined an example of what might be required under the new system.

The Interim Director went on to say that the national milestone target for NI 130 (Social Care clients receiving self directed support) was 30%, and that Herefordshire was behind other areas in delivery against this target.  Work was being undertaken in this are, and it was intended that all eligible clients should be offered a personal budget by March 2011.

She went on to say that NI 142 (the number of vulnerable people supported to maintain independent living) was below target, but that there would be changes to the service which would improve the situation.

The Interim Director said that the number of safeguarding referrals continued to increase, but that this was a positive outcome from increasing awareness and increased publicity.  There was a question as to how this should be effectively managed.  The introduction of a new customer services officer to screen new referrals should alleviate some of the pressure. 

Improvements in discharge planning have been identified for improvement and efforts were being made within the County Hospital to improve its patient Discharge Policy.  Further improvement would be made as part of the next year’s commissioning intentions and priorities.

RESOLVED

THAT:

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

(b)         Areas of concern continue to be monitored; and;

(c)         That the Health Scrutiny Committee should be invited to give further consideration to the issue of delayed discharges from hospital.

To provide an updated report on the progress towards the achievement of national performance indicator targets and other local performance indicators for Homes and Communities (formerly Strategic Housing Services) within the Sustainable Communities Directorate and to consider the subsequent plans to improve performance in 2010/11.

The Committee noted an updated report on the achievement of national performance indicator targets and other local performance indicators for the Homes and Communities (formerly Strategic Housing Services within the Sustainable Communities Directorate and to consider the subsequent plans to improve performance in 2010/11.

The Cabinet Member (Environment and Strategic Housing) replied to a question from a Member, and said that he agreed that there was a need for additional three to four bed affordable housing within the County, and the Council would continue to work with Herefordshire Housing in order to help ensure that this happened.

RESOLVED

THAT:

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

(b)         Areas of concern 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.