This was the first meeting of the committee since the death of Councillor Jenny Hyde.  The chairperson paid tribute to work of Councillor Hyde, especially in terms of corporate parenting and looked after children, and expressed sincere condolences to her family.

No apologies for absence had been received.

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

No substitutes were present.

To receive any declarations of interests in respect of schedule 1, schedule 2 or other interests from members of the committee in respect of items on the agenda.

There were no declarations of interest.

To approve and sign the minutes of the meetings held on 29 January 2019 and 4 February 2019.

Resolved:

That the minutes of the meetings held on 29 January and 4 February 2019 be approved and be signed by the chairperson.

To receive any written questions from members of the public.

For details of how to ask a question at a public meeting, please see:

www.herefordshire.gov.uk/getinvolved

The deadline for the receipt of a question from a member of the public is Wednesday 27 February 2019 at 5.00 pm.

To submit a question, please email councillorservices@herefordshire.gov.uk

No written questions had been received from members of the public.

To receive any written questions from councillors.

The deadline for the receipt of a question from a councillor is Wednesday 27 February 2019 at 5.00 pm.

To submit a question, please email councillorservices@herefordshire.gov.uk

No written questions had been received from councillors.

To report on progress following the approval of the Learning Disability 10 year strategy in June 2018.

The senior commissioning officer presented the learning disability strategy update (appendix 1 to the report), the key points included:

a.    The learning disability strategy was a ten-year, joint strategy of Herefordshire Council and NHS Herefordshire Clinical Commissioning Group (CCG).

b.    The strategy and implementation plan aligned to the four themes: where I live; what I do during the day; being healthy and safe; and having choice and control.

c.    The Learning Disability Partnership Board involved a broad range of partners, including service users and providers.

d.    A learning disability dashboard was being developed to capture key data and track progress across the health and social care system.

e.    The implementation plan actions were currently on track to be delivered within the identified timescales.

f.     Examples were given of developments in progress to meet the priorities, including:

•        Where I live: joining together with Worcestershire County Council to commission specialist provision.

•        What I do during the day: improving the opportunities for people into paid employment through a staged employment project.

•        Being healthy and safe: the Herefordshire and Worcestershire Sustainability Transformation Partnership aligned the national priorities, developed local delivery plans, shared best practice and provided governance.

In response to a question, the senior commissioning officer and Jade Brooks, the acting director of operations of the CCG, both emphasised the importance of national programmes and working collectively to reduce health inequalities.  The chairperson noted the premature mortality profile of people with learning difficulties.

•        Having choice and control: embedding user engagement and promoting advocacy in all areas, with a number of initiatives to be launched during learning disability week (17 June).

g.    It was reported that there was significant work being undertaken to reposition services to deliver the strategy and the implementation plan would continue to be updated, with input from experts by experience.

The chairperson invited comments and questions from committee members, the principal points included:

1.       Committee members welcomed the high quality of the report and the presentation.

2.       Attention was drawn to the fact that all GP surgeries except one had improved systems to indicate on patient records when a person has a learning disability.  Jade Brooks confirmed that all the GP surgeries were expected to implement this measure.

3.       The senior commissioning officer advised the committee that the supported employment service focused on the individual, so opportunities in the localities and would be explored.  She added that a piece of work was being undertaken with community transport providers with a view to working together more closely.

4.       The chairperson noted that Herefordshire Council was a major employer and questioned what it was doing to encourage employment for people with a learning disability.  The senior commissioning officer recognised that more could be done to make job roles and the recruitment process more accessible.

5.       The senior commissioning officer said that the Learning Disability Partnership Board had undertaken work to promote bus passes and travel trainers were available to provide support.

6.       The senior commissioning officer clarified that the  ...  view the full minutes text for item 57.

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

Alex Crawford, service manager for Addaction Herefordshire, gave a presentation on (appendix 1 to the report), the key points included:

a.       100% completion of treatment outcome profiles (TOPs), used to monitor substance misuse and overall progress of clients.

b.       100% completion of risk and recovery plans, used to assess risks that clients might present to themselves or others and to inform individual care plans.

c.       Re-presentation rates to treatment services following successful discharge remained low, demonstrating that treatment was effective and sustainable.

d.       The ‘maintaining change’ group provided support and skills development for clients for twelve weeks following successful completions.  Arising from this, two independent peer led groups had formed to continue the work of this initiative in the community.

e.       Addaction Herefordshire had been awarded an ‘overall good’ rating from the Care Quality Commission (CQC) and clients had spoken positively about the service.

f.       There had been a ‘slight dip’ in opiate and non-opiate successful completions.  This was due to tackling more complex service users who had been in treatment for an extended period of time; Herefordshire had a larger number of older opiate users in treatment for 6 years or more (43.2%) compared to the national average (32.4%).

g.       A recovery mentor, who had come through treatment, had been appointed recently and was helping to dispel myths and encourage people to engage with the service.

h.       Alcohol and non-opiate rates had improved, reflecting high levels of participation in the new group offering.

i.        To build upon the good rating and summary from the CQC, Addaction Herefordshire was working to streamline its assessment process and would run a pilot scheme to obtain feedback from clients.

j.        Attention was drawn to the CQC’s positive comments about staff and their approach, the recovery-oriented care plans, the active involvement of clients in care planning, and how records and procedures demonstrated good practice in a number of areas.

k.       An overview was provided of the group provision and wide range of activities in Leominster, Ross and Ledbury, and Hereford.

l.        Funding had been received for a new lead role to provide a specialist service for veterans.

m.     An overview was also provided of the young persons’ service which involved young people taking the lead and encouraging their peers to come forward and seek support.

The chairperson commented that Addaction Herefordshire had improved dramatically in three years.  Alex Crawford acknowledged the initial difficulties but, with significant progress already made, there was excellent potential for people to make successful recovery journeys in Herefordshire.

In response to a question about interactions with partner agencies, the committee was advised that Addaction Herefordshire and 2gether NHS Foundation Trust were working holistically in the interests of clients with substance misuse and mental health issues.  Professor Jane Melton added that colleagues in adults’ and children’s services had also commented on the positive working relationships.

The senior commissioning officer public health said that the aging population had to be taken into account, both nationally and locally, in terms of commissioning strategy  ...  view the full minutes text for item 58.

To review the council’s approaches to avoidance of homelessness, and the local impact of the homelessness reduction duty, mental health, and universal credit.

The head of prevention and support gave presentations on the Homelessness Reduction Act 2017 (appendix 1) and on Universal Credit, mental health and vulnerable people (appendix 2).  The key points of the presentations and questions arising are summarised below.

Homelessness Reduction Act 2017

a.       The key legislation was contained in the Housing Act 1996, the Homelessness Reduction Act 2017 (HRA) amended Part VII of this legislation and came into effect in April 2018.

b.       The HRA placed increased statutory duties on local housing authorities to prevent homelessness and, if that duty fails, to relieve homelessness, including: the provision of a personal housing plan for every client and undertaking reviews at each stage; the provision of temporary accommodation at the prevention stage for a minimum of 56 days; earlier intervention to prevent homelessness; a new relief duty to provide assistance when preventions fail prior to homelessness; a new ‘duty to refer’ on other public services working with people who were at risk of homelessness or were homeless, albeit this duty did not apply to the police; and increased rights for clients to seek reviews of the council’s decisions.

In response to a question, the team leader housing solutions clarified that anyone who presented to a local authority who was at risk of homelessness would need to be provided with temporary accommodation and the local authority would have to meet the financial burden; previously a local connection had to be demonstrated.

c.       The duty to provide continued temporary accommodation protection for families had been extend from 28 days to 56 days, increasing the financial burden and placing pressures on the available temporary accommodation; the council had recently increased its provision from 41 to 45 places.  This additional burden was also reflected in increased use of bed and breakfast accommodation in Herefordshire; there had been five successive months of double figure placements in the period before Christmas 2018.  The housing solutions team were working with local landlords and with the housing strategy lead to secure additional accommodation and a wider range of housing types.

In response to questions, the team leader housing solutions advised: temporary accommodation provision was mainly in Hereford but there were units in Leominster and Ross, with some bed and breakfast accommodation was used in the market towns; and, if the authority had a statutory duty, 56 days was a minimum and clients would continue in temporary accommodation until suitable permanent accommodation could be found.

d.       The HRA had increased workload for the housing solutions teams, metrics included: the average allocation of cases had increased to over 20 per day; footfall into the service had increased by 59%; there had been 9884 presentations in the last twelve months; and the current caseload was 562 people.

e.       The rough sleeping outreach service currently identified 12 rough sleepers, mostly in Hereford but also in Ross and in other rural areas.  The service continued to provide support to 50 people, who had been rough sleeping previously, to help them sustain the accommodation secured  ...  view the full minutes text for item 59.

To consider the committee’s work programme.

The chairperson introduced the item and the committee discussed the following items for potential inclusion in the work programme.

a.       A committee member suggested that the committee could examine the role of police community support officers in identifying and reducing vulnerability, and building community resilience.

b.       The chairperson proposed that the first item for the new council term should be the NHS Long Term Plan, system leadership, and integration.

c.       In response to a question from the chairperson about NHS England’s report on Continuing Health Care (CHC), Jade Brooks confirmed that the report had just been received by the CCG, it would be shared with the director of adults and communities, and endorsed this being featured in the work programme.

d.       A committee member suggested that the issue of ‘digital in the NHS’ be included in the work programme.

The chairperson noted that it would be for the committee to finalise its work programme for 2019/20 in the new council term.

Resolved:

That the potential work programme items for 2019/20 be noted.

Monday 24th June 2019, 2.30pm (provisional)

The provisional date of the next meeting was Monday 24 June 2019.

At the conclusion of the meeting, the chairperson and vice-chairperson thanked members and officers for their hard work in making this an effective scrutiny committee during the last four years.