Apologies for absence had been received from Councillors PE Crockett and JA Hyde.

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

Councillor J Hardwick was a substitute member for Councillor PE Crockett.

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 meeting held on Tuesday 27 November 2018.

RESOLVED:

That the minutes of the meeting held on 27 November 2018 be confirmed as a correct record 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 23 January 2019 at 5.00 pm.

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

Accepted questions will be published in an agenda supplement prior to the start of the meeting.

It was reported that one question had been received; the accepted question and response are attached as an appendix to these minutes.

The chairperson thanked Paul Symonds, a Ross-on-Wye Town Councillor, for his question and advised that the question would be considered during the committee work programme item (minute 41 refers).

To receive any written questions from councillors.

The deadline for the receipt of a question from a councillor is Wednesday 23 January 2019 at 5.00 pm.

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

Accepted questions will be published in an agenda supplement prior to the start of the meeting.

It was reported that no written questions had been received from members of the council who were not members of the committee.

To review the annual report of the Herefordshire Safeguarding Adults Board (HSAB).

The chairperson invited Ivan Powell, the Independent Chair of the Herefordshire Safeguarding Adults Board (HSAB), to present the annual report 2017/2018.

Mr. Powell introduced the report, drawing attention to the following:

i.           The function of HSAB was to oversee multi-agency safeguarding arrangements across the county.

ii.         The opportunity to speak to the committee was welcomed, especially in view of the need to raise the profile of adults safeguarding with the public.

iii.        The annual report focused on how HSAB had delivered against the following strategic priorities: partnership working; prevention and protection; communications and engagement; and operational effectiveness. 

iv.        Informed by board development days, the annual business plan formed the foundation for the work of sub-groups to deliver outcomes.

v.         Emerging issues included modern slavery and drugs activity and exploitation known as ‘county lines’.

vi.        There were issues with consistent attendance at HSAB meetings, especially by the National Probation Service, and Warwickshire and West Mercia Community Rehabilitation Company.  It was anticipated that bespoke agenda items would encourage participation at specific meetings going forward.

vii.       Although performance information from the council and health partners was timely and accurate, the police remained unable to provide meaningful data but work was ongoing to address this situation.

viii.      Although noting limitations with the national data set, the ‘proportion of people who use services who feel safe’ and the ‘proportion of people who use services who say that those services have made them feel safe and secure’ performance was considered very good.

ix.        There had been a steady reduction in the ‘number of concerns raised’ but there was still too big a gap between the number of concerns raised and the number progressing to enquiry stage, reflecting over referral by some agencies.

x.         More work was needed to embed ‘making safeguarding personal’; HSAB had disseminated Local Government Association toolkits to partner agencies.

xi.        Another area of work would be to triangulate the type of risk, the location of risk, and the person presenting the risk.

Mr. Powell responded to questions from committee members, the principal points of the discussion included:

a.         The chairperson sought clarification about the following paragraph in the foreword to the annual report ‘We also have more to do to secure the engagement and feedback from adults who have been involved in safeguarding so that we can learn from their experiences.  Healthwatch are leading on this work locally and I am determined that we will build on what has been a slow start for this piece of work.’

Mr. Powell advised the committee that, informed by the exemplary work of Cheshire East Safeguarding Adults Board, HSAB had tried to secure engagement and feedback in previous years but this had not been effective; it was challenging to obtain experiences without retraumatising the individuals concerned.  Healthwatch Herefordshire had offered to support this process and a short survey had been developed to prompt appropriate conversations.  The number of respondents remained low but represented an improvement on the previous approaches. 

Mr. Stead added that Healthwatch Herefordshire  ...  view the full minutes text for item 39.

To make recommendations to the executive regarding the updated joint domestic abuse strategy for Herefordshire.

The chairperson welcomed the involvement of members, from the adults and wellbeing scrutiny committee and the children and young people scrutiny committee, in workshops to inform the development of this updated strategy.

It was reported that, as strategic delivery and leadership would be provided by the Community Safety Partnership, it would be for general scrutiny committee to monitor implementation going forward; statutory community safety and policing scrutiny powers were delegated to that committee.  In view of the recently formed adults and communities directorate, the chairperson considered that the scrutiny committee remits should be reviewed.  The chairpersons of the general scrutiny committee and of the children and young people scrutiny committee concurred that safeguarding matters should be delegated to the most appropriate scrutiny committee.

The senior commissioning officer gave a presentation, updated to reflect recent feedback, and drew attention to the following:

I.          The work had been led by adults and communities but had been developed in conjunction with other teams and partner organisations.

II.         This was a complex issue and, with no single place that a person might disclose domestic abuse, a shared approach to identifying and responding to domestic abuse was of vital importance.  It was a high priority across the public sector and emergency services but no additional resources were available for implementing the strategy.

III.        An overview was provided of the research and engagement activity undertaken; details of the discussions with stakeholders were included in an appendix to the strategy and would inform the development of the action plan.

IV.       It was reported that significant progress had been made to achieve the outcomes in the 2014-17 strategy and outstanding actions had been incorporated into the 2019-22 strategy.

V.        It was recognised that many incidents were not reported to the police.  In the year ending March 2017, West Mercia Police recorded 3,071 victims but it was estimated that, applying national self-reported prevalence rates, there were approximately 5,900 victims aged 16-59 in the county.  In England and Wales, 16 to 19-year-olds were most likely to say that they had experienced domestic abuse in the last year but it was anticipated that, due to Herefordshire’s demographics, there could be an older age profile of potential victims in the county.

VI.       Following feedback from the Community Safety Partnership, a revised shared vision was suggested as follows: ‘Our shared vision is that domestic abuse is unacceptable to people and communities in Herefordshire and the harm it causes will be prevented as people and communities: understand and have the skills to establish healthy relationships; recognise and reject all forms of domestic abuse; and seek, are offered and receive effective help and support early.’

VII.      An overview was provided of the priorities of prevention, provision of service, and partnership working.  It was noted that the published presentation referred to the fourth priority as ‘criminal justice’ but this should read ‘pursuing perpetrators’.

There was a brief discussion about the complexities of managing risks to individuals, especially where victims chose to remain in relationships, and the  ...  view the full minutes text for item 40.

To consider the committee’s work programme.

The chairperson introduced the item and drew attention to the following:

Updated work programme 2018/19

1.         The updated work programme included an additional meeting on 4 February 2019 to consider the alternative budget proposal 2019-20 submitted by the It’s Our County group.

Question from Paul Symonds

2.         In view of the question, ‘Would the committee consider building into its work programme the review and scrutiny of the decision by Wye Valley NHS Trust to close a number of Minor Injury Units (MIU) in the county?’, the observations of NHS Herefordshire Clinical Commissioning Group (CCG) had been sought on the matter.

3.         It was reported that the acting director of operations of the CCG had commented that the temporary closure was in effect and would re-open on 26 April 2019 and the volume of people supported by the MIU in Ross-on-Wye and Leominster was very low.

4.         The chairperson proposed that a report on emergency and urgent care, including the MIU, and on the broader performance of Wye Valley NHS Trust, be brought back to the committee during the new council term.

Request from the audit and governance committee

5.         The audit and governance committee, in considering corporate and directorate risk registers (minute 348 refers), had requested the scrutiny committee to consider including delayed transfers of care and care home ratings in its future work programme. 

6.         The chairperson proposed that these topics be considered by the scrutiny committee as part of its work programming session during the new council term.

7.         The chairperson advised that the director of adults and communities had made a draft presentation available for circulation to scrutiny committee members on the care market.

Response of the CCG on NHS Continuing Healthcare (CHC) Framework in Herefordshire recommendations

8.         It was reported that, following the 20 September 2018 meeting, recommendations were submitted to the CCG.  The chairperson had received a letter in response from the managing director of the CCG dated 16 November 2018.

9.         The chairperson commented that it was disappointing that, given the recommendation ‘The CCG be requested to influence the report of the NHS England to be a system review and to include the local authority in that review’, work had gone ahead without the local authority being involved.  She added that, whilst CHC may be led by the CCG, it required a system wide understanding and response.   Nevertheless, it was encouraging that staff training and new working arrangements had been put in place since the joint review.

10.      It was requested that a joint CCG and local authority update on the report findings be provided as part of the scheduled item on health and care system leadership, integration and the better care fund.

RESOLVED:  That

1)         the updated work programme for 2018/19 be approved;

2)         Herefordshire NHS Clinical Commissioning Group and Wye Valley NHS Trust be requested to prepare a report on emergency and urgent care, including the Minor Injury Units, and the broader performance of Wye Valley NHS Trust for consideration during  ...  view the full minutes text for item 41.

To confirm the date of the next scheduled meeting in public.

Monday 4 February 2019 at 10.00am.