To provide an overview of the services within the portfolio of the committee, including good practice and challenges, in order to provide context for the committee and to identify any items that they may wish to explore further as part of their ongoing work programme.

The Chairperson advised the meeting that the purpose of this item was to introduce the services within the scrutiny remit of the committee, including good practice and challenges, in order to provide context and to inform work programming.  The slide pack was published to the webpage for the committee following the meeting (link to the presentation).

The slides presented by officers from the Community Wellbeing Directorate are outlined below, with a summary of the principal lines of questioning by committee members.

A            The Corporate Director Community Wellbeing presented: Purpose of the Presentation; What is Community Wellbeing?; Who Are We?; and Transformation Strategy.

B            The Service Director - Social Care Delivery presented: Social Care Delivery – Overview of Services; Social Care Delivery – Challenges and Opportunities; and Social Care in Practice - Achievements 22/23.

b.1.      With reference made  to ‘CQC inspection readiness’, it was clarified that CQC was the acronym of the Care Quality Commission, the independent regulator of health and social care in England.

b.2.      In response to a question from the Chairperson about meeting the challenges of increasing demand, the Service Director – Social Care Delivery outlined the work that was underway in terms of: the Talk Community programme to understand and harness universal services; linking with other council departments and external partners to enhance connection into communities; and utilising technology.  The Corporate Director Community Wellbeing added that there was a need for better insight in terms of the people paying for their own care (self-funding) given the implications for the council when their savings went below the upper capital limit.

b.3.      In response to questions from the Vice-Chairperson, the Corporate Director commented on: the importance of appropriate information sharing between health and care providers; the additional challenges posed by inflationary pressures; and the need for people to maximise the benefits that they were entitled to.  The Chairperson said that the ‘discharge to assess’ process (where people were discharged from hospital to their own home or another community setting) could help to capture relevant intelligence.

b.4.      In response to questions from a committee member, the Corporate Director commented on: the need to factor in changing demographics and lifestyles, such as the increasing number of renting households; how Herefordshire's Joint Strategic Needs Assessment would inform the modelling going forward; the focus on supporting people in their own homes, involving a range of housing options; the challenges associated with recruitment and delivering services in Herefordshire, particularly given the issues around rural sparsity and geography; and the use of forecasting to inform future housing development.  The Chairperson noted that the authority was mindful of the concept of intergenerational living.

C            The Service Director - All Age Commissioning presented: All Age Commissioning - Service Overview; All Age Commissioning - Cycle; All Age Commissioning – Need; and All Age Commissioning – Opportunities and Challenges.

c.1.      The Chairperson requested that future reports and presentations avoid the use of acronyms and abbreviations, or should include glossaries.

c.2.      The Chairperson welcomed the involvement of the Local Government Association in supporting transformation initiatives.

c.3.      In response to a question, an overview was provided of the ‘Community Paradigm’ approach which considered how more power and resources could be given to communities, including opportunities to take more flexible and innovative approaches to commissioning.

c.4.      In response to concerns expressed about out of county placements, the committee was advised about: the development of the Placement Sufficiency Strategy for Children and Young People which set out a number of actions to ensure sufficiency of provision; and the ongoing engagement with local providers, particularly given the increasing numbers of looked after children nationally, to ensure that the authority was a referrer of choice and to encourage the development of the offer within the local footprint.

c.5.      The Vice-Chairperson commented on the merits of previous scrutiny activity which had engaged openly and frankly with local providers, demonstrated that proprietors and staff cared passionately about their clients, and identified the need for flexibility within contracts.  The Service Director – All Age Commissioning confirmed that officers were meeting with current providers regularly and had contacted others to understand the barriers to contracting with the council.  It was also reported that officers continued to explore issues around flexibility and geographic boundaries within contracts.

D            The Director of Public Health presented: Public Health – Service Overview; Population Outcomes of Concern; and Opportunities and Challenges.

d.1.      The Chairperson commented that: Public Health was a small team but had a big agenda; testing commissioned services could help to achieve best value for money; and the Joint Strategic Needs Assessment provided important data on health and wellbeing needs.

d.2.      In response to questions about NHS health checks, it was explained that: local authorities were required to invite 20% of their eligible population (40-74 year olds) each year; the authority was not performing particularly well in terms of uptake but there had been improvements; consideration was being given to targeting those people who might benefit the most; and the checks were standardised but, depending on the risk score, other investigations may be undertaken.

d.3.      The importance of tacking health inequalities in the most deprived areas was acknowledged, including issues around mental health especially given the additional factors following the Covid pandemic and with the cost of living.

d.4.      A committee member commented on interactions between sports and leisure centres and health services which supported early intervention and prevention aims.

[Note: There was a short adjournment before the next topic]

E            The Strategic Housing Manager presented: Housing; Housing – Key Data; and Housing – Opportunities and Challenges.

e.1.          A committee member commented on the impact of interest rates on the ability of housing associations to deliver and maintain social housing.  In response to a question, the committee was advised that the council was not a ‘stock-holding’ authority, as it owned less than 200 units, but it did acquire properties on the open market for supported housing for specific client groups, working closely with housing associations and operated under full repairing leases.

e.2.          A committee member commented on the importance of building ‘complete communities’ to promote social cohesion.  In response to a question, it was noted that the capital investment budget had made provision of £20m for strategic housing development but there were potential challenges in terms of achieving sufficient rents to pay the interest on loans.  The committee was advised that a mixture of affordable housing types was sought in negotiation with developers.

F            The Head of Prevention and Support presented: Prevention and Support; and Prevention and Support - Opportunities and Challenges.

f.1.            The Chairperson noted the difficulties associated with recruitment and retention, including the national shortage of occupational therapists.

f.2.            A committee member commented on the need to assist people to overcome any apprehensions around technology enabled living, and on the need for volunteers to feel supported in their endeavours.  The Head of Prevention and Support spoke about the potential use of technology to engage and inform people pro-actively, focused on their particular needs and interests.  The committee member noted the social value of investment in transformational programmes, particularly to enable people to live happier and more independent lives.

f.3.            In response to comments by another committee member, it was noted that both broadband and mobile telephony based technology solutions were required to ensure geographic coverage and resilience.

G           The Service Director – Communities presented: Talk Community - Building Stronger, More Connected Communities Where Everyone Can Thrive; Talk Community – Activity Infographic; and Talk Community - Challenges and Opportunities.

g.1.          A committee member said that the potential of the Talk Community concept was recognised but the profile and activity of some hubs needed to be addressed, and the identified review of the Talk Community offer was welcomed.

g.2.          Another committee member suggested that further thought could be given to the ‘Talk Community’ title.

The Cabinet Member Adults, Health and Wellbeing made concluding comments about: the level of enthusiasm demonstrated by all the officers during the session and the hard work undertaken throughout the directorate; the value of social prescribing in relation to prevention; the challenges of achieving economies of scale in terms of council housing but there could be opportunities to utilise council-owned land to facilitate development to meet specific housing needs; a review of Talk Community was needed to ensure that the hubs were effective and as accessible as possible; and the increasing demand for services and other budgetary pressures highlighted the importance of invest to save initiatives to deliver longer-term benefits.

The Chairperson thanked the attendees for their participation and valuable contributions.

Resolved:

That the presentation be noted and the slide pack be published to the webpage for the committee, (link to the presentation).