Agenda and draft minutes

Apologies for absence had been received from Councillor Sandra Smith (North Warwickshire Borough Council) and from Councillor Penny-Anne O'Donnell for her late arrival.

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To receive the Minutes of the committee meeting held on 15 February 2023.

The Minutes of the committee meeting held on 15 February 2023 were approved as a true record and signed by the Chair.

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Up to 30 minutes of the meeting is available for members of the Committee to put questions to the Portfolio Holder: Councillor Margaret Bell (Adult Social Care and Health) on any matters relevant to the remit of this Committee.

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Members of the Committee are invited to give notice of questions to NHS commissioners and service providers at least 10 working days before each meeting. A list of the questions and issues raised will be provided to members.

Councillor Colin Cape had submitted the following questions:

“What is being done to monitor the provision of care to veterans, in line with the Armed Forces Covenant legislation? Are the principles being followed and do ex-servicemen and women get the focus that they should?

As part of the covenant veterans are supposed to receive accelerated or enhanced provision, depending on need. How is this monitored? What percentage of the target populations are veterans?

On Social Care, how many veterans are on the books, what enhanced treatment do they receive? Access to mental health resources, how many veterans etc. If we don’t have the figures, we cannot monitor. If we don’t monitor, we don’t know if the covenant is being met and it is purely words on a page”.

A written reply to these questions would be provided after the meeting.

For the Committee to consider and comment on the Quarter 3 organisational performance and progress against the Integrated Delivery Plan.

Pete Sidgwick, Assistant Director, Adult Social Care introduced this item and gave a presentation to pull out the key messages. The report summarised the Council’s performance at the end of the third quarter (April-December 2022) against the strategic priorities and areas of focus set out in the Council Plan 2022-2027. This report drew out relevant areas within the Committee’s remit from that presented to Cabinet on 16 February. Sections of the report together with detailed supporting appendices focussed on:

·   Performance against the Performance Management Framework

·   Progress against the Integrated Delivery Plan

·   Management of Finance

·   Management of Risk

The report provided a combined picture of the Council’s delivery, performance and risk. Overall, there had been an improvement in performance when compared with the Quarter 2 position. There were ten key business measures (KBMs) within the remit of the committee. Of these, nine were reportable in this quarter. A table set out the quarterly performance data, with eight of the KBMs assessed as being on track and one was not on track.

The report detailed key emerging themes. These included increasing service demand, capacity and workload issues impacting delivery across the organisation and difficulties in recruiting and retaining staff in a highly constrained national and local labour market.

There were notable aspects of positive performance, with the report highlighting that no care providers had exited the market due to business failure. Another area was the consistently reducing data for people with a learning disability or autism in an inpatient unit.

Performance challenges were reported, the main one being a steep decline in the number of carers in receipt of support during this quarter. However, this could be attributed to additional support being provided by the Carer’s Trust.

The report set out services’ projected performance trajectory. This was positive, in terms of delivery of the 29 Adult Social Care actions set out in the Integrated Delivery Plan, with 80% being on track and 3% complete. Seventeen percent of actions were classified as at risk and these actions were reported on in more detail.

One of the Councils strategic risks related to Adult Social Care and Health directly and currently had a ‘red’ status. Two other red rated strategic risks related to inflation and the cost of living, and the economy might impact on service provision and service demand. At the service level, two risks were rated ‘red’, being the risk of care market failure and the risk of an ongoing impact on public health resources of responding to Covid-19.

The presentation included slides on:

·   Council Plan 2022-2027: Strategic Context and Performance Commentary

·   Performance relating to this Committee

·   Area of focus: Support people to live healthy, happy, and independent lives and work with partners to reduce health inequalities 

·   Projection

·   Integrated Delivery Plan

·   Financial performance

·   Management of risk

Questions and comments were invited with responses provided as indicated:

• A member asked which area was the biggest concern to officers. Pete Sidgwick spoke about the subsequent item on the work being undertaken to  ...  view the full minutes text for item 5.

The Committee will receive a presentation to share the arrangements being made to prepare for forthcoming CQC inspection.

Pete Sidgwick and Ian Redfern gave a presentation to outline the work being undertaken to prepare for the recommencement of CQC inspections.

The presentation included slides on:

• Who are the CQC?
• Why are CQC assessing local authorities?
• The assessment framework for local authorities
• The key aspects of CQC local authority assurance
• The key components of the approach
• Theme 1: How local authorities work with people
• Theme 2: How local authorities provide support
• Theme 3: Ensuring safety within the system
• Theme 4: Leadership
• The CQC six evidence categories
• How we have approached CQC assurance
• What we have done to prepare
• Our CQC assurance opportunities
• Our CQC assurance challenges
• What improvement work we are doing
• Next steps

Pete Sidgwick provided a summary of the CQC approach over the next two years to undertake baselining activity of performance across the country. This would include a significant new area for client level data for every person supported, by every local authority in the country. It would be challenging as each organisation had different ways of recording the data.  It was viewed as a sensible way forward and would give assurance to the public. He talked about the CQC approach for one-word judgements ranging from ‘Outstanding’ to ‘Inadequate’. Pete provided assurance, exploring the areas where Warwickshire needed to focus around waiting lists and reviews. He explained the requirement for an annual review or assessment for clients in receipt of long-term support as a particular focus. From meeting with the CQC it was expected their focus would be on safety. There would be a need to demonstrate that services were safe and that clients’ care and support needs were being met. Ian Redfern added there was a CQC expectation that there would be areas for improvement in each local authority. It was expected that local authorities should be aware of the improvement areas and have realistic plans in place to achieve them. Pete added that this would be a different oversight regime to that of the Ofsted approach.

Questions and comments were invited with responses provided as indicated:

• A member welcomed this approach, whilst posing questions around the integration of health and social care IT systems to provide the single assessment. She asked about the arrangements for dementia services, using an example to show the challenges faced. She looked forward to the new framework. Pete Sidgwick spoke of the narrative for the documents which needed to be concise and could not detail every service. It did explain how people in different cohorts/groups were supported, including those with dementia and their carers, also the services provided direct and those commissioned from other providers. This process could be uplifting and should be enabling rather than punitive. It was considered that there was a positive account to give of Warwickshire’s services, whilst wanting to learn and improve.
• A councillor considered inspection to be essential, particularly for public sector services in identifying strengths, reinforcing good behaviour, reassuring staff and to give examples of good practice that could be replicated, whilst  ...  view the full minutes text for item 6.

For the Committee to review and update its work programme.

The Committee discussed its work programme. The Chair noted that some items had been deferred due to the pre-election period. It was agreed to discuss the future agenda content at the next meeting of the Chair and party spokespeople. The Chair closed this meeting, the last of the municipal year thanking members and officers for their contributions. Chris Bain similarly thanked the Chair.

Resolved

That the Committee notes the work programme as submitted.