Agenda and minutes

Councillor Arash Fatemian, Cabinet Member for Adult Services, sent apologies.

Councillor Lawrie Stratford substituted for Councillor Peter Skolar and  Councillor Charles Shouler substituted for Councillor Peter Jones.

Councillor Jenny Hannaby declared an interest as Chair of the Wantage Day Centre.

To approve the minutes of the meeting held on January 17^th 2012 (AS3) and to receive information arising from them.

The  minutes of the meeting of the meeting of January 17th 2012 were signed and approved. Future correspondence between the monitoring officer and Councillor Richard Stevens regarding matters arising from the minutes, will be sent to members of the committee.

None

10:00

The Director for Social & Community Services will give a verbal update on key issues.

John Jackson, Director for Social and Community Services, updated the committee on national and local developments. A summary of these are presented below:

National Items

Adult Social Care White Paper

There are lots of stories in the media about what this will include (in particular whether it will address the recommendations from the Dilnot Commission).  There are also reports (such as in this week’s Observer) that it will not be issued this month.  From my perspective I have no intelligence about when it will be published except that it will not be published in April (due to the local elections in early May).  If it does not address Dilnot then this will be an opportunity missed in my opinion.

Local Items

Oxfordshire Care Partnership

I promised the Committee that I would update you on developments.  However, at this stage I have nothing to report other than that the negotiating team are discussing a series of very detailed issues with the Orders of St. John and Bedford Pilgrims Housing Association.  We are still working to the approach agreed by the Cabinet.  Nick Graham has responded to some questions raised by Cllr Stevens.  Members of this Committee have been copied into that correspondence.  Cllr Stevens came back with some further questions yesterday.  Nick Graham will respond to those questions as soon as possible.

Four Seasons Healthcare

Members have understandably shown a key interest in what is happening to the homes that Four Seasons Healthcare took over in Oxfordshire that were currently previously run by Southern Cross.  Southern Cross ran 6 homes in Oxfordshire, 5 of which were transferred to Four Seasons Healthcare, bringing the total number of Four Seasons Healthcare homes in Oxfordshire to 6. We have carried out quality monitoring visits to all the former Southern Cross homes in Oxfordshire including those that transferred to Four Seasons Healthcare.  Staff who carried out the monitoring visits noted an improvement in quality at all of them.  There is a notable improvement in staff morale coupled with significant investment (reported by Four Seasons to be in the region of £200,000) in the buildings and equipment. All the homes have new managers and staff training for all staff is being refreshed. New care documentation from Four Seasons Healthcare will be launched next month and we believe this will lead to further improvements.

The Crown, Harwell

That said I do need to report that Four Seasons Healthcare announced last Friday that one of the homes transferred from Southern Cross will close – The Crown in Harwell.  This is a very small home (only 16 places) with a proportionately high number of vacancies (there are only 7 residents currently – 4 funded by the County Council and 3 funded privately).  Significant financial investment would be required to improve the home and Four Seasons Healthcare has received no applicants for the post of Home Manager, which is currently vacant. The home was transferred to Four Seasons Healthcare under a management agreement; the landlord has now decided to sell  ...  view the full minutes text for item 198/12

10:30

Jonathan McWilliam, Director of Public Health, will present to the committee in the new agenda for Health and Social Care in local governement

Jonathan McWilliam, Director of Public Health, delivered a presentation on the opportunities for local government under the proposed reforms to the health system. The presentation covered the structure of the Health and Wellbeing Board and sub-committees, with particular reference to the continuing relevance of the role of scrutiny.

Members questioned whether the structure of sub-committees for Children and Adult Services risked creating an unnecessary bureaucratic burden. The Director responded that some bureaucracy was essential to ensure accountability. It was pointed out that counties without sub-committees have found that the Health and Wellbeing Board lacks the powers to implement strategy and affect change.

Responding to concerns about the difficulties inherent in increased partnership working, the Director suggested that this was a matter of relationships and leadership. It was pointed out that existing good practice at in Oxfordshire means that the county is well placed to take advantage of the changes.

The committee sought clarification on the resource implications of the transfer of Public Health into the County Council. There was some concern that this might mean extra responsibilities for the County Council without extra funding. The Director pointed out that the Public Health budget is relatively small at around £20m, and that the new arrangements would greatly increase the scope to influence the strategic direction of health and social care resulting in a more joined up ecosystem.

In terms of accountability and measuring success, the committee was informed that one of the first tasks of the Health and Wellbeing Board would be to agree a set of priority measures and outcomes which would be assessed periodically.

11:00

John Dixon will update the committee on waiting lists in Adult Social Care.

John Dixon, Interim Deputy Director for Adult Services, introduced the paper on Waiting Lists in Adult Social Care. Current performance on a number of timeliness indicators was discussed and the workstreams in place to improve the transition of clients at known bottlenecks in the system were highlighted.

Members received the report positively stating that problems were apparently being managed appropriately. However, it was felt that a more detailed assessment of the affect of care at home on the severely disabled might be needed. Officers acknowledged the fact that care at home is not suitable for everybody and for this reason the council will continue to need residential and nursing care placements for people with complex needs.

11:30

Simon Kearey, Head of Strategy and Transformation, will give an update on current progress within the day services programme. The key areas covered will be Tier 3 services and Transport.

Simon Kearey, Head of Strategy and Transformation, and Sara Livadeas, Deputy Director for Joint Commissioning, discussed the attached document outlining the developments in the strategy for day opportunities.

Officers drew attention to the two key changes to the strategy: the reduction in the savings target; and the continued provision of transport, funded by increased fees.

It was pointed out that the proposed increased fees (to £15) for day opportunities is driven by Self-Directed Support, which means that services must remain attractive to ensure their sustainability. It was pointed out that fee increases would only effect non-FACS eligible clients.

Whilst members were complementary of the quality of the report and the level of detail provided, an opinion was expressed that the principles of the report should not be agreed since the costs appeared to be too high, and no account had been taken of the variable levels of affluence across the client group. Officers agreed to explore the potential to introduce a waiver on transport fees for clients under difficult financial circumstances.

It was suggested that the increase in fees could be phased to align with the development of an increasingly attractive offer.

12:15

Sara Livadeas, Deputy Director for Joint Commissioning, will present proposals to the committee on ensuring quality and developing a robust monitoring framework for commissioned services.

Sara Livadeas, Deputy Director for Joint Commissioning, and Martin Bradshaw, Strategic Lead Major Projects, introduced the paper outlining the principles on which the development of the Quality Assurance service is progressing.

The key aim, as agreed with the scrutiny workgroup, was to take an intelligent approach to contact monitoring, based on a number of factors such as the size of contract and workforce, and the level of risk.

Officers stated that there is a need to be realistic about the level of oversight and intervention the organisation can have once a contract is established and therefore a need to ensure that the right organisations are contracted in the first place.

Members welcomed the report and agreed the principles on which the programme will proceed. It was felt that a clear statement was needed about the importance of whistleblowing and the mechanisms needed to ensure its effective functioning.

On the question of the appropriate level of member involvement for care home monitoring, a range of views were expressed. Whilst it was felt that this would increase member understanding of the services and increase scrutiny of the service, the committee also felt that without extensive training there could be inconsistent application. Officers agreed that member involvement should be informal with an aim to increase the traffic in and out of homes as opposed to any official inspection capacity.

12:45

The committee will receive an update on the local involvement network.

Adrian Chant, LINk Locality Manager, and Yvonne Cox, delivered an update from the Local Involvement Network. They discussed focussed work being undertaken by Oxfordshire Wheel to assess what works well with regards Personal Assistants and Support services. A report will be shared with the committee at a future date.

12:55

The Committee is asked to suggest items from the current Forward Plan on which it may wish to have an opportunity to offer advice to the Cabinet before any decision is taken, together with details of what it thinks could be achieved by looking at any items.

None

13:00

The meeting closed at 13:20