Agenda and minutes

Councillor Patrick Green attended as a substitute for Councillor Peter Jones.

None

The committee are invited to approve the minutes of the meeting held on March 6^th 2012 (AS3) and to receive information arising from them.

The minutes of the meeting of March 6^th were signed and approved.

In anticipation of possible changes to the cabinet, Councillor Arash Fatemian, Cabinet Member for Adult Services, thanked the committee for it’s valuable challenge during his time as Cabinet Member for Adult Services.

10:00

John Jackson, Director for Social and Community Services, will update the committee on local and national issues in Adult Social Care.

John Jackson, Director of Social and Community Services, updated the committee on local and national issues in Adult Services. The key points and actions arising are summarised 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  From my perspective I have no intelligence about when it will be published except that it will not be published in April (due to the local elections in early May).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.

It was AGREED that future correspondence between Cllr Stevens and the Monitoring Officer will continue to be shared with committee members.

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  ...  view the full minutes text for item 210/12

11:00

Alan Sinclair, Lead Commissioner for Older People, will lead a discussion on the steps being taken to improve the Reablement Service in Oxfordshire with Oxford Health.

A paper outlining recent developments is attached (AS6). The paper was originally delivered as a response from the Cabinet Member for Adult Services to a question from Councillor Jenny Hannaby at the meeting of the County Council on April 3^rd.

Alan  Sinclair, Lead Commissioner for Older People,  and David Bradley, Chief Operating Officer at Oxford Health, introduced the committee to recent changes to the reablement service contract with Oxford Health. Discussion covered the reasons for the underperformance of the service in recent years and the benchmarks against which future success will be judged.

The contract changes mean that future payment will be based on the number of episodes completed with further bonus payments being made for meeting targets. In addition the Director will meet regularly with the Chief Executive of Oxford Health to ensure that operational objectives are aligned with those of the wider care system. The changes have led to an improvement in performance during the past quarter.

Members queried whether the system of provider led monitoring reports would be sufficiently reliable and requested further detail on the monitoring process.

Alan Sinclair assured the committee that Oxford Health uses the same system as the Council to log episodes and AGREED to send further detail on the monitoring process outside of the meeting.

The committee AGREED that Oxford Health should be present at the September meeting for the item covering the range of services aimed at preventing unnecessary admissions and accelerating discharge.

11:40

John Jackson will outline the county council’s position on the findings of the Equality and Human Rights Commission report on home care for older people ‘Close to Home’. The committee are invited to comment on the implications of the report.

An executive summary of the report is attached (AS7) for information. A briefing note reflecting the county council’s position will be circulated prior to the meeting (due to the timing of the request, Officers have been unable to prepare this in time for inclusion in the agenda).

Councillor Stevens introduced the item on the Close to Home report, stating that at the local level the findings may be of particular relevance to the externalisation of Home Support Provision. Three key questions were identified:

1)     Should there be a target for the reduction of 15 minute visits?

2)     Should the council be doing more to monitor the pay and conditions of external home support staff?

3)     Do we need a clearer route for complaints?

On the issue of 15 minute visits, Sara Livadeas, Deputy Director for Joint Commissioning, stated that this was possible but would have a resource implication to the council.

It was AGREED that a report outlining the resource implications would be discussed at a future meeting of the Quality Assurance Workgroup.

John Jackson responded to the issue of pay and conditions, stating that the council currently pays a relatively high price for an hour of care at around £19. This is moving towards the £15 target set for the resource allocation system but will remain above the level of a number of other authorities (£12) The rates of pay for external home support workers are equivalent to those received through the internal service although this excludes pension contributions.

Regarding the question of a clearer route for escalating complaints, Cllr Fatemian highlighted the ongoing work to ensure that people feel comfortable raising concerns. Key to this is creating an environment where people feel comfortable . This issue will continue to be discussed at length by the Quality Assurance Workgroup.

Members applauded the quality of the discussion paper, stating that it offered an excellent template for future scrutiny papers.

It was AGREED that the paper and the content of discussions would be considered by the Quality Assurance Workgroup.

12:00

Adrian Chant, LINk Host Manager, and a member of the LINk Core Group will deliver an update from the Local Involvement Network and answer the committee’s questions.

A newsletter outlining recent developments is attached (AS8).

Adrian Chant, LINk Host Manager, updated the committee on the recent activity of the Local Involvement Network.

The LINk are working closely with the Contracts Team and the Workgroup in their program of visits to care homes. A full report will be shared with the committee following the completion of the program of visits.

The recent Hearsay event picked up issues on how relatives can raise concerns. Through attendance at the meetings of the Quality Assurance Workgroup, the LINk will input these findings into wider discussions about the escalation of concerns.

It was AGREED that a report on the Hearsay event will be shared with the committee at a future date.

Further discussions covered the timetable for the procurement of Healthwatch and the establishment of new links with the Military.

12:20

The Meeting closed at 12:30.