Return to Agenda
|
Agenda Item |
Officer Attending |
5. |
Director for Social & Community Services, P. Purnell & H. Ellis (Social & Community Services) |
6. |
Director for Social & Community Services, P. Purnell & S. Thomas (Social & Community Services), A. Webb (Oxfordshire PCT) & A. Murphy (Oxford Radcliffe Hospitals NHS Trust) |
7. |
Director for Social & Community Services |
The Scrutiny Committee considered the matters, reports and recommendations contained or referred to in the agenda for the meeting, together with a schedule of addenda tabled at the meeting and agreed as set out below. Copies of the agenda, reports and schedule are attached to the signed Minutes.
19/09 APOLOGIES FOR ABSENCE AND TEMPORARY APPOINTMENTS
Apologies for absence and temporary appointments were received as follows:
Apology from |
Temporary Appointments |
Councillor Barbara Gatehouse |
- |
Councillor Janet Godden |
- |
20/09 DECLARATIONS OF INTEREST
Councillor Sue Haffenden declared a personal interest at Agenda Item 2 in relation to Agenda Items 5 and 6 by virtue of being Chairman of the Learning Disabilities Partnership Board.
21/09 MINUTES
The Minutes of the meeting of the Committee held on 11 February 2009 were approved and signed.
Matters Arising
Item 6/09 – Annual Report by the Commission for Social Care Inspection on Adult Social Services – Mr Purnell undertook to see whether officers could do more to thank those home support workers who go “the extra mile”.
Item 8/09 – Commissioning of Adult Learning – Funding for Adults with Learning Disabilities – the Committee noted that:
(a) some activities would be provided by the County Council that would be suitable for adults with mild to moderate learning disabilities;
(b) The Learning Disabilities Partnership Board would be writing to the Learning & Skills Council expressing concern regarding the lack of funding for courses for adults with learning disabilities;
(c) officers had considered whether to transfer resources from the Adult Social Care budget into the Adult Learning budget. However, this could not be justified given the pressures on the Learning Disabilities budget and other areas of the budget requiring funding;
(d) the Council had funded its share for demographic growth and the PCT would be doing so. However, the Council would not be receiving any more money from the government for people with learning disabilities;
(e) the Cabinet Member for Social & Community Services had spoken to his relevant Cabinet colleagues regarding recommendation(d) (strongly urge the County Council’s Human Resources and Organisational Development Service to determine by the end of February 2009 those needs in the corporate Learning and Development Plan which should be met by the Adult Learning Service). There were moves underway of a wider nature to improve the usage of the Adult Learning Service by the Council generally. This work was ongoing and would continue after the elections. It was hoped that a new policy would be formulated which would make the Adult Learning Service more sustainable. If a cost benefit to Adult Social Care could be proved (in terms of prevention) as a result of commissioning services from the Adult Learning Service, then this would not be ruled out as an option. Officers needed to reflect on how any benefit could be measured. It then might be necessary to undertake additional pilot work in order to provide further evidence;
(f) with regard to the Committee’s recommendations made at its previous meeting, the County Council’s Management Team and the Lead Member had been discussing this. Work was underway in spreading the word regarding how the Learning and Skills Council agenda operates nationally. Some discussion had already taken place and would continue at various meetings, with a report to be provided to Cabinet to address these issues.
In response to a question from a member of the Committee, the Cabinet Member for Social & Community Services stated that he hoped that the potential for redundancies would be avoided.
22/09 SPEAKING TO OR PETITIONING THE COMMITTEE
The following requests to address the meeting had been agreed:-
Request from |
Agenda Item |
Mrs Pam Blustin, Chair of the Oxfordshire Older People’s Panel |
5. |
23/09 SAFEGUARDING ADULTS
(Agenda Item 5)
The Committee had before it a report (SC5) which provided the following information:
· The Annual report of the Oxfordshire Safeguarding Adults Board for 2007/08;
· Improvements in Safeguarding Adults achieved so far in 2008/09; and
· Further planned developments in Safeguarding Adults.
Mrs Pam Blustin, Chair of the Oxfordshire Older People’s Panel had requested that the following note be circulated in relation to this Agenda Item:
“The Older People’s Panel has for some years been active in pursuing at [a] national level developments in Elder Abuse, including contact with the Minister Ivan Lewis in the matter of Human Rights.
The Panel is pleased therefore to note in the Annual Report 2007 - 2008 the progress that the Safeguarding Adults Board has made and in the covering Report, that among the developments being implemented in 2009 is the launch of a major public awareness campaign.
The public’s obvious concern for children ‘at risk’ needs to be harnessed for other vulnerable people, not least for older people.
Increased awareness in the community may also help to reduce the risk to those who are no longer seen ‘out and about’.
Also mentioned among developments being implemented in 2009 is extending membership of the Board to GPs, Housing and Probation.
Could consideration also be given to extending membership to minority cultural and faith groups - both to support the awareness campaign and for the longer term, to increase the chances of safeguarding all Oxfordshire’s adults?”
Mr John Jackson (Director for Social & Community Services), Mr Paul Purnell (Head of Social Care for Adults) and Mr Hugh Ellis (Safeguarding Adults Manager), together with the Cabinet Member for Social & Community Services attended before the Committee in order to answer any questions which members of the Committee may have wished to ask.
Mr Purnell reported that the Care Quality Commission would be inspecting Adult Social Care, covering three service areas, one of which would be Safeguarding Adults. This inspection would take place on the week commencing 15 June and the week commencing 22 June. He then made the following points:
· the Service was protecting more people, was now better at detecting and responding to abuse, a new Safeguarding Team had been established and new processes were in place;
· the Safeguarding Adults Board Website, located at www.oxonsafeguardingadults.org.uk, set out how the public might be exposed to risk and how to protect them;
· there were many other developments underway which had been in train prior to notification of the inspection;
· one of the areas of preparation that officers had invested time and money in was an audit of approximately 400 case files which was their record of what they were doing to protect people at risk of abuse. Most of the cases needed more work but it was mainly a recording issue. This work was now underway. In a small number of cases (approximately 10 out of 400 case files) some of the basic work that should have been done had not been undertaken, which was a concern. Auditing the casework files should be part of the Service’s core business and officers were looking at whether they needed to appoint someone to do this or whether to ask an existing member of staff to do this as part of their job.
Members of the Committee then asked a number of questions, a selection of which, together with the responses, is listed below:
· The use of advocacy was very important. A lot of abuse occurred because people were pushed beyond their limits. Could more information be provided on this please?
The Cabinet Member for Social & Community Services responded that he would be meeting with an advocacy organisation in Oxfordshire within the next month and that Age Concern also carried out advocacy work for older people.
· The CSCI Inspection report had said that more needed to be done for people who directed their own support. Although a process had been set up for this, surely the potential for abuse would be greater as self directed support was rolled out county wide?
There was very little research evidence regarding the effect of self directed support on safeguarding. Initial research showed that concerns arose less frequently when self directed support was in place, but many of the pilot projects had been very controlled in their setup. Officers were working hard on the procedure for the risk assessment of people taking up self directed support. More work needed to be carried out in relation to brokerage - especially when more brokers came on board - to safeguard against any unscrupulous brokers. Brokers would also need to be informed of how to safeguard. It was yet to be established what the level of risk in relation to self directed support would be but officers would need to be very careful regarding how they developed it.
· What level of training and awareness raising was provided to hospital staff and GPs?
The likely amount of training that a GP or nurse would receive on safeguarding issues was approximately half an hour.
· In terms of Safeguarding Adults Level 2 (multi agency), it appeared that a significant amount of time was involved, how could officers help the person at risk whilst procedures were underway?
An initial assessment had to be carried out within five days. This was not an emergency service although the police would be contacted if it was an emergency.
· What types of activities should have been performed in the case of those case files where basic work had not been carried out?
There were a range of examples. There were a small number of files where it appeared that very limited action had been taken with regard to the individual concerned. One example might be insufficient focus on the abuse issues that had occurred in that case. Often there had not been a clear link between the record in the file and work that had been undertaken in another place. There were also recording omissions in terms of recording meetings and ensuring that they were occurring. A great deal of supervision was taking place but had not necessarily been recorded on the client’s file. It was likely that the Inspectors would ask for cases going back to the previous year.
· The report said that the best Councils were demonstrating active leadership on safeguarding and building strong strategic partnerships locally. Was Oxfordshire?
Oxfordshire had received a rating of ‘good’ for promoting dignity and respect. The highest possible rating was ‘excellent’. When the service was inspected in June it would be awarded a more specific rating in relation to the quality of its safeguarding.
· How would the general public be told about how to report abuse?
Leaflets and posters would be sent out next month. Officers were looking at all outlets where members of the public go on a regular basis.
During the questioning and answer session and ensuing discussion, a number of action points were agreed as listed below:
· The Director for Social & Community Services and the Head of Social Care for Adults undertook to reflect on:
(a) how to ensure that children and young people who were moving from children’s to adult services who were a cause for concern or could face the risk of abuse as a result of their change in circumstances (eg. leaving school) but were not on the Child Protection Register, did not fall out of the loop in the transition to Adult Social Care;
(b) the question asked in Mrs Blustin’s paper to the Committee as listed below:
‘Could consideration also be given to extending membership to minority cultural and faith groups – both to support the awareness campaign and for the longer term, to increase the chances of safeguarding all [of] Oxfordshire’s adults?’.
(A member of the Committee also suggested that they might want to include lesbian, gay, bisexual and transgender groups).
· The Head of Social Care for Adults undertook to speak with the police and other partners regarding the possibility of bringing the issue of domestic violence under the remit of the Safeguarding Adults Board prior to raising it with the Board; on the grounds that although its current limit of responsibility was people defined as ‘vulnerable’ by the ‘No Secrets’ guidance and in receipt of services from Adult Social Care, and whilst recognising that the police were currently viewed as the lead agency for tackling domestic violence, this matter was an issue for vulnerable people as well as for the general public.
· Councillor Haffenden undertook to provide a copy of the video that raised the issue of the abuse of people with learning disabilities to Ms Coldwell to enable Councillors and members of the public to watch it. It would also be provided to officers in the hope that years 10 & 11 could watch it as part of their citizenship classes.
· Ms Coldwell undertook to liaise with Mr Thomas regarding when the public inspection report would be available following the June inspection of this service as the information would probably still be embargoed by the time of this Committee’s July meeting.
The Committee then AGREED to:
· thank Mr Purnell and Mr Ellis for their report;
· request that the next report to this Committee on Safeguarding Adults contain less procedural information and more detail regarding actions taken to protect vulnerable adults;
· invite members of the Learning Disabilities Partnership Board to this Committee’s September meeting, to give a presentation on its work in order to raise its profile.
24/09 DELAYED TRANSFERS OF CARE
(Agenda Item 6)
At its previous meeting this Committee had agreed that:
· it wished to consider another report on delayed transfers of care at its meeting on 24 March;
· it wished the report to include the reasons for any delays and which organisations were causing them, including any delays which were the responsibility of the county council, together with information on comparative authorities (Wiltshire, Dorset and Somerset were suggested).
The Cabinet Member for Social & Community Services, together with Mr John Jackson (Director for Social & Community Services), Mr Paul Purnell (Head of Social Care for Adults), Mr Steve Thomas (Performance Information Manager), Mr Andrew Murphy (Oxford Radcliffe Hospitals NHS Trust) and Mr Alan Webb (Oxfordshire PCT) attended before the Committee in order to answer any questions which members of the Committee may have wished to ask.
The Committee asked a number of questions, a selection of which, together with the responses, is listed below:
· Did it matter that people stayed in hospital longer than they wanted to?
It was not the right place for them to be for their sake and there were social and medical risks in terms of social isolation and infection. Hospitals also needed the beds and operations had to be cancelled if the beds were not available. Research had shown that old people were more likely to end up in institutional care if they stayed a long time in hospital.
· Of the 150 authorities with a social care responsibility did it matter that Oxfordshire County Council was ranked 130th out of the 150 Councils with a social care responsibility?
If the number of delays in Oxfordshire was very low and Oxfordshire was ranked as the worst performer it would not matter. However, this was not the case. Oxfordshire needed to get to the middle of the league table and stay there.
· What was the average time that people were blocking beds in Oxfordshire?
The majority of people were delayed for less than a week. Some people were delayed for significantly longer. Sometimes sensitive discussions had to take place regarding where a patient went to. Where considerable adaptations had to be made to a person’s home before they returned home, this could take some time. Some delays were caused by patients who wanted to go their choice of residential home.
· It appeared that the continuing care figures did not compute. The number of continuing care figures appeared to be smaller than they should be for the county’s population. Were all authorities measuring the same thing? Were we comparing like with like?
There was a standard definition for what local authorities should be counting. Officers needed to get behind the numbers for continuing health care and work to improve services. A project team was working on this.
Following the question and answer session the Committee AGREED to thank Mr Webb and Mr Murphy for attending for this item and Mr Thomas for the comprehensiveness of his report.
Mr Webb undertook to circulate the following information to all members of this Committee via Ms Coldwell:
· data showing delay responsibility for social care and the NHS in Oxfordshire for this time last year as well as this year to enable a comparison to be made; and
· NHS existing commitment target data (where the PCT and ORH are measured on the % of delays on the number of beds they commission) (although this was only a snapshot measurement taken every quarter).
The Director for Social & Community Services undertook to circulate recent statistics which showed that levels of NHS Continuing Health Care were better in Oxfordshire than in other parts of the country to all members of this Committee via Ms Coldwell.
25/09 TRACKING SCRUTINY ITEMS
(Agenda Item 7)
Report back on advice by this Committee to the Cabinet or Council.
· Service and Resource Planning 2009/10 – 2013/14
In December this Committee had agreed to forward the following advice to the Cabinet via the Corporate Governance Scrutiny Committee:
This Committee:
(a) agrees that it will be possible to find up to £500k further genuine efficiency savings in addition to the £340k savings yet to be found from the Social and Community Services budget, which will be specified later, but in view of the efficiency savings already proposed in the 2009/10 Social and Community Services budget, it believes that it will not be possible to find further efficiency savings without inflicting damaging cuts on the services provided;
(b) expects to be fully informed concerning the detail of the £840k savings to be made as soon as possible and wishes to comment on them by email before these details are passed to the Cabinet;
(c) is satisfied that the remainder of the budget, apart from £340k of yet to be found efficiency savings, constitutes a balanced and sensible budget;
(d) is of the view that the capital spending programme is sound and sensible; and
(e) wishes to record its concern over the future funding of Learning Disabilities, especially in view of the planned transfer of responsibilities from the NHS to Local Authorities, without “future proofed” accompanied funding.
With regard to the money management service the Committee had agreed to advise the Cabinet via the Corporate Governance Scrutiny Committee as follows:
· this Committee wishes to bring it to the Cabinet’s attention that:
- there is likely to be increased demand on the money management service in future, especially in light of the introduction of self directed support and the increased take-up of direct payments;
- the establishment figures for the team need to be reviewed to ensure that sufficient numbers of staff are provided to the service.
· this Committee wishes to review the operation of and waiting lists for the money management service in six months’ time following the implementation of the new client database which is due to ‘go live’ in April 2009.
On 10 February the Council had agreed:
(a) (in respect of revenue) to approve:
(1) a budget for 2009/10 as set out in Annex 4a and a medium term plan to 2013/14 as set out in Annex 1 to the report;
(2) a budget requirement for 2009/10 of £379.170m;
(3) the Council Tax and Precept calculations for 2009/10 set out in Annex 5 to the report and in particular:
(i) a precept of £272.398m; and
(ii) a Council Tax for Band D equivalent properties of £1,130.62;
(4) the allocation of £34.674m proposed in paragraph 28 and Annex 4b for the Older Persons Pooled Budget
(5) the allocation of £5.269m proposed in paragraph 29 and Annex 4c for the Mental Health Commissioning Pooled Budget.
(6) the creation of a reserve from 2008/09 for LABGI and the use of the LABGI funding as set out in Annex 2c;
(7) the disposition of Dedicated Schools Grant as set out in Annex 6 to the report;
(8) virement arrangements for 2009/10 as set out in Annex 7 to the report;
(b) (in respect of treasury management) to approve:
(1) the Treasury Management Strategy Statement as at Annex 8 including:
(i) the Prudential Indicators;
(ii) the use of internal funds instead of external borrowing up to a maximum of 25% of the portfolio;
(2) that in relation to the 2009/10 strategy any further changes required to the credit matrix be delegated to the Chief Finance Officer in consultation with the Cabinet Member for Finance and leaders of the Opposition and other groups.
(c) to approve the Minimum Revenue Provision Methodology Statement as set out in paragraphs 10 to 13 of Annex 9.
(d) (in respect of Capital) to approve:
· the Capital Strategy at Annex 10 and Corporate Asset Management Plan at Annex 11;
· the Capital Programme for 2009/10 to 2013/14 as set out in the capital programme at Annex 13;
· the prudential indicators for capital set out in Annex 14 to the report.
The Committee noted the verbal update from the Director for Social & Community Services and the Head of Social Care for Adults. The main points were as follows:
· the 1% increase in inflation was a reasonable increase for care homes and the costs of their capital should be generally less;
· there would be pressures on adult social care budget as a result of the recession and an inflationary increase of only 2½ %;
· it would be a difficult financial year and the budget would have to be monitored very tightly;
· although recruitment had generally improved because more people were chasing jobs, officers were still struggling to recruit people to older adults mental health services as it was not a popular area. It had also been hard to recruit intermediate care staff.
· Commissioning of Adult Learning
This item had been dealt with under Matters Arising.
· Demographic Challenge Conference
This conference had been held on 19 March. The Committee AGREED to thank Mr Edwards, Ms Brodie-Levinsohn and Ms McCraw for their excellent organisation of the conference and noted that a report arising from the conference would be sent to all attendees and to all members of this Committee and the Social & Community Services Scrutiny Committee.
26/09 FORWARD PLAN
(Agenda Item 8)
The Committee was asked to suggest items from the current Forward Plan on which it might have wished to have an opportunity to offer advice to the Cabinet before any decision was taken.
No items had been identified for consideration.
................................................................................... in the Chair
Date of signing.................................................................. 2009