Agenda and minutes

Councillor Don Seale was elected to Chairman for the current Council year.

Councillor Mrs Anda Fitzgerald O’Connor was elected to Deputy Chairman for the current Council year.

Councillor Ray Jelf attended in place of Councillor David Wilmshurst.

Councillor Dr Peter Skolar declared a personal interest at Agenda Item 9 (Progress Update on the Delivery of the National Dementia Strategy) in relation to that item on the grounds that:

-          His mother in law is now in a care home and is suffering from dementia

-          He was a GP for 40 years.

To approve the minutes of the meeting held on 10 February 2010 (AS5) and to note for information any matters arising on them.

The Minutes of the meeting held on 2 December 2009 were approved and signed subject to the following amendments in bold italics and strikethrough:

Councillor Dave Sexon Councillor Jim Couchman (in place of Councillor Dr Peter Skolar)

Agenda Item 8 – Ms Lindsay Smith, Mr Paul Isaacs and Ms Kathy Erangey (all by invitation).

Agenda Item 9 – Mrs Meg Barbour (by invitation).

10:15

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

The Director for Social & Community Services gave a verbal update on key issues, a summary of which is given below:

·        there was national debate underway in relation to the National Care Service White Paper (Building the National Care Service) which had been published at the end of March and it was hoped that the debate would continue in the new parliament;

·        the Personal Care at Home Bill was now an Act. The Government had accepted a delay in implementation until 1 April 2011 if it was to go ahead. This had financial implications for the County Council that would be covered in the monthly monitoring report to Cabinet. The Act would only be implemented if passed by both Houses in the next parliament;

·        in terms of the Annual Performance Assessment the Directorate held regular meetings with the Area Manager and a follow up meeting had been held in response to the Inspection that took place last year. The Inspectorate were happy with progress including that made on safeguarding issues. Key statistics supported this as there had been a large increase in the number of referrals and a considerable improvement in the speed of completion of referrals. It was hoped that these improvements would be reflected in the Annual Performance Assessment in December;

·        in light of self directed support and the personalisation agenda, information in relation to initial ideas on the future of Day Services for Older People would be provided to this Committee’s June meeting. The Directorate wished to consult with providers and service users prior to discussion with Scrutiny and would be doing this at the end of May. Letters would be sent out that week;

·        the Directorate had gained two awards from Improvement and Efficiency South East (IESE): an award for the work undertaken by the Council to support carers who work for the Council and an award in relation to extending the benefits of personalisation to people in residential care homes. Even if people were paying for residential care they were still left with some money which they could use, for example, to be taken out fishing or to visit the hairdressers;

·        John Bolton, whilst Director of Strategic Finance at the Department of Health had looked at the use of resources in Adult Social Care in comparison with his visits to other local authorities and had provided the Directorate with positive feedback in relation to its effective use of resources;

·        Members would be tasked with agreeing the Resource Allocation System (RAS) for self directed support and would need to agree a budget which led to a fair outcome for all service users. It was important that the budget was not “age biased” ie, there would need to be equity between younger and older adults. The RAS must also be fair to council tax payers in that an appropriate level of resources must be given to both self directed support - neither too much nor too little - and to other services, as doing so would have serious  ...  view the full minutes text for item 56/10

10:25

Contact Officers: Fenella Trevillion (01865) 334626, Martin Mellors (01865) 334652, Ann Nursey (01865) 323669

Ms Fenella Trevillion (Head of Joint Commissioning, NHSOxfordshire), Mr Martin Mellors (Service Development Manager – Mental Health,NHS Oxfordshire) and Ms Ann Nursey (Assistant Head of Adult Social Care - Learning Disabilities) will attend for this item.    

A report is attached at AS8.  

The Committee will have the opportunity to hear from two young people with Asperger’s Syndrome, Ms Lindsay Smith and Mr Paul Isaacs, who will start this item by describing the issues they face and what would help them.

They will be accompanied by Ms Kathy Erangey, the parent of an eighteen year old son with Asperger’s Syndrome, who is also assisting Oxfordshire County Council and NHS Oxfordshire with the work they are doing on Asperger’s Syndrome specific service development as both a Consultant and an expert by qualification and experience.

The contact officers will then talk to their paperand the Committee will conduct a question and answer session.

The Committee is invited to conduct a question and answer session.

Ms Fenella Trevillion (Head of Joint Commissioning,NHS Oxfordshire), Mr Martin Mellors (Service Development Manager – Mental Health,NHS Oxfordshire) and Ms Ann Nursey (Assistant Head of Adult Social Care - Learning Disabilities) attended for this item in order to update the Committee and to answer Member’s questions. The Cabinet Member for Adult Services also attended for this item.   

A report was before the Committee (AS8) which covered a definition of autism, the national and local contexts, prevalence levels, an outline of the needs analysis, costs to the system, emerging trends/information, potential service models and issues for discussion.  

Two young people with Asperger’s Syndrome, Ms Lindsay Smith and Mr Paul Isaacs also attended for this item in order to describe the issues they faced and what would help them and people on the autistic spectrum in future.

They were accompanied by Ms Kathy Erangey, the parent of an eighteen year old son with Asperger’s Syndrome, who was also assisting Oxfordshire County Council and NHS Oxfordshire with the work they were doing on Asperger’s Syndrome specific service development as both a Consultant and an expert by qualification and experience.

Ms Smith began the discussion by making the following points:

·        support was needed at college. It would be helpful if there was a room where students with Asperger’s Syndrome could go if they wanted to be on their own for a while. Socialising was hard work;

·        it would be helpful to have someone to talk to once a week, for example, about going to college or finding a job.

Mr Isaacs then made the following points:

·        diagnostic services for people with Asperger’s Syndrome needed to be improved. He had been to Charter House in Thame (Thame Adult Community Mental Health Team) for an assessment and on requesting his notes had discovered that he had been misdiagnosed with schizotypal personality disorder and psychosis and also as having Asperger’s traits with a complex personality. He would not be able to tell a future employer that he had Asperger’s traits with “a complex personality”’ as it was a bizarre and meaning less diagnosis;

·        he had finally managed to obtain a Statement of Special Educational Needs from a specialist in Asperger’s Syndrome at Littlemore Hospital;

·        too many people with Asperger’s Syndrome were being misdiagnosed and wrongly labelled, which was upsetting for both the person concerned and for their family;

·        a cluster of symptoms created this complex syndrome: dyspraxia (includes clumsiness and co-ordination/motor difficulties), social emotional agnosia (eg “blindness” to body language, facial expressions and the intentions of the individual) and alexithymia (eg. understanding of one’s own feelings), as well as being on the autistic spectrum (eg restricted social capabilities);

·        coping at work was very difficult for many people with this condition. Pre-diagnosis he had experienced a nervous breakdown as a result of finding work difficult but had not been sure what was wrong with him. Many people with Asperger’s Syndrome found it difficult to find work and not being able to obtain benefits or work support  ...  view the full minutes text for item 57/10

11:15

Contact Officers: Varsha Raja, Assistant Head of Adult Services, tel (01865) 323618; Suzanne Jones – Senior Service Development Manager, Older People,  NHS Oxfordshire, tel (01865) 334613.

A report on progress is attached at AS9.

Ms Varsha Raja (Assistant Head of Adult Services) will attend to present the paper and to answer the Committee’s questions, together with the Director for Social & Community Services and the Cabinet Member for Adult Services.

Mr Duncan Saunders (Service Development Manager - Older People’s Mental Health – NHS Oxfordshire),together with ex carers Mrs Meg Barbour and Mrs Joyce Ruizwill also attend for this item.

The Committee is invited to conduct a question and answer session in relation to progress, with a particular focus on the issues and gaps in provision identified at its October meeting.

The Director for Social & Community Services, together with Ms Varsha Raja (Assistant Head of Adult Services), Mr Duncan Saunders (Service Development Manager – Older People’s Mental Health – NHS Oxfordshire) and Ms Marie Seaton (Head of Joint Commissioning – Older People – Oxfordshire County Council and NHS Oxfordshire), attended for this item in order to update the Committee on progress and to answer Members’ questions. They were accompanied by the Cabinet Member for Adult Services.

Mrs Meg Barbour (ex carer) also attended for this item in order to share her personal experiences with the Committee.

The Committee had before it a report on progress (AS9) which covered Oxfordshire’s approach and progress to date in terms of improved quality of life, early diagnosis and complex care, early onset dementia, improved information provision for carers and people with dementia and cross cutting areas of work.

Mrs Barbour made the following points:

·        her husband had died five years ago. He had been very well educated and had worked in the Department of Nuclear Physics at Oxford University. They had four children together and he had run a Cub Scouts pack;

·        he had retired at age sixty four and the following year the family were told that he had possible dementia. It is not possible to recover from dementia, and prospects for the person’s carer are quite sad;

·        at the time of diagnosis people didn’t talk about it. She had to search for the information as there was not much information available;

·        Mr Barbour never accepted the diagnosis and thought that he was fine;

·        early diagnosis is very important because you have to get the person’s consent to manage their affairs whilst they still have the mental capacity to give it;

·        a diagnosis of dementia is very isolating. It is easy to feel that you are the only person in that situation;

·        help for the carer of the person with dementia is very important. She had received assistance from a “flexible carer” from Age Concern once a week and a support worker from the Alzheimer’s Society. She had also received great support and assistance from a carer’s support group;

·        she had taken her husband to her WI group. He was a very private man and would not have wished to go when well, but did not mind at that stage. As time went on she had to stop taking him out and apart from a day centre that he went to twice a week she was with him constantly. She had found respite support very important;

·        she was very excited to be involved in the implementation of the new dementia strategy.

A selection of the Committee’s questions to Mrs Barbour, together with her responses, is given below:

·        Did you have a problem obtaining an early diagnosis?

Obtaining a diagnosis at a GP surgery can be a big problem. She was lucky in terms of GP awareness, as one of the doctors at their surgery had suffered from dementia. She was quickly sent to a  ...  view the full minutes text for item 58/10

12:00

Contact: Alan Sinclair, Programme Director – Transforming Adult Social Care (01865 323665)

It has been agreed that a report on transforming Adult Social Care will be brought to every meeting of this Committee (AS10) and will include detail on self directed support.

The Cabinet Member for Adult Services and Mr Sinclair will attend to answer any questions the Committee may wish to ask.

The Self Directed Support Task Group is also invited to give an update on their work as part of this agenda item. The Group comprises Councillors Jenny Hannaby, Sarah Hutchinson and Larry Sanders.

The Committee is invited to track progress and conduct a question and answer session.

It has been agreed that a report on transforming Adult Social Care will be brought to every meeting of this Committee (AS10) and will include detail on self directed support.

The Cabinet Member for Adult Services together with Mr Sinclair (Programme Director – Transforming Adult Social Care) attended for this item in order to answer any questions which the Committee may have wished to ask.

The Committee noted that four hundred and sixty-six people now had a personal budget.

A number of communication leaflets were tabled which provided the Committee with a flavour of work underway. These would be distributed to libraries and GP surgeries amongst other places and an article would be published in Oxfordshire News in September.

Following the update the Committee AGREED to:

·              thank Ms Irving (Self Directed Support Development Officer) on the Improving Lives Award received for her work on extending the benefits of personalisation to people in residential care homes;

·              note that:

o       it would consider a report on the Adult Social Care Resource Allocation System Policy post Cabinet consideration (20 July), which would be aligned with the report covering the new guidance in relation to adult social care eligibility criteria that had been issued earlier in the year;

o       the Institute of Public Care research on Community Building (which would be used to develop best practice models) would be forwarded to the Committee for information once it was available.

The Self Directed Support Task Group also gave an update on its work as part of this agenda item (Councillors Hannaby, Hutchinson and Larry Sanders). They were looking forward to sitting in front of a computer and seeing how the resource allocation system would work in practice.

In response to concern expressed by Councillor Sanders, Mr Sinclair undertook to undertake some further analysis on the results of the Accelerated Review Process for Older People and provide this information to the Committee. He stated that although significant savings had been made, the review process had been robust, fair and equitable and that the reviews had been done properly and well. Officers had looked at different ways of meeting people’s needs which were cheaper.

Mr Sinclair also undertook to circulate a summary version of the Draft TASC Information and Advice Strategy to the Committee.

Any members of the Committee wanting a copy of the full report (over 120 pages) were asked to contact Mr Sinclair directly.

12:30

The Committee is asked to note any items for possible consideration.

The current version of the Forward Plan covers May to August 2010.

The Committee noted that the Retender for Young People and Teenage Parent Services would be considered by the Cabinet Member for Adult Services on 1 June.

12:35

Members of the Committee are reminded that last October they had agreed to include the following items in their future work programme:

·        Duty to involve – Q&A and report at its February meeting on what this new statutory commitment involves and what the Council will be doing Completed;

·        Services for Adults on the Autistic Spectrum – Q&A and report at its April meeting or once the Joint Needs Assessment has been finalised if later Completed;

·        Dementia Strategy – Q&A and report at its April meeting in order to monitor progress in relation to issues and gaps in provision Completed;

·       Telecare– Q&A and report at its October 2010 meeting;

·         Domiciliary Care – consider at a future meeting once both inspections have been completed. Possibly to the October 2010 meeting.

The Committee will also look at the current situation with regard to delayed transfers of care at its June meeting.

Given that the Committee has now considered a number of these items, Members are invited to put forward any suggestions for future scrutiny consideration.

It would be appropriate for any suggestions to be related to the Council’s priorities and the remit of this Committee, although suggestions which cut across more than one scrutiny committee could also be put forward for consideration.

Committee members are asked to submit any suggestions prior to the meeting and as soon as possible to Mr Fitzgerald.

Proposal forms working up these ideas will then be brought to this Committee’s June meeting for consideration.

Members are reminded that a proposed scrutiny work programme will be brought to Committee for consideration later in the year.

Members of this Committee are invited to put forward any items for future scrutiny consideration.

Following discussion the Committee AGREED:

• to keep ‘Services for Adults on the Autistic Spectrum’ and ‘Progress in relation to the delivery of the National Dementia Strategy’ under review, including looking at the report on the outline commissioning strategy (or draft strategy if it is ready) in September and progress in relation to the latter item in October;

• to continue to monitor NHS Continuing Health Care - given the financial pressure on all PCTs from the Strategic Health Authority - and that a paper on the above from Ms Stapley with the Director’s comments should be sent to the Oxfordshire Joint Health Overview and Scrutiny Committee.

Ms Coldwell undertook to ask Dr Alvi to provide the scope for the Safer and Stronger Communities Scrutiny Committee’s Select Committee into Community Pride to be held at its July meeting to Councillor Larry Sanders once available, as he had expressed an interest in this topic.

12:45

A response from the Leader of the Council on this Committee’s budgetary advice is attached (AS13(a)).

A response from the Leader of the Council on this Committee’s budgetary advice was before the Committee (AS13(a)).

The Committee:

• noted Councillor Mitchell’s response in relation to its budget advice and was pleased to see that the Cabinet had accepted the Directorate’s risk analysis in relation to the two risks to the service identified by the Director;

• thanked Mr Chant for the Oxfordshire LINk update and noted that:

o       the Directorate Leadership Team would consider the LINk Hearsay report on 6 May;

o       the LINk Research Group into personalised budgetswas about to start work.

13:00

Following the meeting members of the Committee will have the opportunity to receive a presentation on NHS Continuing Health Care from Ms Sandra Stapley (Assistant Head of Adult Social Care – Older People & Physical Disabilities).

Members of the Committee are asked to note that a working lunch will be provided in committee room 2 prior to the presentation.

The Committee AGREED to defer the presentation on NHS Continuing Health Care to the rising of its June meeting.