Agenda and minutes

Councillor Melinda Tilley attended in place of Councillor Tim Hallchurch MBE

Councillor Dr Peter Skolar declared a personal interest at Agenda Item 5 in relation to that item on the grounds that:

• he had passed on money from his parents to his grandchildren when his parents had died to enable them to buy their own homes; and
• his mother in law had sold her flat to pay for care when she went into a care home.

To approve the minutes of the meeting held on 9 September 2009 (AS3) and to note for information any matters arising on them.

The Minutes of the meeting were approved and signed.

10:15

Contact Officer: John Jackson, Director for Social & Community Services, tel (01865) 323572

On 14 July 2009 the Department of Health issued a consultation document on the future shape of the care and support system in England.This document is available on the Department of Health’s website (140 pages). http://www.dh.gov.uk.The Executive Summary is a useful starting pointand has already been circulated to members of this Committee.

Shaping the Future of Care Together sets out a vision for a new care and support system. It highlights the challenges faced by the current system and the need for radical reform, ‘to develop a National Care Service that is fair, simple and affordable for everyone’.

Within the Green Paper are a number of consultation questions [page 130 onwards]. The closing date for responses is 13 November 2009.

A paper which focuses on the different issues within the Green Paper is attached at AS5.

The Director for Social & Community Services, together with Mr Paul Purnell (Head of Adult Social Care), Mr Simon Kearey (Head of Strategy and Transformation) and the Cabinet Member for Adult Services, will attend for this item to answer any questions which the Committee may wish to ask.

The views of this Committee will be taken into account in considering what response the County Council will make to the Green Paper.

Any response will be submitted in the name of the Cabinet Member for Adult Services and the Leader of the County Council (as Cabinet Member for Finance).

The Committee is invited to discuss its views on the consultation questions and to forward its views to the Directorate, for inclusion in any response.

On 14 July 2009 the Department of Health issued a consultation document on the future shape of the care and support system in England.The Committee had been circulated with a copy of the Executive Summary prior to the meeting and directed to the Department of Health’s website, should Members wish to view the full document.

The closing date for responses was 13 November 2009.

A paper which focused on the different issues within the Green Paper was before the Committee (AS5).

The Director for Social & Community Services, together with Mr Paul Purnell (Head of Adult Social Care), Mr Simon Kearey (Head of Strategy and Transformation) and the Cabinet Member for Adult Services, attended for this item to answer any questions which the Committee may have wished to ask.

The views of this Committee would be taken into account in considering what response the County Council would make to the Green Paper and any response would be submitted in the name of the Cabinet Member for Adult Services and the Leader of the County Council (as Cabinet Member for Finance).

The Committee discussed its views on the Green Paper and AGREED to comment on a draft minute of its advice prior to submission to the Cabinet Member for Adult Services’ and Leader of the Council’s (with responsibility for Finance) Delegated Decision on 4 November.

Following the meeting, the Scrutiny Committee endorsed the proposed response from the County Council (refer Annex 1) which covers the main points which emerged during the scrutiny discussion and had cross party and universal endorsement.

Ms Coldwell undertook to circulate a copy of the Local Government Association’s response to the Green Paper to all members of the Committee.

11:45

Contact Officers: Varsha Raja, Assistant Head of Service – Strategic Commissioning, tel (01865) 323618; Suzanne Jones, Service Development Manager – Older People, Oxfordshire PCT, tel (01865) 334613.

The Committee will have the opportunity to conduct a question and answer session in relation to the current position and issues regarding Dementia, with a view to identifying any issues for a ‘select committee’ investigation at its February meeting.

A briefing paper is attached at AS6.

Colour copies of the map have been given limited circulation and placed on public deposit.

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.

Ms Suzanne Jones (Service Development Manager - Older People - Oxfordshire PCT) and Mr Duncan Saunders (Service Manager - Oxfordshire and Berkshire - The Alzheimer’s Society) will also attend for this item.

The Committee is invited to receive the update and to conduct a question and answer session on the current position and issues, with a view to conducting a select committee investigation at its February meeting.

The Committee was provided with the opportunity to conduct a question and answer session in relation to the current position and issues regarding Dementia, with a view to identifying any issues for a ‘select committee’ investigation at a future meeting.

A briefing paper was attached to the agenda (AS6).

Ms Varsha Raja (Assistant Head of Adult Services), together with the Director for Social & Community Services, Mr Paul Purnell (Head of Adult Services), the Cabinet Member for Adult Services, Ms Suzanne Jones (Service Development Manager - Older People - Oxfordshire PCT) and Mr Duncan Saunders (Service Manager - Oxfordshire and Berkshire - The Alzheimer’s Society) attended for this item to answer any questions which the Committee may have wished to ask.

Ms Raja summarised some of the key information set out in the briefing paper to Committee as follows:

·        approximately 40% of the expected population of people with dementia in Oxfordshire had actually been diagnosed. This was in line with the national picture in terms of diagnosis of people with dementia, as nationally between 20 and 40% of people had received a diagnosis of dementia;

·        although there was some service provision in Oxfordshire, there was a lack of universal access across the county to these services and there were some gaps in service provision;

·        more detailed analysis was required to assess the quality of provision;

·        Adult Social Care had not been allocated any ring fenced funding to deliver the National Dementia Strategy, although an initial sum of £150,000 had been delivered from the pooled budget to deliver key priorities;

·        Oxfordshire was also one of the 22 demonstrator sites for dementia advisors and a total of £207,000 had been allocated by the Department of Health to deliver this project, which is a pilot information prescription for people with dementia and their carers. Other activities were also underway, as set out in the paper.

Mr Saunders then made the following points in response to a number of questions:

·        Dementia was an umbrella term for a variety of similar conditions with broadly similar symptoms - with Alzheimer’s disease being the most common condition - although all forms of dementia were degenerative and incurable;

·        ongoing research was underway regarding how best to prevent and slow down the onset of dementia and research evidence was showing increasing links between lifestyle and dementia. Some types of dementia were thought to be entirely due to alcohol abuse. The usual advice in terms of staying active and eating a healthy diet was relevant in terms of prevention. Staying mentally and socially active, for example by learning a musical instrument, was also thought to be beneficial;

·        people with Down’s Syndrome were at increased risk of developing dementia.

Ms Jones then stated that all of Oxfordshire PCT’s work in relation to dementia was undertaken jointly with Social & Community Services and that a county wide steering group was in place, with high level clinical leadership.

A further selection of the Committee’s questions is listed below, together with the officers’ responses:

·        Was Oxfordshire  ...  view the full minutes text for item 26/09

12:30

Contact Officer: John Jackson, Director for Social & Community Services, tel (01865) 323572

The Director for Social & Community Services will attend to give a brief explanation of the process being followed, accompanied by the Cabinet Member for Adult Services.

The Committee is invited to receive the update.

WORKING LUNCH 12:40 – 13:10

BUSINESS PLANNING

The Director for Social & Community Services attended for this agenda itemin order to give a brief explanation of the process being followed. He stated that the Council was planning for difficult financial times ahead and that there was clear consensus across the political parties nationally of this. The Director then summarised the process between the Summer and up to budget scrutiny at the November/December meetings.

The Committee noted that there was an £8.0m savings target for Social & Community Services for the next financial year (4% of the budget for Adult Social Care), together with any new pressures that might crop up. This figure would then grow to £26.0m by the end of the five year timeframe. This would involve taking 20% out of the budget overall. Officers had not yet identified how to save £26.0m from the budget and would not have identified this in time for the December meeting of this Committee. However, they had identified how to balance the budget for next year which would deliver net savings of £8.0m next year.  The efficiencies would require the Directorate to either pay less for the services it purchased, avoid the need for some services as a result of the move towards prevention or work smarter.

Councillor Dr Peter Skolar requested that it be minuted that as Chairman of the Strategy and Partnerships Scrutiny Committee he wished to make the point that that the above Committee would not necessarily just accept a paper from each Directorate describing services and costs agreed at Star Chamber. He added that he hoped that Scrutiny would not just be told how the service intended to save £8.0m, as in his view,  this would not be acceptable, adding that all of the scrutiny committees should be provided with some choices as to how the efficiency savings could be made.

The Director responded that the service and resource planning report for 2010/11 – 2014/15 which had been provided to the September Council meeting gave some choices for next year dependent on all of the Directorates delivering their savings targets.

The Cabinet Member for Adult Services reminded the Committee that as the Directorate was only half way through the Transforming Adult Social Care Programme, many of the potential future efficiency savings would not have been worked up in time for the next financial year. He added that the impact of some of the changes might not be apparent until the third year of the programme and further stated that Scrutiny would have to put forward alternative options if it was not content with the proposed budget.

13.10

Contact: Des Fitzgerald, Policy and Review Officer, (01865 810477)

The attached paper (AS8) notes the items which the Committee is already scrutinising as part of its work programme, and briefly lists other items (suggested by Members and Directorate officers) which may be considered and prioritised for possible future work. Members are asked to note the items already identified and to identify their priorities for other work, from the items listed.

The Committee is asked to consider the proposals and to identify its priorities for its work programme.

SCRUTINY MATTERS

To consider matters where the Committee can provide a challenge

to the work of the Authority and its partners

Mr Des Fitzgerald (Policy and Review Officer) introduced the proposed annual scrutiny work programme for this Committee (AS8).

Following discussion, the Committee AGREED to include the following items in its 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;

·        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;

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

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

·        Domiciliary Care – consider at a future meeting once both inspections have been completed.

13:55

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

At this Committee’s previous meeting it was agreed that Mr Sinclair would respond in writing to some of the Committee’s questions. A response is attached at AS9.

Mr Sinclair will attend for this item to answer any questions which the Committee may wish to ask.

The Committee is invited to consider the attached responses and whether it wishes to ask any further questions.

REVIEW WORK

To take evidence, receive progress updates and consider tracking reports.

The Committee noted the responses to its previous questions which had been sent out with the agenda (AS9) and AGREED that it did not wish to ask any further questions.

14:15

Contact Officer = Julian Hehir, Scrutiny Review Officer, tel (01865) 815982

[Lead Member Task Group comprises Councillors Jenny Hannaby, Sarah Hutchinson, Larry Sanders and Lawrie Stratford]                                                                          

The Committee is invited to receive an update on the work of the Task Group.

BUSINESS PLANNING

To consider future work items for the Committee

[Lead Member Task Group comprises Councillors Jenny Hannaby, Sarah Hutchinson, Larry Sanders and Lawrie Stratford].

The Committee AGREED that it was satisfied with progress to date and that there were no major issues of concern.

14:25

The Committee is asked to note any items of interest.

(The current forward plan covers the time period October 2009 to January 2010).

No items were identified for consideration.

14:30

No items have been identified for tracking.

14:30           approx Close of Meeting

No items had been identified for tracking at this meeting.

ANNEX 1

Shaping the Future of Social Care Together

Response of Oxfordshire County Council to the Green Paper

1.                  This paper sets out the response of Oxfordshire County Council to the Green Paper “Shaping the Future of Social Care Together”.  It reflects informal discussions with Cabinet colleagues and discussions at our Adult Services Scrutiny Committee on 15^th October 2009.  However, ultimate responsibility for this response rests with us as the Cabinet Member for Adult Services and the Leader of the Council (with responsibility for Finance).  This response was agreed under our delegated powers on 4^th November 2009.

2.                  Oxfordshire County Council believes that there is a need to change the current arrangements but that any changes must build on good practice currently in place.  We give examples of good practice already in place here in Oxfordshire in paragraph 8 below.  We recognize that there are serious financial pressures on the adult social care system and that those pressures will get worse over the medium and longer term.  Oxfordshire County Council has made a very significant investment to respond to the demographic pressures that we face (investing £35m extra annually by the end of the current medium term service and resource plan ending in 2013/14).  This investment has been made despite the absence of any additional resources from central government.  However, it is difficult to see how the County Council can make a similar investment over the next five year period unless extra resources are contributed from other sources.

3.                  We believe that there are some serious shortcomings with the Green Paper.  In particular we would highlight the following:

·        The Green Paper has been several years in gestation.  As a result it does not reflect the very serious financial pressures now facing the public sector.

·        Any changes will require reform of primary legislation such as the National Assistance Act 1948.  We would support changes to bring this legislation up to date.  However, there is no mention in the Green Paper of how this legislation should be amended.

·        There is no mention of eligibility criteria and the review of Fair Access to Care Services (FACS).  It is completely unclear how the proposals will impact at a local level where eligibility criteria vary currently.

·        We do not believe that the Green Paper is especially helpful in taking forward the agenda set out in Putting People First (see paragraph 7 below).

·        It is unfortunate that the Green Paper places so much emphasis on the costs of residential care when Putting People First rightly places so much focus on community based services, prevention and early intervention.

·        It is also unfortunate that the Green Paper focuses so much on the issues facing older people at the expense of younger adults who will receive or already receive social care.

·        There is no consideration of the impact on providers of social care whether domiciliary care or residential care.

·        Overall, there is a significant lack of detail which makes it very difficult to come up with definitive  ...  view the full minutes text for item 33/09