Agenda and minutes

Apologies were received on behalf of Councillor Sarah Hutchinson (Councillor Richard Stevens substituting).

To approve the minutes of the meeting held on 26 October 2010 (AS3) and to note for information any matters arising on them.

The minutes of the meeting held on 26 October 2010 were agreed and signed.

10:50

• Strategic Commissioning Framework for Day Opportunities for Older People

On 16 November the Cabinet approved the implementation of the strategic commissioning framework to move to day opportunities for older people and carers within Oxfordshire.

Strategic Commissioning Framework for Day Opportunities for Older People

The Scrutiny Committee noted that on 16 November 2010 the Cabinet approved the implementation of the strategic commissioning framework for day opportunities for older people and carers within Oxfordshire.

The Committee received an update from Councillor Peter Skolar and noted the following:

1.         Oxfordshire County Council was part of the early implementation group – one of twelve County Councils setting up a health & Well Being Board in advance of others. The County Council had a good record of working with our NHS colleagues.

2.         A high level team was working on the implications of the move of Public Health coming within Local Authority control. There was a great deal to be done to implement the changes but once completed the group would go on to look at the setting up of the new Health & Well Being Board. It was expected that the new Board would become be set up initially as a Shadow Board and would eventually be a Commissioning Group.

3.         Responding to a query about the Chairmanship of the new Board Councillor Skolar advised that the PCT would disappear and that the Chairman would be a member of the Local Authority.

4.         It was hoped that the Health Overview & Scrutiny Committee would continue possibly with a right of referral but this was not yet definite.

11:04

The Committee is asked to note any items from the current Forward Plan which covers the time period December 2010 to March 2011.

No items were raised.

11:05

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 (AS7) 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 its progress update to the Committee as part of this item.

[Task Group comprises Councillors J. Hannaby, S. Hutchinson, L. Sanders and L. Stratford].

The Committee is invited to track progress, conduct a question and answer session and receive the update from the Self Directed Support Task Group.

The Scrutiny Committee considered the latest in a series of reports on transforming Adult Social Care (AS7) that included detail on self directed support.

The Committee also received an update from the Self Directed Support Task Group.

During a question and answer session the following were amongst the matters discussed:

1.         Assurances were sought over the availability and suitability of sufficient brokers to ensure people were properly supported. Mr Sinclair gave details of the current position relating to personal budgets and stressed that the transition period was key. Two new brokerage services were in place and locality teams were involved. Information days were being held, three so far in Oxford, Witney and Didcot. Attendance had been good although there were less members of the public than expected at the Oxford and Witney events. Once completed the Events would be evaluated.

2.         The Committee had not yet had a report on the Internal Home Support Service. It was noted that a report was to go to Cabinet and the matter would be addressed at a future Scrutiny Committee meeting.

3.         Alan Sinclair advised that his role as Programme Director and the work of his Team was coming to a end and he was  focussed on the need to sustain the changes to ensure that they were properly embedded. This would be taken forward by others with reports to the Scrutiny Committee on sustaining the change.

4.         Concern was expressed about the timing of the change where only 10% of a 30% target had been reached and it was suggested that methods other than road shows, such as leaflets should be considered.

5.         There was a query about the engagement of the process with the issue of delayed discharges. Alan Sinclair responded that although delayed discharges were not within his responsibility the work was aligned. The flexibility of personal budgets could have a positive impact on the speed at which people could be released from hospital.

6.         Asked about the impact on people who were unable to get brokerage services Alan Sinclair commented that th4e impact would be felt most by new service users and they would be prioritised. For people already receiving services there would be no major impact.

7.         The Chairman stated that the Task Group would continue but the intention was to bring the three groups into one. The continuation of the Task Group was supported although Councillor Larry Sanders expressed the view that the User Group remain as a separate and independent group.

8.         Councillor Tim Hallchurch asked that consideration be given to holding road shows in village locations.

9.         It was confirmed that new users would be dealt with through the ‘single front door programme’ and referred to the Locality Team as appropriate after that. Anyone receiving services would have a named contact.

10.       There was some discussion on the way in which people with learning disabilities and people with mental health issues would be dealt with as part of the transition to personal budgets.  ...  view the full minutes text for item 105/10

11:20

An update from the Oxfordshire LINk is attached at AS8.

The Committee is invited to receive the update from the Oxfordshire LINk.

The Committee considered the update (AS8).

Adrian Chant  and Mr Dermot Roaf, Chair of the Oxon LINk Stewardship Group attended for this item.

Adrian Chant informed the Committee that the next Hearsay Event was to be held provisionally on 11 March 2011. The Event on 26 October did not have a major turn out of service users but heard from 28 users and the quality of the feedback was good.  The report would be available in January 2011.

During discussion on the funding of future LINk’s work Dermot expressed concern at the scale of the reduction in funding . They would look carefully at their programme. The Chairman suggested that to remain effective it would be necessary for them to focus on a smaller number of items and to look in depth at them. Dermot commented that they would welcome suggestions about work areas but that it was important to retain independence. The Cabinet Member thanked LINks for their work and agreed that it was important that they remained independent. He would be happy to consider providing support for individual events such as Hearsay. The funding was to recognise that this would be a transition year.

Members generally welcomed that LINks were Visiting Care Homes and it was hoped that an initial report on this could be made to the next meeting.

11:30

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

In April this Committee received a progress update in relation to the national dementia strategy and agreed to review further progress in six month’s time. It is now time to review progress.

A report is attached at AS9(a), together with a minute from the Committee’s April question and answer session (AS9(b)).

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

Mr Duncan Saunders (Service Development Manager - Older People’s Mental Health – NHS Oxfordshire) will also attend for this item.

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

Working Lunch 12.30 – 12.45

(a)       Implementing the National Dementia Strategy in Oxfordshire - Briefing on Progress to Date as at 28 October 2010

(b)       Dementia Q&A Minute from the Committee's April meeting

Committee considered a progress update in relation to the national dementia strategy AS9(a), together with a minute from the Committee’s April question and answer session (AS9(b)).

Ms Varsha Raja (Assistant Head of Adult Services) attended for this item, together with the Cabinet Member for Adult Services.

Mr Duncan Saunders (Service Development Manager - Older People’s Mental Health – NHS Oxfordshire) was also in attendance.

Ms Raja informed the Scrutiny Committee that dementia continued to be a priority for the national agenda. The Minister had made a key note speech setting out the revised priorities;

·                    Good quality services, early diagnosis and intervention;

·                    Improved quality of care in general hospitals;

·                    Living well with dementia in care homes; and

·                    Prescription of anti-psychotic drugs for dementia.

The approach being taken locally would be reshaped to take account of the revised priorities.

Responding to a question from the Chairman, Ms Raja advised that the revised criteria on continuing health care for people with dementia focussed on those with challenging behaviours and psychological problems. This would mean that older people as they became frailer would see care withdrawn with the result that responsibility fell on the Local authority and families. Asked how information was gained so that funding was withdrawn, such as by re-assessment, Ms Raja stated that their was a key final piece of work as there was a need to understand the local position. It was suggested by Councillor Dr Peter Skolar that  this was another way that the PCT was seeking to reduce its core funding and that he would wish to monitor it very carefully. Ms Raja undertook to provide a briefing note on this matter including an explanation of the way in which re-assessments would take place.. She added that the funding was in a pooled budget but that it was accounted for separately. Further work was needed to understand the local position.

It was AGREED that the Committee return to this matter as part of their meeting in March 2011 and that officers discuss a possible referral to the Joint Health Overview & Scrutiny Committee.

The Chairman commented that there was still lack of awareness of telecare and queried what could be done to correct this position? Ms Raja indicated that they had just awarded a contract to expand the service which had been patchy. There would be a co-ordinated service across Oxfordshire.

Asked about the provision of information on dementia serices Ms Raja commented that there was agreat deal of information but that it was a struggle to personalise the information to individual needs.

Responding to a query about the work of Dementia Advisors in doctor’s surgeries Ms Raja advised that they were extremely successful. Initial analysis indicated that with 4 Advisors it would be possible to deliver a County wide service.

In response to a question about  ...  view the full minutes text for item 107/10

12:45

The Director for Social & Community Services will give an oral update on key issues, to include an update on service and resource planning.

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The Director for Social & Community Services briefly outlined the results of the National Spending Review and referred to discussion at a meeting when attending the Adult Services National Conference. He undertook to circulate a copy of a summary note produced. There was more money for Adut Services but only in the context of a poor settlement generally.

The Scrutiny Committee was advised of the publication of a ‘Vision for Adult Social Care’ a link to which would be circulated to members. The Director for Social and Community Services commented that he did not disagree with the White Paper but was disappointed that there was no mention of putting people first. He also referred to a paper entitled Thinking Strategically Acting Locally that was published in November and would also be circulated to Members.

The Scrutiny Committee was advised that the Funding of Local Care Commission had published a call for evidence. A link would be provided for members and it was AGREED that this matter be considered at the next meeting if required.

The Director for Social & Community Services provided an update on the following local issues:

Annual Performance Assessment – The Council was performing well overall with an assessment of performing well in five categories and performing excellently in two categories.

Delayed Transfers – The Director informed the Scrutiny Committee on the action being taken that was seeing the figures coming down steadily in recent weeks.

Turn Round System –  It was AGREED that a reort on this project come to a future meeting.

Support for Carers – The Scrutiny Committee was advised that although support was not being cut there had been considerable debate on this matter. The Cabinet had agreed a Strategy that would use the Customer Service Centre together with out reach work and related services. An explanation was given of the procurement process being followed and it was confirmed that carers were involved in the evaluation process. A decision was expected at the Cabinet meeting in January 2011.

Internal Home Support Service – The Director for Social & Community Services advised that political groups had been briefed and that a report would be considered at the Cabinet meeting in December. Staff affected would be briefed before the report was published and a briefing made available to all Councillors and MPs.

Service & Resource Planning 2011/12 – 2015/16 – The Director for Social & Community Services gave a brief overview of the main points arising from the Service & Resource Planning process that would be fully considered at the meeting on 20 December 2010.