Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 27 June 21017.

The Minutes (copies of which had been circulated) of the meeting held on 27 June 2017 were approved as a correct record and signed by the Chair.

Councillors and officers were invited to declare any interests they had in any of the items on the agenda for the meeting.

The following interests were declared:-

Personal Interests

There was no call-in to consider.

The Stockport Clinical Commissioning Group is consulting on decommissioning the standalone angiography site at Stepping Hill Hospital.

The Scrutiny Committee will be invited to comment on the proposals.

Dr Cath Briggs (Clinical Director for Quality & Provider Management) and Gillian Miller (Associate Director of Commissioning), Stockport Clinical Commissioning Group (CCG) attended the meeting to outline proposals by the CCG to improve the quality of care for patients with chest pain and at risk of coronary heart disease.  The proposal would mean that Stockport patients requiring angiography for diagnosis of coronary heart disease would in the future be referred to a specialist centre, such as Wythenshawe Hospital or Manchester Royal Infirmary (MRI), instead of Stepping Hill Hospital.  Angiography would no longer be provided at Stockport Foundation Trust.  This was to ensure that patients received the highest quality, clinically evidence based care for investigation of heart disease. 

Stockport CCG estimated that approximately 500 people per year, over four CCG/Local Authority footprints, would be affected by this change. Stockport CCG had involved Healthwatch in discussions and proposed to undertake further public engagement of existing users and potential new users of the service.

Councillors highlighted likely concerns from patients about the travel implications of having to travel to either Wythenshaw or MRI for diagnostic tests who might otherwise have been referred to Stepping Hill, although it was acknowledged that in some areas of the Borough a referral was more likely to be made to these hospitals in any case.

It was further commented that for many of those who required further treatment after diagnostic testing there would then be a reasonable chance of a further referral to specialist services at Wythenshaw or MRI.

A further comment was made that although personal experience of the service at Stepping Hill was positive, the benefits of the proposals outweighed this consideration.

RESOLVED – That the Scrutiny Committee support the proposals for the decommissioning of the Angiography Service and supports the proposed public engagement arrangements.

To consider a report of the Corporate Director for People.

This report outlines the approach that has been taken to reviewing care home fees for 2017/18 and proposes fee uplifts for this financial year. It also refers to the approach to be taken in preparation for 2018/19 implementation.

Scrutiny Committee is asked to:

·      Consider and comment on the contents of this report;

·      Note the recommendations in 8.2 that will be made to the Cabinet at their meeting of 15 August 2017.

Officer contact: Vincent Fraga, 0161-474-4401, vincent.fraga@stockport.gov.uk

A representative of the Corporate Director for People submitted a report (copies of which had been circulated) outlining the approach and outcome of a review of care home fees for 2017/18 and proposals for an uplift in the fees in the current financial year. The report also set out the approach to be taken in preparation for the 2018/19 implementation.

The Cabinet Member for Adult Social Care (Councillor Wendy Wild) attended the meeting to respond to questions.

The following comments were made/ issues raised:-

·         Clarification was provided in response to questioning that the categories of provision used by the Council were at its discretion but followed a pattern used by many other local authorities.

·         Concerns were expressed that there was insufficient capacity available in those categories of provision most needed, and capacity in that provision that was rated as inadequate. Comment was made that greater consideration should be given to remunerating providers on the basis of quality. In response it was stated that this approach was being explored in conjunction with other Greater Manchester authorities.

·         Concerns were expressed that as resources were reduced and providers sought to minimise costs that staff roles were being lost that had previously been dedicated to support residents’ wellbeing to the detriment of residents.

·         Comment was made that the lack of engagement from providers was disappointing given that these businesses were not engaging with their single largest block customer.

·         The report was commended for its clarity and for building on previous work in this area.

·         There was no direction correlation between the cost and quality, with some of the highest cost providers being rated poorly by the Care Quality Commission. This was an indication that good quality service could be provided with relatively modest revenue.

RESOLVED – (1) That the report be noted.

(2) That the Corporate Director for People be requested to submit a further report to the Scrutiny Committee on work to increase capacity in the residential and nursing home sector.

To consider a report of the Corporate Director for People.

The First Update Portfolio Performance and Resource Reports (PPRRs) for the Adult Social Care and Health Portfolios are presented for consideration by the Committee. These provide a summary of progress in delivering the portfolio priorities, reform programme and other key projects in the first quarter of the year (April to June). They include forecast performance and financial data (where this is available) for the Portfolios, along with an update on the portfolio savings programmes.

The Scrutiny Committee is asked to:

·         Consider the First Update Portfolio Performance and Resource Reports;  

·         Review the progress against delivering key projects, priority outcomes, targets and budgets for 2017/18;

·         Highlight key areas of and responsibility for taking forward corrective action to address any performance or resource issues;

·         Highlight any significant issues or changes to be fed back to the Cabinet alongside the Corporate Performance and Resource Report;

·         Identify how areas of strong performance and good practice can be shared in other services.

Officer contact: Karen Kime / Emma Bowe, 0161 474 3574/ 218 1026, karen.kime@stockport.gov.uk / emma.bowe@stockport.gov.uk

The Cabinet Members for Adult Social Care and for Health submitted the Portfolio Performance and Resources Reports (copies of which had been circulated) summarising progress in delivering priorities, reform programme and other key projects for the Adult Social Care and Health portfolios during the first quarter of 2017/18. The reports also included forecast performance and financial data for the portfolios, along with an update on the portfolio savings programmes.

Adult Social Care Portfolio Performance and Resources Report

The Cabinet Member highlighted the following issues:-

·         The ongoing engagement with the public and stakeholders on the Stockport Together draft Outline Business Cases.

·         Proposed review of preventative services and the Alliance for Positive Relationships against the commissioning objectives.

·         Work to redesign and integrate mental health services was currently paused pending the completion of the refurbishment of premises at Baker Street.

·         In relation to Learning Disabilities work was continuing on the outsourcing of learning disability tenancies, engaging with users, families and support staff; it was hoped to move toward full staffing at Heys Court; Stockport was one of small number of pilot areas for a Department for Work and Pensions project to develop innovative ways to support people with additional needs into employment.

·         A recent recruitment day for care workers had been held that had good representation from providers.

·         Further recruitment was taking place to enhance the Adult Social Care quality team to support providers to raise standards.

·         Work had begun to develop business cases for how the enhanced Better Care Fund would be invested.

The following comments were made/issues raised:-

·         The work of the Adult Social Care Quality Team was commended, including their close working with Healthwatch and positive relationships with providers.

·         The Council’s development of the Autism Strategy was welcomed.

·         Clarity was sought on whether or not there was a particular problem with domestic homicide that had prompted the thematic review. In response it was stated that any incidents were too many, although no specific pattern had prompted the review.

·         At the previous meeting there was an assurance that the Core Neighbourhood team need not be GP lead, but the current report could be read to imply otherwise. Concern was expressed that a uniform approach to GP lead teams would medicalise social care and may marginalise preventative work. In response it was stated that General Practice was fundamental to the model, not least because it provided clinical leadership, but that leaderships of the teams could also come from community health and social care.

·         Clarity was sought on whether Stockport’s relatively high incidence of dementia was due to demographic pressures. In response it was commented that demographic profile was one contributing factor, but also that locally partners had worked hard to improve early diagnosis and treatment.

·         Concern was expressed about the deterioration in performance relating to new social care clients waiting for care packages. In response it was acknowledged that waiting lists did exist but that there were a number of initiatives to improve this situation, not least the Stockport Together programme. There had been increases in homecare provision but there continued to be increases in demand. Better understanding of the type of packages in demand was needed to ensure it matched capacity.

·         Clarification was sought on why performance was judged to be good when the proportion of social care bed capacity was in settings judged by the CQC as inadequate or requiring improvement. In response the apparent anomaly was acknowledged although the proportion was reducing from the previous year so performance was improving. It was further commented that those providers who were consistently judged as good tended to be those who had consistent management and leadership. Cost and price were not necessarily a useful measure for quality. The Council were also actively supporting providers to improve.

·         Emphasising the value of working as a carer was important as there were often negative news stories in the press that did not reflect the workforce.  ...  view the full minutes text for item 6.

To consider a report of the Democratic Services Manager.

The report outlines the agreed process for the selection of Scrutiny Review topics for 2017/2018.

A suggestion was made at the last meeting to undertake a review of the obesity/ diabetes during the 2017/18.

The Scrutiny Committee is invited to consider and confirm its preferred topic for inclusion in the 2017/2018 Scrutiny Work Programme.

Officer Contact: Jonathan Vali, 0161 474 3201, jonathan.vali@stockport.gov.uk

A representative of the Democratic Services Manager submitted a report (copies of which had been circulated) inviting the Scrutiny Committee to suggest topics for in-depth review to be carried out during the 2017/18 municipal year.

The Scrutiny Committee had considered possible topics at its previous meeting and had requested consideration of the topic of obesity and diabetes. The Democratic Services Manager and the Deputy Director of Public Health outlined a possible scope for the review, focussing on a ‘whole system approach’ to addressing the causes of unhealthy weight.

RESOLVED – That the Democratic Services Manager be requested to include the topic ‘A whole-system approach to tackling unhealthy weight’ in the draft Scrutiny Work Programme for submission to the Council Meeting on 14 September 2017.

To consider a report of the Democratic Services Manager.

The report sets out planned agenda items for the Scrutiny Committee’s next meeting and Forward Plan items that fall within the remit of the Scrutiny Committee.

The Scrutiny Committee is invited to consider the information in the report and put forward any agenda items for future meetings of the Committee.

Officer contact: Jonathan Vali, 0161 474 3201, jonathan.vali@stockport.gov.uk

A representative of the Democratic Services Manager submitted a report (copies of which had been circulated) setting out planned agenda items for the Scrutiny Committee’s next meeting and any relevant Forward Plan items.

RESOLVED – That the report be noted and the Democratic Services Manager be requested to programme the following items for future meetings:-

·         Diabetes 100 Day Review

·         Increasing provision of residential and nursing home beds