Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 13 October 2022.

The Minutes (copies of which had been circulated) of the meeting held on 13 October 2022 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 were no call-in items to consider.

To consider a report of the Director of Public Health and Interim Director of Adult Social Care.

The Mid-Year Portfolio Performance and Resource Report (PPRR) for the Health and Adult Social Care Portfolio is presented to Members for consideration. The report focuses on highlights and exceptions in relation to delivering the portfolio priorities since the Agreement was drafted and includes forecast performance and financial data (where this is available) for the Portfolio, along with an update on the portfolio savings programme.

The Scrutiny Committee is recommended to:-

a)    Consider the Mid-Year Portfolio Performance and Resource Report.

b)   Review the progress to date (and forecasts) relating to delivering key targets and budgets for 2022/23.

c)    Highlight key areas of and responsibility for taking forward corrective action to address any performance or resource issues.

d)   Highlight any significant issues or changes to be fed back to the Cabinet alongside the Corporate Performance and Resource Report.

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

Officer contact: Gaynor Ward on 0161 474 3186 or email: gaynor.ward@stockport.gov.uk and Paul Graham by email: paul.graham@stockport.gov.uk

The Director of Public Health and Interim Director of Adult Social Care submitted a report (copies of which had been circulated) which focussed on the highlights and exceptions in relation to delivering the portfolio priorities since the Agreement was drafted and included forecast performance and financial data (where this was available) for the Portfolio, along with an update on the portfolio savings programme.

The Cabinet Member for Health and Adult Social Care (Councillor Keith Holloway) attended the meeting to respond to questions from the Scrutiny Committee.

The following comments were made/issues raised:-

·         In relation to a previous request of the Committee that Greater Manchester Integrated Care System senior colleagues be invited to a future meeting of the Committee to ensure accountability for the residents of Stockport, it was commented that the decision making around the Adult Social Care Discharge Fund would be welcomed as a future discussion topic.

·         In relation to the number of Deprivation of Liberty Safeguarding referrals awaiting assessment and percentage of safeguarding cases where risk reduced or removed, it was queried what work is being undertaken to improve these ratings.

·         In response it was commented that in relation to the Deprivation of Liberty Safeguarding assessments, workforce pressures and increasing demand continued to impact on the ability to meet the requirements to undertake Deprivation of Liberty assessments, however the service was exploring options to increase workforce capacity and around best interest assessments to improve performance. In relation to safeguarding, it was commented that there were reviewing all safeguarding adults pathways, recording to ensure residents were being recorded correctly, and the workforce training and development offer in order to ensure that the right offer is available for people who need safeguarding. Whilst this was not fully resolved, work was ongoing to ensure that the ethos around making safeguarding personal was embedded.

·         Welcomed the commitment to improve the measures and reviewing workforce capacity.

·         It was requested that an item relating to Adult Social Care workforce capacity around safeguarding be programmed into the Scrutiny Committee’s work programme for the 2022/23 municipal year.

·         In relation to measuring performance and reporting progress on nursing beds, it was noted that a number of the measures were on a downward trend and queried whether this was connected to lower staffing levels.

·         In response it was acknowledged that the figures were disappointing and linked to the aftereffects of the pandemic and lockdown. In addition, the attention to the regulations within CQC assurance required improvement linked to issues with stability of leadership including higher turnover in registered managers amongst other workforce challenges and a reliance on agency staff. It was noted that work was ongoing to support recruitment and care homes to alleviate these pressures which was covered in detail within the transformation programme to build on the improvements made.

·         It was queried whether the workforce improvements would include continued training and development.

·         In response, Members were assured that workforce training and development was included at a local, Greater Manchester and national level to support care homes. Within the transformation programme there was a specific priority linked to the internal and external workforce.

·         Welcomed the improvements made in the uptake of the Breast Cancer Screening Programme in Brinnington. 

·         It was queried what steps were being taken to support care providers during the cost of living crisis.

·         In response it was stated that the cost of living crisis had been the focus of much of the ongoing social care reform work including the fair cost of care work, sustainable rates and the impact on the workforce. In addition, there was an ongoing large programme of work exploring what support could be provided to residents and employees including an online and in person smart money advice tool which had been shared with all providers. All support information continued to be available on the Council’s website under the cost of living hub which any individual could access. Work was  ...  view the full minutes text for item 4.

To consider a report of the Director of Public Health.

The report provides a third update of the progress of the motion on Automated External Defibrillators that was agreed at Full Council.

The Scrutiny Committee is requested to note the progress made against the actions set out in the motion agreed at full Council in November 2021.

Officer contact: Jennifer Connolly on 0161 474 2442 or email: Jennifer.connolly@stockport.gov.uk

The Director of Public Health submitted a report (copies of which had been circulated) which provided a third update of the progress of the motion on Automated External Defibrillators that was agreed at Full Council.

The Cabinet Member for Health and Adult Social Care (Councillor Keith Holloway) attended the meeting to respond to questions from the Scrutiny Committee.

Members welcomed the progress made in relation to Automated External Defibrillators, queried where the map would be available for residents to access and how this could be made more readily available. In response, Members were advised that currently a map was not available, however the council had recommended to The Circuit that they contact Google Maps to suggest the addition of this data and information to their maps for maximising public access. Whilst the Council were able to publicise the latest data via a map on the website, the maintenance of the register was the responsibility of The Circuit and therefore any data would be out of date. However, work was ongoing to produce a new, dedicated webpage through the council website which would include links to the Defib Finder website for accurate up to date information regarding the location of defibrillators across the borough as a useful resource for community groups and residents.

RESOLVED – That the report be noted.

To consider a report of the Director of Adult Social Care.

The report outlines the proposal to set up a Greater Manchester Mental Health and Dementia Complex Needs flexible purchasing system.  The FPS will be divided into two lots;

·         Lot 1 People with complex mental health conditions including those with substance misuse

·         Lot 2 People with Complex Dementia 

The Scrutiny Committee is recommended to note the report.

Officer contact: Vincent Fraga on 0161 474 4401 or email: vincent.fraga@stockport.gov.uk and Yvonne Winskill by email: Yvonne.Winskill@Star-procurement.gov.uk

A representative of the Director of Adult Social Care submitted a report (copies of which had been circulated) which outlined the proposal to set up a Greater Manchester Mental Health and Dementia Complex Needs flexible purchasing system. The flexible purchasing system would be divided into two

lots; Lot 1 People with complex mental health conditions including those with substance misuse and Lot 2 People with Complex Dementia.

The Cabinet Member for Health and Adult Social Care (Councillor Keith Holloway) attended the meeting to respond to questions from the Scrutiny Committee.

The following comments were made/issues raised:-

·         Welcomed the inclusion of people with lived experience to form the panel scoring the bids.

·         It was queried what the social value of this contract equated to and why the social value weighting was low.

·         In relation to annual fee setting, it was queried whether this frequency was sufficient given the inflationary pressures.

·         In response it was reported that annual was a guide in line with the annual fee setting of local authorities. However, on a regular basis as part of contract monitoring and contract management, it was not uncommon to extend this dialogue and where there were legitimate pressures there would be an option to enter into negotiations with the support of Finance officers.

·         It was noted that there were 15 bids on this occasion and queried whether there would be a further opportunity for additional bids.

·         In response it was commented that it was to be determined how often the procurement framework would open. The service operated a flexible procurement framework for domiciliary care in Stockport which was opened regularly and approximately twice a year for additional bids.

RESOLVED – That the report be noted.

To consider a report of the Director of Adult Services.

The report provides an overview of the proposed changes to the Adult Social Care Direct Payments Policy, which have been made in response to recent feedback. It will also provide an overview of the public consultation feedback and the equality impact assessment of the policy changes. 

The Scrutiny Committee is asked to:-

a)    Review the consultation feedback (Section 4.0)

b)   Review the EIA (Appendix 2)

c)    Comment on the Implementation Plans and Risks (Sections 5.0 and 7.0)

Officer contact: David Eckersley on 0161 218 1754 or email: david.eckersley@stockport.gov.uk  

The Director of Adult Services submitted a report (copies of which had been circulated) which provided an overview of the proposed changes to the Adult Social Care Direct Payments Policy, which had been made in response to recent feedback. It also provided an overview of the public consultation feedback and the equality impact assessment of the policy changes.

The Cabinet Member for Health and Adult Social Care (Councillor Keith Holloway) attended the meeting to respond to questions from the Scrutiny Committee.

The following comments were made/issues raised:-

·         It was queried whether legal services, clients and carers had been consulted in advance of the policy being adopted.

·         In response, it was stated that the initial consultation was inadequate which left the service in a vulnerable position when it came to delivering and administering the policy. As a result, a subsequent consultation has been completed in a meaningful way to produce a report that contains people’s views. It was envisaged that this policy would be produced in a way which is accessible and encompasses the spirit of the council’s objectives and what a direct payment should be.

·         Thanked officers for their honesty and welcomed the revised policy as a step in the right direction and tone of accountability.

·         It was suggested that it would be useful to explore the differences in enthusiasm between the client and carer column and staff column in each of the proposals to reflect with staff on why this is different, individual roles and where the agency sits.

·         In relation to the administration of the policy, Members welcomed the inclusion of workforce development and suggested that the operational issues be considered to deliver a timely, effective service for residents.

·         It was queried what safeguards were in place to ensure that the payments were spent in a meaningful way.

·         In response it was commented that there would be appropriate auditing as part of the provision of a direct payment, with an Audit team supporting people around the account and spending in line with their Care Act assessment and agreed outcomes. In addition, there would be a social work review on a regular basis to support people.

·         It was queried how regular these audits would take place.

·         In response it was stated that the plan was a six-monthly audit and annual social work review. However, there was some staffing capacity issues which would form part of the workforce plan going forwards to ensure those reviews were done in a timely manner.

·         Requested clarification in relation to the timeline of the policy and when this would be presented to scrutiny.

·         In response, it was confirmed that the service was operating on a draft policy at this time due to the withdrawal of the previous policy as a result of the concerns outlined. Whilst the final policy was being approved and would be considered at future meeting of the Committee, it was necessary to adopt a framework to operate within to continue to deliver direct payments.

·         It was queried what would be the position where an individual did not have a social worker.

·         In response Members were informed that there was a finite number of social workers, as a result there was ongoing discussions within the workforce work to devise a mechanism which ensured residents had regular reviews to deal with issues and the overall administrative process to prioritise the allocation of social workers to ensure residents had the right support at the right time.

·         It was noted that the report referenced that direct payments cannot be used for services or support that was considered to be the responsibility of the NHS, however noted the difficulties in accessing services such as dentistry in the current climate and queried whether it was possible for this to be revised.

·         In response it was stated that it was illegal for the local authority to fund services which should be funded by the national health service  ...  view the full minutes text for item 7.

To consider a report of the Director of Health, Quality and Improvement/ Deputy Place Lead.

The report provides an update on the maternity care provided to Stockport women.

The Scrutiny Committee is recommended to discuss the information provided and note the report.

Officer contact: Sharon Hyde on 0161 419 5510 or email: Sharon.hyde@stockport.nhs.uk

RESOLVED – That consideration of this item be deferred to the next meeting of the Scrutiny Committee.

To consider a report of the Strategic Head of Service & Monitoring Officer (Legal & Democratic Governance).

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: Georgia Latham on 0161 474 3229 or email: georgia.latham@stockport.gov.uk

A representative of the Assistant Director - Legal & Democratic Governance (Monitoring Officer) submitted a report (copies of which had been circulated) setting out the planned agenda items for the Scrutiny Committee’s next meeting and any Forward Plan items.

It was requested that the Maternity Services report deferred to the next meeting of the Committee references the link between poorer outcomes and the Black, Asian and Minority Ethnic sub-group.

RESOLVED – (1) That the report be noted.

(2) That the Assistant Director - Legal & Democratic Governance (Monitoring Officer) be recommended to programme the following item into the Scrutiny Committee’s work programme for the 2022/23 Municipal Year:

·         Adult Social Care workforce capacity around safeguarding.