Agenda item

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

The report provides details relating to the 2022/23 Portfolio Performance and Resource Agreement (PPRA), which was considered by the Committee on 8 September 2022 and approved by Cabinet on 28 September 2022. It also provides a comprehensive summary of progress against portfolio priorities, performance indicators and budgets during 2022/23, but with a specific focus on the fourth quarter (January to March 2023).

The Scrutiny Committee is asked to:

a)      Consider the Annual Portfolio Performance and Resource Report.

b)      Review the progress against delivering key projects, priority outcomes, 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 by email: gaynor.ward@stockport.gov.uk or Paul Graham by email: paul.graham@stockport.gov.uk

The Director of Adult Social Care and Interim Director of Public Health submitted a joint report (copies of which had been circulated) providing details relating to the 2022/23 Portfolio Performance and Resource Agreement (PPRA), which was considered by the Committee on 8 September 2022 and approved by Cabinet on 28 September 2022. The report also provided a comprehensive summary of progress against portfolio priorities, performance indicators and budgets during 2022/23, but with a specific focus on the fourth quarter (January to March 2023).

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 flu vaccination targets for 2-3 year olds and under 65 year olds, it was noted that the service were not reaching the targets set and queried whether there were any strategies in place to meet the targets in the future.

·         In response, it was commented that the targets set for the flu uptake numbers were challenging and the actual achieved in Stockport amongst pregnant women were the best nationally and for 2-3 year olds the third best nationally. Whilst they were strong figures, they did not meet the high targets set by the service partly relating to public appetite and uptake which had been experienced at a national level. Moving forwards, the service would continue to work with communities, NHS partners and providers who commissioned these services to understand what steps could be taken to improve vaccine uptake in Stockport.

·         In relation to the £0.298m overspend in mental health, it was queried what the long-term plan was in place to meet the growing need for mental health services.

·         In response, it was stated that mental health was a key priority reflected in the development and approval of the Mental Health & Wellbeing Strategy. Work was also ongoing to develop the in-house support available for residents. It was commented that in terms of mental health support from an adult social care perspective, it was important that the service work with health colleagues in an integrated way to use resources in the best way including ensuring early help and information was available so residents and service users situation didn’t escalate. It was noted that in terms of supported care packages, the service was working with colleagues to develop a specialised and supported housing strategy that looked at the anticipated need, develop flexible opportunities such as technology and incorporate a more independence based offer.

·         In relation to the weight management programme, it was queried whether the data reflected the number of people on the waiting list for the programme.

·         In response, it was clarified that the data was for people who had commenced the programme and for a 12 month period as opposed to individuals on the waiting list. It was acknowledged that there was a long waiting list for the weight management services and whilst the list was decreasing, it was at a slow rate. It was commented that based on an average completion rate, it was estimated that a further 37 people will complete, which would exceed the target set.

·         It was suggested that it would be useful to measure the size of the waiting list in addition to the number of people who had successfully completed the programme.

·         Concerns were raised in relation to the red status and downward trend of the performance indicators relating to the number of high and medium priority DOLs referrals awaiting assessment and the percentage of safeguarding cases where risk had been reduced or removed. It was noted within the commentary on performance that the issue was national issue and that the Council were waiting government action, however queried what steps were being taken to address the issue.

·         In response, Members were advised that the service were using the national ADASS tool to prioritise people on the waiting list. It was reported that currently there were 357 people in the high to medium priority group. The Council had invested in additional resources to help to reduce that wait and had commissioned an external provider to take 300 people in the first instance. In addition, another review was ongoing of the pathway systems around DOLs including how the service was managing the flow and if there are any further improvements that could be made to speed up the process. An additional 18 members of staff were also undergoing training which would support the improvement work.

·         Welcomed the improvements made, green status and upward trend of the performance indicators relating to the percentage of clients with a learning disability living independently and percentage of adults with autism living independently.

·         In relation to the percentage of people accessing short-term services who no longer required long-term care, it was queried why there had been such a big increase in comparison with the previous years. In response, it was agreed that a written response would be provided.

·         In relation to the percentage of safeguarding cases where the client outcomes had been wholly/ partially achieved, it was commented that whilst it was encouraging that the percentage was high, it was queried how the residual number of people were being monitored, supported and if they were still a priority.

·         In response it was stated that the 94% figure was positive and the service were continuing to monitor those people with some closely due to the level of risk involved and because the level of risk hadn’t reduced. Whilst advice and support was given to help individuals manage their risk, the service were unable to assure the outcome relating to individual capacity and choices so would continue to monitor the situation with their consent.

·         Relating to positive investments in mental health and addiction services, it was requested that the Committee considered and provided accountability for the Delivery Plan for the Mental Health Strategy.

·         Members thanked officers for the inclusion of a comprehensive commentary around the performance indicators.

·         Clarification was requested in relation to the new adult drug and alcohol service and comment that the data reported predominantly related to the previous model.

·         In response, it was commented that adult drug and alcohol service was retendered, and a new service commenced from April 2022. It was noted that most of the clients described in the data had started their patient journey with the previous provider and generally where there was a provider change there was usually a transition period where performance trends decrease whilst the service was established and beds in.

·         Concerns were raised in relation to the number of adults who were overweight or obese and queried what the Council can do to control planning applications for fast food or other similar outlets.

·         In response, it was clarified that the percentage of 63% related to any individual whose weight was above what’s being defined as being the normal range optimal for their health. It was commented that the planning regulations give limited ability to intervene when new, fast food takeaway and similar establishments are proposed. However, the council had an existing policy which allow some discretion to consider declining a planning application on health grounds for hot food takeaways within a certain radius of a school providing the premises were not in the town centre area. Work was ongoing with planning colleagues to understand if there was work that could be done to strengthen that policy. It was also noted that the Council was in the process of developing a food strategy for Stockport which would look at a whole system approach within the context of food poverty with the food industry as a key partner.

·         In relation to the percentage of adults with autism in paid employment, it was queried what services were available for adults with autism seeking employment and how successful they were.

·         In response, it was commented that nationally the measure required that individuals with learning disabilities and/ or autism who gained paid employment also had to of received care and support to meet the criteria. It was noted that paid employment was an essential area to increase people’s independence and an action plan was being developed around how the Council could further the support around helping people to get a job. There were services that support people with learning disabilities provided through Opportunities Together which was an in-house provider and also some support from the voluntary sector.

RESOLVED – That the report be noted.