Agenda and minutes
Health, Housing and Adult Services Overview and Scrutiny Committee
Wednesday, 15 June 2011 7:00 pm
Venue: Salon - York House. View directions
Contact: Angus Huck on 0208 891 7191 or Email: Angus.Huck@richmond.gov.uk
Apologies were received from Councillors John Coombs and Meena Bond, and from Margaret Dangoor and Keith Sangster (both Co-optees).
Councillor Coombs was substituted by Councillor Elengorn.
DECLARATIONS OF INTEREST
Members are asked to declare any interests in matters for consideration at the meeting.
There were no declarations of interest.
To approve the minutes of the meeting held on 22rd March and the call-in meeting 4th May.
The minutes of the meeting held on 22nd March 2011 were AGREED as a correct record and the Chairman was authorised to sign them.
The minutes of the call-in meeting held on 4th May 2011 were AGREED as a correct record and the Chairman was authorised to sign them.
To receive a presentation by Dame Jacqueline Docherty (Chief Executive, West Middlesex University Hospital) and Tom Hayhoe (Chairman, West Middlesex University Hospital).
Dame Jacqueline Docherty (Chief Executive, West Middlesex University Hospital), Tom Hayhoe (Chairman, West Middlesex University Hospital) and Andrew Murphy (Project Manager, West Middlesex University Hospital) gave the Committee a Powerpoint presentation entitled “Update June 2011” (this has now been added to the Council’s website alongside the Agenda pack).
The following key points were highlighted for particular attention:
- All savings proposals had been risk-assessed. No proposal would be taken that put patients at risk. The Trust was committed to “Quality first, savings second”.
- The use of agency staff had largely been eradicated by filling vacancies, leading to a substantial saving.
- Two wards had been closed, and a third would also close, due to the reduction in length-of-stay.
- West Middlesex was one of the first organisations in England to pass all NHSLA standards.
- The feedback from the Patient Survey had improved only by a very small margin, but the response rate was very low, thereby increasing the proportion of negative comments. The Trust was looking to see how more feedback could be elicited from patients on a more regular basis.
- There was a need to improve the patient experience.
- The Trust was confident that it would resolve its historic debt. It had broken even in 2010/11.
In response to questions and comments from Members, the following information was given:
- The Maternity Unit was the Hospital’s “jewel in the crown”: it carried out 4,700 deliveries per annum. In addition, a new Birth Centre had opened two years previously and had done 2,000 deliveries; there was a low Caesarean rate; and Maternity Services had passed level 3 with flying colours, one of the first so to do.
- The Hospital had signed up to carbon reduction and was looking at waste management. A new bus service was being negotiated and a turning area was being installed. In addition, there had been a modest increase in the threshold for staff parking.
- The Trust was looking at ways of maximising the use of the estate. For example, it was considering bringing GP practices on to the site in order to fill up under-utilised space.
- The Trust continued to look for a partner to share the site and thereby enable it to get Foundation status. The Trust had demonstrated that it could break even. Slippage in the timetable would leave more time to resolve the outstanding issues. Reorganisation in the North West Sector might lead to more services coming to West Middlesex.
- Although the PFI was one of the reasons that West Middlesex had a high level of historic debt, it was not the only one. The PFI burden was not as severe as it was for St Bartholomew’s, for example.
- It made sense for West Middlesex to have a first-class A+E facility that serviced Hounslow, Richmond and part of Ealing. West Middlesex had a brand new building, and it should not be the first to see the wrecker’s ball.
- With regard to ... view the full minutes text for item 73.
CABINET MEMBER ANNUAL PRIORITIES
The Committee will hear the annual priorities of the Cabinet Member for Adult Services, Health and Housing, Councillor Urquhart.
Councillor Nicola Urquhart (Cabinet Member for Adult Services, Health and Housing) outlined her priorities for the coming year.
- She would continue to pursue the efficiency agenda. This meant finding ways to do things differently while at the same time giving value for money (VFM).
1. There would be changes in back office working, with some of these functions carried out jointly with Kingston.
2. She expected the Reablement Programme to deliver its first savings in the coming year.
3. The Council would discharge its responsibility to provide information that showed service users where to go to get the services to which they were entitled.
4. A tight rein would be kept on finances.
- There was an opportunity to develop a social partnership for People with Learning Disabilities (PWLD).
- The Council was about to acquire a new responsibility for public health provision in the Borough. In view of this, the Council was moving to integrate health and social care, and was continuing with the formation of the Health & Wellbeing Board.
- An Older Peoples’ Champion would be appointed, and would work in much the same manner as the Tenants’ Champion.
- She wanted to see a detailed planning brief for the Barnes Hospital site that included social housing for people with mental health difficulties, and she wanted it up-and-running as quickly as possible.
- The Council would support government proposals to prioritise housing in London, and would continue to make copious use of the Housing Capacity Programme to get funding from the Homes & Communities Agency (HCA).
In response to queries about Southern Cross, the care home provider that was in financial difficulty, officers responded as follows:
- Of the few service users placed in Southern Cross homes by Richmond, most were placed in Hounslow.
- There was an on-going dialogue between the Council and Southern Cross.
- Care managers were geared up to work with families as the need arose.
- No relatives had contacted the Council thus far.
- There had been contingency planning since December 2010.
In response to a question about early prevention, the Cabinet Member advised the Committee that early prevention amounted to an efficiency saving that would save the Council money as well as benefiting the service users. In addition, the Access Programme was making huge inroads.
In response to a question about financial advice, officers responded that the Council could not give financial advice to residents as it was not a licensed financial adviser, but it had put general information on the Council’s website and would advise enquirers to go to a financial advisor.
Q4 PERFORMANCE INDICATORS and PROVISIONAL REVENUE & CAPITAL OUTTURN REPORT
To receive a report of the Director of Adult and Community Services (ACS) detailing the performance of the ACS Directorate in relation to projects and indicators that monitor the council priorities for Adult Social Care, Health and Housing for the period January to March 2011.
Gill Ford (Head of Performance and QA) and Jeremy DeSouza (Head of Finance, Adult & Community Services) presented the Committee with a report entitled “Performance Indicators – not met target for 6 months or more” (pages 5-11 of the Agenda pack).
Following questions and comments from Members, the following information was given:
- Some care providers were unwilling to negotiate realistic revisions to their charges, thereby impacting upon the Council’s ability to make savings. The Council was working together with neighbouring boroughs, where appropriate, to achieve a joint approach.
- The Council was not applying the Care Funding Calculator to Supported Living.
- The Council’s had experienced a number of mixed referrals for its Reablement Service.
- The Reablement Service was offering its services to anyone who would benefit from them, as part of the preventative agenda.
- An independent provider, Housing 21, was providing reablement services in the Borough.
- The increase in the number of people in B+B accommodation was attributable to the usual annual spike just after Christmas.
- The plateau in short-term lets was attributable to the Council’s success in getting more people into rent deposit schemes.
- Government funding for Community Safety had been reduced in 2011/12, so alternative Council funding had been found to plug the gap from the 2010/11 underspend.
Officers undertook to circulate information to Members on the issue of whether or not the Sheen Lane Day Centre was a centre of excellence.
Note - The following information was provided by officers on 30/6/2011:-
Since the merger of Twickenham and Sheen and the official re launch of Sheen Lane Day Centre by Cllr Urquhart on Tuesday 10th May, we have been working towards developing the centre of excellence model.
To date we have conducted a service users’ survey to ascertain how the merger has been for service users and find out what we can do to improve the service for them.
· Two new activities have been introduced to the Centre (Sheen Lane Day Centre choir and multi–media). The choir is led by a volunteer and the group meet every Thursday afternoon. The multi-media group meets twice a week and they use the internet to research various topics of interest to the group.
· Results showed that 92% felt that the merger has gone well.
· The regular activities and therapies, such as word / table-top games, music, bingo, cookery class, aromatherapy, falls prevention class, remain popular and are enjoyed by all attendees.
· We are working towards setting up Friends of Sheen Lane Day Centre and recruiting skilled volunteers.
· We are building relationships with other organisations, such as Friends of Barnes Hospital, Barnes Green Day Centre, Caring Café, The Stroke Association, The Music Trust and local colleges, to link in with their apprenticeship programme to bridge the intergenerational gap.
· We are currently reviewing staff training needs to ensure that all staffhave the required skills in dementia careand Parkinson’s disease to ensure they can work across the two centres.
For your information, the ... view the full minutes text for item 75a
To receive a report of the Director of Adults & Community Services (ACS) setting out the provisional outturn position for the ACS budget.
Gill Ford (Head of Performance and QA) and Jeremy DeSouza (Head of Finance, Adult & Community Services) presented the Committee with a report entitled “Provisional Revenue and Capital Outturn 2010/11 and Performance Report 4th Quarter 2010/11” (pages 13-26 of the Agenda pack).
The report set out the provisional outturn position for the Adult and Community Services budget supported by performance data. It went on to detail the implications for the service and the Council’s Medium Term Financial Strategy (MTFS). It also provided details of where performance had not met target, in relation to indicators and projects that monitored the Council’s priorities for Adult Social Care, Health and Housing for Quarter 4, 2010/11.
The report was presented to the Health, Housing and Adult Services Overview & Scrutiny Committee to provide Members with a summative report following regular Budget Monitoring Reports throughout the 2010/11 financial year.
It was RESOLVED that the following be noted:
(1) The provisional revenue outturn variance as detailed in paragraph 4.
(2) The provisional capital outturn position as detailed in paragraph 6.
(3) The outlook for the service and implications for the MRFS as detailed in paragraphs 16 to 17.
To receive reports of LBRuT and Partners on changes and updates to local health services. In addition, the Committee will receive a report of South West London & St George’s Mental Health Trust (attached).
Dr Peter Nash (South West London & St George’s Mental Health NHS Trust) and Jane Coppock (Barnardos) presented the Committee with a report entitled “June 2011 Update Report - South West London Child Sexual Exploitation and Substance Misuse Project – a partnership between Barnardos and South West London & St George’s Mental Health NHS Trust” (pages 27-32 of the Agenda pack).
The purpose of the report was to inform the Committee of the progress of the Project and to persuade the Council to write to the Mayor of London to ask for continued funding for it.
Dr Nash highlighted the following key points:
- The starting point for the Project had been the experiences of a young person in Richmond four years previously.
- The Mayor of London was committed to supporting the Project until 2012.
- The Project was launched in Richmond in March 2011, and there had already been seven referrals.
- A high level of referrals had always been anticipated in Richmond.
- The Project had been in the Mayor’s Plan, but the Treasury had then said to all strategic health authorities (SHAs) that they could not spend outside their programmes, but that had now been rescinded.
- Only the South West part of the Project had been implemented.
- The cost of the Project was £600,000 per annum. However, the public sector incurred a cost of £2 million for each abused child. For as little as £12,000, the state could save £2 million.
- The City Bridges Trust was providing funding until 2012, but the statutory sector had to provide long-term funding.
Ms Coppock explained that Barnardos had opened its first Sexual Exploitation Centre in Bradford, and now had two in London. She said that the guiding principles were the “four A’s”:
- Access (the Project office was in Richmond Hospital).
- Assertive outreach.
She pointed out that any child could be sexually abused; it was not just looked after children (LAC) or children from dysfunctional families. Around 95% of sexually abused children had substance misuse issues, she said, and the Project would work with families to support them. At the moment, the Project offered a block intervention of six months, she explained, and there was an outcome monitoring system in place for each young person. The Project also provided training for professionals, she added.
Dr Nash highlighted the following further points:
- The Barnardos side was part funded by the City Bridges Trust and itself. The South West London and St George’s Mental Health NHS Trust provided both accommodation and the CAMHS service through a block grant.
- Richmond had huge income disparities that drove mental illness. There was a high incidence of people with personality disorders (PWPD) in Richmond, and that was a risk to children. There were also high levels of alcohol and cocaine misuse.
- Richmond was close to Heathrow, which was a major trafficking route for children.
- The Child Exploitation ... view the full minutes text for item 76.
To receive a report of the Kingston & Richmond Tobacco Advisory Group on the prevalence of smoking in Richmond and an update on the work of the Group to encourage smoking cessation.
Dominic Wright (Borough Director, NHS Richmond) presented the Committee with the following papers:
- “Smoking Services in Richmond”.
- “Kingston & Richmond Tobacco Control Advisory Group – Terms of Reference".
- “Kingston & Richmond Tobacco Control Alliance – Tobacco Strategy – January 2009 – March 2012.”
- “Minutes from the Tobacco Control Alliance Group, Wednesday, 17th March 2010”.
The purpose of presenting these papers was to help the Committee decide if it would be expedient to establish a Smoking Task Group as recommended by the Annual Meeting of the Council.
Mr Wright advised the Committee that the Tobacco Control Strategy had been successful in getting the smoking prevalence rate in Richmond down to one of the lowest in the country, but that more needed to be done to deal with the stubborn residuum, and that could be helped by having a Task Group. He said that the Advisory Group was particularly concerned about the high prevalence of smoking in Whitton and among young people and was open to the kind of fresh thinking that a Task Group would bring.
Members felt that establishing a Task Group might not be an effective use of Member and officer time, given the low smoking rate already achieved in the Borough, and that tobacco control might be getting too much attention relative to drug and alcohol misuse.
Mr Wright responded that tobacco killed 1,200 people in Richmond per annum, which was a huge cost.
It was RESOLVED that a decision be deferred until the next meeting in September 2011 so that a detailed report could be prepared that particularised the work of the Strategy Group and suggested specific actions that the Task Group might undertake.
To receive the Committee’s Work Programme for the municipal year 2011/12.
Update on the Housing Task Group
Councillor Blakemore updated the Committee on the work of the Housing Task Group. She highlighted the following points for particular attention:
- The introduction of a Housing Benefits cap would mean that people would be dispersed from their present homes. Brian Castle (Joint Assistant Director, Services & Housing) had been asked for a briefing.
- The “Southwark” judgment imposed a statutory duty on local authorities to house 16-17 year-olds who were homeless. Children’s Services was using mediation in order to limit the number of young people in that age group evicted by their parents. Mr Castle had given Members a briefing on this subject the previous day.
- The Task Group would look at how these changes were affecting the statutory homeless and other vulnerable groups in the Borough. A timetable had been agreed to complete the Review, and in July and August input would be sought from the Department of Work & Pensions (DWP), and from another London Borough that had yet to be selected.
- It was likely that a new Homelessness Strategy and allocations policy would go to Cabinet on 26th January 2012 and O&S Committee in November 2011.
In response to questions about the Housing Benefits cap, Mr Castle advised the Committee that Richmond had the most expensive property of all outer London boroughs, so the level of displacement into the Borough would probably not be great. Nonetheless, he expressed concern as to the availability of social housing were any displacement to happen.
It was RESOLVED that the update be noted.
Work Programme 2011/12
The Committee was presented with a paper entitled “Work Programme 2011/12.
In response to a request that dementia care be included in the Work Programme, the Committee was advised that the September meeting would be looking at the mental health strategy consultation, and dementia care would be part of that.
In response to a request that chronic diseases be included in the Work Programme, the Committee was advised that this might form the subject matter of a paper in the October Briefing Pack. A briefing paper on diabetes should also be available.
It was RESOLVED that the Work Programme 2011/12 be agreed.