Agenda and minutes

To receive apologies from members of the Committee unable to attend.

Apologies were received from Councillor Rita Palmer who was engaged in other Council business.

To receive declarations of interest from councillors and co-optees pertaining to items on the agenda.

Councillor Bouchier declared a personal interest in housing or homelessness items for discussion by virtue of her membership of Spear.

Co-optee Margaret Dangoor declared a personal interest in items relating to Adult Social Care by virtue of her role as carer.

To receive the minutes of the last meeting held on 22^nd November 2011 and approve for signing by the Chairman.

The minutes of the meeting held on 22^nd November 2012 were agreed as a correct record and the Chair authorised to sign them.

Requests were made for updates on two items relating to the minutes of the last meeting:

• 105 (i) – MMR vaccinations – Councillor Mathias did not consider e-mails received from officers to be sufficient and requested a full briefing paper be produced.  Officers agreed to provide this.
  
  
• 104 – Croydon PCT – Councillor Mathias requested information seeking to establish whether further information was now available relating to the investigation by Ernst and Young.  [This was discussed under Item 6. see minute 117]

Any member of the public registered to speak will be asked to make their representation at the beginning of the relevant agenda item.

No representations had been received.

To receive reports relating to Cabinet decisions called in by the Committee.

[There are no call in reports to receive at this meeting].

No executive decisions had been called in.

To receive a verbal update from the Director of Adult and Community

Services and the Managing Director of NHS South West London

Richmond Branch on the latest changes to local health services.

Apologies were received from Dominic Wright, Director of Service Transformation at NHS Richmond PCT.

Cathy Kerr, Director of Adult and Community Services at LBRuT and Dagmar Zeuner, Director of Public Health for Richmond were in attendance to address the Committee.  They reported the recent changes to local health services in particular they drew the attention of the committee to the following:

(i)      That a JSNA update had been produced and would be followed up in order to ensure members received it as part of the next briefing pack.

(ii)    [In response to the query raised by Councillor Mathias minute 115] The report by Ernst and Young regarding the financial position at Croydon PCT had not yet been released.  The previous evaluation that there would be no negative implications for Richmond in the findings remained unchanged at the present time.

(iii)   That GP’s locally had taken steps to organise further in preparation for becoming commissioners.  The election and selection process for the shadow board would be in place by April 2012.  This Board would need to demonstrate a sound constitution and clinical commissioning support in order to be authorised.

(iv)  Arrangements around commissioning continued to be clarified.  It was likely that out of hospital commissioning would remain with local GP’s but that commissioning for acute care could rest with a commissioning support service arranged at S or SW London level.

(v)    That a Public Health Outcomes Framework had been produced and would be brought to the Committee for consideration as part of a more detailed report at the March meeting.  The financial details of such provision had not yet been released but it was hoped that these could also be reported in March.

(vi)  The development of the Health and Wellbeing Board continued and it had been meeting regularly in the form of a shadow board. One recent session had been held to consider commissioning groups and commissioning support.

(vii)Mental health issues and commissioning had also been considered in anticipation of the upcoming consultation for which agreement would be sought from Cabinet in March and considered by the committee in June. [Sue Denby, Kim Goddard and Peter Molyneux were all in attendance from SWL and St George’s mental health trust] 

(viii)                       The next meeting of the Health and Well-being board would consider patient involvement.  Bonnie Green of Link  would introduce this item and, as well as regular members, Cllr Jaeger has been invited to this meeting. ,

(ix)  A formal announcement had been made by the government that the establishment of Healthwatch had been postponed until April 2013, therefore work would continue with Richmond LINk until that time.

The item was discussed and the following themes were explored by councillors and information provided by officers:

(i)      That reported increases to GP salaries to cover additional responsibilities for commissioning and related loss of provider work were not unfounded but often exaggerated.  In London Borough of Richmond GP salaries were moderate in comparison to national benchmarks.

(ii)    That the intention of  ...  view the full minutes text for item 118.

To receive a report of the Corporate Complaints Manager containing for consideration a summary of Adult Social Care complaints that were concluded during the 2010 -11 financial year.

The Committee received a report of the Corporate Complaints Manager containing a summary of those complaints closed during the 201/11 financial year.  The Director of Adult and Community Services was in attendance to present the report to the committee and she briefly outlined the key themes within it, as follows:

(i)      Details of the number of complaints upheld, partially upheld and not upheld.

(ii)    Response times in which complaints had been dealt with, these had improved on the previous year.

(iii)   That no clear trends were identifiable from the information gathered but that each complaint had related learning outcomes and these were listed in the appendix to the report.

(iv)  Actions on the learning outcomes were strongly implemented and maintained.

The item was discussed and the following themes were explored by councillors and information provided by officers:

(i)      That complaints relating to West Middlesex hospital related to services provided by LBRUT and staff stationed at the hospital.  Where the complaint concerned more than one provider, efforts are made to work jointly to resolve the issue and produce actions to prevent further problems.

(ii)    That the introduction of electronic timesheets was being considered for carers who provide care in the home.  Information was requested regarding the system at present and whether the cared for person also signed the time sheet if they had the capacity to do so. This information would be provided and circulated to Members after the meeting.

(iii)   Regulation of care services was the responsibility of the Care Quality Commission but the council also has a monitoring team in place to ensure the quality of care received by residents.  Concern was expressed that staffing levels should be adequate that monitoring was effective.  Members of the team would go to visit homes where concerns had been expressed about the level of care received by residents.  Officers emphasised that Richmond does more than many Councils in this area.  The team was made up of 5 or 6 dedicated people.

(iv)  That the report did not include complaints to South West London and St Georges but this could be requested from the trust and was comparable; having the same structure. [Kim Goddard confirmed that should the committee request it this could be provided and it was agreed that this would be included in future report]. 

(v)    That although the presentation of the annual report to the committee was a statutory requirement, it was felt that the report would be better provided as an information item.  Any areas of interest or concern could then be brought to the committee where more in depth discussion could be facilitated.

It  was RESOLVED:

1.                  That in future years the annual report be presented to the Committee as part of the regular briefing packs.

2.                  That in future the report would include summary and learning from complaints received by the Mental Health Trust

3.                  That the report be noted.

To receive a report of the Director of Adult and Community Services detailing the revenue budget and capital programme for the Directorate and highlighting key financial risks.

The Committee received a report of the Director of Adult and Community Services containing financial information to facilitate the scrutiny of the Adult and Community Services revenue and capital budget management.  The Head of Finance (ACS) was in attendance to present the report to the Committee and in doing so he drew attention to the following pertinent information:

(i)      That there was a predicted overall underspend of £1.52m, which represented just over 2% of the total budget, £64.751m.

(ii)    The main areas contributing to this underspend where:

·         A reduction in contributions to the London Grants Scheme following the result of a judicial review.

·         Savings made following the implementation of an administrative hub within ACS.

(iii)   Overspends had occurred in areas of the revenue budget in particular within the provision of mental health services and an increased demand for residential care for people suffering from mental illness.  This had been caused by the closure of NHS facilities and NHS monies had been used to offset the increased demand.

(iv)  The area most at risk of substantial overspend in the short term future was within the Temporary Accommodation budget.  Demand for temporary accommodation was likely to increase after the introduction of new legislation pertaining to housing services.

The item was discussed and the following themes were explored by councillors and information provided by officers:

(i)      That part of the underspend was a result of positive improvements made by the reablement services and the resultant reduction in need.  Other reasons why care was not needed or sought were more difficult  to identify.

(ii)    That the increase in those people in temporary accommodation was partly a result of landlords refusing Local Authority tenants owing to the uncertainty surrounding new legislation but also a result of the cold weather over Christmas which meant that people not usually considered to be vulnerable were required to be housed.

(iii)   That pressure on temporary accommodation would reduce early this year when new building projects were finished and wholly designated for social housing to be allocated by LBRuT.

(iv)  That the funding received form the NHS to help to alleviate ‘delayed transfers of care’ was a national funding project and was not a sign that Richmond had a particular problem in this area. 

(v)    That funding was available to incentivise moving to a smaller house for those who no longer needed the rooms in the houses they inhabited.

(vi)  That overspends in some areas were met from underspend in others.  This was common accounting practice.

It was RESOLVED that the report be noted.

To receive a report of the Adult and Community Services, setting out the detailed revenue budgets for the Directorate for the financial year 2012/13, highlighting significant changes from the previous year. 

The report offers the Committee the opportunity to comment on budget proposals for the forthcoming financial year and to pass comments on to the Cabinet for them to consider when making the final recommendations to Council.     

The Committee received a report of the Director of Adult and Community Servicessetting out the detailed revenue budgets for the Adult and Community Services Directorate for the financial year 2012/13 and highlighting significant changes from the previous year.

The Head of Finance (ACS) introduced the report to the Committee and in particular drew attention to the following:

(i)      The areas where significant changes had occurred, as follows:

• Inflation
• Changes in Government Grants
• Other Government or Outside Body Changes
• Demand Led Growth
• Other Growth and Savings
• Investment Priorities
• Service Reductions and Efficiency Savings
• Budget Transfers between directorates
  
  

(ii)    That some contracts had been successfully renegotiated and in particular the ‘Care Funding Calculator’ had been a success.  Other contracts remained to be renegotiated, where inflationary increase still formed part of the terms, or to finish and be recommissioned on different terms.

(iii)   Concern was expressed that commissioning may lead to a loss of control over the effects of inflation.  Officers assured the Committee that the strengthening of the procurement function at the council would ensure all contracts for commissioned services achieved the best outcome possible for the council and for service users.

It was RESOLVED that the report be noted.

The Committee received a report of the Director of Adult and Community Services providing information regarding the setting of fees and charges for Adult and Community Services in 2012/13.  The report sought comments from the committee on these proposed fees and charges before they would being implemented 1^st April 2012

The Head of Finance (ACS) was in attendance to present the report to the Committee.  He briefly outlined the main changes to the current fees and charges; in particular he drew the attention of the committee to the following:

It was proposed:

(i)      That the majority of Fees and Charges would rise by 2.5%, in line with council policy, and at a rate lower than inflation.

(ii)    That the maximum contribution towards the cost of services would increase from £335 to £350.  This change would only affect maximum contributors.  Other contributions would continue to be assessed as part of personal budgets in the same way.

(iii)   That a new charge be introduced to cover the administration costs associated with a Loan application.  This had previously been a free service and would now cost £500. 

(iv)  That interest on deferred payment relating to loans granted would be increased from 6.5% to 8%.  This would be for new customers only and on deferred payments only; where houses were sold within 56 days the loan would remain interest free.

(v)    That there would be a higher percentage rise in meals at the Access Project for adults with physical disabilities, 26%, in order to bring prices in line with others subsidised by the council, as current policy currently encouraged.

The Committee discussed the information received, the following further information was sought and themes explored with the officer in attendance:

(i)      Councillors felt that an interest rate of 8% was high in comparison to other lenders.

(ii)    Councillors welcomed the recently announced freeze on council tax in difficult economic times and there was some support for a similar freeze in fees and charges.

(iii)   In relation to the deferred payments interest, concern was expressed that houses may take longer to sell in the current economic climate, it was suggested that research might be undertaken to ensure that 56 days was a reasonable length of time.

(iv)  That the introduction of a £500 charge where there had not been one before represented a huge percentage increase.  Officers clarified that the charge was for new customers only and would not be profit making; it would only cover the cost of processing and legal checks etc.

(v)    Councillors questioned the proposal to charge the maximum allowed by central government, £10, for a blue badge.  It was noted during this discussion that the Blue Badge was assigned to a person and not a vehicle; therefore the holder may not own a car.

Additional information was requested regarding:

(i)      The numbers of people using Day Centres and whether increased costs had contributed to a decline in numbers.

(ii)    How many people were likely to be affected by the increase  ...  view the full minutes text for item 122.

To receive a joint report of the Assistant Director for Commissioning Corporate Strategy & Policy and the Assistant Director of Community Operations which provides a summary of the Draft Homelessness Strategy and the strategic approach and consultation plans.  It also provides a brief summary of the key messages from the Revised London Housing Strategy, a consultation document published by the Greater London Authority in December 2011.

The Committee received a joint report of the Assistant Director, Commissioning Corporate Strategy and Policy and Assistant Director Community Operations providing a summary of the draft Homelessness Strategy and outlining the strategic approach and the plans for consultation. It also provided a brief summary of the key messages from the Revised London Housing Strategy, a consultation document published by the Greater London Authority in December 2011.

The Assistant Director Community Service Operations was in attendance to present the report to the Committee and he briefly highlighted the key areas of interest for the Committee.  In particular he described how the changes in housing benefits were likely to affect residents of the Borough.  400 cases of families with children had been identified as being at risk of a cut in housing benefits of at least £20 per week from those changes and two full time Housing Benefit officers had been seconded to comprehensively assess each case before the introduction.

The report was discussed and the following themes considered by the committee and additional information offered by officers:

(i)              That people with mental health difficulties while not automatically identified by the housing benefit payments, officers assessing cases on an individual basis would always take this factor into account when suggesting pathways for the family.  It was recognised that forced movement of people suffering from mental Illness could be detrimental to their health.

(ii)            That those people who did suffer from mental illnesses could be harder to place in new homes owing to reluctance on their part to move and reluctance of landlords to rent properties to people with mental illness.

It was RESOLVED that the report be noted.

To receive a report of the Scrutiny Officer and Chairman of the Tobacco Control Task Group, seeking approval of the proposed Terms of Reference.

The Committee heard a verbal update from Chairman Councillor Jones regarding the work of the Tobacco Control Task group of which she was a member.  She reported that the group had met twice.  The first meeting discussed the work of the committee, conducting a scoping exercise and drafting terms of reference; and the second discussed Public Health issues.

The draft terms of reference were put before the committee for approval.

Following a brief discussion councillor Jones confirmed that witnesses would be called form all relevant areas including GP representation.

It was RESOLVED that:

1. The Terms of Reference be agreed.
   
   
2. That the information received be noted.

To receive a verbal update form the Chairman and officers regarding work undertaken toward the scrutiny of procurement activities in the future.

The Committee received a verbal update from the Director of Adult and Community Services briefly describing the work done so far to integrate procurement strategy and activity with the Scrutiny work programme including the first of a regular series of meetings between the Chairmen of the Overview and Scrutiny Committees.

The committee heard that at present this work programme dealt with council procurement only but in the future may extend to include any health responsibilities that the council takes on eg public health procurement or joint commissioning led by the council.  It would not extend to the commissioning of acute services as this would remain an NHS function.  Whilst this area of procurement would not be included in the council procurement report, it was something that the committee could scrutinise as part of its NHS scrutiny function.   

That further information on the procurement of services for a memory clinic would be included in the future Mental Health report to the committee.

In the absence of the Assistant Director for Commissioning Corporate Policy and Strategy, who was unwell, further in depth discussion was not possible, however the Committee heard that a further, written report would be brought before the committee in March.

It was RESOLVED that the information received be noted.

To receive a report of the Director of Adult and Community Services which provides an update on performance in relation to projects and indicators that monitor the council priorities for Adult Social Care and Housing for the period October 2011 and January 2012. 

There are no outstanding criteria to report on this occasion and the report is for noting only. 

There were no outstanding indicators or projects that met the requirements of reporting to the committee for underperformance.

It was RESOLVED that the performance information be noted.

To receive a report of the Head of Democratic Services containing at Appendix A the Work Programme for the municipal year for consideration and comment.

The Committee received a report of the Head of Democratic Services detailing the work plan for the rest of the municipal year.

The Senior Democratic Services Officer in attendance described for the Committee the issues at hand and suggested that a report be received at the next meeting which would put forward new methods of dealing with the increasing work load led by changes in legislation and other factors such as the efficiency programme locally.

Committee members suggested that the Ambulance Service and Urgent Care be added to the workplan for future scrutiny.

Councillor Jones suggested that and extra meeting be agreed for the year 2012/13.

It was RESOLVED

1.                  That an additional meeting be drafted in to the calendar for the year 2012/13

2.                  That this arrangement be for one year only

3.                  That the suggested topics be added to the work plan for consideration at an appropriate time.