Agenda and minutes
Health, Housing and Adult Services Overview and Scrutiny Committee
Tuesday, 22 March 2011 7:00 pm
Venue: Salon - York House. View directions
To receive any apologies for absence.
No apologies were received.
DECLARATIONS OF INTEREST
To receive any declarations of interest from members of the committee pertaining to items on the agenda.
Co-optee Margaret Dangoor declared a personal interest in discussions pertaining to Self Directed Support by virtue of her husband being a user of social care services in the Borough.
The Committee is asked to consider and approve the minutes of the last ordinary meeting held on 18th January 2011 and the extraordinary meeting of the 6th January 2011.
The Minutes of the meetings of the 25th October and 11th November 2010 were agreed as a correct record and the Chairman authorised to sign them.
REPRESENTATIONS BY MEMBERS OF THE PUBLIC (IF ANY)
Any member of the public registered to speak will be asked to make their representation at the beginning of the relevant agenda item.
There were no representations from members of the public.
EXECUTIVE DECISIONS CALLED IN (IF ANY)
There were no decisions of the Executive called in.
The Committee will consider the report of the Local Government Ombudsman, as required by the Local Government Act 1974.
The Committee should note the finding of maladministration and decide what action the Council needs to take in light of the findings and recommendations.
The report of the Director of Adult and Community Services report is attached; full report of the Local Government Ombudsman attached as Appendix.
The Committee received a report of the Head of Housing Operations the purpose of which was to report the findings of the Local Government Ombudsman into a complaint that the Council had refused to take a homelessness application and make enquiries when a customer requested assistance when presenting as homeless.
The Head of Housing Operations and Assistant Director of Community Service operations were in attendance to present the report to the Committee. They described the background to the case, the ensuing events that had lead to the complaint being made and the findings of the Ombudsman.
The Local Government Ombudsman had found that there had been “maladministration causing injustice, with remedy agreed by the Council”.
Officers explained that the remedy agreed was as follows:
Ø Make an offer of social housing on a reciprocal basis with Wandsworth Council.
Ø Pay Compensation of £500 for distress and anxiety and the time and trouble of pursuing the complaint
Ø Provide assistance with removal costs.
In addition officers explained that lessons had been learned from the case pertaining to the appropriate training of staff and the monitoring and tracking of complaints.
Furthermore the Council was required to report back to the Ombudsman in 3 months time with details of the progress made in these areas.
In response to comments made and questions raised by the Committee the following information was received from officers:
(i) That it would be possible to provide a copy of the report back to the Ombudsman to members of the Committee.
(ii) That as housing legislation was currently experiencing considerable change the housing department was regularly updated on Housing Case law through the receipt of journals and copies of Jordan’s Case Law, as well as briefings and more formal training.
(iii) That the Council’s corporate complaints system had recently undergone changes and was now reduced to a two stage process, although this was not done as a result of the complaint in question it would further strengthen the process for the Housing Department.
(iv) That audits conducted on the Housing Department by both Internal and External Auditors had found that the systems in place were robust and that there was good separation of duties between staff.
(v) That the Committee should be assured that ‘gatekeeping’ was not practiced by any officer of the Council responsible for Housing.
The Committee expressed regret that this complaint had arisen, but felt assured that the structures in place and additional measures identified by the Ombudsman would ensure that this was not repeated.
It was RESOLVED that the report be NOTED.
The Committee is asked to consider the findings of the LINk Self Directed Support report on user satisfaction with the assessment process, compiled from results of a survey recently undertaken.
The report and supporting documents are attached.
The Committee received a report of LINk and presentation from Mary Martin and Phillip Darling, representatives of LINk on the recent survey of service user satisfaction with the self-assessment process of self-directed support provided by LBRuT.
During the presentation they particularly referred to the following [the full presentation is attached as appendix A to these minutes]:
Ø That from anecdotal evidence collected the importance of a good experience during the assessment process could not be underestimated.
Ø The importance of the study in proving the commitment of LINk to research complex issues on behalf of local users.
Ø That the response rate to the survey was very low; just under 20%. This sample was not high enough to draw statistically sound conclusions but some analysis had been possible.
Ø The analysis found that:
§ Satisfaction levels were generally high
§ Lowest levels of satisfaction were also brought to the committee’s attention and these included waiting times for assessments and not having sight of the completed questionnaire.
Ø From the analysis conducted LINk had made two recommendations these were:
§ Gather more data
§ Examine the areas of lowest satisfaction as part of the process of delivering continuous improvements in service standards.
The Committee discussed the information before them; the following pertinent comments were made by the committee and representatives of LINk:
Ø That vulnerable people traditionally score services received more highly than other groups of people.
Ø That the sample had been chosen from all of those people receiving assessments between July and November 2010 except those with Mental Health problems. Advice had been received that other methods would be better received by this group of users than the traditional survey and innovative work was ongoing in this area.
Ø That although the survey was not robust owing to the low response rates it was a good starting point for further investigatory research.
The Director of Adult and Community Services responded to the presentation and comments of the Committee. In particular she referred to the following:
Ø That the study was warmly welcomed and a formal written response had been sent to LINk, a copy of which is attached as appendix B.
Ø That although the difficulties in drawing conclusions from a small sample had been noted in the study itself, the satisfaction rate that was returned even from a small sample was positive.
Ø LINk and the Committee could be assured that steps would be taken as a result of the work in those areas where potential for improvement was identified.
Ø That nationally there was a shortage of data available in this area for similar reasons. ACS was currently in negotiations with Kingston University to develop new and better ways of collecting and meaningfully analysing such qualitative data.
Ø That the satisfaction rate that was returned, even from a small sample was welcomed, the department would strive to continue to improve those satisfaction levels.
Ø In taking work forward in future, it would be important to ... view the full minutes text for item 60.
The Committee will be asked to consider a progress report of the Director of Adult and Community Services describing the Council’s Learning Disability Change Programme. The report provides context and background, a summary of work to date and highlights progress in each work stream, with particular emphasis on transitions of young people from Children’s to Adult Social Care Services.
A copy of the report is attached.
The Committee received a report of the Director of Adult and Community Services the purpose of which was to provide the Committee with an update on the Council’s current Learning Disability Change Programme.
The Assistant Director of Community Services presented the report to the Committee and highlighted the following points for particular consideration:
Ø He briefly described for the Committee the national and local history of the programme to date.
Ø He described the programme as it stands and the work streams contained within it and these are set out below:
o Needs and Commissioning Analysis – having a clear understanding of the current and future needs of local people with Learning Disabilities and developing local services to meet those needs
o Local Housing Options – the need to develop a range of housing options within the Borough and nearby. In addition the programme aimed to manage as far as possible any negative impact on people with Learning Disabilities of future legislative changes to housing benefits and allocations.
o Reducing the costs of residential care - both in and outside of the Borough. An individual project has been established to this end.
o Transitions – Improving transitional arrangements for those children with learning disabilities who become adult services users by planning proactively.
o Reviewing and Modernising In-house Services – in response to changing needs it would be imperative to ensure that in-house residential services were responsive to current and future needs, including the future management arrangements of such services
o Quality Assurance and Contract Compliance – ensuring that all services are of high quality and that service users are involved in the design, development, delivery and evaluation.
o Engaging Local Partners in Change – promoting partnership working
Ø In summary he acknowledged that the current economic climate demanded changes in the way that services were delivered but that this was an opportunity to refresh and improve delivery at the same time. Steps had been made to these ends already and he was optimistic of what the future of the programme would achieve. In particular steps were being taken to review the ‘red status’ of the Value for Money review project .
The Assistant Director acknowledged that the changing emphasis to self directed support, the future models of social work and the Council’s strategic intention to becoming a Commissioning Authority were contextual to on-going developments and operation of learning disability services within the Borough.
In response to questions raised and comments made by the Committee the Assistant Director offered the following further information:
Ø The bulk of the Borough’s residential care for people with a learning disability was provided by private, non for profit, charitable and independent sector providers, with a moderate sized Council, directly managed provision . The challenge was to ensure that all externally commissioned and internally managed residential care services were of a high quality and met service users’ assessed needs. The Care Quality Commission (CQC) was key in this regard, as was the Council’s own Quality Assurance ... view the full minutes text for item 61.
The Committee is asked to consider 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 October to December 2010.
The report also provides an update on the social work vacancy position In Adult social Care.
The report of the Director of Adult and Community Services is attached.
The Committee received a report of the Director of Adult and Community Services the purpose of which was provide summarised details of the performance of the Adult and Community Services Directorate, in particular those performance targets rated as red (underperforming).
The Head of Performance and Quality Assurance presented the report to the Committee; in particular she referred to the following:
Ø The Reablement and Learning Disabilities programmes had both delivered savings lower than those expected.
Ø Both programmes had been subject to remedial actions and were expected to achieve targets during 2011/12.
In addition to the regular update on performance, the report referred to the vacancy rates for social workers. The reasons for the vacancies and high level of agency staff had been reported at a previous Committee meeting, and it was agreed that an update should be provided to the Committee. The final stage of the restructure was now complete and posts were being recruited to. The vacancy rate had been reduced from 43.1% in September 2010 to 15.7% at the time of reporting and would be further reduced to 12% by the end of March 2011. The long term aim was to reduce the vacancy rate to 10% where it would be maintained in order to allow the flexibility to respond to service changes where necessary.
The Committee commended the work that had been undertaken and acknowledged that whilst performance targets had been optimistic, good progress was being made towards difficult ends.
It was RESOLVED that the report be NOTED.
CHANGES TO LOCAL HEALTH SERVICES
To receive a verbal update from the Director of Adult and Community Services and the Director of Public Health on the latest changes to local health Services.
The Committee heard a verbal update on the changes to local health care services since the last meeting. The update was provided by Dagmar Zeuner the Director of Public Health, Richmond and Twickenham PCT and LBRuT, Dominic Wright, the Managing Director of Richmond PCT, Dr Marylyn Plant, GP lead on Commissioning and Cathy Kerr, Director of Ault and Community Services at LBRuT.
The Director of Public Health reported the following:
Ø That the Committee should note that Joan Mager, who had announced her retirement as Chief Executive of the PCT at the last meeting had now left her post.
Ø That in preparation for the transfer of commissioning powers to GP’s in line with the proposed Public Health White Paper, a SW London Cluster of PCTs had been created and this group would work together to aid the smooth transition of these and other services. It had already incorporated the functions previously belonging to the PCT.
Ø The SW London Cluster aimed to amalgamate some back office functions of the local PCTS, ease development towards GP Commissioning and work towards a more integrated approach to Public Health.
The GP lead on Commissioning for the Borough reported that:
Ø Richmond was in a privileged and unusual position to have the Pathfinder approach in place, and although there were no resources as yet it was a valuable opportunity to upgrade the skills of existing colleagues.
Ø That the move to GP commissioning would be a challenge but that good relationships within the Cluster would help to ease the transition.
Ø That it was hoped that the work of the PCT would be continued with the addition of further clinical leadership and expertise to the commissioning process that GP’s could provide.
The Managing Director of Richmond PCT added:
Ø That relations between the groups involved in delivering public health in the Borough were strong and mutually beneficial.
Ø That the next phase of the process would be increasingly challenging; NHS Richmond would be reduced by 55% and Local authority structures would be changing and reducing also.
Ø He would be in post for the next 18months and during that time would be expected to deliver the same services whilst developing new ones. Joint commissioning and the QIPP (Quality, Innovation, Productivity & Prevention) challenge would prove a useful tool in this challenge.
Ø That a road map to 2014 had been produced and would be circulated to Committee members.
In response to comments raised and questions asked by members of the committee officers offered the following further information:
Ø All GP’s in the Borough were signed up to the programme for change, contracts would be drawn up at the cluster level to cement these commitments.
Ø That peer performance would be employed to measure referrals and efficiency. Where GP’s failed to meet targets they would be incorporated into a bigger practice.
Ø That complex relationships with other boroughs and with national commissioning bodies would form as the process progressed and the strengths and weaknesses ... view the full minutes text for item 63.
TASK GROUP REPORTS
To receive a verbal update from Councillor Lisa Blakemore on the work of the Housing and Homelessness Task Group.
The Committee received a verbal report from the Chairman of the Housing Task Group, Councillor Blakemore. She reported that the task group had reflected upon and refined the broad remit handed to it by the Committee at its inception. It had been decided that the group would focus on Homelessness in the Borough and as this particularly affected younger people, it would also look at the needs specific to this group of people.
The Group would work with the Cabinet Lead Member for Health, Housing and Adult Services to formulate council policy in this area and would maintain close contact with her even before the task group reports back to the committee to attempt to create a new kind of task group ethos whereby policy is influenced at inception rather than critiqued on production.
It was RESOLVED that the update be NOTED.
FEEDBACK FROM MEMBERS
To receive verbal updates from Councillors relevant to the committee. To include an update from Councillor Butler on his visit with the Health Scrutiny Officer to Kingston Hospital.
Vice-Chairman Councillor Butler reported that he had visited Kingston Hospital on the 10th March with Health Scrutiny Adviser and had been impressed with the innovative ways in which they were making efficiencies whilst protecting patient care. Innovations would include new computer systems and more technologically advance ward care which would reduce demands on staff. Ward closures would be part of those changes but that he had been assured that service provision would be maintained and improved by new methods.
Chairman, Councillor Jones reported that she had attended a recent London Councils meeting providing information on the new Health Bill.
Councillor Mathias reported that she had attended an LGG course dealing with issues of Safeguarding adults.
Councillor Blakemore had attended internal Scrutiny Training.
Co-optee Martyn Kingsford had attended a CLG event on the Localism Bill and the introduction of Tenant Panels. He reported that LBRuT was the only London Authority to have an elected member tenants champion, Councillor Blakemore and he congratulated her on the paper she delivered at the event and was well received.
The updates from Councillors were NOTED.
The Committee is asked to consider, agree and amend as required, the work programme of the committee for the remainder of the municipal year.
The Committee received a report of the Head of Democratic Services containing the current Committee work programme.
It was RESOLVED that the work programme be NOTED and authority delegated to the Chairman, Vice Chairman and officers to adjust as necessary.