Agenda and minutes

Health and Adult Social Care and Communities Overview and Scrutiny Committee
Thursday, 18th January, 2018 10.00 am

Venue: Committee Suite 1,2 & 3, Westfields, Middlewich Road, Sandbach CW11 1HZ. View directions

Contact: Helen Davies  Scrutiny Officer

No. Item


Also Present


Councillor Janet Clowes- Portfolio Holder for Adult Social Care and Integration

Mark Palethorpe- Acting Executive Director of People

Linda Couchman- Interim Director of Operations



Apologies for Absence


Councillors E Brooks, O Hunter and S Pochin.


New Chairman appointment


Councillor Stewart Gardiner addressed the Committee as the newly appointed Chairman for this Committee.  He advised his previous role of Deputy Cabinet Support ended when he took on this new role.


Councillor Gardiner thanked Councillor Beverley Dooley as Acting Chairman in the interim period.


Minutes of Previous meeting pdf icon PDF 70 KB

To approve the minutes of the meeting held on 7th December 2017.



Councillor Edgar noted that his attendance was missing from the minutes and he was present.


Councillor Gardiner noted that Councillor Janet Clowes and he were present and referred to in the minutes but not the attendance.


RESOLVED: That the minutes of the meeting held on 7 December 2017 be confirmed as a correct record and signed by the Chairman.


Declarations of Interest

To provide an opportunity for Members and Officers to declare any disclosable pecuniary and non-pecuniary interests in any item on the agenda.


There were no declarations of interest.


Declaration of Party Whip

To provide an opportunity for Members to declare the existence of a party whip in relation to any item on the Agenda


There were no declarations of the existence of a party whip.


Public Speaking Time/Open Session

A total period of 15 minutes is allocated for members of the public to make a statement(s) on any matter that falls within the remit of the Committee.


Individual members of the public may speak for up to 5 minutes, but the Chairman will decide how the period of time allocated for public speaking will be apportioned, where there are a number of speakers.


Note: in order for officers to undertake and background research, it would be helpful if members of the public notified the Scrutiny Officer listed at the foot of the Agenda at least one working day before the meeting with brief details of the matter to be covered.




There we no members of the public present who wished to speak.


Home First Model

To receive a presentation on the Home First Model.


The Committee noted that there were no papers circulated with the agenda although it was acknowledged this was an information item.  Members requested that where possible, papers should be circulated with a more informative description of the item on the agenda.


Linda Couchman, Interim Director of Operations, attended the Committee and gave a short presentation on the Home First Model.  She advised the Committee that the High Impact Change Model was the context for the Home First Model, this had previously been used to inform the work on Delayed Transfers of Care (DToC). 

Home First was a national initiative that promoted independence to enable patients to stay in their own homes.  Patients had an assessment of their support needs and rehabilitation including an assurance that the patients home was safe for them to return to.  Nursing Home and Care Homes were seen as a last option.


Linda advised the model was being presented to external health colleagues imminently and an update would be given to the Committee.


The Committee asked for clarification in respect of any cuts experienced by the Clinical Commissioning Groups (CCGs) and how this might affect the Home First model.  Mark Palethorpe, Acting Director of People, acknowledged that whilst the CCGs have proposed reductions to the sector, the council was working to commission with them.


Clarity was sought about the frequency of assessment reviews, Linda advised the Committee that assessment is continual.  The Home First model moved away from the traditional approach of care workers on timed appointments and sought to better understand where time was more valuable for the patient.



a)    That Linda be thanked for her presentation and it be noted;

b)    That a Home First update be provided to this Committee on the 5th April 2018.


Budget Setting Proposals 2018-21 pdf icon PDF 264 KB

To give consideration to the Health and Adult Social Care and Communities budget proposals for 2018-21



The Committee considered the Health, Adult Social Care and Communities budget proposals for 2018-21 specifically outcome 1 (Our local communities are strong and supportive) and outcome 5 (People live and well for longer) of the Council’s Corporate Plan.


Mark Palethorpe, Acting Director of People, presented the areas of the budget and gave an overview of the key proposals pertinent to the responsibilities covered by the Committee.  Mark invited questions on each of the proposals as they were discussed.


1)    Review Environmental Enforcement Service based on outcomes (Summer 17) of Flytipping pilot and procurement of patrol company pilot.


The Committee noted that proposal one, mentioned two pilot projects that improved environmental enforcement and requested clarity about what these pilots were and if the Corporate Scrutiny Committee had looked at them.  Councillor Janet Clowes confirmed one of the pilots had been to do with dog fouling, and acknowledged this was a difficult area to both police and enforce.  Councillor Suzanne Brookfield wished to publically acknowledge thanks to the dog warden in the Crewe area who had been carrying out patrols outside of hours.


2)    Increase Community Grants.


The Committee asked for clarification as to who set the criteria for Community Grants.  Mark advised this was done locally by Cheshire East Council, Councillor Janet Clowes added that details of eligibility to apply could be found on the council’s website.


47) Commissioning all services currently provided by, Care4CE.


48) Operational Pathway Redesign.


Mark advised this item was an opportunity to streamline, and focussed on how to commission services differently.  The Committee asked for more explanation on this item. 


49)Independent Living Fund- Attrition Factor Reductions.


Mark advised this fund began last year but there was a gradual reduction this year and the next.  The fund enabled people to bid for funding to top up their packages of care.  The Committee asked for context on the reduction.


50)Operational and Commissioning Restructure (Revenue Savings).


51) Reducing Agency Spend.


57) Alignment of teams to create a People’s Commissioning Service.


59) Restructure to create “front gate”, across communities.


60) Review all funding and shift to “asset-based” model.


61) Reshape commissioning framework.


Mark advised this item related to how the council commissioned domiciliary care.  Currently there were 97 providers across Cheshire East each with different prices for care and the council was working to standardise this to achieve better outcomes for individuals.


62) New assessment and review framework.


Mark advised this item related to new contracts with providers for the most vulnerable.  The Council was in discussion with the NHS to determine how those living outside the borough could be repatriate back in to avoid paying higher prices. 


63) Implement more flexible and responsive.


Linda Couchman, Interim Director of Operations, advised the Committee that previously, the council had been over commissioning beds.  The emphasis now looked to work differently so that people in respite would have provision.  Home First was always the preferred model.


64) Review of Public Health contracts.


67) Cease provision of services at Lincoln House  ...  view the full minutes text for item 73.


Work Programme pdf icon PDF 66 KB

To review the current Work Programme

Additional documents:


The Committee reviewed its Work Programme.  Helen Davies advised the Committee that Linda Couchman had suggested the Committee carry out a spotlight review of mental health services across Cheshire East similar to the work completed on Delayed Transfer of Care (DToC), the Committee agreed this would be a pertinent piece of work.


Councillor Jill Rhodes advised the Committee that Crewe was nationally recognised as being in the top 10% for national deprivation and asked if this Committee could consider adding something to the work programme to reflect this inequality. 



(a)  the Home First Model be brought back to this Committee for feedback in April, with a view to further assessment in six-months time;

(b)  a spotlight review of mental health services be added to the work programme and Helen to provide further detail to follow;

(c)  the appropriate items for overview and scrutiny relating to the deprivation in Crewe be added to the work programme following discussions between the Chairman and Fiona Reynolds.


Forward Plan pdf icon PDF 168 KB

To note the current forward plan, identify any new items, and to determine whether any further examination of new issues is appropriate.



The Committee reviewed the Forward Plan.

RESOLVED: That the Forward Plan be received and noted.