Agenda and minutes

To approve the minutes of the meeting held on 20 July 2011.

RESOLVED – That the minutes of the meeting held on 20 July 2011 be approved as a correct record and signed by the Chairman.

Councillor Irene Faseyi declared a personal interest on the grounds that she was an employee of Southern Cross Healthcare Group PLC.

Councillor D Flude declared a personal interest by virtue of being a member of the Alzheimer Society and of the Central Cheshire Advocacy for People with Learning Difficulties.

Charlotte Peters-Rock attended to address the Committee. She expressed concern over the future of adult social care services in the Knutsford area for those who receive services and their respective carers. It was asserted that the proposed closure of the Stanley Centre in Knutsford would result in service users being moved to other, less appropriate venues which were often out of easy reach by public transport. Mrs. Peters-Rock continued to state that this would cause considerable stress on service users and carers.

The Chairman invited Jacqui Evans, Head of Local Delivery/Independent Living Services, to comment. Jacqui Evans reported that a consultation process had begun and that the Committee could be reassured that this was extensive and comprehensive. The point was made that no decisions had been made to close facilities and that the rationale of starting the consultation was to discover whether services could be delivered in a better way for Cheshire East residents. It was confirmed that this could mean moving service users to different locations and venues but that this would only be done when appropriate and desirable. The emphasis on any change of policy would be to make sure that services were local, appropriate and of good quality. In terms of public transport to facilities, Jacqui Evans reported that a successful pilot had been carried out in the Crewe area and that this was being fully evaluated before implementing a full roll out to the rest of the Borough.

To receive a verbal update from the Strategic Director (Children, Families and Adults).

Lorraine Butcher, Strategic Director of Children, Families and Adults, attended to provide a verbal update on changes to the management structure. It was reported that a re-organisation of the corporate management team had be undertaken and within this it had been endorsed that the positions of Director of Children’s Services and Director of Adults Services be merged into one position of Strategic Director.

Lorraine Butcher explained that this change had not been driven by a need to create greater efficiencies, although there would be potential for this in the future but rather from a recognition of a convergence between both the children’s and adult’s agendas. Attention was drawn to the way that Cheshire East might have appeared to have gone ‘full circle’ with the re-appointment of a Strategic Director of Children’s and Adult’s services. Lorraine Butcher explained that when the two Directorates had been brought together under one Director previously, both departments had not been in the position to make the most of the opportunities available. There had been a need to keep them apart in order for them to develop. It was stated that Cheshire East was now in a position were joint working between the children’s and adult’s services would be mutually beneficial.

Lorraine Butcher continued to report on a number of challenges and opportunities that would arise from the ‘joining up’ the management of both Directorates. It was highlighted how a number of common elements along with strong leadership and existing robust processes would enable both Directorates to make the most of the opportunities and overcome the challenges.

The point was made that the transition between children’s and adults services was often difficult for service users. It was queried how the service were planning to manage this and whether the newly developed management structure would aid this in any way. Lorraine Butcher confirmed that this had been recognised and improvements were being sought.

A number of Members noted their appreciation of being provided with an outline of the respective budgets of the children’s and adults’ Directorates. It was noted however, that it would be useful in future for the Committee to receive a detailed breakdown of the adults’ budget, including statutory and discretionary (ring fenced and non ring fenced) elements and information on overspend and under spend.

It was queried whether children’s services tended to take precedent over adults’ services in terms of time and resources due to the extensive regulation framework that existed around children and safeguarding. Lorraine Butcher reported that whilst this might have happened in the past, the regulation framework around adults’ services had increased considerably over the last few years. Additionally, Lorraine Butcher confirmed that neither Directorate would be in competition for resources and that each respective budget would be demand led.

A final point was raised in terms of learning from complaints. It was queried whether there were any good examples of were this had taken place. Sandra Shorter drew attention to the moving of service users from Santune House in Shavington  ...  view the full minutes text for item 23.

To consider a report of the Strategic Director (Children, Families and Adults).

Lorraine Butcher attended to present a report on the recent OFSTED Inspection of Safeguarding and Looked after Children Services. She explained that whilst most of this report had been considered by the Children and Families Scrutiny Committee there were a number of overlapping issues which had relevance to the remit of the Adult Social Care Scrutiny Committee.

In particular, Lorraine Butcher drew attention to the following area for improvement which had been outlined in the report:

“Ensure that staff in adult mental health and the Independent Living service are fully equipped and knowledgeable to identify children’s safeguarding issues in their day-to-day contact with people who use services and these issues are routinely addressed in supervision and performance management arrangements”

In addition, Lucia Scally, Head of Strategic Commissioning and Safeguarding, outlined a number of additional areas for improvement arising from the report that related to adult social care. These were as follows:

·         Improving the transition between children’s and adult’s social services.

·         Evidencing that Cheshire East was sensitive to culture and diversity issues.

Having said this, Lucia Scally also outlined a number of areas in which OFSTED had recognised that improvements had already been made. These were as follows:

·         Improved generic out-of-hours service and continuity with day services

·         The positive working relationships that had developed with the Multi-Agency Risk Assessment Conference (MARAC) and the Sexual Assault Referral Centre (SARC).

·         That the integrated commissioning pilot had driven increased integration, co-location and value for money solutions for meeting local needs.

Members drew attention to the recent Southall Judgement and it was queried how this might possibly effect the authority. Lucia Scally confirmed that it would have an impact on service delivery and that this would be addressed in the future.

It was queried what percentage of households with Adult Mental Health issues had children present. Lucia Scally confirmed that a check on this information would be made and if available, circulated to the Committee.

In relation to the action plan provided as an appendix to the report, it was commented that whilst this useful, it could be improved by having more time related, measurable outcomes.

RESOLVED –

a)    That the report be noted.

b)    That a check on information relating to the number of households with Adult Mental Health issues with children present be made and if available, be circulated to the Committee for information.

c)    That in six months, the Strategic Director bring back the following to the Committee:

a.    Progress made against areas for improvement relevant to the Adult Social Care Scrutiny Committee with measurable and time related outcomes.

b.    Information on the further steps that were taken to demonstrate Cheshire East’s ambition to become at least good if not outstanding in the forthcoming years.

d)    That it be noted that a consultation on the inspection framework was being undertaken by OFSTED.

To receive a report from the Strategic Director (Children, Families and Adults) – To Follow.

Lorraine Butcher explained that due to time restraints it had not been possible to provide the Quarter 1 Performance/Finance Report. She confirmed that this would be provided at a subsequent meeting.

It was suggested that for future meetings, the budget report presented to Cabinet could be brought to Scrutiny with a report outlining the potential implications and reasons behind the figures.

RESOLVED –

a)    That the Quarter 1 Performance/Finance Report be brought to a future meeting.

b)    That for future meetings, the budget report presented to Cabinet be brought to Scrutiny with a report outlining the potential implications and reasons behind the figures.

To consider a report of the Commissioning Manager, Prevention and Reablement and Carer Team.

Rob Walker, Commissioning Manager and Carers’ Lead attended to present on the Strategy for Carers in East Cheshire 2011-2015. Rob Walker explained that the starting point for the newly developed Carers’ Strategy was from a vision which aimed to “support all Carers to live their lives on their own terms”. He reported that the strategy had been developed in partnership with Carers, the Central and Eastern Primary Care Trust and Voluntary, community and faith sector organisations. The strategy set out the collective commitment to Carers across Cheshire East and demonstrated the value the council and its partners placed in supporting Carers and their families.

Rob Walker continued to outline the six proposed outcomes of the strategy and how these would be achieved and measured. As a final point, Rob Walker reported that the Carers Strategy would be reviewed independently on an annual basis through the Cheshire East Carers Reference Group – a group consisting primarily of Carers. It was also noted that updates on the progress of the Strategy would be brought to the Adult Social Care Scrutiny Committee on a regular (six monthly) basis.

Lucia Scally added that the service was seeking endorsement for the principle and the vision of the strategy at Cabinet on 3 October 2011 and if approved, she reported that it would feed directly into the commissioning strategy.

A number of comments were made with regard to the implementation plan. It was suggested that the desired outcomes needed to be measurable and time related.

It was suggested that it be fed to Cabinet that they should be lobbying the government and local MPs for more respite provision for carers and for perverse benefit outcomes to be stopped (considering the value of carers to the state and local authorities).

A concern was raised over what happened to a carer once they ceased to be a carer. It was queried what support was available in terms of signposting and employment opportunities. Rob Walker agreed to take this point to the Carers’ Interagency Group and the result of this discussion would be fed back to the Committee when appropriate.

With regards to young carers a concern was noted over the pressure that they were under and it was queried what was being done to flag up any potential issues, particularly around their health and educational achievement. It was suggested that there needed to be an inter-agency dialogue established with schools and other partners and that the efficacy of this process would need to be performance monitored. Rob Walker confirmed that this point would be taken on board and the Committee would be updated on the progress in six months.

RESOLVED –

a)    That the Strategy for Carer’s 2011-2015 be noted.

b)    That progress on the implementation plan be brought back to the Committee in six months time and this include:

a.    Measureable and time-related outcomes

b.    Progress on the development and efficacy of an inter-agency dialogue process to flag up issues regarding young carers’ needs.

c)  ...  view the full minutes text for item 26.

To receive a presentation from the Compliance Manager, Cheshire and Warrington Areas, Care Quality Commission.

Debbie Westhead, Compliance Manager, Cheshire and Warrington Areas – Care Quality Commission, attended to provide a presentation on the work of the Care Quality Commission (CQC) and how the Adult Social Care Scrutiny Committee could contribute to this.

She noted that the Committee were in an ideal position to provide valuable comment to the CQC as it reflected the views of local people and often took a detailed look at the efficacy of various services. Attention was drawn to the variety of ways that the Committee could share information with the CQC:

·         By joining the CQC national sounding board.

·         By working with the CQC on national development projects.

·         By sending information through the CQC website, and by commenting on consultations.

·         By meeting with local CQC staff to discuss the Committee’s work, including plans to review services or to gather views about proposed changes to services. The local compliance managers being the main contact point.

It was queried that if the CQC only had five inspectors for 264 sites, how were they managing an effective inspection regime. It was suggested that there could be a role for Town and Parish Councils to assist with inspections. Debbie Westhead confirmed that they were looking to recruit more staff and that the involvement of Town and Parish Councils would need further discussion on how it would be facilitated.

Attention was drawn to the CQC’s whistleblowing policy and how it was implemented. Debbie Westhead explained that concerns are listened to and then the appropriate action was taken. It was reported that this would often result in a visit.

RESOLVED –

a)    That the presentation be noted

b)    That the Committee join the CQC national sounding board. 

To give consideration to the work programme.

Members considered the work programme.

RESOLVED –

a)    That a Task and Finish Review on the future arrangements/provision of residential care be established with the following Membership:

a.    Councillor Peter Raynes

b.    Councillor Laura Jeuda

c.    Councillor Frank Keegan

d.    Councillor Dorothy Flude

e.    Councillor Irene Faseyi

b)    That the Quarter 2 Performance/Finance report be added to the work programme and for it to include emerging budget proposals for 2012/13.

To consider the Committee’s training requirements for the 2011/12 Civic year.

Members considered the Committee’s training requirements for the 2011/12 Civic year.

RESOLVED –

a)    That an independent training session on the emerging policy context for adult social care, linked to each respective department, be added to the work programme.

b)    That a number of appropriate site visits be arranged.

c)    That a full structure chart be distributed to the Committee.

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

The Committee gave consideration to the extracts of the forward plan which fell within the remit of the Committee.

RESOLVED – That the forward plan be noted.