Agenda and minutes

Councillor R Domleo, Portfolio Holder for Adult Services

Councillor O Hunter, Cabinet Support Member for Adult and Health Services

Fiona Field, Central and Eastern Cheshire Primary Care Trust

Mike O’Regan, Central and Eastern Cheshire Primary Care Trust

Lucia Scally, Adults, Community, Health and Wellbeing Department

Jill Greenwood, Adults, Community, Health and Wellbeing Department

Allison McCudden, Adults, Community, Health and Wellbeing Department

Urvashi Bramwell, Policy and Performance Team

Mike Flynn, Scrutiny Team

Ross Paterson, Scrutiny Team                         

To provide an opportunity for Members and Officers to declare any personal and/or prejudicial interests or members to declare the existence of a party whip in relation to any item on the agenda.

RESOLVED:  That the following declarations of interest be noted:

      Councillor D Flude – personal interest as a Member of the Alzheimer’s Society and Cheshire Independent Advocacy.

      Councillor S Jones – personal interest as a Member of the Alzheimer’s Society. 

This item was withdrawn.

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 any 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 were no members of the public present who wished to speak.

To approve the minutes of the meeting held on 11 November.

RESOLVED: That the minutes of the meeting of the Committee held on 11 November 21010 be confirmed as a correct record.

To receive a presentation by Ted McGuiness, Dementia UK, on the role of Admiral Nurses.

Members received a presentation by Ted McGuiness from Dementia UK, on the role of Admiral Nurses.

Admiral Nurses are specialised mental health nurses who work with the carers of people with Dementia. They work within an integrated nursing role which involves the carers and the families of people suffering from dementia, and they provide education, training, practical advice and emotional support amongst many other services to the families and carers.

Admiral Nurses works in partnership with NHS Trusts and Dementia UK. They work using a best practice model to ensure high quality support and services for carers and people with dementia. All of their nurses are highly trained and receive continuous training and development in partnership with Dementia UK.

After consideration of the presentation the following points were raised:

      How the organisation was funded, and whether there were opportunities for Admiral Nurses to work with other agencies. It was explained that the organisation is funded by sponsorships, and their structure is similar to that of the Macmillan Cancer Trust, in that their nurses are NHS or Social Care staff who are also supported by the charity.

      Further clarification was sought on the costs to patients and carers, and also whether the trained Admiral mental health nurses were able to get access to development opportunities. It was confirmed that are no costs for the patient or carer, and Admiral Nurses do have development opportunities within their academy, with Dementia UK providing most of the training in this area.

      Whether nurses would be trained initially as a mental health nurse, following which they could apply through the appropriate channels such as through the NHS and partnerships to become Admiral Nurses.

      Whether the PCT and the Council should consider a pilot scheme to examine the impact of Admiral Nursing availability in the area.

      Councillor Flude undertook to raise the possibilities at the Cheshire and Wirral Council’s Joint Scrutiny Committee. 

RESOLVED: That

1.      Ted McGuiness be thanked for a most interesting presentation;

2.      The possibility of setting up a pilot scheme for Admiral Nursing in the Cheshire East area be investigated with Central and Eastern Cheshire Primary Care Trust and a further report be made to this committee in due course.

The Committee was advised that the Dr Foster report for the period April 2009 – March 2010 published in November had highlighted that Mid Cheshire Hospitals NHS Foundation Trust had a higher than expected Hospital Standardised Mortality Ration (HSMR) for the year. Although the Committee had considered a report on the previous year’s performance, Members felt that further information on the latest findings by Dr Foster should be provided. This was supported by the PCT, and it was hoped that representatives from the Hospital would be able to attend the next meeting.

RESOLVED: That a report and explanation concerning the Dr Foster data on the Hospital Standardised Mortality Rate (HSMR) be provided by Mid Cheshire Hospital foundation Trust at the next meeting.

Mike O’Regan explained that a level 2 consultation was undertaken in November and the conclusion was that the Willow Day Care Centre in Macclesfield should be closed. Officers reassured the committee that everyone at this centre will be assessed and cared for despite its closure.

After consideration of the update provided to the Committee, the following points were raised:

      That despite the issues going to consultation, people were concerned that the closure is going to happen anyway and this may raise false hopes for the public.

      Removing the “social” aspect of care for people with mental health problems and moving towards more personalised care may lead to people becoming isolated.

      Relating to the movement of social care to more personalised care, Mike O’Regan explained that for some people a social environment is very useful and rewarding. However for others, this environment can become too comfortable and prevent people from progressing and moving on. He gave assurances that this would be done with as limited upheaval to people as possible.

      It was encouraging that the various service providers were now cooperating and working together to address these complex issues.

      The extent to which there was scope for the Voluntary Sector to offer support and services particularly with regard to the social care dimension. However the potential risks of people falling through the net due to the complexity of mental health issues was noted, and provision must be made to guarantee that the voluntary sector which is increasingly taking up these services is properly regulated.

      That care is only successful if provided by trained professionals and concerns that reliance on the voluntary sector required careful planning and preparation, and the necessary professional input.

RESOLVED: That the Report be received.

To consider a report on the proposed closure of Riseley Street Respite Service.

Background information on this issue was provided to the committee by Mike O’Regan and Fiona Field. It was explained that a level 2 consultation had been carried out in November, in which some issues have been raised with regards to the Respite Centre in Winsford, which had been flooded.

Currently there was a proposal to close the facility at Primrose Avenue. The proposal was made as the three sites that were operating were running at around 40-45% occupancy. After consultation with legal advisors the decision was made to have a further 4 week consultation on the proposed closures at both Riseley Street and Primrose Avenue.

A change of wording in the report was noted by committee as it should have read; “discussed” rather than “accepted in principle” on page 12 of the Agenda. 

The committee was asked to note the reasons for the further consultation on the proposals, which once completed will be taken back to the CECPCT Board for consideration.

After consideration of the issues, the following points were raised:

      Whether Cheshire West and Chester Council had commented on the proposals, given that service users from their area were also affected. It was understood that the relevant Overview and Scrutiny Committee would consider the issues at a meeting in the next week.

      It was explained that work was being carried out to ensure the best possible outcome and that there would be the capacity within the system for everyone who currently requires care, however the level of future referrals was expected to be low.

      Primrose Avenue is viewed as not being fit for purpose and would have been closed as originally planned if it were not kept open as a necessity due to the flood at Crook Lane that prevented its closure.

RESOLVED: That the Report be received and the position with regard to further consultations noted.

To receive a presentation on two Adult Services’ consultations currently taking place on Charging and Transport.

The Committee received a presentation by Allison McCudden on two Adult Services’ consultations currently taking place on Charging and Transport.

It was stated that this review will address inequality between people who pay their full contribution toward a Direct Payment and those who have services purchased for them by the council at subsidised prices.

The presentation outlined the major proposals of the review and explained the planned charging mechanisms, whilst giving charging case examples in the form of a table, to emphasise how people in varying circumstances would pay for their care.

Committee was informed that the consultation runs from 2^nd November 2010 and had been extended until 31 January 2011. Cabinet will meet in February 2011 to discuss the outcomes, with any changes likely to be implemented in April with more possibly phased in over the year.

After consideration of the presentation, the following points were raised:

      Concerns over the closing down of information centres at bus stations, which would deter people from moving around independently, without the necessary advice and information services.

      That the current “dial a ride” system is working extremely well and should be supported. Clarification was sought over what will replace the Integrated Transport System when it ceases in March.

      Officers should ensure that the press and public are made fully aware that there is an extension of the consultation period until the end of January, and that other suitable venues,  perhaps more centrally located in Cheshire East should be explored, with Sandbach being suggested due to its good transport links.

      The extent to which there would be competitive pricing, and also that the reduced bus service to Leighton Hospital could create difficulties for members of the public accessing the hospital.

RESOLVED: That the Report be received and a further report be made in due course on the outcome of the public consultations. 

To consider the report to Cabinet on the Care Quality Commission’s assessment of adult social care services in Cheshire East.

The committee was invited to consider the report to Cabinet on 18 January on the Care Quality Commission’s assessment of adult social care services in Cheshire East covering the period April 2009 to March 2010. This would be the last report by CQC in this format, as assessments were moving to a more outcomes and improvement focus in the future. The Government had published an “Outcomes Framework” last November as the basis for the new approach.

Lucia Scally reported to committee on the main outcomes, which scored the Council positively as “performing well” across the seven areas covered by the assessment.

After consideration of the report the following points were raised:

      Concern over problems in dealing with mental health referrals, only half of which were completed. This was partly due to incompatibilities between the Council’s PARIS and the ICT systems operated by mental health services, and assurances were needed that this will improve.

      The Report from the Care Quality Commission commented very favourably on the Council’s key strengths, particularly in areas of safeguarding dignity and respect and that the section entitled “areas for improvement” set out clearly the main issues which the Council and it’s Partners would have to address in the following year.

      That there needs to be improvement in the way services are integrated across authorities, especially in relation to information and communication.

      In terms of “Areas for Improvement” it would be beneficial if the committee could have future reports on progress. Members also felt that a development event on this subject would be beneficial.

RESOLVED: That the Report be received, and a further Report be made in due course on progress with the areas for improvement and the new outcomes framework.

To receive a presentation by Urvashi Bramwell, Policy and Performance, Cheshire East Council, on the consultation process for the Public Health White Paper – Healthy Lives, Healthy People

Urvashi Bramwell explained that the White Paper, together with associated consultations on Public Health Outcomes, Funding and Commissioning would be considered in detail at the Member Development event arranged for 28January.

The deadlines for responses were 8 March for the Public Health White Paper, and 31 March for the associated consultations. The views of the Scrutiny Members on the issues would be included in the Council’s response, to be considered following the Member development event at the Midpoint meeting on 10 February.

RESOLVED: That the Report be received.