Agenda and minutes

To note any apologies for absence from Members.

There were no apologies for absence.

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

During consideration of item 5 (Cheshire East Place Mental Health Plan 2024-29 Update), Councillor Gardiner, in the interests of openness and transparency, declared that he had previously been the Chair of the Mental Health Partnership Board.

To approve as a correct record the minutes of the previous meeting held on 25 March 2024.

RESOLVED:

That the minutes of the meeting held on 25 March 2024 be approved as a correct record and signed by the Chair.

In accordance with paragraph 2.24 of the Council’s Committee Procedure Rules and Appendix on Public Speaking, set out in the Constitution, a total period of 15 minutes is allocated for members of the public to put questions to the committee on any matter relating to this agenda. Each member of the public will be allowed up to two minutes each to speak, and the Chair will have discretion to vary this where they consider it appropriate.

Members of the public wishing to speak are required to provide notice of this at least three clear working days’ in advance of the meeting.

Petitions - To receive any petitions which have met the criteria - Petitions Scheme Criteria, and falls within the remit of the Committee. Petition organisers will be allowed up to three minutes to speak.

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Councillor Alift Harewood (Macclesfield Town Councillor) addressed the committee in relation to agenda item 5 (Cheshire East Place Mental Health Plan 2024-29 Update). Cllr Harewood stated that she was the Chair of the Cheshire East Mental Health Partnership Board. Cllr Alift spoke in support of the Partnership Board and work undertaken to date. 

To receive an update on the Cheshire East Place Mental Health Plan (2024-2029).

The committee received an update on the Cheshire East Place Mental Health Plan (2024-29) and the work of the Cheshire East Mental Health Partnership Board. The committee noted the update provided on the six priorities of the plan.

Officers committed to providing a response to the questions raised by committee members, as summarised below:

-       Members requested further information in relation to early intervention and prevention such as talking therapies.

-       Members requested further information in relation to the schools programme and if the Mental Health Leads offer would be extended to academies, and what steps were being taken to support small/rural schools across the borough.

-       Members requested an update on steps being taken to address long waiting times for neurodiverse diagnosis and assessments more broadly.

Members requested that future updates provide more detailed data/analysis for members to consider including key information such as KPI’s and direction of travel.

RESOLVED:

That the update and presentation provided be received and noted.

To consider a report on the revised Protocol for Joint Health Scrutiny Arrangements for Cheshire and Merseyside.

The committee considered the report which sought approval to recommend, to Full Council, a revised Protocol for joint health scrutiny arrangements for Cheshire and Merseyside. The committee noted that the protocol and establishment of the Cheshire and Merseyside Integrated Care System Joint Health Scrutiny had previously been agreed by Full Council in July 2022, however changes to the Protocol were required following legislatives changes introduced in January 2024 as summarised within the report. The committee noted that the Protocol required approval from all 9 local authorities that formed the Cheshire and Merseyside joint health scrutiny committee.

RESOLVED (by majority):

That the Adults and Health Committee recommend the revised Joint Health Scrutiny Protocol for joint health scrutiny arrangements for Cheshire and Merseyside (Appendix 1) to Full Council for approval.

To consider a report to nominate members to the bodies referred to in the report.

The Committee considered a report on the appointment of and appointments to sub-committees, working groups, panels, boards and joint committees for the 2024-25 municipal year. A list of nominations submitted by the political groups was circulated at the meeting.

RESOLVED (unanimously):

That the Adults and Health Committee agrees the appointment of, and appointments to sub-committees, working groups, panels and joint committees for 2024-25 as set out in the report, as follows:

Cheshire East Health and Wellbeing Board (1 elected member)

Councillor Jill Rhodes

Joint Extra Care Housing Management Board (1 elected member)

Councillor Arthur Moran

Safer Cheshire East Partnership (3 elected members)

Councillors Martin Edwards, Arthur Moran and James Pratt.

Cheshire East Combating Drugs Partnership (2 elected members)

Councillors Sam Corcoran and John Place.

To consider a report on the recommissioning of accommodation-based learning disability respite services based on the findings of a review of current service provision.

The committee considered the report which sought approval to recommission accommodation-based learning disability respite services based on the findings of a review of the current service provision.

The committee noted that the new service model would include two respite services across the borough that would replace the currently commissioned respite services and the Care4CE provision a Warwick Mews Short Breaks. Assurance was provided that all options available had been fully considered and that the proposed approach would provide the best outcomes for individuals by delivering a more person-centred service that was flexible and meet a wide range of different and complex support needs. It was noted that the proposed new model, and a planned reduction in spot purchasing arrangements, would significantly contribute towards meeting agreed 2023-24 MTFS savings. It was stated that whilst serious consideration would be given to insourcing services in the future, there was no action that could be taken that would have a direct impact within the next 3 years and that a business case would need to be developed to ensure that the cost of insourcing services would not be higher than commissioning contracts as proposed.

The committee sought assurance that the market had been thoroughly tested. It was confirmed that there was confidence in providers to provide good quality of care within the cost envelope over an initial five-year period.

RESOLVED (by majority):

That the Adults and Health Committee

1.    Approve the proposed new model for learning disability respite services and for consultation to be progressed with the Trade Unions and staff based on all necessary considerations included within the report.

2.    Agree to delegate authority to award contracts to providers to deliver commissioned learning disabilities respite services to the Executive Director of Adults, Health and Integration.

To consider a report on the final outturn for Adults and Health Committee services for the financial year 2023/24.

The committee received the report which set out the final outturn for 2023-24. Members considered the financial challenges being experienced by the Council and recognised the important activities aimed at minimising the impact on council services. Members noted that the final outturn for the council would be considered by the Finance Sub Committee on 25 June 2024.

Members queried the cost of care packages and noted that this had increased significantly particularly care for individuals transitioning from children’s services to adult social care. It was stated that a total of £6.6m was spent each year on supporting 44 individuals under the age of 65 and that £8.2m was spent on 109 individuals in supported living. Members acknowledged the increasing complex demands being placed upon the service with more individuals requiring 1:1 and 2:1 support for up to 24-hours a day to meet physical, behavioural and mental needs. Members agreed that the work being undertaken to review EHCP plans would play a key role in reducing costs.

The committee asked if costs were anticipated to reduce as a result of falling inflation and energy prices, and if the council would seek to challenge providers on business cases put forward against costs charged to the authority. The committee noted that the North-West region was considered an outlier on cost and activity for people with learning disabilities and that a piece of work was underway with the North-West ADASS to analyse the cost drivers and identify any intervention that might be needed.

The committee were pleased to note the steps being taken to reduce the overall number of agency staff across the service and acknowledged the issues the service had faced in recruiting staff in Care4CE, mental health professionals and Occupational Therapists.

RESOLVED (unanimously):

That the Adults and Health Committee

1.    Note the factors leading to an adverse Net Revenue financial outturn of £11.8m against a revised budget of £138.0m (8.6%), for Adults and Health Committee services.

2.    Approve the Supplementary Revenue Estimate Requests for Allocation of Additional Grant Funding (Specific Purpose) over £500,000 up to £1,000,000 in Annex 1, Section 2, Table 2.

3.    Note the contents of Annex 1 and note that any financial mitigation decisions requiring approval will be made in line with relevant delegations.

To receive the report setting out the allocation of the approved budgets for 2024/25 to the Adults and Health Committee.

The committee considered the report which set out the allocation of the approved budgets for 2024-25 to the Adults and Health committee. The committee thanked officers for introducing RAG ratings to the report which provided the committee with a clear picture of progress on decision-making throughout the municipal year.

The Medium-Term Financial Strategy (MTFS) for Cheshire East Council for the four years 2024/25 to 2027/28 had been approved by full Council on 27 February 2024. Service committees were being allocated budgets for 2024/25 in line with the approved MTFS. The financial reporting cycle would provide regular updates on progress on delivery of the budget change items, the forecast outturn position, progress on capital schemes, movement on reserves and details of any supplementary estimates and virements.

The committee queried the pressures relating to SEND and noted that a piece of work was underway to ensure that children had a review of their EHCP status prior to transitioning into adult social care. It was stated that the costs of providing care set out within EHCPs for adults was a significant cost to the service, but the authority had a statutory duty to provide this care.

RESOLVED (unanimously):

That the Adults and Health Committee 

1.    Note the decision of the Finance Sub-Committee to allocate the approved revenue and capital budgets, related budget policy changes and earmarked reserves to the Adults and Health Committee, as set out in Appendix A.

2.    Note the financial reporting timetable for 2024/25 set out in Appendix B as approved at Finance Sub-Committee on 22 March 2024.

3.    Note progress on the delivery of the MTFS budget policy change items, the RAG ratings and latest forecasts, and to understand the actions to be taken to address any adverse variances from the approved budget.

To receive the minutes of the Cheshire East Health and Wellbeing Board – 19 March 2024.

The committee noted the minutes of the Cheshire East Health and Wellbeing Board meeting held on 19 March 2024. Cllr Gardiner stated that it would be helpful if minutes could, going forward, indicate which organisation each individual was representing (for those in attendance and sending apologies).

RESOLVED:

That the minutes of the Cheshire East Health and Wellbeing Board be received and noted.

To consider the Work Programme and determine any required amendments.

The committee considered the Work Programme. The following was noted:

-       Update on One You to be provided informally.

-       First Financial Review 2024-25 to be considered in September 2024 to include a summary of the direction of travel for Q2.

-       Item to be added to the Work Programme which considers how the transformation programme will impact adult social care.

-       Informal briefing to be arranged for the committee on care funding and how this works.

-       Cllr Kolker asked for consideration to be given to rolling out the opportunity of health screening for staff across Cheshire East. Officers committed to providing a written response.

Cllr Kolker queried if members could undertake visits of Care Homes (as previously done under the committee system of Children’s Homes). Officers committed to providing a written response.

-       Concerns were raised in relation to the lack of communication between strategic and statutory partners. The committee requested that the partnership working and communications be considered and an item, if appropriate, added to the Work Programme.

-       Cllr Burton queried if there was an opportunity for members to get together to discuss local care issues within their ward to share information and key contacts. Officers committed to considering this further and providing a written response.