Agenda and minutes

To note any apologies for absence from Members.

Apologies for absence were received from Councillors B Evans and A Kolker. Councillor D Edwardes substituted for Councillor Evans.

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

In relation to item 9 - Cheshire East Safeguarding Adults Board Annual Report (2021-2022) in the interests of openness Councillor S Gardiner declared that he had previously been a member of the Local Safeguarding Adults Board but had not discussed the report which was being presented to committee and Councillor L Jeuda declared that she was a member on the Local Safeguarding Adults Board.

To approve as a correct record the minutes of the previous meeting held on 23 January 2023.

RESOLVED:

That the minutes of the meeting held on 23 January 2023 be approved as a correct record.

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.

Steve Nichols, Chief Executive of the Rossendale Trust attended the Committee and spoke in respect of item 7 - Market Sustainability Plan.

Mr Nichols enquired as to when Cheshire East were going to support the complex care cohort (of which the Rossendale Trust represent circa 30%) with a rate in line with their peers and not at a rate which ranked 68^th out of 69 Local Authorities according to the recent reliable independent national survey.

Mr Nichols felt that Cheshire East Council should be suitably rewarding and protecting those providers by significant partners who had shown outstanding loyalty and recognised achievement over a sustained period.

In response to Mr Nichol’s request for comments the Executive Director for Adults, Health and Education thanked Mr Nichols for his attendance at the meeting and recognised that Rossendale Trust was an important provider for Cheshire East. The way in which services had been commissioned in the past had been through a dynamic purchasing system, which enabled providers to bid for packages of care in the expectation of that the price that is submitted, is able to be sustained for the lifetime of the contract. There have been some very significant pressures on prices over the past two years and that was having a direct impact on providers, which is difficult for them but equally difficult for the Council within the context of the amount of money available for adult social care.

The draft market sustainability plan which was on the agenda for consideration looked at how the Council would invest more in its providers over the next year and how it might change its approach to supporting providers in the medium to longer term. It was recognised that supported living and care at home were the cornerstone of the care the Council wanted to support in Cheshire East. Time was needed to move from a position of funding people competitively to a position of more collaborative working in partnership with providers such as Rossendale Trust. It was hoped that there would be an increase in the amount being paid to the Rossendale Trust over the next twelve months and discussions would be held with Mr Nichols over the next few days. The Council would not be able to go as far as the organisation would wish it to in a single year, but there was definitely a strategic trajectory that would lead it closer to the market rates for supported living.

The Chair commented that it was acknowledged that Mr Nichols was concerned for the vulnerable adults that the Rossendale Trust cared for but the Council was also facing extremely difficult budgetary considerations. The Adults and Health Committee was £8.9 million overspent which was down to wage inflation and as a Council it was duty bound to have what was turned by the government's value for money for our residents.

Whilst the Council shared the same concerns around its vulnerable people it only had a limited budget and officers were trying their best  ...  view the full minutes text for item 63.

To receive the financial update for the year 2022/23.

The Committee received a report which provided an overview of the Cheshire East Council forecast outturn for the financial year 2022/23 and a financial update and forecast outturn for the adults and Health Committee’s areas of responsibility.

In response to questions and comments from members officers reported that

-       in respect of the Discharge fund, spending for this year and the next financial year was very much focused on the Home First model with beds being used at the bare minimum. In previous years, mainly due to covid and the need to spend very quickly and to get people out of hospital as quickly as possible beds were used by the Council and by health colleagues out of necessity so there would have been an impact from previous years. Forecast overspend for adult social care in the current year was due to 50% price increases and about 50% additional activity linked to discharge. There had been an overspend last year which was linked to people in beds post discharge and as result through the current year the full year effect had been felt and more people had been in beds as a result of supporting the NHS with discharge. Some of those had converted to long stay placements which had resulted in an increase in that area. However as a result of some really concerted work by the Council and NHS colleagues there had been a shift following the implementation of the Home First strategy. What had underpinned that was the 14% inflationary increase that had been given to domiciliary care providers in year in order to increase the amount of domiciliary care capacity that the Council had been able to purchase. That had impacted on the Council’s waiting lists and the number of people coming out of hospitals which had resulted in a decrease in the number of people in short stay beds. It was important to maintain momentum for 2023/24.

-       the pay offer currently out to the workforce was in excess of the amount incorporated into the budget. From the 1st of April, the Council would be under pressure on pay inflation for the employed workforce for the local authority so the Adults and Health committee would need to find off setting savings to cover that.

RESOLVED: That the Committee

1     note the report of the Finance Sub Committee held on 8 March 2023 and the recommendations of that Committee to Service Committees to

1.1 note the financial update and forecast outturn relevant to their terms of reference.

1.2 note the delegated decisions relating to supplementary revenue estimates for specific grants coded directly to services in accordance with Financial Procedure Rules as detailed in Appendix 1, Section 2, Table 3.

2     Note Appendix 1 of the report and the following sections specific to this Committee:

·         Changes to Revenue budget 2022/23

·         Corporate Grants Register

·         Debt Management

·         Capital Strategy

·         Reserve Strategy

To receive an update on progress in delivering the Cheshire East All Age Carers Strategy since presenting the strategy to committee in March 2021.

The Committee received a report which provided an update on progress in delivering the Cheshire East All Age Carers Strategy. The new all age carers service had gone live on the 1 January 2023 and the strategy had focused on six main priorities which would be taken forward over the next five years.

The update evidenced how the carer pathways had been implemented through strong partnership working with heath, social care, commissioning, voluntary, community and faith sector organisations, and embracing carers across all age groups and disability groups.

The challenges faced included educating colleges so that young carers was part of the curriculum and ensuring that getting information to those carers at the right time was a priority.

Following questions and comments from members, officers reported that:

-       there had been a budget proposal to close centres, but there would be a consultation period prior to a decision being made and people would continue to receive the care and support required to meet their assessed needs.

-       work was underway with Making Space and education colleagues to raise the profile around carers and an all-round communications plan to reach those unregistered carers.

Members welcomed the report and thanked Jill Stenton for her presentation.

RESOLVED:

That the Adults and Health Committee note the progress in delivering the All-Age Carers Strategy 2021-2025.

To consider a report which seeks approval for Cheshire East Council’s Market Sustainability Plan for onward submission to the Department of Health and Social Care (DHSC) and publication on the Council’s website.

The Committee considered a report which sought approval to publish the Market Sustainability Plan for onward submission to the Department of Health and Social Care (DHSC) and publication on the Council’s website. The report was a follow up to the Cost of Care report which was brought to the 23 January Adults and Health Committee.

The Market Sustainability Plan was the second requirement to securing funding and must be submitted and published on the Council’s website by 27^th March 2023 and that no special dispensations would be considered by the DHSC to extend the deadline.

The Market Sustainability Plan related to a segment of the market which included registered domiciliary care for people over the age of 18 and registered residential and nursing care for people over the age of 65.

In response to questions and comments raised by Members, Officers reported that

-       In relation to the differentials of rates between areas a lot of work had been undertaken in analysing the market in respect of the current capacity in domiciliary care and what was required to build on that capacity in order to provide a service across the borough. There was a proposal to invest more money in the areas where it is difficult to access care capacity, including rural areas, and where recruitment was challenging in order to deliver care at home, and this was the main reason behind those rates. However, it was acknowledged that there was challenge around health inequalities and that the best way to address those was to invest in good jobs and good salaries where possible and within budget.

-       The cost of the commissioned independent consultants had partly come out of grant funding and commissioning consultants had saved time on the Council’s workforce.

-       There was no process in place to ensure providers report back on how they direct fee uplifts directly to the workforce, however, as result of the cost of care exercise there was some insight provided on what providers were spending the hourly rate on i.e. staff costs/salaries

-       Fee uplifts as a result of the 2023/24 Market Sustainability Grant have not yet been implemented  therefore the outcomes in relation to the objectives have not been seen yet.  However, there had been a mixed response from providers in response to proposals, and  it was hoped that it would be seen as an opportunity for some providers to expand outside Crewe.

-       Investment in fees for the supported living sector would take place this year with an aim to do the same the following year. However, the Market Sustainability Grant criteria means that it  is not intended for the supported living sector, it is for registered care and specifically those over the age of 65 and domiciliary care.

The Council had been allowed to keep some of the money received upfront from the DHSC for being a trailblazer, and for early implementation of the policy and this would run for the current financial year. Negotiations in respect of  ...  view the full minutes text for item 66.

To consider the key performance indicators/measures from Quarter 3, 2022/23.

Consideration was given to a report that outlined the performance data and measures related to services that fell within the responsibility of the Adults and Health Committee, from Quarter 3 of 2022/23.

RESOLVED:-

That the Committee

1          note the performance of Adults Social Care Services for Quarter 3

2          provide scrutiny in relation to the performance of Adults Social Care

To receive the 2020/21 Annual Report of the Local Safeguarding Adults Board.

The Committee received the annual report of the Local Safeguarding Adults Board 2021/2022. The Local Safeguarding Adults Board Independent chair, Geoffrey Appleton had recently stepped down and the Board had appointed Kevin Bennett as the new chair. The Committee welcomed Kevin to the meeting

and requested that a letter from the Committee be sent to the outgoing chair, Geoffrey Appleton, thanking him for all of his hard work during his time as chair of the board.

The report included the work that had taken place in 2021/22 which included the impact of covid-19, adults safeguarding training and performance activity. The numbers of safeguarding adult review referrals (SARs) had increased during the pandemic which was the national picture, specifically cases around self-neglect. The patterns seen throughout 2021/22 continued to be seen in 2022/23 which included an increase in safeguarding referrals, SARs and domestic homicide reviews.

Preparation was underway for Care Quality Commission (CQC) inspection of adult social care which would commence from October onwards.

Following questions and comments from members, officers reported that

-       The board had received reports from the communities team regarding the hotels, the Afghan refugees, Homes for Ukraine and asylum seekers and from an operational perspective officers had visited those hotels to address any issues around the different cultures and addressed any safeguarding needs.

-       More work was being undertaken to getting people registered as carers, so that officers were being more proactive and planning ahead rather than being reactive.

-       In the future it was hoped that an initiative around ‘Who will care when I’m gone?’ would be launched, specifically for parents of learning disabled and individuals who may have lived at home all their lives, who may not even be on the radar.

-       Domestic abuse did play a part in education within the Afghan hotels and the asylum seeker hotels.

-       any training would be included as part of the induction for new members following the elections in May.

-       In respect of asylum seekers if abuse or neglect was tangible the police would investigate in the first instance but the obligation of the board would be to look at learning.

The Board and the officers were thanked for all their hard work.

RESOLVED:

That the Local Safeguarding Adults Board Annual Report 2020/21 be received and noted.

The Committee adjourned for a short break.

To receive the Safer Cheshire East Partnership Annual Report 2022-23.

Prior to the 2022/23 Annual Report of the Safer Cheshire East Partnership (SCEP) being presented to committee the Director of Adults Social Care reported that The Channel Panel and Prevent which also reported in to SCEP had its annual benchmarking with the Home Office recently and was rated ‘good to outstanding’.

The Committee received the SCEP report which included:

·         a comprehensive overview of how Strategic Partners worked together during 2022/2023 to reduce crime and increase reassurance to members of the public across Cheshire East.

·         new areas of work which had been driven by central government which included a new Combating Drugs Partnership and a Serious Violence Duty which would impact on the work of SCEP going forward.

·         the purpose, aims and priorities of the Safer Cheshire East Partnership and evidenced activity, challenges, and achievements during the year including reference to any on-going impact of COVID influencing Crime and Disorder responses in Cheshire East.

·         a number of examples of how impact had been measured as part of the core business and project delivery, providing information describing how the Strategic Aims of SCEP had been implemented and how financial support provided by the Police and Crime Commissioners Office was directed to support identified priorities agreed by SCEP Partners.

The report evidenced that the Safer Cheshire East Partnership was undertaking its statutory responsibilities and that SCEP was fulfilling the functions to protect and support communities and provide the reassurance that Cheshire East was a safe place to both work and live.

Following comments and questions from members officers reported that:

-       In respect of education some work had been carried out with schools with the police who went in and talked to young people about attitudes towards women and what behaviour would be acceptable and what wouldn’t, and the consequences of that behaviour if it fell short.

-       Physical support had been provided in conjunction with My CWA, and following work with the survival group practical items such as torches, personal alarms were purchased.

-       Following the safer streets work an application called ‘Hollie Guard’ which was free to download and could be used in a variety of situations had been introduced along with the introduction of safety buses which would be visiting the night time economy sites and were now a permanent fixture.

RESOLVED:

That the 2022/23 Annual Report of the Safer Cheshire East Partnership (SCEP) be noted.

To receive a report on the progress of the Council and its partner organisations in addressing the inequalities experienced by the Gypsy, Roma and Traveller communities within the borough.

The Committee received a report which provided an update on the progress of the Council and its partner organisations in addressing the inequalities experienced by the Gypsy, Roma and Traveller communities within the borough.

Following the increase in inequalities experienced by those communities following the recent pandemic the Council took the opportunity to start working with its partners in addressing the inequalities, and ensuring services were accessible and welcoming to those communities.

The Multi Agency Gypsy, Roma, Traveller Operational group was set up as a direct result of the impact of the ‘We Are Still Here’ report.  The group was made up of representatives from, council services, health providers and the volunteer sector, as well as the police and the Romani community.  The purpose of the group was to establish a clear and consistent approach to working with Gypsy, Roma, Traveller communities and to help address inequalities.

By working with the communities and involving them throughout the processes would lead to a better understanding for all, and increased satisfaction in services from those communities, and a reduction in inequalities; as well as giving the communities a voice.

Progress which had already taken place included

·         an increase in interest in the group from council services and partners

·         redesigned webpages dedicated to Gypsy, Roma, Traveller communities

·         the launch of Pride of Romani (24^th June 2022) -a newly constituted group supported by SCEP funding.

·         Work towards the development of a framework to improve inequalities within Gypsy, Roma, Traveller communities, as well as support staff working with the communities.

It was acknowledged that there was more work to do to build trust with communities but tangible improvements had been seen in recent times and an update would be brought back to Committee at a future date.

RESOLVED: That:-

1)    the ongoing work of the multi-agency operational group and support for the development of a framework be noted.

2)    an update will be brought back to Adults and Health Committee at a future date.

To receive the minutes of the following sub-committee of the Adults and Health

Committee:

Cheshire East Health and Wellbeing Board – 29 November 2022

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 Executive Director of Adults, Health and Integration reported that officers would be working on the forward plan in terms of the decisions that would be coming forward to committee.

A request was made for consideration to be given to scheduling the report following the end of the consultation period in respect of the proposed closure of the Stanley Centre and Warwick Mews as soon as possible in the new municipal year.

RESOLVED:

That the work programme be noted.

As this was the last meeting of the Adults and Health Committee for this municipal year and before the local elections, the Chair thanked all Members for their helpful and constructive contributions. Thanks was given to officers past and present for their support, in terms of preparing and presenting the reports, answering Members’ questions, and supporting the meetings.

The Chair also said farewell to all members, and in particular those who would not be seeking re-election in May.