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.

In the interests of openness and transparency the following declarations were made:

Councillor S Gardiner declared that in relation to agenda item 8 (Cheshire East - Learning Disability and Mental Health Plans) he had used mental health services in the past, and that he was also a member of the Cheshire East Learning Disabilities Partnership Board.

Councillor L Wardlaw declared that she occasionally worked for the Cheshire and Wirral Partnership NHS Foundation Trust.

Councillor J Place declared that he was a member of the Together Trust in Cheadle.

Councillors N Cook and D Clark are members of the Cheshire East Mental Health Partnership Board.

To approve as a correct record the minutes of the previous meeting held on 25 September 2023.

RESOLVED:

That the minutes of the meeting held on 25 September 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.

There were no members of the public present.

To receive a report on the Medium Term Financial Strategy Consultation for 2024/25 – 2027/28.

The Committee received the report which set out the indicative financial envelope for this committee to support consultation on the development of the Cheshire East Medium-Term Financial Strategy 2024/25 to 2027/28.

Officers reported that they were working on proposals in response to the additional savings being sought and that an informal meeting would be scheduled for December to give all committee members an opportunity to go through the budget and proposals in detail.

RESOLVED:

That the Adults and Health Committee

(a)  Note the indicative budget envelope for this committee, as approved at the Finance Sub-Committee on 2 November, as a way of setting financial targets in support of achieving a balanced budget for 2024/25.

(b)  Note that officers will develop further proposals in consultation with Members to enable wider stakeholder consultation prior to approval by Council.

(c)  Note that Committees will be presented with the opportunity to further review financial proposals, designed to achieve a balanced budget, as part of their January cycle of meetings prior to recommendations being made to Council for approval.

To receive the report on the second financial review of 2023-24.

The Committee received the report which provided the second review of the Cheshire East Council forecast outturn for the financial year 2023/24.

Members sought further information regarding the current revenue forecast for Adults and Health which showed in-year forecast pressures of £4.7M and the reasons why the Council had arrived at this point so rapidly when a balanced budget had been set earlier in the year.

The Executive Director of Adults, Health and Integration outlined the factors driving increased costs in adult social care. These included price inflation in social care, with staffing costs in the care sector running ahead of headline inflation; the rate of growth of the aging population in Cheshire East which was higher than other parts of the country; more complex needs leading to higher unit costs; and the numbers of people being discharged from hospital into the community and requiring more complex care.

The Executive Director outlined measures that were being taken to address budget pressures, including a reduction in the use of short-term residential and nursing placements, investment in voluntary sector organisations, a reduction on the reliance of domiciliary and residential care, and capping price increases.

A piece of work had been commissioned to look at how the change within the no criteria to reside criteria and how the numbers of people flowing through hospital post pandemic may be affecting the bottom line.

During the pandemic, to facilitate discharge from hospital at a rapid rate social care teams were funded by central government to facilitate people leaving hospital rapidly. The funding for this had ceased in April 2022 although there was still an expectation that adult social care would act the way it did during the pandemic. It was emphasised that discharge from hospital did not make people eligible for adult social care and it was important to understand this.

A request was made for future reports to be clearer when information was for noting only. Some members felt that the use of ‘consider’ in recommendations could appear that members were being asked to do more than receive the information.

An amendment to the recommendations in the report was moved and seconded which sought to amend ‘consider’ to ‘note’. This was carried unanimously.

RESOLVED:

That the Adults and Health Committee:

1. Note the report of the Finance Sub Committee: Finance Sub-Committee, 2nd November, 2023
2. Note the factors leading to a forecast adverse Net Revenue financial pressure of £4.7m against a revised budget of £136.5m (3.4%).
3. Note the forecast and further mitigations needing to be identified, aimed at bringing spending back in line with budget.
4. Note the in-year forecast Capital Spending of £0.02m against an approved MTFS budget of £0.47m, due to slippage that has been re-profiled into future years.
5. Scrutinise the contents of Annex 1 and Appendix 1 and note that any financial mitigation decisions requiring approval will be made in line with relevant delegations.
6. Note that Council will be asked to approve the fully funded supplementary revenue estimate over £1,000,000 in accordance  ...  view the full minutes text for item 32.

To receive an update on the Safeguarding Adults Review.

The Committee considered a briefing report about the Safeguarding Adults Review regarding “ANTON”. The Safeguarding Adults Review Report had been commissioned by the Safeguarding Adults Board and written by an independent author. The Safeguarding Adults Review was a review of the circumstances and to identify lessons learned.

Members made the following comments in relation to the report and its recommendations:

-       The use of language should be challenged as fault should not be put on those being protected.

-       Request that an update on the recommendations come back to committee at a future date.

-       non engagement was not a reason to stop trying it was a reason to try harder.

-       if someone did not have English as their first language this should be flagged on the system.

In response to a question raised in respect of how many people were known to have lost settled status in Cheshire East and whether there was a way of tracking those people, a written response would be provided to members outside of the meeting.

in response to a question raised about whether people in communities who speak varying languages could be asked to join a register to help support those people in their communities where English was not their first language, officers would undertake to have discussions with the Head of Service for Integration and Communities.

In response to a question raised in respect of what post local authority supervision was given to foreign nationals and what it meant for the current cohort of refugee’s, officers agreed a response would be circulated to members outside of the meeting.

In response to a question raised in respect of multi-agency input and who if anyone would take the lead, officers reported that if a Section 42 Enquiry had commenced the Local Authority would take the lead in completing the enquiry, including making recommendations and setting actions. It was noted that in some circumstances another agency may be more appropriate e.g. the Fire Service.

The Executive Director for Adults, Health, and Integration informed members that in future, people that Adult social care supported would look more like ANTON and that there was a need to change the response to that and a need to transition from where we are to where we need to be as sometimes people best placed to deal with those case were outside adult social care.

The SAR will be published on the Safeguarding Adults Board Website.

RESOLVED: (Unanimously)

That the Adults and Health Committee accept the SAR Report and recommendations.

To consider the report on the co-production of the Cheshire East Place – Mental Health Plan and Cheshire East Place - Learning Disabilities Plan.

The Committee received a report which sought approval of the Cheshire East Place Plans for Learning Disabilities and Mental Health.

Members welcomed the all-age approach to the strategy and the direction of travel but sought assurance that there was as much attention given to rural areas as there was to other areas. In response officers assured members that they were fully aware of the need to have outreach teams for rural areas and that there was a need to emphasise this more in the plans. There was an area of gaps in provision, so work was ongoing with provider engagement and officers were looking at setting up peer support groups.

In response to a question on how the policies linked in with the national police initiative ‘Right Care Right Person’ officers reported that they were fully involved with the police in the development of the initiative and following discussions it was acknowledged that there was a need to change and adapt accordingly on how police respond to calls for welfare checks.

Members queried the currency of the Tartan Rug data and the mixed references used within the report. Officers hoped that with the digitalisation of the Tartan Rug the information would update more quickly but it was recognised that it had its limitations as it was part of the national level data collection which had its own timescales. The Tartan Rug provides a snapshot of inequalities and more comprehensive analysis of needs is undertaken through the JSNA programme.

Following concerns raised in respect of the easy read version officers assured members that the easy read version had been produced by officers in the council who had undergone easy read training and had been tested by self-advocates.

RESOLVED (Unanimously):

That the Adults and Health Committee:

1. Approve the Cheshire East Place Learning Disabilities Plan

2. Approve the Cheshire East Place Mental Health Plan

The Committee Adjourned for a short break.

To receive an update on the priorities from the Learning Disabilities Conference.

The Committee received an update in respect of the progress made following the Learning Disabilities Conference which took place in June 2022. The update included the work undertaken to achieve the 3 actions that had come out of the conference that Cheshire East would look at to help people with disabilities live better lives.

1)    Make things better for people to stay up late.

2)    Give people more chance to have their say on services and what they want to do.

3)    Provide better information about services for people with learning disabilities and carers.

The Director of Adult Social Care expressed their disappointment in not being able to move as quickly as they would have liked, specifically in relation to the action in respect of making things better to stay up late. This was due not to the events themselves, but the contracts the Council had with the providers.

The Committee welcomed the update and expressed thanks to officers and Tom, co-chair of the partnership board for all their hard work.

RESOLVED:

That the update be noted.

To receive an update on the progress made on the Day Opportunities Flexible Purchasing System.

The Committee received a progress update on the Day Opportunities Flexible Purchasing system which was approved by committee in March 2022.

Members sought assurance that there was monitoring of the provisions which were being offered by providers once they had been commissioned. In response officers confirmed that there was a contract monitoring process in place in which providers had to provide information on an annual basis. Market engagement was undertaken to look at any barriers in developing services in particular areas, and any gaps in provision.

It was agreed that a written response would be circulated to members in respect of a question in relation to where the new services were located.

RESOLVED:

That the update be noted.

To consider a report on appointments to the Safer Cheshire East Partnership (SCEP).

The Committee considered its appointments to the Safer Cheshire East Partnership (SCEP).

The elected members who had been nominated to SCEP were noted as follows:

Councillor M Edwards, Councillor A Moran and Councillor J Pratt.

RESOLVED: (Unanimously) :-

That the Adults and Health Committee

1. Appoint 3 elected Members to the Safer Cheshire East Partnership Board (SCEP).

2.    Agree the draft Terms of Reference.

3.    Agree that the names of the Members appointed will be submitted to the Head of Democratic Services and Governance.

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

Cheshire East Health and Wellbeing Board – 26 September 2023

The Committee queried the use of the term ‘Sub-Committee’ on the agenda as the Cheshire East Health and Wellbeing Board was a Committee in its own right. It was agreed that in future the word ‘Committee’ would be used.

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.

It was agreed that an update report on the Domestic Homicide Reviews which had been presented at committee would be added to the work programme for March 2024.

Members requested that prior to the budget being set in February, they were provided with an idea of the impact of the results for the items scheduled for March committee which involved consultation results.

RESOLVED:

That the work programme be noted.

To consider a report in respect of the use of capital funding and revenue measures to support the development of Extra Care Housing.

The Committee considered a report which sought an in-principal decision to the provision of capital funding to support the development of Extra Care Housing (ECH). The intention of such provision was to stimulate the market to prioritise the development of the council’s model of ECH. It was acknowledged that there was a need for planning and housing officers to work together on the corporate strategy to deliver this as a priority.

Members were supportive of the strategy in principal but emphasised the need for different committees to work together, having joint meetings, and sharing strategic and policy objectives.

RESOLVED: (Unanimously)

That the Adults and Health Committee approve in principle the use of capital funding and revenue measures to support the development of Extra Care Housing.