Agenda and minutes

RESOLVED that the Minutes of the meeting held on 16 November 2010 are correctly recorded and they be signed by the Chairman.

Matters Arising

Two items, ‘Think Local, Act Personal’ and ‘Capable Communities and Active Citizens’, on which future reports had been offered in the Director’s oral update, had not been able to be reported back yet as the first was still in preparation and the second was still in consultation.  Reports on both of these, and on the Public Health White Paper, will be submitted to the POSC’s April meeting.

1.         The Chairman reported the receipt of an announcement from the Group Managing Director, Katherine Kerswell, which listed the first tier appointments under Change to Keep Succeeding, and he read out the appointments related to the POSC; Mrs Howard had been appointed as Director of Learning Disability and Mental Health and Mrs Tidmarsh as Director of Older People and Physical Disability.

2.         The announcement also included notice of some officers who would be leaving the Council in the Spring of 2011, once the new structure had been completed. These included Mr Mills, Miss Highwood, Director of Strategic Business Support, and Mrs Huntingford, Transforming Social Care Lead Officer.

3.         Mr Mills confirmed that he would be very active in setting up the new KASS structure but advised Members that this was the last POSC meeting at which he would be present.  He thanked Members for their support, both individually and as a Committee, in maintaining a constructive dialogue with his officer team and for their ‘critical friend’ role in scrutinising the Directorate’s work.  He also thanked his officer colleagues for the quality of reports which the Committee received, which had helped them to understand and scrutinise issues.

4.         The Chairman thanked Mr Mills for his work as Director of Operations and then Managing Director in leading KASS to achieve national recognition for its pioneering policy development and service delivery. Mr Christie, Mr Koowaree, Mrs Allen, Mr Jarvis and Mr Angell also thanked Mr Mills for his guidance and support of them personally through their political careers and in helping them to address problems brought to them by local residents. 

5.         Mr Gibbens added that many people across Kent had reason to appreciate Mr Mills’ leadership of a service which had consistently received good ratings from national regulators and has a good reputation nationally. He had heard first hand from SECASS and ADASS contacts that Mr Mills was respected and well thought of among his peers. He also remembered and paid tribute to Mr Mills’ support and guidance to him as a new Cabinet Member.

1.         Mr Gibbens gave an oral update on the following:-

a)         District Partnership Groups meet in each district every three months to address issues raised by people with Learning Disabilities.  Mr Gibbens explained that he is actively involved in these groups and encouraged Member colleagues to become involved as champions for people with Learning Disabilities.  He asked that any Members interested in taking on this role contact him.

2.         Mr Mills then gave an oral update on the following issues:-

a)         CQC Annual Performance Assessment: KASS had developed an Action Plan to address, over the next six months, the areas which were marked as needing improvement, and the POSC would need to oversee the delivery of this;

b)         NHS changes: The changes currently being made to the NHS are the largest since its launch 1948, and would be far-reaching. The government announced on 4 January that £162m had been made available nationally, which would be transferred from the PCTs for social care to benefit the NHS. In 2011/12 a further £648m nationally will be transferred to social care but this was not shown in the current budget book as KASS did not yet have access to it. The National Operating Framework for 2011/12 had been published, which sets out the clustering of PCTs which will mean the amalgamation of the three Kent PCTs to tackle winter pressures until the end of March.  Separately, a new combined Community Services NHS Trust will be established from 1 April which will combine the two PCT provider services and will be the Foundation Trust.  The POSC would have further updates on both these issues at future meetings; and

c)         Change to Keep Succeeding: Work on the new structure was continuing and there was much detail still to be worked through. East and West Kent would no longer be covered separately, and the new senior management posts being established under CKS would cover the whole of the county.  Support Services were to be centralised and would no longer come under KASS line management.  Members expressed concern at how well this would work, and asked for future reports on the bedding-in of the new structure so they could monitor very closely the effectiveness of the new arrangement, in particular the finance function.

Miss M Goldsmith, Directorate Finance Manager, was in attendance for this and the following item.

1.         Miss Goldsmith introduced the report and said that she hoped to balance the KASS budget at the end of the financial year. The extra NHS funding, announced in the oral update, would certainly help with this.  The pattern of debt in two consecutive months had been influenced by a technical failure of the invoicing system and then the postal backlog caused by the bad weather, both of which had affected the ability to issue and process invoices.  The pattern was expected to normalise, however, in the current billing period.

2.         In discussion, and in officers’ response to questions asked by Members, the following points were highlighted:-

a)         a decrease in the number of older people entering permanent residential care had at first been a very small difference, but the pattern had since repeated and so had been factored in as a trend;

b)         none of the debt written off in the period had related to any client currently receiving services, but was old debt and related mostly to clients who had deceased and whose estates did not contain sufficient funds to make any payment;

c)         delayed transfers carried no direct financial cost to the local authority, but did have an indirect cost in terms of staff time and involvement.  The main cause of delayed transfers used to be a delay in arranging social care packages, but in the last two years this had changed to being mainly health-related delays; and

d)         the general pattern of reducing debt (taking into account the temporary change outlined above) had demonstrated that bringing the debt recovery and management service in-house a year ago has had a positive effect.  However, this service, along with other support services, would be centralised under CKS, and the POSC would need to monitor this very closely to ensure that debt management did not suffer as a result.

3.         RESOLVED that the information given in the report and in response to Members’ questions be noted, with thanks.

The Chairman secured the Committee’s agreement to consider this item as urgent business, as the papers could not be placed in the public domain with the required five clear days’ notice, due to the late publication of the draft budget.

1.         Miss Goldsmith introduced the report and she and Mr Mills and Mrs Howard responded to comments and questions from Members. The issues highlighted were as follows:- 

a)         KASS headings in the published budget book showed net budgets reductions in some service areas.  Some/many of these had been caused by the end of some specific grants including Transforming Social Care Grant. Some payments to the voluntary organisations were time limited specifically whilst this grant funding existed. No cuts to specific voluntary organisations are proposed other than for this reason;

b)         KASS had strategies in place to address these reductions, as well as ways to generate income, and these are listed on pages 89 and 90 of the budget book;

c)         the ongoing increase in the number of clients using Direct Payments to buy services would lead to reduced expenditure on residential services;

d)         the KCC was previously expecting to lose £5m of funding (a reduction of 50% from the former level) when the Preserved Rights formula changed, but this expected loss had not materialised.  Similarly, other funding which the KCC had feared would move from specific grants to formula funding had not changed;

e)         Members expressed the opinion that the layout of the budget book made it difficult to follow, and some entries did not show enough detail to give a helpful picture.  Miss Goldsmith undertook to advise Members outside the meeting of specific details requested; and

f)          the headings presented in the budget represented the headlines only, and if these were agreed by the Council in February, the detail of the budget would then be worked out, using the Fairer Charging guidance. 

2.         RESOLVED that the information given in the report and in response to Members’ questions be noted, with thanks.

Mr N Sherlock, Head of Planning and Public Involvement, was in attendance for this and the following two items.

1.         Mr Sherlock introduced the report and answered questions from Members.  Points arising in comments and questions were as follows:-

a)         the shaded chart on page 51 of the meeting papers would be clearer if it included numbers to identify the intensity of risk. Numbers would be generated by multiplying the likelihood by the impact and entering the numerical value in the column where the two intercept.  Alternatively, the boxes currently shaded in greys could contain the words High, Medium and Low;

b)         due to the way in which risks are identified, it is difficult to say how KASS risks compare in severity to those of other Directorates. For instance, ‘financial’ risk would include all financial risk across all Directorates and would not allow those specific to KASS (eg client debt) to show up individually.  Some risks are also common to, or shared by, more than one Directorate. Members were advised, however, that KASS did not have any more High rated risks than any other Directorate;

c)         all change and transition generates some level of risk, and Members asked that future risk management reports to the POSC highlight and take full account of the risks arising from the Change to Keep Succeeding restructure, in particular the concerns which have been expressed about centralising the KASS finance function, so Members can monitor the impact of this change;

d)         public expectations of service delivery, particularly in relation to increasing demand for services, is managed by ongoing liaison with public bodies such as Links;

2.         RESOLVED that:-

a)         the information in the report and in response to questions be noted, with thanks; and

b)         future risk management reports to the POSC highlight and take full account of the risks arising from the Change to Keep Succeeding restructure, in particular the concerns which have been expressed about centralising the KASS finance function, so Members can monitor the impact of this change. 

1.         Mr Sherlock introduced the report and he and Mr Mills responded to comments and questions from Members.  The issues highlighted were as follows:-

a)         the figures currently presented were collected in September 2010, but figures for December would be available very soon and would be shared with Members as soon as possible.  It was expected that the December figures, when available, would show that KASS had met its target; and

b)         there were two ways of measuring progress in establishing personal budgets; the National Indicator NI 130 and the new ADASS indicator, of which the latter was the most helpful in the way it measured performance and gave a more realistic picture of progress as it counted only those using a personal budget for ongoing rather than one-off service provision.

2.         RESOLVED that the information given in the report and in response to Members’ questions be noted, with thanks.

1.         Mr Sherlock introduced the report and said how proud he was of KASS achieving such an excellent result in a period of major change. Mr Mills added that the Directorate had made steady progress over recent years and scored more ‘Excellent’ and ‘Good’ ratings each year. 

2.         Members agreed and added their thanks and congratulations. Mr K Pugh proposed and Mr C Smith seconded that Members’ sincere congratulations be passed to all KASS staff on achieving another excellent performance result despite the major change and upheaval.

Agreed without a vote 

3.         Mr Sherlock, Mr Mills and Mrs Howard answered a number of questions from Members, and the points arising from comments and questions were as follows:-

a)         the six areas for improvement identified in the report were now the subject of an action plan, and progress on this would be reported to and monitored by the POSC, as mentioned earlier in the meeting in the Director’s oral update;   and

b)         Members commended the way in which KASS reports its performance information, as reports include commentary on the outcomes of its performance for the people of Kent and do not rely solely on presenting figures and graphs. Members particularly appreciated this full and rounded information and asked that it be continued in future reports.

4.         RESOLVED that:-

a)         the information given in the report and in response to Members’ questions be noted, with thanks;

b)         Members’ thanks and congratulations be passed to all KASS staff on achieving another excellent performance result despite major change and upheaval; and

c)         KASS performance monitoring reports continue to include commentary on the outcomes of its performance for the people of Kent, so Members have a full and rounded picture.

Mrs A D Allen declared an interest in this item as the Chairman of Dartford Age Concern.

Mrs L Hardware, Policy Manager, was in attendance for this item.

1.         Mr Mills introduced the report and, with Mrs Hardware, Mrs Howard and Mrs Tidmarsh, responded to comments and questions from Members.  Points highlighted were as follows:-

a)         Mrs Howard and Mrs Tidmarsh are closely involved with Age Concern’s County Advisory Group, which is next due to meet in February;

b)         a three-year agreement/contract between KCC and Age Concern had been entered into. Due to the uncertainty of future budgets, funding would be reviewed each year rather than set for the whole three-year period;

c)         Members were advised that Age Concern branches would be allowed to monitor their own performance, helped by the KCC, and expressed concern that this joint monitoring arrangement was not made clear in the report;

d)         it was still the intention of Dartford, Gravesham, Northfleet, Swanscombe and Darenth Valley Age Concerns to merge, but progress had not been as rapid as hoped.  Mrs Allen confirmed that the Dartford, Gravesham and Swanley group would be meeting twice in January, its main concern being to move forward steadily and be thorough with its arrangements; and

e)         the current changes were planned and had started to happen before the national merger in 2010 of Age Concern and Age UK, and one of the new groups’ earliest tasks would be to work through the implications of the merger.

2.         RESOLVED that the information given in the report and in response to Members’ questions be noted, with thanks.

Ms S Smith, Policy Officer, was in attendance for this item.

1.         Mr Mills introduced the report, which had been requested to keep the POSC updated on the rapid and complex changes going on in the NHS and the far reaching implications of them for the KCC. He and Ms Smith responded to comments and questions from Members.  Points highlighted were as follows:-

a)         the plan is that all NHS provider organisations become Foundation Trusts by 2014. All Trusts need to have Governors with a connection to the locality, and will work with GPs’ consortia. The new organisations will be large and complex but work locally;

b)         Members expressed concern and disappointment that they had not been given the opportunity to take part in the consultation or contribute to the development of the new vision.  Mr Mills sympathised and reassured Members that no decision on the detail of the new arrangements would be taken until statutory guidance had been received;

c)         The Chairman offered to set up a meeting to allow any ASSPOSC Member who wished to comment the opportunity to do so by the next consultation deadline in February, and undertook to advise Members of the date of this meeting;

d)         it was suggested that an innovative way of engaging Members in the consultation would be to have a ‘virtual panel’ in which Members receive emailed updates on latest developments between the POSC’s formal meetings; and

e)         Members expressed concerns about the suitability and effectiveness of the new arrangements and whether or not the model was the right one.  

2.         RESOLVED that:-

a)         the information given in the report and in response to Members’ questions be noted, with thanks;

b)         further updates be made to the POSC, in the same style, starting with the April meeting of the POSC; and

c)         the Chairman look into setting up some arrangements for consultation and information sharing between POSC meetings and advise Members of an arrangement.

Mr R Brookbank, Mr G Cowan, Mrs T Dean, Mr P J Homewood, Mr R J Lees, Mr J F London, Mrs J Rook, Mr R Tolputt and Mr J N Wedgbury were present for this item as local Members.

Mr D Weiss, Head of Public Private Partnerships and Property Team, Mrs C Holden, Project Manager/Better Homes Active Lives PFI Contract Manager, and Ms J Barnes, Head of Provision – Modernisation (Older People – West Kent), were in attendance for this item.

During discussion on The Limes in Dartford, Mr Brookbank declared an interest as the Chairman of Darent Valley Age Concern.

1.         Mrs Howard introduced the report and the officers who had worked on the modernisation programme and were in attendance at the meeting to respond to Members’ questions. She presented a series of slides which set out the background and rationale for the proposals, listed the services currently provided at each of the eleven premises, summarised the outcomes of the consultation and the recommendation relating to each of the premises, on which the Cabinet Member for Adult Social Services would later be taking a decision. 

2.         The Chairman invited Members to comment and ask questions of detail on any of the premises. No comments were made about the Dorothy Lucy Centre or Cornfields, but points arising in relation to the other premises were as follows:-

WAYFARERS

a)         the staff who would transfer when a new provider took on the centre would do so under the TUPE regulations, and would transfer over on their existing terms and conditions and a comparable pension scheme as at present.  The KCC would need to seek assurance that a prospective purchaser would be able to cover these costs, but this commitment does not appear to have been an obstacle for the 14 prospective purchasers who had declared an interest in the Centre. These costs would be set out in the details of the contract between KCC and the new provider.

BLACKBURN LODGE

a)         the partnership arrangements proposed for this centre would consist of the KCC working closely with a partner provider, to commission from them the range of services at a quality and cost that the KCC requires; and

b)         assurances were sought that the new provision proposed would meet the needs of the people of Sheppey, that the new build would be located on Sheppey, that it would provide new services not currently available there, and that no client would be transferred from the existing premises until the new provision was up and running.

DOUBLEDAY LODGE

a)         the comment that no services would close until there were replacements in place also applies to Doubleday Lodge, so that provision for the people of Swale was not compromised.

KILN COURT

a)         the comment that no services would close until there were replacements in place would also apply to Kiln Court, so that provision for the people of Swale was not compromised;

b)         all the expressions of interest received for all homes had  ...  view the full minutes text for item 111.

The Chairman secured the Committee’s agreement to consider this item as urgent business, as the papers could not be placed in the public domain with the required five clear days’ notice.

Mrs P Huntingford, Transforming Social Care Lead Officer, Ms C Grosskopf, Policy Officer, and Mrs J Marsh, Directorate Exchequer Officer, were in attendance for this item

1.         Mr L Christie said he had asked for the item to be added to the POSC agenda to allow full discussion of an issue on which the Cabinet Member was shortly to take a decision.

2.         Mrs Huntingford introduced the report and explained that the change in policy had been made to address an inequity in the way home owners were treated.  The change KCC had decided to make had a firm legal basis, as the KCC was obliged to maximise its income so it could provide maximum services to those who needed them.

3.         Cases were complex and each had to be considered on its own merits, requiring a balance of judgement.  The change in policy could bring in potential annual income of £500,000 to £1million, and it was hoped that the first year’s income could be between £250,000 and £500,000.

4.         Mrs Huntingford responded to comments and answered questions from Members.  The points highlighted were as follows:-

a)         the principal of the policy change was accepted, but it was suggested that a review needed to be included to take account of circumstances in which the value of a home had reduced below the value of the care package, ie when the client would become eligible for KCC funding;

b)         it was also suggested that a review of the policy change be undertaken after one year to allow Members to monitor the cost of it as set against the income it generates, to evaluate the cost-effectiveness of it.  This suggestion was generally supported;

c)         if a client were purposefully to dispose of their property to avoid it being considered in the funding assessment, this would count as ‘deprivation of assets’ and the KCC could treat the assets as still belonging to the client.  If the transfer had been made in the last six months, the KCC could seek redress from the recipient of the assets, but if the transfer had been made years ago, it would be difficult for KCC to prove that the intention had been to avoid contributing towards care; and

d)         the policy change would apply only to new clients entering KCC-funded residential care, and not to existing residents.

5.         RESOLVED that:-

a)         the information given in the report and in response to Members’ questions be noted, with thanks; and

b)         a review of the policy change be undertaken after one year to allow Members to monitor the cost of it as set against the income it generates, to evaluate the cost-effectiveness of it.

Members thanked Mrs Huntingford sincerely for her advice and support over many years and paid tribute to her work as a senior member of the KASS management team.  Mrs Huntingford thanked Members for their comments.

RESOLVED that the information given in the report be noted, with thanks.