Agenda and minutes

The Committee noted that Ms Diane Marsh had joined the Committee to fill the vacancy left by the recent death of Robert Brookbank.

To receive apologies for absence and notification of any substitutes present.

Apologies for absence had been received from Mr H Birkby. Mr Terry was present as a substitute for him.            

To receive any declarations of interest made by Members in relation to any matter on the agenda.  Members are reminded to specify the agenda item number to which it refers and the nature of the interest being declared.

Mrs A D Allen declared interests as the Co-Chairman of the Dartford and Gravesham Partnership Forum for Adults with Learning Disabilities, and as an observer at ‘Choices’, North West Kent Women’s Aid.

Mr S J D Koowaree declared an interest as his grandson was in the care of the County Council.

To consider and approve the minutes as a correct record.

RESOLVED that the minutes of the meeting held on 12 July 2016 are correctly recorded and they be signed by the Chairman. There were no matters arising.

To receive a verbal update from the Cabinet Member for Adult Social Care and Public Health, the Corporate Director of Social Care, Health and Wellbeing and the Director of Public Health.

Adult Social Care

1.            Mr G K Gibbens introduced Hattie Oliver from the Kent Youth County Council, who was shadowing him for the day.  He then gave a verbal update on the following adult social care issues:

Launch of Adult Social Care Strategy Consultation

King’s Fund/Nuffield Social Care for Older People – this was looking at how social care would need to change in the future.

29 September – Spoke at Hot Potato Dementia Event in Herne Bay, which was seeking to create dementia-friendly communities. A similar event was planned shortly in West Kent.  

5 October – Spoke at Safeguarding provider event as part of Safeguarding Awareness Week

Kent Learning Disability Partnership Awards – this had been an excellent event, attended by Penny Cole, which celebrated the achievement of people with Learning Disabilities.

2.            Mr A Ireland then gave a verbal update on the following issues:

Statutory Care and Support Guidance published on 26 September had included new regulations and feedback which would build on the guidance issued with the Care Act.

National Survey on the Care Act would seek people’s accounts of personal involvement with the new Care Act and what difference it had made to them.

Consultation on changes to Attendance Allowance – a vital part of local authorities’ push to retain 100% of local business rates would be to use some of this money to enhance attendance allowances.

Adult Public Health

3.            Mr G K Gibbens gave a verbal update on the following public health issues:

Child Obesity Plan

Parliamentary Select Committee report on Public Health post-2013 reforms

13 September – Attended Public Health England Conference at Warwick University in Coventry - at this, there had been much support for the campaigns for smoke-free play areas and smoke-free school gates.  Mr Gibbens added that he would be using some of his Individual Member Grant to help promote these locally.

20 September – Attended roundtable at The King’s Fund about the role of pharmacies as a community asset.The National Pharmacies Association had attended all the Party Group conferences in the autumn to promote the role of community pharmacies. In response to questions, Mr Gibbens explained that:

·         the issue of community pharmacies would be included in local launches of the Health and Social Care consultation, and would be taken forward as part of this; and

·         previous representations about community pharmacies made to the Minister and the Department of Health had received good responses, and there would be a fund made available to support pharmacies in rural and urban fringe areas.  A response from the new Minister was currently awaited. 

4.            Mr A Scott-Clark then gave a verbal update on the following issues:

Introduction of new Deputy Director of Public Health, Dr Allison Duggal

Diabetes Wellness (DWELL) programme – this work would seek to establish the link between type 2 diabetes and wellness, and assess the impact of lifestyles upon diabetes.  £1.6m of European funding for this would be made available over four years.

New Health Profiles published  ...  view the full minutes text for item 5.

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Corporate Director of Social Care, Health and Wellbeing on the proposed commissioning approach for domestic abuse service provision in Kent, which the Committee is invited either to endorse or make a recommendation to the Cabinet Member.

Ms M Anthony, Commissioning and Development Manager, was in attendance for this item.

Mrs A D Allen declared an interest in this item as an observer at ‘Choices’, North West Kent Women’s Aid.

1.            Ms Anthony introduced the report and, with Mr Ireland, responded to comments and questions from Members, as follows:-

a)    the increase in the number of recorded cases of domestic abuse was due partly to raised awareness and partly to an increased confidence and willingness to report incidents. To have a reliable overview of patterns across the county would make it easier to target resources and ensure that services covered all areas evenly;

b)    the need for alternative accommodation for families escaping domestic abuse was whole-heartedly supported. Individual local councils sometimes struggled to provide such accommodation, so an holistic county-wide approach was needed;

c)    cases of domestic abuse among elderly couples would sometimes come to light when domiciliary carers went into their home as part of a general care package.  Patterns of abusive behaviour may have become ingrained over a lifetime and become accepted as the norm; and

d)    the County Council would work with the Police and Crime Commissioner to shape its approach to service provision, and would work in close partnership with other organisations to ensure that their respective service provisions were mutually compatible. The Council had agreed with its partners that it would retain overall control, management and monitoring of countywide service delivery, to ensure that service provision continued to be appropriate and consistent across the county.

2.            The Cabinet Member, Mr G K Gibbens, directed Members’ attention to the timing of the tendering process required to serve a contract start date of 1 April 2017, which meant that the key decision to award the contract would need to be taken between meetings of this committee. He offered to provide an additional briefing to any Member who wished to have one. There was general acceptance around the table that this would be the way forward, with an additional special meeting of this committee being convened if necessary.

3.            RESOLVED that:-

a)    the funding for domestic abuse services from 2017/18 be noted; and

b)    the decision proposed to be taken by the Cabinet Member for Adult Social Care and Public Health, to commission integrated services for domestic abuse support and to delegate to the Corporate Director of Social Care Health and Wellbeing, or other suitable nominated officer, authority to implement that decision, be endorsed, taking into account the comments made by Members, set out above.

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Corporate Director of Social Care, Health and Wellbeing on the future provision of accommodation-based short breaks for children, young people and adults with a disability.  The Committee is asked to consider and endorse or make recommendations to the Cabinet Member on the proposed way forward.

Ms S McGibbon, Change Implementation Officer, and Ms R Adby, Infrastructure Business Relationship Manager, were in attendance for this item.

1.            Ms Southern introduced the report and presented a series of slides which set out the planned development of the service and set out the key aims of the current proposed development, for example, to achieve a smooth transition between children’s and adults’ services. She reassured Members that there was no proposed reduction to service provision and demonstrated that the accommodation-based short break services were countywide services and therefore accessed based on which service could best meet the needs of the individual, rather than the location of the building.

2.            The Cabinet Member, Mr Gibbens, drew Members’ attention to the easy-read report, which had been presented in the agenda pack with the usual papers, as had become customary when reporting on a range of public-facing services, and said he would welcome Members’ views on how to improve and clarify the presentation of future reports.

3.            RESOLVED that the decision proposed to be taken by the Cabinet Member for Adult Social Care and Public Health, to proceed with the accommodation-based short break model, to end service provision from Osborne Court,  to identify alternative services for the 58 service users and family carers and close Osborne Court, and to delegate authority to the Corporate Director of Social Care, Health and Wellbeing, or other nominated officer, to undertake the necessary actions to implement the decision, be endorsed.

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Corporate Director of Social Care, Health and Wellbeing on the commission of day services through the external marketplace. The Committee is asked to consider and endorse or make recommendations to the Cabinet Member on the proposed decision to recommission.

Ms S Sheppard, Commissioning Manager, Community Support, was in attendance for this item.

1.            Ms Southern introduced the report and, with Ms Sheppard and Mr Lobban,  responded to comments and questions from Members, as follows:-

a)    it was suggested that the wording in para 2.6 be amended from ‘index-related price increase’ to ‘annual price increase’, to clarify how increases would work and how this system would operate;

b)    it was confirmed that the open framework for participants in the tendering process would open at intervals of 6, 12, 24 and 36 months and that the paper would be amended to reflect this; and

c)    the clarity of the plans for day services was commended and it was suggested that these plans be used as a ‘pledge’ to people with learning disabilities, in the same way that the County Council had issued a pledge of services and support it would give to children in its care. It was important also that the County Council’s partners, including district and borough councils, should be fully involved in these plans so that service users received a consistent message.

2.    RESOLVED that the decision proposed to be taken by the Cabinet Member for Adult Social Care and Public Health, to recommission Community Day Services for people with a Learning Disability and/or Physical Disability (External), and to delegate authority to the Corporate Director of Social Care, Health and Wellbeing, or other nominated officer, to take the necessary actions to implement the decision, be endorsed.

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Corporate Director of Social Care, Health and Wellbeing on the annual Local Account report, which the Committee is invited either to endorse or make a recommendation to the Cabinet Member.

Ms S Smith, Head of Performance and Information Management, and Ms T Easdown, Project Officer, Performance and Information Management, were in attendance for this item.

1.            Ms Smith introduced the report and, with Mr Ireland and Ms Easdown, responded to comments and questions, as follows:-

a)    Members who attended the workshop at the end of September were thanked for their contributions, which had been built into the final version of the document which the Cabinet Member would sign off;

b)    the local account document included an overview of the number of complaints and compliments received, but more detail of the subject of complaints and the responses to them was set out in the annual complaints and compliments report, which had recently been reported to this committee.  Mr Ireland emphasised the importance of the investigation of complaints being approached with an open mind; and

c)    the clarity of the document was praised and it was suggested that it be included in the briefing pack given to newly-elected Members. Ms Smith added that the final document would be accompanied by an easy-read version and a series of short videos, all of which would be available on the County Council website.

2.            RESOLVED that the draft Local Account document ‘Here for you, how did we do?’ (April 2015 – March 2016) be endorsed as the final version and it be signed off by the Cabinet Member for Adult Social Care and Public Health.

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Director of Public Health on the commissioning of sexual health services.  The Committee is asked to consider and endorse or make recommendations to the Cabinet Member on the proposed extension of the existing contracts to 31 March 2019.

Ms KSharp, Head of Public Health Commissioning, was in attendance for this and the following item.

1.            Ms Sharp introduced the report and explained that the extension currently proposed would take advantage of a clause already present in the current contract.  As the current provider was achieving 100% in relation to mandated performance against key performance indicators, officers had no hesitation in seeking the extension.  Ms Sharp and Mr Scott-Clark responded to comments and questions from Members, as follows:-

a)    the targeting of the condom programme would be based upon areas where demand was highest; and

b)    although the condom programme covered a wide age group, including an increasing number of older people, the age group which most used the service was 20 – 24, with 16 – 19 year olds being the second largest user group.

RESOLVED that the decision proposed to be taken by the Cabinet Member for Adult Social Care and Public Health, to extend the existing contracts for sexual health services to 31^st March 2019, be endorsed.

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Director of Public Health on procurement of services in East Kent and in the Prisons service.

1.                  Ms Sharp introduced the report and explained the different commissioning arrangements for services in East Kent and those for Her Majesty’s Prison Service, which the County Council commissioned on behalf of NHS England. The latter had the challenge of responding to the changing profile and needs of the prison population.

2.                  RESOLVED that the planned procurement processes for East Kent and Kent and Medway Prisons Substance Misuse services be endorsed.

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Corporate Director of Social Care, Health and Wellbeing on the Care Quality Commission Strategy, on which the Committee is invited to comment.  

Mr M Thomas-Sam, Head of Strategy and Business Support, was in attendance for this and the following three items.

RESOLVED that the content of the report be noted.

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Corporate Director of Social Care, Health and Wellbeing on the implementation of the Care Act from April 2015, on which the Committee is invited to comment.

1.            Mr Thomas-Sam introduced the report and he and Mr Ireland responded to comments and questions from Members, as follows:-

a)    the County Council had been happy to accept the changes made to its policy and procedures to cover its new responsibilities and ensure that they continued to comply with the Care Act’s revised requirements; and

b)    carers’ safeguarding had been an area of increased activity before the advent of the Care Act, and much work had already been going on to identify future patterns of need.

2.            RESOLVED that the extent to which the County Council had embedded, and continued to embed, the statutory requirements into practice, be noted.

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Corporate Director of Social Care, Health and Wellbeing on the draft Strategy, on which the Committee is invited to comment.

Ms J Dixon-Sherreard, Policy Advisor, was in attendance for this item, with Mr Thomas-Sam.

1.            Mr Thomas-Sam and Ms Dixon-Sherreard introduced the report and explained that the final draft of the Strategy would be reported to this committee on 6 December 2016, prior to a formal decision being taken by the Cabinet Member to approve it for adoption.  Mr Thomas-Sam, Ms Dixon- Sherreard and Mr Ireland responded to comments and questions from Members, as follows:

a)    the offer of a Member briefing to explain the detail of the strategy was welcomed. Mr Ireland emphasised the significance of the strategy in predicting and planning for what social care might need to look like in the next 5 – 10 years, including its offer, its sustainability and the way in which it linked to and integrated with other services;

b)    it was important that the strategy take account of the growing number of older carerswho were continuing the carer role into their senior years, while also needing to continue working, who would need support to cope with their own health problems; and

c)    concern was raised about whether or not respondents would know how to answer the question on the consultation document (included with the strategy) which asked if they considered themselves to be disabled, as set out in the Equality Act of 2010. Mr Thomas-Sam advise that this was a usual question in consultations and had been tested before being included. It gave the County Council the opportunity to identify any special needs and was part of its concern to promote the interests of disabled people and help them to participate.

2.            The Cabinet Member, Mr Gibbens, thanked Members for their comments and said he would take account of them when approving the final strategy. He emphasised the growing importance of integrating health and social care, the wide range of issues to be covered within this and the need to consider how effectively this was being pursued.  He also offered a briefing on the detail of the strategy to any Member who wished to contact him to request one.

3.            RESOLVED that the draft Vision and Strategy for Adult Social Care 2016 – 2012 be noted and Members’ comments, set out above, be taken into account when preparing the final strategy.

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Corporate Director of Social Care, Health and Wellbeing on equality and diversity work and progress on the County Council’s equality objectives for 2015/16.

Ms A Agyepong, Corporate Lead, Equality and Diversity, was in attendance for this item, with Mr Thomas-Sam.

1.            Mr Thomas-Sam and Ms Agyepong introduced the report and explained that this would be the last such annual report to be made to the Cabinet Committee as equalities work would in future be included in the regular dashboard reports. 

2.            Mr Thomas-Sam and Ms Agyepong responded to comments and questions from Members and explained that, to help the County Council improve service delivery to gypsy and traveller communities, it was seeking to encourage them to declare their ethnicity and was also seeking to identify and make earlier contact with such communities.  This would be supported by improved staff training, to encourage suitable questions to be asked, by reviewing the monitoring guidance currently in use and by continued partnership working with other agencies, and information sharing.   

3.            RESOLVED that:-

a)    the current performance and proposed priorities be noted, andequality governance continue to be observed in relation to decision making;

b)    the proposed changes to equality objectives be noted, and revised objectives be received in 2017; and

c)    the Cabinet Committee continue to receive the report annually in order to comply with the Public Sector Equality Duty (PSED) and ensure progress against the County Council’s objectives.

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Corporate Director of Social Care, Health and Wellbeing on progress made in commissioning the new service, its strategic direction and performance, on which the Committee is invited to comment.

Ms S Scamell, Commissioning Manager, Mental Health, and Ms V Tovey, Commissioning Manager, Public Health, were in attendance for this item.

1.            Ms Scamell introduced the report and explained that a new contract to work with strategic partners had commenced in April 2016. Outcomes of this initial stage of working would start to become apparent in 2017; currently, data was available only for the first quarter of the 2016/17 financial year, which showed performance above target. The monitoring process was as important as the procurement process. Ms Scamell and Ms Southern responded to comments and questions from Members, as follows:-

a)    asked about the extent to which front-line staff were familiar with the new work, Ms Scamell offered to look into specific examples with the questioner outside the meeting; and

b)    asked about the classifications, used in the literature, of serious mental illness (SMI) and common mental illness (CMI), Ms Scamell explained that anyone having been seen by a secondary mental health treatment service in the past five years would be counted as having an SMI.  The aim was that as many people as possible would be seen earlier than this, by a primary mental health treatment service. Ms Southern added that the contract would clearly identify these categories so that suitable resources could be provided to serve them.

2.            RESOLVED that the early progress made in commissioning the new service, the performance information and the strategic direction of the new service be noted.

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Director of Public Health on the new service model in West Kent substance misuse services and an update on the procurement process, on which the Committee is invited to comment.

Ms K Sharp, Head of Public Health Commissioning, was in attendance for this item.

1.            Ms Sharp introduced the report and summarised the main differences between the new model and the previous. She outlined changing patterns of activity, including the increased use of technology and an increase in the number of people over 60 accessing services.  She explained that this service would link into others, such as the Adult Health Improvement service.

2.            RESOLVED that the new service model of West Kent substance misuse services, and the update on the procurement process, be noted.

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Corporate Director of Social Care, Health and Wellbeing on a proposal to re-provide the dementia day care currently provided by the Dorothy Lucy Centre through existing external provision, rather than a block contract, from April 2017.

Ms S Sheppard, Commissioning Manager, Community Support, was in attendance for this item.

1.            Ms Sheppard introduced the report and explained that the market for dementia care services had developed since the decision had been taken in March 2016 to close the Dorothy Lucy Centre and find alternative ways of delivering care.

2.            RESOLVED that the proposal to re-provide dementia day care through existing external provision, rather than a block contract, from April 2017, be noted.  

To receive a report on the Committee’s work programme.

RESOLVED that the committee’s work programme for 2016/17 be agreed.