Agenda and minutes

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

Apologies for absence had been received from Mrs C J Waters.

There were no substitutes.

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.

Mr S J G Koowaree declared a personal interest as his grandson had autism.

Mr H Birkby and Mrs P Brivio declared personal interests as their respective spouses were both living with Dementia.

Mrs A D Allen declared a personal interest as a member of an advocacy group for adults with learning disabilities.

To consider and approve the minutes as a correct record.

1.            In response to a question about the performance of the Community Mental Health and Wellbeing service (Minute 16), Ms Southern clarified that performance on activity and outcomes had indeed scored above target for the first quarter of the 2016/17 financial year, but some outstanding issues around non-performance-related issues had yet to be resolved.

2.            The above having been clarified, it was RESOLVED that the minutes if the meeting held on 11 October 2016 are correctly recorded and they be signed by the Chairman.  There were no matters arising.

To note that the following dates have been reserved for this committee’s meetings in 2017/2018:-

all will commence at 10.00 am at Sessions House, County Hall, Maidstone.

* thisdate was changed shortly after the meeting, from 31 January 2017

RESOLVED that the dates reserved for meetings of the Cabinet Committee in 2017 and 2018, listed below, be noted. All meetings will commence at 10.00 am at Sessions House, County Hall, Maidstone:-

Tuesday 30 January 2017*

Tuesday 14 March 2017

Friday 9 June 2017

Friday 29 September 2017

Thursday 23 November 2017

Friday 19 January 2018

Friday 9 March 2018

* thisdate was changed shortly after the meeting, from 31 January 2017

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 gave a verbal update on the following adult social care issues:

Local Government Association Children and Adults Annual Conference in Manchester – this had included some good sessions and was an opportunity for the Ministers, Edward Timpson and Justine Greening, to hear at first-hand about the challenges of children’s and adults’ social care work.  He had also attended a useful session on Deprivation of Liberty Safeguards (DOLS).

Social Worker of the Year Awards 2016 – Yasmin Ishaq won the Creative and Innovative Social Work Practice Award for her development of a peer-supported mental health treatment model.

Occupational Therapy Show Awards 2016 – Jane Miller won the Outstanding Senior Occupational Therapist award.

Mr Gibbens requested that Mr Ireland write to Yasmin and Jane on behalf of the committee to congratulate them on their successes.

In response to a question about the lack of clarity in the autumn statement about the expected 2% social care precept, Mr Gibbens advised that the Community Wellbeing Board of the Local Government Association, of which he was a member, was in ongoing discussions with the Treasury about the need to fund adult social care adequately.

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

Social Worker of the Year Awards 2016 - Yasmin Ishaq had undertaken an outstanding piece of work and the award had been a great achievement for her and for Kent.

A view was expressed that the County Council should do more to celebrate staff achievements.

Sustainability Transformation Plan (STP) – this was moving on quickly, and officers and members were both well engaged with it.  The County Council was working with Medway Council in taking this forward. 

Feedback from Association of Directors of Social Services (ADASS) South East Branch meeting - this had been a good meeting, involving a discussion of emergency care. Once national data on this subject had been ratified, it could be shared with the committee.

Adult Public Health

3.            Mr G K Gibbens gave a verbal update on the following adult social care issues:

Smoke-free school gates – this campaign had been very well received publicly and had had much good feedback.  He suggested that Members could support local campaigns in their area by using their Member grants.

Community Pharmacies –funding for these had been reduced on 1 December 2016, but approximately 50 pharmacies in Kent, particularly those in rural and edge-of-town areas, would be eligible to receive a pharmacy access payment, to help them to stay open. He would continue to address the issue with MPs and Ministers.

Kent’s ‘Release the Pressure’ suicide prevention and awareness campaign had won a silver award in the ‘Best Public Sector Campaign’ category in the South East England Chartered Institute of Public Relations Awards. The number of men calling the campaign helpline had increased by 56% and an average of 500 men were now making contact each month. More activity was planned in the new year and the  ...  view the full minutes text for item 24.

To receive a report and presentation from the Cabinet Member for Adult Social Care and Public Health and the Corporate Director of Social Care, Health and Wellbeing, and to consider and endorse or make recommendations to the Cabinet Member on the proposed decision to approve the final draft of the strategy, with the supporting Accommodation Strategy for Adult Social Care and the Community Support Market Position Statement.

Mr M Thomas-Sam, Head of Strategy and Business Support, and Ms S Annan-Veitch, Policy Advisor, were in attendance for this item.

1.            Mr Thomas-Sam introduced the report and presented a series of slides (included in the agenda pack) which set out the context of the strategy, the range of responses received during the consultation exercise and the resulting changes made to the draft strategy since last reporting to the Cabinet Committee in October 2016.  Mr Ireland added that the strategy had been generally well received in focus group sessions with staff and partners as part of the consultation. The strategy was both forward-looking and aspirational in seeking to determine the future of social care in Kent.  Mr Ireland and Mr Thomas-Sam responded to comments and questions, as follows:-

a)    the strategy had been awarded a  crystal mark by the Plain English Campaign  at its first attempt, for which Mr Thomas-Sam received Members’ congratulations;

b)    the easy-read version of the document was also much welcomed, and Members asked that this be made available to all Members ahead of the strategy being considered by the County Council on 8 December;

c)    concern was expressed that, as the strategy was aspirational, and as the economic situation worsened and staff and resources became more scarce, the County Council may not be able to put into practice what it had set out in it.  Mr Ireland responded that, although aspirational, the strategy was not naïve, and although external events would have an effect, the strategy was robust;

d)    it was important that such a document take account of the support needs of people with learning disabilities, especially young people making the transition from children’s to adults’ services.  Ms Southern advised that much work had been done on the needs of the 16 – 25 age group and was now continuing to identify the best model for the 26+ age group.  This would be reported to the Cabinet Committee when completed; 

e)    concern had been expressed during the consultation that some people may be forced into living independently when this did not suit them or was not what they wanted.  Mr Thomas-Sam reassured Members that the revised strategy relied on ‘needs–led’ assessments, which would be carefully undertaken to ensure that the support being put in place was appropriate;

f)     in response to a question about how well the strategy had been received by the voluntary sector, Mr Thomas-Sam advised that the County Council had increase the emphasis placed on the role of the voluntary sector and had linked the strategy to those of other organisations which provided related services; and

g)    concern was expressed about the impact of carers needing to continue in paid work later in life, and hence not being so able to fulfil the carer role that they might traditionally have taken on, and how this shortfall could be covered.  Mr Thomas-Sam advised that part of the role of the carers’ assessment process would be to take account of changing patterns such as  ...  view the full minutes text for item 25.

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Director of Public Health, and to consider and endorse or make recommendations to the Cabinet Member on the proposed decisions to (a) change the service delivery for individual lifestyle services into an integrated service called One You Kent and to (b) extend current contracts for health lifestyle services until 20 September 2017, to take account of emerging changes in the health and social care system.

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

1.            Ms Sharp introduced the report and the new model of service delivery, which was the latest stage in a process of extending and re-aligning services, reported to the committee over the last 18 months. The NHS Sustainability and Transformation Plan (STP), published on 23 November 2016, had set out clear aims which supported this direction. However, to allow further work on developing the new model to take full account of this most recent document, it was proposed that current contracts be extended until September 2017. Ms Sharp and Mr Scott-Clark responded to comments and questions, as follows:-

a)    the extension of current contracts was generally supported by speakers, as was the holistic approach being taken to assessments;

b)    the importance of including allergy testing was emphasised, as it was known that people often had more than one health problem and that such problems could impact upon each other.  Ms Sharp explained that, although key performance indicators would continue to be used to monitor future progress, linked behaviours could be identified and measured within monitoring activity; and

c)    concern was expressed about the limited impact, so far, of current healthy eating campaigns, and the resistance of some people to change their habits. Although fast food in moderation was not harmful, too many people relied upon it as their regular daily diet. Mr Scott-Clark emphasised that much of the chronic disease caused by unhealthy lifestyles was preventable. Public health campaigns were committed to continuing to tackle these lifestyle choices, to minimise the future burden upon health and social care services of having to deal with the longer-term effects of them. Life expectancy was not consistent across the Kent population and services would be targeted where there was greatest need.

2.            Mr Gibbens thanked Members for their comments and undertook to take account of them when taking the decision.

3.            RESOLVED that:-

a)    the work with partners to shape the new model for Adult Lifestyle Services and NHS Health Checks be noted; and

b)    the decisions proposed to be taken by the Cabinet Member for Adult Social Care and Public Health, to change the service delivery for individual lifestyle services into an integrated lifestyle service called One You Kent and extend current contracts for healthy lifestyle services until 30 September 2017, to take account of emerging changes in the health and social care system, be endorsed.

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Director of Public Health, and to consider and endorse or make recommendations to the Cabinet Member on the proposed decision to award a contract for East Kent Drug and Alcohol Services to the successful bidder, following competitive tender.

1.            Ms Sharp introduced the report and, in response to a question about the competitive tendering exercise, explained that past tendering exercises had shown the market for drug and alcohol services to be robust.  Many current providers were in the voluntary sector and were experienced within that service area and familiar with the County Council’s contracting process.

2.            RESOLVED that:-

a)    the progress of the procurement of the East Kent drug and alcohol service be noted; and

b)    the decision proposed to be taken by the Cabinet Member for Adult Social Care and Public Health, to award the contract for East Kent drug and alcohol services to the successful bidder, following competitive tender, be endorsed.

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

Ms C Holden, Head of Commissioning (Accommodation Solutions), was in attendance for this item.

1.            Ms Holden introduced the report and presented a series of slides (included in the agenda pack) which set out an overview of the provision of residential care beds across Kent, for older people and those with learning disabilities and mental health needs, and how the County Council was working with partners to develop and support this provision. Ms Holden responded to comments and questions, as follows:-

a)    the provision of extra care sheltered housing (ECSH) around the county was supported and the point made that many more places were needed. Ms Holden agreed that this should be increased but explained that development had temporarily halted while consultation was being undertaken, arising from the Housing and Planning Act. Some people who could potentially benefit from ECSH may believe that it was not an affordable option for them, so clarification around eligibility and access to benefits would help this understanding, and this clarification could be approached by liaising with local housing authorities;

b)    concern was expressed that some areas of the county did not have adequate provision of beds to allow older people to be discharged from hospital in a timely way; and

c)    Ms Holden clarified that any home receiving an ‘inadequate’ rating would be supported to develop an action plan to implement improvements. Families would be advised of this process and given the opportunity to move their relatives to alternative accommodation if they wished to.

2.            RESOLVED that the information set out in the report and presentation, and given in response to comments and questions, 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 which the committee is invited to comment.

Mr T Wilson, Phase Three Programme Manager, was in attendance for this item.

1.            Mr Wilson introduce the report and he and Mr Ireland responded to comments and questions, as follows:-

a)    an apparent reduction in the provision of enablement or ‘access to independence’ services had arisen from difficulties in the home care market, which had in turn led to problems providing long-term services; and

b)     the work undertaken so far with the County Council’s efficiency partner was praised.  Mr Wilson advised that the team of County Council and Newton Europe staff was developing skills which the County Council would retain within its staff once the arrangement with Newton Europe had ended.

2.            RESOLVED that the information set out in the report, and given in response to comments and questions, 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 B Palmer, Manager, Sensory and Autism Services, and Mr G Offord, Commissioning Officer, were in attendance for this item.

1.            Ms Palmer introduced the report and advised that the consultation period had been extended until 24 December to allow Members to comment on the draft strategy.  Mr Ireland added that identifying and providing services for adults with autism was one of the largest challenges facing education and social care authorities.  Ms Palmer responded to comments and questions, as follows:-

a)    many adults would never receive a diagnosis of autism, and this was partly because many people did not meet the new criteria for diagnosis;

b)    tools such as travel training, used to great success for children with autism, would be developed and used by the special social care team for adults, working with the University of Canterbury. However, to be most effective, this training would need to be undertaken soon after diagnosis; and

c)    the special social care team for adults would also be proactive in engaging carers of adults with autism and assessing their needs, particularly those approaching old age.

2.         RESOLVED that the information set out in the report, and given in response to comments and questions, 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, outlining current performance, on which the committee is asked to comment.

Ms S Smith, Head of Performance for Adult Social Care, was in attendance for this item.

1.            Ms Smith introduced the item and responded to comments and questions, as follows:-

a)    the method of measuring and showing the direction of travel was clarified; the arrows shown in the chart indicated if performance was moving towards or away from the target. The Cabinet Member, Mr Gibbens, suggested that future dashboard reports could make this method clearer; and

b)    the number of referrals for enablement services had fallen; this was partly due to changes in the home care market and the increasing complexity of clients’ needs at the time they sought to take up services. The drop in referrals had come from various sources, for example, social care and hospitals or a combination of the two, working in integrated services.

2.            RESOLVED that the information set out in the report, and given in response to comments and questions, be noted.

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Director of Public Health, outlining current performance and actions taken by Public Health, 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 explained that the areas of activity currently rated amber were improving their performance.

2.            RESOLVED that the information set out in 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 progress made in supporting adult carers and the work which has started on re-commissioning adult carers’ services from 1 April 2018, on which the committee is invited to comment.

Ms E Hanson, Head of Strategic Commissioning, Community Support, was in attendance for this and the following item.

1.             Ms Hanson introduced the report and responded to comments and questions, as follows:-

a)    although unpaid carers played a vital role in the Kent economy, there was always the possibility that some carers were not  identified as such, partly because they did not identify themselves as carers;

b)    new carers were always coming into the role and one ongoing strand of work was to identify and engage them, to offer support.  This work was important and ongoing as the identification of new carers was one of the key performance indicators (KPIs) in the carers assessment and support contract; and

c)    carers’ support organisations had expressed to their local elected Member their concern about securing future funding, once current contracts came to an end in March 2018.  Ms Hanson explained that it would not be possible to identify future contractors until the formal tendering and award process had been fully completed. However, all current providers would have an opportunity to compete within the process.

2.            RESOLVED that the progress made in supporting adult carers, the information set out in the report and given in response to comments and questions, and the work beginning on the process to recommission adult carers’ services from 1 April 2018, 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 progress made in supporting people living with Dementia and their carers and work being undertaken with the NHS to ensure that Dementia services in Kent are of a high quality and consistently available, on which the committee is asked to comment.

1.            Ms Hanson introduced the report and outlined the work currently going on to develop and re-design dementia services in Kent. Phase 3 the Adult Social Care transformation programme would build on lessons which had been learnt from previous work as the Council moved into the design phase for the older persons’ wellbeing offer.  Ms Hanson responded to comments and questions, as follows:-

a)     although parts of Kent fell below the national target of 67% for dementia diagnoses, much good work had been undertaken and most clinical commissioning groups (CCGs) had now achieved this target.  Low diagnosis was shared by many CCGs nationally.  Many people simply did not want to be given a diagnosis, and this factor would inevitably help to shape the national pattern;

b)    as people with learning disabilities now lived longer and would reach an age at which they might develop such conditions, it was important that they be included in work on dementia services;

c)    the work of dementia cafes was praised, as music therapy was very helpful in bringing back distant memories and times of enjoyment at youthful dances and old films, and the opportunity for social contact was important for those who might otherwise be isolated; and

d)     ‘drop-in’ services for people with dementia were also well-run and much enjoyed by local people.  The first thing visitors asked for when they attended such services was information about dementia and the services available.  It could be difficult and confusing for those coping with a new diagnosis to find out what services were available and by whom these were provided. Some information seemed to be duplicated while some was not available at all. Elected Members could also be helped to better understand what services were provided by whom so they could be in a better position to help local people to find information. Ms Hanson supported the points made and commented that, with such information, it was important to remember that one size did not fit all. The aim was to achieve ‘a life, not a service’, as set out in the ‘Your Life, Your Well-being’ strategy, discussed earlier in the meeting.

2.         RESOLVED that:-

            a)        the progress made in supporting people living with dementia and their carers, and the information set out in the report and given in response to comments and questions, be noted; and

            b)         the approach of working with the NHS through the next stage of the Adult Social Care Transformation Programme, to ensure that dementia services in Kent were of a high quality and consistently available, be endorsed.

To receive a report from the Head of Democratic Services on the Committee’s work programme.

RESOLVED that the committee’s work programme for 2017 be noted.