Agenda and minutes

Apologies for absence were received from Mr Webb, Ms Grehan, Mr Campkin and Mr Ross.  Ms Constantine was attending virtually as substitute for Ms Grehan. Mr Cole was attending as substitute for Mr Ross.

Ms Meade declared an interest as she was a carer.

Mr Shonk declared that his daughter worked for the NHS and was a social prescriber.

Mr Streatfeild asked for the minutes to be corrected to show he and Ms Meade voted against, rather than abstained, the key decision – 22/00073 – Everyday Life Activities, Skills Development and Training Opportunities for People in the Community – Dynamic Purchasing System - at paragraph 77 of the minutes.

RESOLVED that, subject to the above amendment, the minutes of the meeting held on 13 July 2022 are correctly recorded and a paper copy be signed by the Chairman.

1. The Cabinet Member for Adult Social Care and Public Health, Mrs Clair Bell, gave a verbal update on the following:

(a)  Mrs Bell updated the committee on the Adult Social Care Charging Policy in relation to savings credit disregard which last came before the committee on the 18^th of May 2022. A Key Decision along with an Officer Decision was taken on the 10^th of June to prevent people who the Council supported from being overcharged and reassessments would be carried out to correct charges for those who had been overcharged. Phase two of the savings credit disregard would involve a consultation for those who had been potentially undercharged. The policy change that may result from this would only affect charges for new people under the auspices of the Authority’s Adult Social Care while current users, totalling around 650 users, would continue to receive the more generous allowance. Legal advice had been sought and had supported this action. 

(b)  Mrs Bell informed the committee that the Kent Drug and Alcohol Strategy 2023-28 consultation had been launched to gather views from Kent residents, who had been encouraged to share their experience of local drug and alcohol services to inform the 5-year strategy. This had been overseen by the Kent Substance Misuse Alliance. The strategy aimed to tackle drug and alcohol misuse through prevention, treatment and recovery and community safety. The priorities in the Kent strategy had been informed by local needs and aligned with the national drug strategy ‘From Harm to Hope’. Mrs Bell stated that the figures from 2021 showed that 308,000 people were drinking above the recommended level of alcohol, with 15% estimated to be binge drinkers. Self-reported drinking had declined among younger age groups significantly since 2011 while there had been an increase for those aged 45 or older, and highest amongst 45–65 year olds. Illicit drug misuse had remained a pervasive issue in Kent with around 10% of adults self-reported to have used recreational illicit drugs within the past 12 months, with an increasing trend among 25–29 year-olds. Mrs Bell noted that the 2023-2028 Kent Drug and Alcohol Strategy had 13 strategic priorities. The consultation sought participants impacted by drug and alcohol, those who had experience of treatment and recovery services, relatives of those impacted and practitioners. The consultation would close on the 31^st October 2022. 

(c)  Mrs Bell noted that World Suicide Prevention Day had taken place on the 10^th September 2022 and made Members aware of training and services that had been provided, and made available, by Mid-Kent Mind. The Council had published suicide support helplines on its communication channels.

(d)  Mrs Bell informed the committee that to mark Blue Badge Enforcement Day on the 4^th August 2022 the Kent Fraud Team had joined Swale Borough Council’s Parking Team as they conducted inspections of Blue Badge users. 209 people were inspected with 13 badges seized and around a dozen people spoken to regarding blue badge queries.

(e)  Mrs Bell updated  ...  view the full minutes text for item 86.

Ms Sharon Wilcock (Interim Senior Commissioner), Ms Mel Anthony (Senior Commissioning Manager) and Ms Akua Agyepong (Assistant Director, Adult Social Care and Health) were in attendance for this item.

1. Ms Wilcock introduced the report regarding the extension of the current Integrated Community Equipment Service contract to 31^st March 2024. She noted that in this time a new service would be designed that aligned with the Council’s new strategic direction and provided for future sustainability due to rising costs. She then provided an overview of the Integrated Community Equipment Service. 

2. Ms Wilcock then responded to questions and comments from the committee, including the following:

(a)  Asked why no date had been given for the period of time the calculations and assessment took place, whether the current financial calculations and monies required still fit, and if flexibility had been built in given financial volatility and inflation fluctuations, Ms Wilcock responded that the current extension was for 16 months, but this was a conservative estimate. She confirmed that contingencies had been built into the financial calculations.

(b)  Asked to expand on point 7.7 in the report in relation to the incorporation of digital technology to promote self-directed support, specifically how this would make the service more effective, Ms Wilcock replied that the service would provide all the current provisions along with a greater choice of equipment for users.

RESOLVED that the decision to be taken by the Cabinet Member for Adult Social Care and Public Health to:

(a)  Extend the current Integrated Community Equipment Service Contract for 16 months from 1 December 2022 to 31 March 2024;

(b)  Procure a new long term sustainable service model; and

(c)  Delegate authority to the Corporate Director Adult Social Care and Health to take relevant actions, to finalise the terms of the required contract extension and to facilitate procurement activity, as necessary to implement the decision

be endorsed.

Ms Meade asked for her abstention to be recorded in the minutes. 

Ms Katherine Clark (Commissioner) was in attendance for this item.

1. Ms Clark introduced the report and said the Council had a statutory requirement under the Care Act 2014 and Equality Act 2010 to make sure that services were available to everyone including those with a hearing impairment. The provision of specialist communication services for people who were D/deaf and deafblind was an important way for the Council to meet those obligations. 

2. Ms Clark then responded to a question from the committee 

(a)  Asked if the figure of £20,000 per year for the service was correct, Ms Clark confirmed that the £20,000 was from the Adult Social Care and Health Budget with additional spend from other areas of the Council and external partners.

RESOLVED that the decision to be taken by the Cabinet Member for Adult Social Care and Public Health to:

(a)  Approve the procurement of Interpreting and Communication Services for People who are D/deaf and Deafblind; and

(b)  Delegate authority to the Corporate Director Adult Social Care and Health to take relevant actions to facilitate the required procurement activity

be endorsed.

Mr Simon Mitchell (Senior Commissioning Manager) was in attendance for this item.

1. Mr Mitchell introduced the report and said that an extension was sought for the Community Navigation Services Contract and that two single-year extensions were available. He said the extensions would allow time for the strategy and future design of the services to be considered.

2. Mr Mitchell then responded to questions and comments from the committee, including the following:

(a)  Support was expressed for the report and social prescribing.

(b)  Asked if there was opportunity to work with health colleagues to shape services, Mr Mitchell said there would need to be a countywide effort to ensure that community navigation in all areas was available for both adults and children rather than just children which was currently the case in some locations.

RESOLVED that the decision to be taken by the Cabinet Member for Adult Social Care and Public Health to:

(a)  Agree to use the first of the two, one-year contract extension options to extend the current Community Navigation Services Contracts for a period of 12 months, from 1 April 2023 to 31 March 2024;

(b)  Delegate authority to the Corporate Director Adult Social Care and Health to use the second one-year contract extension option (1 April 2024 to 31 March 2025), should it be required; and

(c)  Delegate authority to the Corporate Director Adult Social Care and Health to take relevant actions, including but not limited to finalising the terms of and entering into required contracts or other legal agreements, as necessary to implement the decision

be endorsed.

Mr Simon Mitchell (Senior Commissioning Manager) was in attendance for this item.

1. Mr Mitchell introduced the report and said a county-wide contract was in place with a single provider and a strategy promoted the importance of breaks for carers. The current contract would expire in March 2024 and a further 1-year extension was requested to allow time for work to be carried out with providers, partners, and carers to codesign and coproduce a new model.

2. Mr Mitchell then responded to questions and comments from the committee, including the following:

(a)  Asked why this was the third year running that a 1-year extension was being sought and no optional further extensions were included, Mr Mitchell said a single-year extension had been chosen because of the Covid-19 pandemic and because the Carers’ Strategy would inform the future of carers breaks to make them more secure in the long-term.

(b)  Asked about the use of historic data, whether more up-to-date data was available, and would the plan be able to sustain increased demand, Mr Mitchell said that the Carer’s Strategy included the most up-to-date information and moving forward data would be used from provider and contract management data, and better working across adult social care in supporting carers would ensure the necessary level of provision.

(c)  Asked if a review could be conducted into the use of 1-year extensions and the effects of them on providers, Mr Mitchell said he would be happy to discuss this further outside of the meeting.

RESOLVED that the decision to be taken by the Cabinet Member for Adult Social Care and Public Health to:

(a)  Approve a Direct Award contract for Carers’ Short Breaks for a period of 12 months, from 1 April 2023 to 31 March 2024; and

(b)  Delegate authority to the Corporate Director Adult Social Care and Health to take relevant actions, including but not limited to finalising the terms of and entering into required contracts or other legal agreements, as necessary to implement the decision

be endorsed.

Mr Luke Edwards (Senior Commissioner) and Ms Heather Randle (Commissioner) were in attendance for this item

Mr Edwards introduced the report and said the Community Mental Health and Wellbeing Services Contract was due to end on the 31^st March 2023. He stated that the service had a vision to provide a holistic offer of support for both those living with, and without, a mental health diagnosis and he gave a brief overview of what the service provided and how it was commissioned.

RESOLVED that the decision to be taken by the Cabinet Member for Adult Social Care and Public Health to:

(a)  Award the contract, to the successful providers identified in Exempt Appendix A, for the provision of Community Mental Health and Wellbeing Services (known as Live Well Kent and Medway) for a period of three years with the option to extend for further two years (24 months);

(b)  Delegate authority to the Corporate Director Adult Social Care and Health, after consultation with the Cabinet Member for Adult Social Care and Public Health and the Corporate Director for Finance, to agree the relevant contract extensions as required; and

(c)  Delegate authority to the Corporate Director Adult Social Care and Health to take other relevant actions, including but not limited to finalising the terms of and entering into required contracts or other legal agreements, as necessary to implement the decision

be endorsed.

Ms Paula Parker (Head of Business Delivery Unit) and Ms Michelle Goldsmith (Finance Business Partner Adult Social Care) were in attendance for this item.

1. Ms Parker and Ms Goldsmith updated the committee on Adult Social Care Reform through a PowerPoint presentation (attached to these minutes) which covered the following areas: fair cost of care and market sustainability plan, care cap and extension of the means test, Section 18(3) of the Care Act-New Self Funder right, national assurance framework, financial implications and adult social care reform funding.

2. Ms Parker and Ms Goldsmith then responded to questions and comments from the committee, including the following:

(a)  Asked how much action had been taken on the Significant Action Demand from October 2023 and what the numbers were for Kent, Ms Goldsmith replied that an additional 4,600 assessments and 4,200 financial assessments had been estimated along with the number of additional workers required. Finance figures for this would be circulated amongst Members following the meeting.

(b)  Asked about the timeframe for the user journey under the self-funder pathway, Ms Parker responded that the exact time was currently unknown and that different types of assessment would result in different timeframes. Mr McKenzie added that a transformation would take place in how care was provided in the community which included digital tools and ability to self-serve. He noted that more efficient and effective ways of working would ensue people received timely support when they needed it. Ms Gillivan said the modelling process, working with and learning from other local authorities, would provide more information on the timeframe. 

(c)  Asked if a lot of people fell into the debt burden category and how this was dealt with, Ms Goldsmith said people were, and would continue to be, financially assessed. She added that as more people were expected to use the service the level of debt would increase, but this had yet to be costed.

(d)  A Member sought further clarification on the number of assessments and when this number was expected to peak. Ms Parker responded that the numbers had yet to be modelled and further updates could be provided to the committee at future meetings.

(e)  Asked about the number of self-funders and the recruitment process for additional staff, Ms Goldsmith responded that the number of self-funders was currently unknown, and that modelling would be undertaken. Ms Parker said a recruitment campaign would be designed and other ways of managing the demand, including digital tools, would be explored. 

RESOLVED that the committee considered the content of the report.

Post Meeting Note:

Following the meeting an error was identified in paragraph 7.1 of the Update on Adult Social Care Reform report (and slide 18 on the attached presentation under ‘Financial Implications’) where the correct amount of funding received should have been recorded as £4.16m and not £4.6m.

Mr Matt Chatfield (Head of Performance and Systems) was in attendance for this item.

1. Mr Chatfield updated the committee on the key activity and performance during quarter 1 for 2022/2023.

2. Mr Chatfield and Mr Beale then responded to questions and comments from the committee, including the following.

(a)  Asked about the number of needs assessments not achieved within the 28-day period and the proposed solution for the downward trend, Mr Beale said this was due to a wider range of people with diverse health needs and pressures across adult social care and finding the right level of support for people. Mr Beale said the performance assurance framework and a rigorous set of action plans for each area had been developed to ensure the assessments would be completed within the desired timescales.

(b)  Asked about ASCH18 – Number of DoLS applications received and completed – and the number of applications completed from those received, Mr McKenzie said all the applications were screened and reviewed and then prioritised based on level of need, with those most in need of support being processed in a timely manner. He said the proposed implementation of future Deprivation of Liberty Safeguards would change the way applications were manged.

RESOLVED that the committee noted the performance of services in Q1 2022/2023.

Ms Lisa Clinton (Stakeholder Engagement Manager) and Ms Paula Parker (Head of Business Delivery Unit) were in attendance for this item.

Ms Clinton introduced the report and said that the timeframe for the Local Account had been revised and would be from January 2023 to December 2023. She noted that a person-focussed approach had been taken and engagement with the public would take place.

RESOLVED that the committee noted the Local Account document– ‘Here for you, how did we do?’ (September 2020 – December 2021).

Mrs Bell gave an overview of the decisions and explained why they had been taken outside of the Cabinet Committee meeting cycle.

RESOLVED that the decisions – 22/00075 Kent Homeless Connect Service Termination of the Service and 22/00076 Kent Homeless Connect Service Funding of Transition Phase Through Reserves - had been taken in accordance with the process as set out in Part 2 paragraph 12.36 of the Constitution.

RESOLVED that the Work Programme 2022/2023 be noted.