Agenda item

Mrs Wright declared an interest as an appointee for a family member.

1.    Mr McKenzie and Ms Agyepong introduced the report and provided an overview of the Council’s proposed response to a report published by the Local Government and Social Care Ombudsman (LGSCO) on 2 September 2021 about a complaint received from a Kent resident.  The LGSCO upheld the complaint, and a public report was issued highlighting the Council’s failings in response to the matter concerned and made recommendations.  Ms Agyepong summarised the actions that the LGSCO had recommended the Council undertake, including those where work in achieving them had commenced and those where Officers believed it was not possible for the Council to comply with the LGSCO’s recommendations.  Ms Agyepong highlighted the reasons why the Council was unable to comply with these recommendations including the limited availability of Best Interest Assessors (BIAs).

2.    Ms Agyepong said there would be ongoing scrutiny for the work undertaken by the DOLS team involving regular engagement with the Kent and Medway Adult Safeguarding Board, and the DOLS work would remain on the Council’s risk register.

3.    Ms Agyepong said since the Cheshire West Judgment the Council had invested £1.54 million into services to ensure DOLS work was carried out in accordance with legislation. Continued investment along with wider service improvement driven by the MADE programme would result in an increase in the number and quality of assessments undertaken. 

4.    Ms Stirrup said that performance data indicates that the Council has moved from 11th to 3rd in ranking against its CIPFA neighbours.

5.    Mr McKenzie, Ms Agyepong and Ms Stirrup responded to comments and questions from the committee, including the following:

(a)  asked whether a precedent existed where LGSCO had made unachievable recommendations, Mr McKenzie said he was aware of a report in relation to Staffordshire County Council where recommendations were less punitive on the local authority and more time was given to comply;

(b)  asked about the repercussions of a second report from LGSCO stating the Council had failed to comply, Ms Agyepong said there was a reputational risk for the Council and there was a need to weigh this risk against operational risk.  Ms Agyepong said a large number of additional BIA’s would be required to meet the recommendations and, along with the prioritisation of historical cases, would have an impact on the system including new applications;

(c)  Mr Smith said since the Cheshire West judgment meeting demand had been a challenge for NHS and local authorities nationally. The replacement of the DOLS scheme with Liberty Protection Safeguards (LPS) would reduce demand and pressure on local authorities as assessments would last longer and there would be fewer authorisations made to the Council.  Ms Stirrup said local authorities were still waiting for the Code of Practice which had not yet been published;

(d)  asked about additional resources required to meet the recommendations, Mr McKenzie estimated an additional 96 Full Time Equivalent (FTE) BIAs would be required and said the DOLS team currently had 6.5 FTE BIAs with approximately 44 who worked within community teams and undertaking one assessment per month.  Therefore, twice as many BIA’s would need to be recruited on a full-time basis to undertake the work.  Mr McKenzie said the workforce did not exist and, if attempted, would mean pulling workers away from other local authorities.  In addition, some applications require assessment by Section 12 Doctors who were externally contracted and there would be resource implications for the advocacy service;

(e)  asked how long it would take to train a BIA and whether this training could be promoted through the Council, Ms Stirrup said BIAs needed to be formally qualified as a nurse, occupational therapist, or social work practitioner.  They would then undertake a formal BIA qualification involving a week’s contact time with a university and support from the DOLS team in building a portfolio. Currently there was one cohort per year of 15 trainee BIAs and achieving the qualification took six months from end to end. Under the forthcoming LPS framework the BIA role would be replaced by the Approved Mental Capacity Professional (AMCP) role, and the new Code of Practice would advise further on the assessment process.  Ms Stirrup said the Council was regularly advertising for BIAs but finding suitable candidates with the required qualifications and experience was a challenge;

(f)    asked whether people could choose a medical assessor including a power of attorney, Ms Stirrup said following the assessment there was independent level scrutiny involving family members.  In the event of family members challenging the assessment, the complaint system could be used and those with Power of Attorney could become involved; and

(g)  asked about the 15,000 cases highlighted by the LGSCO as needing to be reviewed and when this would happen, Ms Stirrup said cases in the pending cohort were reviewed on a quarterly basis. Where circumstances had changed these cases were moved through the system.  Ms Stirrup said cases were not left without oversight and where there were no family members the advocacy service was engaged.

6.    Mrs Bell thanked Members for their questions and comments.

7.    It was RESOLVED that the Local Government and Social Care Ombudsman report be noted, with thanks.