Agenda and minutes

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

Apologies for absence were received from Ms S Hamilton and Mr G Koowaree.

Mr M Balfour and Mr D Daley attended as their 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 B H Lewis declared an interest as his wife was employed by Kent County Council.

To consider and approve the minutes as a correct record.

RESOLVED that the minutes of the meeting held on 19 January 2018 are correctly recorded and they be signed by the Chairman.

To receive verbal updates from the Cabinet Member for Adult Social Care and the Corporate Director of Adult Social Care and Health.

1.    Graham Gibbens (Cabinet Member for Adult Social Care) gave a verbal update on the following issues:

Homelessness Commissioning – Kent’s district and borough councils took statutory responsibility of homelessness under the Homelessness Act 2002. Services that were provided in Kent for vulnerable homeless people allowed Kent to meet its obligations under the Care Act and support the achievement of strategic outcomes. The services that were provided in Kent were in place to ensure that vulnerable people had the support that they needed to recover from, or avoid crisis and to gain the skills required to achieve and maintain successful and independent lives. Since discussing Homelessness in the Adult Social Care Cabinet Committee meeting in November 2017, Kent had continued to work closely with all sections of the community with an interest in helping to share and plan the future service. As well as 1-1 meetings with individual organisations, over 30 events had taken place to engage with suppliers and stakeholders, including the districts and boroughs, to garner their views on future provision. Events took place in public spaces such as libraries, Gateways, community hubs and day centres across Kent, providing the opportunity to listen to members of the public, community leaders and those who were currently using the services. Care had also been taken to meet with vulnerable homeless people who were not using services, to try to better understand the barriers that they faced. A public consultation had taken place from 22^nd January to 4^th March and over 265 responses were received. Feedback from the consultation was in the process of being analysed, but it was clear that there was strong support for the Council’s proposals to bring services together and for the potential outcomes presented. The results of the work that had been undertaken in Kent were being used to inform the development of service specification and tender documents for the revised service. The item would return to the Committee for a key decision in time to enable the Council to proceed to a robust, procurement process for the newly designed service, which was due to be operational from October 2018.

Loneliness and Social Isolation – On 27 February, Mr Gibbens took part in the Loneliness Action Group which was chaired by the British Red Cross. The Loneliness Action Group focused on exposing the crisis of loneliness and finding ways to overcome it through both service provision and the group itself.

Safeguarding Update – Members were invited to attend safeguarding sessions at the beginning of March, one of which was a visit to the Central Referral Unit in Kroner House, Ashford. The Local Government Association (LGA) had recently published the Councillors Briefing 2015 Safeguarding Adults document which would be circulated to all Members of the Council.

Digital Conference in London – Kent was one of 19 authorities in the country to receive £50,000 through the LGA to focus on digital activity in relation to Social Care. The County Council were asked to present their activity  ...  view the full minutes text for item 69.

To receive a report which provides an update on the commissioning and performance management of the Commissioned Services for Adult Carers of Vulnerable Adults.

(Jo Empson (Commissioning Manager – Community Support) and Anne Tidmarsh (Director of Older People and Physical Disability) were in attendance for this item)

1.    Jo Empson introduced the report and provided Members of the Committee with an update on the commissioning and performance of the Kent Carers’ Grants and Contracts.

a)    In response to a question, Jo Empson said that, with pre-set budget for carers’ services, it was important for Kent to ensure greater parity of service to ensure as many carers as possible had equal access to services. She said that it was important that Kent continued to show its support for Carers by continuing the commissioning of carers’ services to enable carers to support vulnerable people in Kent. She said that the Kent Integrated Data Set (KIDS) would help Kent to both understand interdependencies and base future commissioning decisions on a sound evidence base. Anne Tidmarsh re-iterated Jo Empson’s comments and said that the intelligence would support Kent to focus on areas which required attention and work being undertaken with both NHS and provider organisations. She said that continuing pressure on Local Authority budgets meant that Kent needed to utilise this information to ensure the best outcomes within financial constraints to balance this.

b)    In response to a question, Jo Empson said that services were in place to both support Carers and prevent the build-up of need as well as provide carers with access to a statutory carers’ assessments. Jo Empson re-iterated that the ‘cared for’ also had a right to a statutory needs assessment.

c)    In response to a question, Anne Tidmarsh said that good progress had been made so far. Carers’ support was in place and teams within Adult Social Care had a good understanding of what carers needed and how best to provide for them. Penny Southern re-iterated Anne Tidmarsh’s comments and said that significant Learning Disability Mental Health (LDMH) funding had been put in place for carers through these contracts, and that Kent could therefore see how people were being supported. She said that the contract allowed for a stable delivery of a network for carers and had enabled people that were isolated to have opportunities to share and benefit from these additional services.

d)    Mr Gibbens invited the Committee to speak to him directly with regards to individual issues or cases that needed to be raised, as each case would be investigated.

e)    In response to a question, Anne Tidmarsh said that a more in-depth report could come back to the Committee in the future, once further work had been carried out following the findings of the research included in the report and would contain general population statistics and those of carers for comparison purposes in regard to carers in Kent.

f)     In response to a question, Jo Empson said that the new contract would allow Kent to better target the areas where there was under-representation and over-representation to ensure greater parity of access to services. Penny Southern supported this and said that  ...  view the full minutes text for item 70.

To receive a report which provides an update on the commissioning of Commissioned Services for Adult Carers of Vulnerable Adults for 2018/19.

(Jo Empson (Commissioning Manager – Community Support) was in attendance for this item)

1.    Jo Empson introduced the report which set out the proposal to implement interim contracts for the period April 2018 to March 2019 to enable the alignment of carers’ Commissioning with broader Wellbeing and Resilience Commissioning.

2.    Jo Empson informed the Committee that the recommendation in the report needed to be amended as a contingency measure to allow more time for a mobilisation process, if required. Mr Gibbens (Cabinet Member for Adult Social Care) said he was aware of the amendments to the recommendation and supported the new recommendation.

a)    In response to a question relating to Clinical Commissioning Groups, Jo Empson reassured Members of the Committee that full agreement had been sought from all Clinical Commissioning Groups to continue funding for 2018/19. Anu Singh (Corporate Director of Adult Social Care and Health) said that a lot of work had been carried out to ensure that the funding from CCGs continued.

3.    RESOLVED that the decision proposed to be taken by the Cabinet Member for Adult Social Care, to

a)    agree the implementation of interim contracts for the provision of carers’ services with carers’ organisations (Carers’ Assessment and Support Organisations and Crossroads) which are jointly commissioned with the seven Kent Clinical Commissioning Groups, for the period 1 April 2018 to 31 March 2019, with the option to extend for up to 6 months at the end of that period, to enable continuation of services to meet statutory requirements and to align the Carers’ Offer with the Wellbeing and Resilience Preventative Offer; and

b)    delegate authority to the Corporate Director of Adult Social Care and Health, or other nominated officer, to undertake the necessary actions to implement the decision and, in consultation with the Cabinet Member for Adult Social Care, agree to utilise the option to extend the contract at the appropriate time, should it be necessary for the successful alignment of services,

be endorsed.

To receive a report which sets out the proposed rates and charges for Adult Social Care Services for the forthcoming financial year.

(Michelle Goldsmith (Finance Business Partner – Social Care, Health and Wellbeing) and Anne Tidmarsh (Director of Older People and Physical Disability) were in attendance for this item)

1.    Michelle Goldsmith introduced the report which set out the proposed rates and charges for Adult Social Care Services for the forthcoming financial year.

a)    In response to a question, Michelle Goldsmith said that the consultation rates within the report related to what Kent would charge other local authorities when taking on their work. She said that the consultation rates were what the County Council charged overall, and were not a specific Social Care charge.

b)    In response to a question, Anu Singh (Corporate Director of Adult Social Care and Health) confirmed that the figures in the report were in line with the figures used within other local authorities and said that the scheme was not an income-raising scheme.

c)    In response to a question relating to consultation work, Anne Tidmarsh said that income was not generated for assessments that were carried out within Adult Social Care.

2.    RESOLVED that the decision proposed to be taken by the Cabinet Member for Adult Social Care, to

a)    approve the proposed changes to the rates payable and charges levied for adult social care services in 2018-19, as detailed in Sections 2.5a, 2.5b, 2.9b,2.10, 2.13, 2.16a, 2.16b, 2.18, 2.20, 2.21, 2.24 and 3 of the report; and

b)    delegate authority to the Corporate Director of Adult Social Care and Health, or other nominated officer, to undertake the necessary actions to implement the decision,

be endorsed.

To receive a report which provides information about the prevalence and effects of loneliness and social isolation.

(Emma Hanson (Head of Strategic Commissioning – Community Services) was in attendance for this item)

1.    Emma Hanson introduced the report which set out information relating to the prevalence and effects of loneliness and social isolation.

2.    A Member suggested that the recommendation be amended to ensure that the Select Committee accommodated all points that had been raised in relationto how Kent were working with others to ensure that vulnerable people received the required support. Members of the Committee supported this.

a)    In response to a comment, Emma Hanson reassured the Committee that significant progress had been made. She said that, although there was only one research officer, there was a body of evidence from other areas that the officer could be supported with.

3.    Mr Gibbens said that he asked for the original report to be shortened to allow the Select Committee to have a broad remit and not feel restricted when discussing the item. He said he felt it was appropriate for the report to outline key areas only that were being focused on.

a)    In response to a question, Emma Hanson said that Kent had worked with Ageless Thanet and a lot of the learning would feed into the model that Kent would be commissioning for older people. Kent had hoped to have the key elements that had worked well in Ageless Thanet rolled out across the whole of the county.

b)    In response to a question, Anu Singh said that the report to the Select Committee would be about recognising that Kent could do more to organise and invest in preventing loneliness and social isolation.

c)    Mr Gibbens said that he appreciated the commitment and support that Members cross-party had given to the item. He said it was a very important issue and an age-limitless, national problem that Kent needed to give much focus.

d)    In response to comments and questions, Emma Hanson said that transport was a major issue with regards to social isolation.

4.    RESOLVED that the report be noted, and that the Select Committee be asked to consider the issues raised by Members in the Adult Social Care Cabinet Committee meeting.

To receive a report which sets out progress against targets set for key performance and activity indicators for December 2017 for Adult Social Care.

(Steph Smith (Head of Performance & Information Management) and Anne Tidmarsh (Director of Older People and Physical Disability) were in attendance for this item)

1.    Steph Smith introduced the report which set out progress against targets set for key performance and activity indicators for December 2017 for Adult Social Care.

a)    In response to a question, Steph Smith said that employment figures for adults with learning disabilities and mental health needs were still monitored.

b)    Anu Singh said that staff had worked very hard to keep the delayed transfers of care indicator in such a stable position during winter.

c)    In response to a question, Anne Tidmarsh said that the need for enablement was varied and that Kent were not always able to reach their target for this indicator. She said the target was still high for enablement because there were people in Kent who could benefit from enablement, but were not being referred.

2.    RESOLVED that the report be noted.

To receive a report which presents the Adult Social Care and Health Directorate Draft Business Plan for 2018-19 and sets out the high-level priorities for the coming financial year.

(Michael Thomas-Sam (Head of Strategy and Business Support) and Anne Tidmarsh (Director of Older People and Physical Disability) were in attendance for this item)

1.    Michael Thomas-Sam introduced the report which set out the Adult Social Care and Health Directorate Draft Business Plan for 2018-19 and the high-level priorities for the coming financial year.

a)    In response to a question, Anne Tidmarsh said that Kent had been working with district councils and the NHS to ensure that sufficient work was being undertaken to ensure that hospitals were providing sufficient care in relation to hospital discharge.

b)     In response to a question, Anu Singh said that the aim of the STP was to bring the healthcare system together in Kent and Medway, bring partners together within the healthcare system, and to allow CCGs and providers to work together in a different way. She said that forums had been set up for partners in the voluntary and community sector and social services in Kent and Medway to allow strategic conversations with health providers and the CCG’s to take place.

c)      In response to a question, Anu Singh said that efficiencies would be made by working in a different way across all providers and CCGs.

2.    RESOLVED that the report be noted.

To receive a report which presents the strategic risks relating to the Adult Social Care and Health Directorate.

(Anthony Mort (Customer Care and Operations Manager) and Penny Southern (Director of Disabled Children, Adult Learning Disability and Mental Health) were in attendance for this item.)

1.    Anthony Mort introduced the report which set out the strategic risks relating to the Adult Social Care and Health Directorate.

a)    In response to a question, Mr Gibbens said that safeguarding was a high risk in Adult Social Care in Kent. He said that the country was facing significant demographic changes with regards to pressures on public sector funding and said that the pressure on finances in strategic authorities would continue to be an issue. He said that Kent needed to work with officers to ensure that the care market was well supported and sustainable.

b)    In response to a question, Penny Southern said that the Deprivation of Liberty Safeguards (DOLS) was a national issue and every local authority had found this a challenge. She said that every assessment would be triaged, and the County Council had a very comprehensive model for DOLS in Kent but required further investment to meet the volume of referrals.

2.    Anu Singh said that the risk register was an improvement tool for the Directorate. She said that Kent had invested approximately £3million into both Safeguarding and DOLS to ensure that sufficient mitigating action and controls were put into place.

3.    RESOLVED that the report be noted.

To receive a report from the General Counsel on the Adult Social Care Cabinet Committee’s work programme for 2018/19.

RESOLVED that the Work Programme for 2018/19 be noted.