Agenda and minutes

Apologies for absence were received from Mr Campkin and there were no substitutes.

Mr Webb declared a non-pecuniary interest under item 10 – Kent Homeless Connect Service - as he had accountability for housing and health on Maidstone Borough Council.

Mr Shonk declared an interest in that a family member worked for the NHS.

RESOLVED that the minutes of the meeting held on 18 May 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)  A hot weather warning had been announced for the week of 11 July 2022 which had led to advice from the Kent Public Health Team to help vulnerable residents stay safe and well.   On 12 July 2022 an amber warning for extreme heat for 17 and 18 July 2022 was issued, and the accumulative effect of the heat was expected to bring widespread impact on people and infrastructure. 

(b)  The Council buildings on the Isle of Sheppey had been closed due to Southern Water supply issues.  Mrs Bell had received assurances that Blackburn Lodge, the Council’s care home on the Isle of Sheppey, and other care homes on the island had a supply of water.

(c)  The Kent Pharmaceutical Needs Assessment had recently been circulated to Members and included a short questionnaire for feedback.  The assessment was used by NHS England in the consideration of new pharmacy applications and helped to inform the Integrated Care Board and the public health teams of the current provision of pharmacy services.  The consultation would be open until 21 August 2022.

(d)  Carers’ Week took place from 6 June to 12 June 2022 and provided an opportunity for everyone to recognise and appreciate the county’s carers, and support them to get the practical, financial, and emotional help they needed.

(e)  Following the decision made on the Council’s Supported Bus Funding Review the Kent Karrier service was to be retained and would be funded in future years from several external sources.

2.    The Corporate Director of Adult Social Care and Health, Mr Richard Smith, then gave a verbal update on the following: 

(a)  The Adult Social Care and Health directorate restructure consultation process had been launched on 12 July 2022.  Mr Smith said an assurance process for the adult social care reform was underway and following active engagement with the workforce, the Social Work Practice Framework and the Quality Assurance Framework had been launched giving the Council’s practitioners the tools to ensure sufficient quality and provision was provided.  The Carers Strategy and Adult Social Care Strategy - Making a Difference Everyday - had also been launched internally and fundamental changes to the current structure was required to deliver on those areas.  Mr Smith said he would be happy to discuss the restructure further with Members outside of the meeting.

(b)  Regrettably, the Adult Social Care Cabinet Committee Away Day on 8 July 2022 had been cancelled due to the rise in Covid-19 infection rates.

(c)  The Kent and Medway Integrated Care System was established on 1 July and the Integrated Care Partnership would develop an Integrated Care Strategy setting out how the health and care needs of people in Kent and Medway would be met.

(d)  Mr Smith had the pleasure of a tour round the Gurdwara temple in Gravesham and spoke with Sikh elders about what they would like to see in  ...  view the full minutes text for item 75.

Mr Paul Stephen, Senior Commissioner, was in attendance for this item.

1.    Mr Stephen introduced the report and said the current contracts for Discharge Pathway 1 Services would end on 30 September 2022 and it was proposed that the current contracts be extended for one year from 1 October 2022 to 30 September 2023.  Mr Stephen said although the maximum number of extensions to these contracts had been used the Public Regulations allowed for modification of a contract where the need was brought about by unforeseen circumstances.

2.    Mr Stephen and Mr Smith responded to comments and questions from the committee, including the following:

(a)  Asked about the annual budgets for the Discharge Pathway 1 Services, if there was any scope for the NHS to contribute financially, and whether any of the costs would be reimbursed, Mr Stephen said there were ongoing discussions with NHS colleagues around funding the services.  To date the NHS has directly contributed towards the services to add capacity and the report included the basic contract costs which were topped up by the NHS. The mechanisms for funding going forward for all discharge services were being discussed. 

(b)  Asked whether there were any failings in the Discharge Pathways 1 Services Mr Stephen said there were issues with the social care recruitment and retention of providers generally and some system issues in the provision of domiciliary care post B services, and effective communication with health colleagues was important to ensure the correct discharges.  Analysis was being undertaken to develop the longer-term approach.

(c)  Asked how much confidence there was that the new integrated solution with the NHS would be in place by September 2023, Mr Stephen said joint workshops had taken place to develop the new model and a Discharge Pathway Group was in place.  The Integrated Care Partnership provided a lot of momentum around joint activities with the NHS.

(d)  Asked whether there would be cost benefits from a jointly commissioned service Mr Smith said mechanisms were in place by way of the Better Care Fund to manage how the NHS and the Council jointly commissioned and risk shared for the best outcomes.

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

(a)          Extend the current Discharge Pathway 1 Services contracts (Discharge to

Assess and Assisted Discharge) for one year, from 1 October 2022 to 30 September 2023;

(b)          Commence activity to develop a long term jointly commissioned Discharge Pathway 1 Services model; 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 legal agreements, as necessary to extend the current Discharge Pathway 1 Services contracts; and to facilitate activity with regard to developing the jointly commissioned Discharge Pathway 1 Services model, with NHS Partners.

be endorsed.

Mr Simon Mitchell, Senior Commissioner, was in attendance for this item. 

1.    Mr Mitchell introduced the report and highlighted the name change of the service from ‘Community Day Opportunities for Individuals with Opportunities’ to ‘Everyday Life Activities, Skills Development and Training Opportunities’.  Mr Mitchell said, as well as supporting adult social care outcomes, the service contributed to the Change for Kent Children Programme to improve outcomes and life chances for children and young people in Kent. 

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

(a)  A Member questioned the change to the service available to people over the age of 26 with learning difficulties, and the subsequent financial savings which would be gained through a self-directed support approach and asked for reassurance that support and better outcomes would be provided.  Mr McKenzie said it was important to understand that the service was part of a wider approach and core to the Making a Difference Everyday Strategy where people were given more choice and control over their lives through individual support planning to enable them to meet their aspirations. Mr McKenzie said he felt the £1million saving would bring financial benefits but more importantly there would be benefits for residents. Mr Smith said self-directed support was a way of giving power and control to individuals to live their lives.

(b)  A Member questioned the use of Dynamic Purchasing Systems for adult social care, in particular for older vulnerable people, where money was withdrawn from basic every day care.

RESOLVED that the decision to be taken by the Cabinet Member for Adult Social Care and Public Health (in consultation with the Cabinet Member for Integrated Children’s Services) to:

(a)      APPROVE the creation of the Dynamic Purchasing System for the delivery of Everyday Life Activities, Skills Development and Training Opportunities for People in the Community;

(b)      APPROVE the opening of the Dynamic Purchasing System on a regular basis to enable new services to join the framework; and

(c)      DELEGATE authority to the Corporate Director Adult Social Care and Health and Corporate Director Children, Young People and Education, to take other relevant actions, including but not limited to finalising the terms of and entering into required contracts or other legal agreements, to implement the decision.

be endorsed.          

Ms Meade and Mr Streatfeild asked that it be noted in the minutes that they voted against the recommendation.

Mr Simon Mitchell, Senior Commissioner, was in attendance for this item.

Mr Mitchell introduced the report and reminded Members that the new contract would include the statutory responsibility of Healthwatch Kent. There were no questions.

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 provider identified as part of the procurement process and as detailed in Exempt Appendix 1, for the provision of People’s Voice Activity (Including Healthwatch Kent) for a maximum of five years (initial three-year contract with options for two one-year extensions);

(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 of 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 Georgina Walton, Senior Project Manager, Innovation Delivery Team, was in attendance for this item.

1.    Ms Walton introduced the report and set out the purpose of the Telecare Contract.  Ms Walton said the contract extension would be for nine months to August 2023 which would allow time to procure and mobilise a new countywide Technology Enabled Care Service from April 2023.

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

(a)  Asked how many of the 5,190 people currently supported by the service used digital technology, Ms Walton said the numbers were constantly changing but the majority (just under 5,000) were using analogue.  There was an opportunity for future contractors to move from analogue to a digital solution.

(b)  Members expressed their praise and support for the service.

(c)  Asked, with reference to Financial Implications in paragraph 4.1 of the report, for clarity on the cost of the contract, Ms Walton said the annual cost of the contract was £650,000 and the contract value for the extended nine months was estimated at £385,000.

RESOLVED that the decision to be taken by the Cabinet Member for Adult Social Care and Public Health to delegateauthority to the Corporate Director Adult Social Care and Health, as set out in Option two, to modify the Telecare contract with Invicta Telecare Limited Trading as Careium for a period of nine months from 30 November 2022 to 31 August 2023 and to take relevant actions as necessary to implement the decision, be endorsed.

Ms Melanie Anthony, Senior Commissioner, was in attendance for this item.

1.    Ms Anthony introduced the report in relation to the proposal to make savings from the Kent Homeless Connect Service, due to end on 30 September 2022 and highlighted the proposed transition period and engagement with local authorities.  The decision in relation to the contractual arrangements for transition and the associated costs was due to be considered at Council’s Cabinet meeting on 21 July 2022.

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

(a)  A Member asked for reassurance that lessons had been learnt from the process, noting that local authorities had been required to take measures to ensure the cut in funding did not affect service provision. Ms Anthony said it was understood that the main challenge had been timing and said good relationships with district colleagues had been made.

(b)  Members discussed whether integrated working between local authorities, where required, would have a negative impact on the service and asked whether help regarding transition plans and integrated working had been given to local authorities to ensure the best level of support was provided.  Ms Anthony said close working and strategic monthly meetings with local authorities and the Kent Housing Group were taking place to share information and to look at how organisations could work together effectively.  Ms Anthony said information from the provider had been obtained, regarding the needs of individuals using the service at present, to predict how organisations would work together in the future.  Many of the proposed changes had been developed during the life of the contract, due to changes in funding and legislation, and some local authorities, for example Folkestone and Hythe District Council and Maidstone Borough Council, were already delivering services and avoiding the issue of duplication. Ms Anthony said work was ongoing with the implementation of transition plans.

RESOLVED that the report be noted.

POST MEETING NOTE: Subsequent to the meeting the Governance pathway of this project was amended resulting in two linked key decisions being taken by the relevant Cabinet Members without collective Cabinet consideration.

1.    Mrs Bell gave an overview of the semi-urgent decision and explained why this had been taken outside of the Cabinet Committee meeting cycle.

2.    Asked whether the additional funding was sufficient, Mrs Bell said there were many factors to consider but it was a substantial amount of money on top of funding provided during the Covid-19 pandemic. Commissioners work closely with the Council’s providers and would continue to review the situation.

RESOLVED that the decision – 22/00063 – Additional Mid Year Adult Social Care Community Contract Fee Uplifts – 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 2022/23 be noted.