Agenda and minutes

Apologies had been received from Mr Meade and Mrs Parfitt-Reid for whom Mr Cole and Mr Dendor would substitute.    

RESOLVED: Ms Wright was nominated and duly elected Vice-Chair of the Adult Social Care Cabinet Committee. There were no other nominations. 

Ms Meade noted that they were a full-time carer and had experience of a family member being subject of a deprivation of liberty order. Mr Shonk said that a family member worked for the NHS. Mr Brady noted that his partner was a senior lecturer at the Tizard Centre, University of Kent. Mrs Game said that a family member worked for the governance team, patient safety at East Kent Hospitals. 

1. A Member noted that there was a spelling error on page 5.
2. RESOLVED, subject to the correction on page 5, that the minutes of the meeting held on 6 July 2023 were correctly recorded and a paper copy be signed by the Chairman.

1. The Cabinet Member for Adult Social Care and Public Health, Mr Dan Watkins, gave a verbal update on the following.

Market Sustainability and Improvement Fund – Mr Watkins said that in July 2023 the Central Government had announced £600 million for Adult Social Care from the fund, of which Kent would receive £10 million. The fund was making the resources available to boost capacity to allow the Council to support the Adult Social Care workforce. Mr Watkins noted that this was most welcome.  

Kent and Medway Domestic Abuse Consultation – The 11-week consultation opened in late July. The Council was running the consultation on behalf of the domestic and sexual abuse partnership. Mr Watkins noted that the Kent and Medway Partnership Domestic Abuse Strategy 2024-2029 set out the new 5-year plan to develop and improve the response to domestic abuse. The strategy aimed to reduce instances of domestic abuse and provide the right to support to victims. It was said that the consultation would be open until 9 October 2023 and Mr Watkins encouraged Members to share link to the online consultation.  

Covid-19 vaccination scheme opened – Mr Watkins noted that the Covid-19 vaccination programme had opened and targeted groups would be invited to receive their inoculations, which was important this winter due to the discovery of a new variant of concern. It was noted that the targeted groups were the 65 years and over, residents in care homes, those 6 months - 64 years in a clinical risk group, carers, close contacts of immunosuppressed and frontline health and social care workers. Mr Watkins urged all qualifying residents to book their vaccinations and for Committee Members to raise awareness.  

Blue Badge Scheme - It was said that the Council was working with District partners to run enforcement sessions to clamp down on the misuse of the badges. This had been made more important following the expansion of the eligibility criteria and the need to ensure that spaces are reserved only for those who are eligible. Residents were encouraged to report misuse through the Kent County Council website Fraud Prevention. Please find a link here: Fraud Prevention - Kent County Council. 

2.    In response to comments and questions from Members, it was said. 

(a) A Member asked about the domestic abuse consultation and how people would be able to access it if they could not get online. Mr Watkins and Ms Agyepong said that there had been lots of outreach work to victims and survivors both directly and through partners, the feedback would be used to update and inform the strategy. Richard Smith a more substantive item down the line may be useful. 

(b) Asked for more information on the Kent Care Summit and the Council plan going forward. Mr Richard Smith suggested a substantive item be brought to a future committee meeting where this could be discussed. 

(c) A Member asked for more transparency on the savings being made across the directorate, as a part of committee papers or  ...  view the full minutes text for item 152.

Rachel Westlake, Senior Commissioner, Akua Agyepong, Assistant Director - Adult Social Care and Health, and Ashleigh Cain were in attendance for this item. 

1. Ms Westlake introduced the item. The reasons for the scheme were provided and an overview was given. Ashleigh Cain then gave details of the procurement process and how a supplier was identified. 
2. In response to comments and questions from Members, it was said:

(a) A member asked if this was designed by the Council from new or based on similar schemes in operation in other Councils. Ms Westlake said there had been other sanctuary schemes run by other Councils but under the Domestic Abuse Act the Council had a statutory responsibility to deliver support to those in safe accommodation. It was said that the team had worked in partnership with other Councils and had learnt from best practice. 

(b) It was asked if there were enough places available. Ms Westlake said there was a recommended number of refuge beds, Kent was currently just under the recommended number. It was noted that the SAFER scheme would allow individuals to remain in their own home, which would expand the number of individuals the service could support and further aspects of support were anticipated. 

3.    RESOLVED the Adult Social Care Cabinet Committee agreed with the recommendations as outlined in the report. 

Sharon Wilcock, Senior Commissioner, and Akua Agyepong, Assistant Director - Adult Social Care and Health, were in attendance for this item. 

1. Sharon Wilcock introduced the item and highlighted the intention to award a contract to the preferred bidder so that the service to be embedded by March 2024 when the current contract ends. It was noted that they were at the midpoint of the procurement process and a preferred bidder had yet to be identified. It was said the aim was to award the contract in early November 2023, to allow for 4 months of mobilisation time.    
2. In response to comments and questions from Members, it was said:

(a) Asked why the committee had not been given more notice as it was too late to provide any meaningful input on the process. Mr Smith said it was not the intention but had to do with the timing of the cycle of committee meetings. It was noted that if it was brought to the following meeting it could lead to a delay. 

(b) A Member asked if there was anything in the contract that targets recycling, it had been reported that residents struggled to have their equipment re-used or donated. Ms Agyapong said that information on the recycling points would be shared. It was noted there may need to be an awareness campaign on this. Ms Wilcock said that there would be recycling targets in the new model. A concern was raised that many of these recycling sites were only accessible if you had a vehicle, it was said this would be taken away and considered.   

(c) It was asked that arrangements be made to ensure that Members were more actively involved when contracts were due to expire. 

(d) Mr Watkins outlined some of the benefits of the new model of service and thanked officers for their work. It was noted that an effort should be made to recycle and re-use all equipment where possible even if credit was not given for doing so.   

(e) A Member raised concern that the contract would allow more economically advantaged residents to purchase equipment that was not otherwise available to those with limited financial means. Ms Wilcock said no this would not occur. It was said that during co-production it was found that many people wished to purchase their own equipment but did not know how to do so under the new contract they would receive support to do this in a safe manner, but it would not be charged extra. Residents could purchase equipment by themselves, but this was not recommended as it may not match their needs. The Member requested reassurance that self-purchase would not replace the requirement that the Council deliver the assessment and the equipment within the first 6 weeks without charge. Ms Wilcock said there would be no reduction to the current level of service. Ms Agyapong said the choice was always based on need and people would not be left to independently select. The consultation highlighted a need  ...  view the full minutes text for item 154.

1. Mark Albiston introduced and gave an overview of the Q1 performance with some key details highlighted. It was noted that the wider context of the performance was characterised by increasing demand and a reduced workforce. It was said that the cost of care was increasing as people were presenting with more complex needs.  
2. In response to comments and questions from Members, it was said.

(a) It was asked if it would be investigated as to why more people needed to use the service, and was there was still an ongoing impact of the COVID-19 lockdown. Mr Albiston said that there was no one single reason why demand was going up. It was said that the NHS waiting times were a challenge as residents were not presenting at an early stage so were not receiving earlier interventions. There would need to be more work on preventative care and a need for prevention and early intervention community hubs, technology and enablement. Front-loading community hubs would need to be the ongoing focus when people come to Adult Social Care. 

(b) A Member asked what was being done to resolve the workforce challenge. It was noted that additional support was needed for unpaid carers. Mr Albiston said that a number of approaches would need to be considered as it was a major challenge. There would be a need to look at skills mixing when a specific role can not be recruited for. Managed services could be brought in to increase capacity to help with critical areas of demand. It was said that retention was also a key focus, as all local authorities are experiencing workforce challenges. Mr Beale said that the Workforce Plan had outlined in detail their approach and recruitment drives going forward. It was noted that certain areas faced a much greater challenge for recruitment, such as Thanet and the South-East Coast. There had been success in the enablement services and there would be an offer of progression for staff that worked in these roles. Mr Albiston said that there was a carers strategy and noted the vital importance of unpaid carers. Work was ongoing to raise awareness of carers and the support and advice available to them. 

(c) A Member asked why there had been a 10% decrease in the number of people receiving the Kent Enablement at Home service, and why this was attributed to the shift to the new locality model. An email response would be provided. 

(d) Asked if data on social prescribing would be built into reports going forward. An email response would be provided. 

(e) It was asked that Members be engaged with more as they could support outcomes in their areas and make a difference. 

3.    RESOLVED the Adult Social Care Cabinet Committee noted the Adult Social Care and Health Performance Q1 2023/2024. 

Lisa Clinton, Stakeholder Engagement Manager, was in attendance for this Item.

1. Ms Clinton introduced the update and gave an overview. It was noted that a full briefing would usually take place but was unable to this time, but it was intended that it would occur next year. Ms Clinton welcomed feedback from Members and would include it in the plans going forward. 
2. RESOLVED the Adult Social Care Cabinet Committee noted the Local Account for Adult Social Care (January 2022 – December 2022).

Xan Brooker, Senior Commissioner, and Marie Hackshall, System Program Lead, were in attendance for this item. 

1. Ms Brooker introduced the update and gave a presentation which provided background to the service and the next steps. Please find attached. 
2. In response to comments and questions from Members, it was said: 

(a) Asked by a Member about the details of the ‘long cool off’ and regulation 33 6. It was noted that there were several examples of language that was not accessible to a layperson. Ms Brooker said that the individual contract was a cool-off from the wider framework and a longer cool-off had to be justified as outlined in the terms and conditions. Ms Brooker said the model of behavioural support was dependent on the diagnosis given as different disabilities required different models, the change had been made following a review of the evidence base to improve support. It was noted that the next stage was to review autistic people without a learning disability who received support under the previous service. 

(b) Asked about the difference in support package based on the three costs, as outlined in the report. Ms Brooker the service was a specialist service that should be used for particular behaviours. It was noted that the cost was for training staff to deliver positive behavioural support and it was a concern it had become overspecialised leading to increased costs. Going forward a blended approach would be taken while recognising there could still be a need for positive behavioural support. 

(c) Asked if there was an intention to bring this item back to a future committee meeting. Ms Brooker said that learning could be brought back if deemed appropriate.  

(d) A Member asked about how property availability could be improved by cooperating with Borough colleagues and if there were any challenges to this approach. Ms Brooker said that they would work on their relationships with district and borough Councils to develop longer-term plans for housing and property to meet the needs of those who are autistic or have learning disabilities.

3.    RESOLVED the Adult Social Care Cabinet Committee noted the update. 

Barbara Rickman, Assistant Director Enablement and Support Services, was in attendance for this item. 

1. Ms Rickman introduced the update and gave a presentation. Please find attached. 
2. In response to comments and questions from Members, it was said. 

(a) A Member asked for geographical data that would provide insights into which areas and locality teams experienced the greatest challenge as it was noted that if done right referrals would produce a cost saving. 

(b) Mr Watkins added that the CQC had given the service a high score, and he thanked officers for their work.  

3.    RESOLVED The Adult Social Care Cabinet Committee noted the content of the presentation. 

The Adult Social Care Cabinet Committee noted the work programme 2023/24.