Agenda and minutes

Apologies were received from Mr Ridgers, Mr Kennedy, Mr Ross and Mr Brady. 

Mr Lewis and Mr Brazier were in attendance as substitutes for Mr Brady and Mr Ross respectively.

1. Mr Collor proposed, and Mr Meade seconded that Mrs Cole be elected to Chair the meeting. No other nominations were received. 
2. RESOLVED Mrs Cole was duly elected by the committee to Chair the meeting. 

Ms Meade noted that she was a carer. 

RESOLVED that the minutes of the meeting held on 13 September 2023 were a correct record.

Zena Cooke, Corporate Director Finance, and Dave Shipton, Head of Finance (Policy, Planning & Strategy) were in attendance for this item.

1. Deputy Leader and Cabinet Member for Finance and Traded Services, Mr Oakford, provided the committee with a high-level overview of the current financial position of the Council and the process of the budget between now and March 2024. Mr Oakford noted the current deficit for this year was around £30 million with a budget gap of £20 million. The current projected overspend for Adult Social Care and Health was at £30.4 million, but the Corporate Director and other directors had identified management action to bring this number down. It was said that spending controls had been put in place with a note sent around to all employees of the Council. For next year the budget gap was at £100 million, with around £50 million of savings identified. Mr Oakford thanked Mr Smith and his staff for finding savings of £50 million which could be made over the next few years. A gap of £50 million remained which would have to be identified through savings or increased revenue by January 2024.  

2. Mr Watkins made some further comments on the impact on the directorate to identify savings. He thanked the corporate director and his team for their work to find savings while maintaining and improving care for residents through the redesign of services. It was noted that solid plans were in place to deliver savings going forward. 

3. Mr Richard Smith noted that it was a very difficult year and that the next few years would also be very difficult. It was said that there was a need to reduce the overall ongoing demand for Social Care services. Going forward prevention would be key and they were working closely with Public Health colleagues on this with a digital prevention offer commissioned as part of the move away from the traditional offer. The creation of community teams would support people in their communities and help prevent people from entering residential care. Mr Smith noted that they would still support those with eligible needs, and it was up to the Council how best to do this. Mr Smith thanked his team, and finance, for their work. 

4. A Member asked the Cabinet Member what the section ‘Adult Social Care service redesign phase 2 of the ASCH restructure’ on page 59 under ‘Transformation & Efficiency’ savings meant for Kent residents. Mr Watkins said it relates to the shifting of care support from a county-wide offer to a community-level offer. There were now 24 community teams that enabled local expertise and it was noted that the wider service redesign includes technology and enablement. Mr Watkins said that Technology Enhanced Lives would launch this week where residents could be supported at home through technology and equipment rather than in residential care homes. Mark Albiston said this was part of the approach to reshape the front door of care with an early intervention and preventative offer as the new model for  ...  view the full minutes text for item 164.

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

Carers Rights Day – Mr Watkins noted that 23 November 2023 marked Carers Rights Day and the Council would be celebrating the work of unpaid carers and highlighting support available to them. It was said that the work of unpaid carers can have a major impact on paid employment and leisure activities and that Kent had over 150,000 adults over the age of 16 providing unpaid care each week. Mr Watkins said the Council had a 5-year plan to work with partners to improve the experience of unpaid carers. The Cabinet Member said that he had recently visited Crossroads Care Kent which provided local carers respite and a helpline. Mr Watkins expressed his and the committee's appreciation for the work of unpaid carers in Kent. 

Vaccinations – The Council was supporting a nationwide campaign encouraging all those eligible to come forward for their seasonal flu and COVID-19 vaccinations. This winter over 11.7 million flu jabs and 9 million Covid-19 jabs had been delivered by the NHS since September 2023.  

Charging Policy – Mr Watkins noted that there would be a review of the charging policy for those in receipt of non-residential services. The findings were expected to be presented at the January 18 2024 meeting of the committee. 

Adult Social Care Pressures – Mr Watkins had recorded a BBC South East podcast on the adult social care pressures and challenges in Kent and how the Council plans to address them. BBC South East also visited the Hospital Base Technology Facilitators Service, which helped to get people back home safely after discharge from hospital. Mr Watkins said that he hoped that the publicity generated would lead to additional support from the central Government. 

All-Party Parliamentary Group (APPG) on Digital Skills – Mr Watkins spoke at the APPG on empowering the UK health workforce through digital innovations concerning the work going on in Kent on the digital rollout. 

World Mental Health Day – Mr Watkins said that to mark the occasion on the 10 October 2023 the Council had given grants to community groups of between £500 and £15,000. 

Kent and Medway Health and Care Symposium – Mr Watkins said he had attended the event on 20 October 2023 which was an opportunity for health and care partners from across the county to come together and discuss progress on the Integrated Care System and generate new ideas.

Blackburn Lodge – The Cabinet Member informed the committee that an emergency closure had to be enforced at the site in Sheerness following high concentrations of iron found in the water supply. To ensure the health and safety of the 13 residents they were transferred to alternative residential care homes. Mr Watkins said he noted the disruption this had caused the residents and their families and he thanked the staff who helped to safely and effectively manage the transition. Officers were considering the future  ...  view the full minutes text for item 165.

Sydney Hill, Assistant Director of North Kent, was in attendance for this item. 

1. Sydney Hill introduced and gave an overview of the report. It was noted that a review of this year's plan would occur in spring 2024 and the findings would be brought to the committee at an appropriate time. A summary of the six key areas of the Pressures Plan was provided. It was said that the Council was successful in its application to the Department for Health and Social Care for Urgent and Emergency Care Grant funding of £2.9 million. The funding would help strengthen the resilience of urgent and emergency care services and support hospital discharge pathways during the winter period. 

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

(a) That the figures on the update on the flu vaccines and the Covid-19 boosters would be shared after the meeting. 

(b) That the paper be shared with all Council Members, to further the understanding of the pressures that Kent’s health and social care services were under.   

3.    RESOLVED The Adult Social Care Cabinet Committee noted the content of the Adult Social Care Pressures Plan 2023 2024 and endorsed the proposed decision attached as Appendix 1 to: 

a)    Accept the Urgent and Emergency Care Funding under the terms set out by the Department of Health and Social Care; and 

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

Mike Gogarty, Strategic Lead Public Health Consultant, and Jenny Dixon-Sherreard, Policy Officer, were in attendance for this item.  

1. Mike Gogarty introduced the report. An overview was provided of why a new approach to public health was required and how the Integrated Care Strategy would support the strategic approach to prevention, the wider determinants of health, lifestyle factors and access to quality health care services. The paper set out how the system as a whole would coordinate actions to support the health and well-being of the population. It was noted that the strategy would be delivered through detailed action plans. 

2. Jenny Dixon-Sherreard noted that the strategy was owned by the Integrated Care Partnership (ICP). In December the ICP would recommend the document for approval by the three statutory bodies, KCC, NHS Kent and Medway and Medway Council. Cabinet would consider the comments made at the four Cabinet Committees that the strategy had been to and whether any changes should be made to the draft strategy, before being asked to approve the final version at Cabinet in January

3. In response to comments and questions, it was said.

(a) A Member asked how the strategy would support the more deprived areas of the county, as they would require extra help. Mike Gogarty agreed that such areas would need to be targeted. It was said that the approach would adopt proportionate universalism which would ensure that areas of greater need would get greater support and that if required bespoke services would be delivered. There would be close working with district colleagues and health services to support those who required additional help.    

(b) Mike Gogarty said that work on the action plans was ongoing and being developed in partnership with NHS and district colleagues, it was expected most plans would be in action or well developed by the beginning of the new financial year 2024/2025. 

(c) Mike Gogarty confirmed that music would be included in the strategy going forward following a Member's suggestion. 

(d) A question was asked if there was going to be any working with partners at the district level to make available affordable housing options for key healthcare professionals. Jenny Dixion-Sherreard said that the issue had been discussed at the ICP and work was ongoing to ensure that the workforce leaders across Kent and Medway worked together when developing workforce plans. It was noted that more information on housing for health and care workers would be shared after the meeting.  

(e) It was noted that difficulties with reduced funding for voluntary services and lack of affordable houses meant staff were attracted to higher wages offered in London.    

4.    RESOLVED the Adult Social Care Cabinet Committee considered and endorsed the proposed decision to approve the Kent and Medway Integrated Care Strategy on behalf of Kent County Council. 

Helen Groombridge, Adult Social Care and Health Performance Manager, was in attendance for this item. 

1. Mark Albiston introduced and gave an overview of the Q2 performance report. It was said that the trend of increasing demand for Adult Social Care services had continued. It was noted that there was a significant workforce challenge that affected Kent which was also the case nationally, certain areas of Kent, particularly the East Kent coastal areas, experienced a very significant challenge. 

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

(a) It was confirmed that the statistics on Deprivation of Liberty Safeguards (DOLS) were only of those completed under the framework, others completed under the Mental Health Act would not be included in these figures. Ms Groombridge said that figures on all DOLS were available but not released publicly. The Member asked if these could be shared with the committee to discuss.   

(b) A Member said that absolute reporting was preferred to relative performing. A comparison may not fully explain how well a service is performing for Kent residents. Mark Albiston said that comparisons were presented to provide context for the performance figures.  

(c) It was asked what plans were in place to meet the target for care needs assessments. How was demand going to be forecasted to ensure that going forward adequate resources were in place to meet the level of demand and meet the targets. Mark Albiston said that planning was constantly ongoing and the Recovery Plan would have more detail on this and would be brought to the committee with the Q3 performance report. Mr Smith said that there was a challenge to recruit staff qualified to complete these assessments and the vacancy levels across the county varied significantly. Mr Smith noted that there were several plans in place to help reduce demand going forward. Mr Watkins said that prevention would be key to creating savings in the budget going forward while maintaining frontline staff numbers, it was noted that the number of social workers was anticipated to increase but more work was needed as they were still behind where they wanted to be. Mark Albiston and Jim Beale gave examples of recent successful recruitment campaigns and the plans going forward to engage on social media and sell Kent as a place to live and work. 

(d) Asked by a Member if a net £46 million increase to the budget was at a scale to meet the demand and if the authority was adequately prepared for the level of demand going forward and would not be caught out. Mr Watkins said the increase to the budget should meet the net increase in the number of people entering care services. It was noted that the challenge was from the increase of instances of people with multiple and complex care needs who took greater resources to treat. The recommissioning of large contracts would help ensure that people's needs are met in the right way and in a way that is financially sustainable for  ...  view the full minutes text for item 168.

Debra Davidson, Customer Care and Complaints Manager for Adult Social Care, and Pascale Blackburn-Clarke, Delivery Manager Engagement and Consultation, were in attendance for this item. 

1. Debra Davidson introduced and gave an overview of the report. It was noted that there had been an increase in all areas of activity during 2022/23.   
2. In response to comments and questions, it was said: 

(a) The Chair expressed thanks on behalf of the committee to the staff for their work. 

(b) It was said that people approach Members of Parliament and Council members in relation to complaints and enquiries for a variety of reasons, not solely or especially because their complaints are not resolved within the time specified.

3.    RESOLVED the Adult Social Care Cabinet Committee considered and commented on the content of the report. 

RESOLVED the Work Programme 2023/24 was noted.