Agenda and minutes

Venue: Council Chamber - Town Hall - Maidenhead

Contact: Andy Carswell 

Items
No. Item

39.

Apologies

To receive any apologies for absence.

Minutes:

Apologies for absence were received from Cllrs Hollingsworth and Coppinger.

40.

Declarations of Interest pdf icon PDF 133 KB

To receive any declarations of interest.

Minutes:

There were no declarations of interest received.

41.

Minutes of Previous Meeting pdf icon PDF 71 KB

To approve the Part I Minutes of the meeting held on February 1st 2017.

Minutes:

The minutes of the meeting held on February 1st were unanimously agreed as an accurate record.

42.

Financial Update pdf icon PDF 134 KB

To note the contents of the report and appendices.

Additional documents:

Minutes:

The Finance Partner gave Members an overview of the Council’s likely Budget position at the end of the financial year. The Finance Partner informed Members that a total underspend of £528,000 had been forecast, which accounted for around 0.6 per cent of the Council’s overall budget for 2016/17. The Finance Partner explained that the underspend would be added to the Council’s reserves.

 

The Finance Partner informed Members that overall the Adult, Children and Health Commissioning budget had been overspent by around £694,000; however much of the overspend related to the Housing area of the budget. The Health and Adult Social Care sector was likely to record an underspend of around £1.25million.

 

The Finance Partner said there had been an underspend of around £919,000 for services relating to older people but an overspend of £59,000 for services relating to people with learning difficulties. The Finance Partner explained that the budget for services relating to learning difficulties was the most difficult to forecast due to its volatility, and a significant portion of the budget being used on a couple of high-spend cases. Underspends in the mental health services budget and other services – which included the Emergency Data Team – were forecast.

 

The Finance Partner explained that the budget for services for older people had been increased significantly from 2015/16 following an overspend in that financial year. However in 2016/17 the rate of increase in spend had not continued as forecast and there had been underspends in four of the five key budget heads relating to services for older people. The Finance Partner explained there had been an overspend relating to Ordinary Residence Adjudication, due mainly to a court case adjudicating against the Council when it had been expected the courts would find in the Council’s favour.

 

Cllr Lenton asked for more details on the case and asked if it could set a precedent. The Deputy Director of Health and Adult Social Care explained it related to the residential costs of a young person living outside of the Royal Borough whilst pursuing education inside it, and there had been an expectation that the other Authority would pay for the residential costs. However the court had ruled against the Royal Borough. The Deputy Director of Health and Adult Social Care stated that the case was expected to be a one-off.

 

Cllr Airey asked if there was any explanation for why so many budget heads were underspending. The Deputy Director of Health and Adult Social Care said there was now a greater emphasis on residents being independent, and for them to receive intensive treatment at the beginning of their programmes in order for them to not reach crisis point. She added that it was sometimes difficult to forecast trends. She said there were early indications that the new methods were successful, more greater analysis was needed.

 

The Finance Partner said that the amount spent by demand-led budgets naturally fluctuates, and it would be expected for there to be an underspend in some budget heads.  ...  view the full minutes text for item 42.

43.

Adult Services Business Plan 2017-2018 pdf icon PDF 119 KB

To review the report and make recommendations to Cabinet.

Additional documents:

Minutes:

The Head of Commissioning – Adults, Children and Health reminded Members that the provision of Adult Services was to be transferred to Optalis, in a partnership with Wokingham Borough Council. She stated that the Business Plan being considered by Members related to the operational delivery of services, and there would be a separate commissioning contract arrangement to sit alongside the operational delivery.

 

Cllr Airey asked if and how the partnership with the Berkshire Healthcare Foundation Trust would change in terms of the Royal Borough discharging its duties through Optalis. The Deputy Director of Health and Adult Social Care stated her belief there would be no change to the way the partnership delivered services, with several meetings between all parties having taken place to reach agreements. Susanna Yeomans stated that the Trust were satisfied that their concerns had been addressed.

 

Cllr Jones asked for an explanation relating to the safeguarding procedures of the new partnership. The Deputy Director of Health and Adult Social Care stated that the Strategic Safeguarding Service would remain with Adult Social Care within Optalis, which would then report to the Safeguarding Adults Board. The Safeguarding Adults Board had been established to scrutinise what was taking place. The Deputy Director of Health and Adult Social Care said that operational safeguarding matters would remain the responsibility of the Council.

 

Cllr Jones asked if the ultimate responsibility for safeguarding remained with the Council. The Deputy Director of Health and Adult Social Care said that it would.

 

Cllr Airey asked what provision there was for early warning indicators, in the event of the working arrangement failing to satisfy need. The Head of Commissioning – Adults, Children and Health said monthly meetings would take place with the Deputy Director of Adult Social Care and Health to discuss the delivery of the contract and associated performance indicators. There would also be a reliance on ‘soft’ intelligence received in the form of complaints and other comments from Members and residents. The Head of Commissioning – Adults, Children and Health said quarterly meetings would take place to review the partnership with Optalis as a whole. This process would also be applicable to Children’s services. Any early warnings would be reported back to the appropriate Overview and Scrutiny Panel.

 

Cllr Airey asked what systems were in place to ensure consistent service delivery from staff that were being transferred. The Head of Commissioning – Adults, Children and Health said a detailed service specification had been provided, and the usual HR procedures were in place within Optalis. The Deputy Director of Adult Social Care and Health said the Service Quality Assurance had been enhanced.

 

The Chairman asked if reviews to check that the necessary services were being provided would be carried out by Optalis or the Council. The Head of Commissioning – Adults, Children and Health said some reviews would be carried out by the Council, while the results of other reviews would be fed back to the Council by Care Watch through the  ...  view the full minutes text for item 43.

44.

Mental Health Services Update pdf icon PDF 566 KB

To receive a verbal update from Angela Morris.

Additional documents:

Minutes:

The Deputy Director of Health and Adult Social Care gave a presentation to Members on Mental Health Services. She informed Members that mental health problems represented the biggest single cause of disability in the UK, and that one in four adults experience a diagnosable condition each year. She said that in the Royal Borough 2,350 people are projected to have dementia by 2020 and 19,000 are projected to have a mental health problem.

 

The Deputy Director of Health and Adult Social Care informed Members that this was a designated year for mental health services and it was a priority area for the Council. Prevention and early intervention, allowing 24 hour access to services, challenging stigmatism and emphasising recovery rates were all considered priorities. The Deputy Director of Health and Adult Social Care also outlined the services currently available to clients.

 

The Deputy Director of Health and Adult Social Care reminded Members that the Community Mental Health Team and the Older People’s Mental Health Team, which was provided jointly by the Council and the BHFT, provided a multidisciplinary service that aimed to support people with ongoing and serious mental ill health and enable them to lead as fulfilling a life as possible. The Deputy Director of Health and Adult Social Care said that under the integrated care programme service users would be given agreed care and risk management plans and a named care coordinator. The Deputy Director of Health and Adult Social Care outlined the makeup of the integrated team. Susanna Yeomans outlined to Members the services that were provided, and stated that staff were trained to consider a patient’s mental health and social care needs together.

 

Susanna Yeomans said there had been five GP-led Crisis referrals within the Royal Borough in January and February, all of which had been attended to within the four hour target time. She said there had also been a 100 per cent success rate in responding to Urgent referrals within 24 hours. In February the Early Intervention Psychosis service had referred 90 per cent of clients for treatment within the two week target timeframe. The Memory Clinic was assessing 90 per cent of its clients within six weeks, ahead of the target of 70 per cent.

 

Susanna Yeomans informed Members that assessments for clients seeking Employment and Support Allowance could be very stressful for some service users, which then had a detrimental impact on their presentation at the assessment. She said that social workers could be provided for clients attending assessments as some of them involved travelling significant distances, leading to an increase in anxiety levels. Support was also provided for clients to assist them filling out application forms for ESA.

 

Members were informed that two case studies had been provided in the agenda to give them an idea of the services provided and the impacts on users.

 

Cllr Jones asked who was responsible for triaging patients and determining if they should be considered, for example, a Crisis or Urgent referral. Susanna Yeomans said that  ...  view the full minutes text for item 44.

45.

Berkshire Healthcare NHS Foundation Trust 2017 Quality Account pdf icon PDF 2 MB

To consider the draft copy of the report and agree comments to be submitted to the Trust.

Minutes:

Members were informed that the Trust were required to circulate their Quality Account report to all of the relevant Overview and Scrutiny Committees for comment, and that a response was required by the end of March. Members were informed that there was not a Trust representative present at the meeting to give a presentation and summary of the report’s contents.

 

It was agreed that a summary of Members’ views would be coordinated outside of the meeting and submitted to the Trust, and for an invitation to be sent to the Trust for a representative to give a presentation at the next Panel meeting.