Web Agenda/Minutes Summary Document

Meeting Name:
Adult, Community Services and Health Overview and Scrutiny Panel

Meeting Date:
05/05/2009 Pick

Meeting Time:


Location:


Sub Committee / User Forum etc (if required):




Members Present:

Non-Members Present:

Confidentiality: Part I


Document Type: Agenda


Document Status: Final

COUNCILLOR MEADOWCROFT (CHAIRMAN)
COUNCILLOR MRS ENDACOTT (VICE-CHAIRMAN)
COUNCILLORS MRS S EVANS, LENTON, MAJEED, MRS NAPIER & MRS PROCTOR

SUBSTITUTE MEMBERS
COUNCILLORS HERDSON, MRS KEMP, MRS LUXTON, MRS NEWBOUND, PENFOLD, D. WILSON & MRS YONG

ITEM	SUBJECT	WARD	PAGE NO
1	APOLOGIES FOR ABSENCE To receive any apologies for absence
2	DECLARATIONS OF INTEREST To receive Declarations of Interests from Members of the Panel in respect of any item to be considered at the meeting.		-
3	MINUTES To confirm the Part I Minutes of the meeting of the Panel held on 3 March 2009.	All	i-v
4	OPTHALMIC RECORDS AT KING EDWARD VII HOSPITAL, WINDSOR To receive an update on the implementation of the new patient records system at the Opthalmic Clinic at King Edward VII Hospital.	Various	-
5	DEVELOPMENT OF ACUTE MEDICINE AND FUTURE PLANS FOR SERVICES AT HEATHERWOOD HOSPITAL - PROPOSALS FOR CONSULTATION To receive details of the consultation on the proposed changes to acute medicine and future plans for services at Heatherwood hospital.	Various	-
6	WINDSOR, ASCOT AND MAIDENHEAD LINk To receive a presentation on the role and current activity of the Windsor, Ascot and Maidenhead LINk.	All	-
7	SUPPORTING PEOPLE STRATEGY 2009/2011 To consider the Draft Supporting People Strategy, which sets the overall vision and objectives of the Supporting People programme locally.	All	1
8	SERVICE MONITORING REPORT To consider activity within the Adult, Community Services and Health services during the period to 31 March 2009.	All	37
9	SAFEGUARDING ADULTS – ANNUAL REPORT To consider the Safeguarding Adults Annual Report.	All	-
10	ANNUAL PERFORMANCE ASSESSMENT OF ADULT SOCIAL CARE To receive an update on how the key areas for development arising from the annual performance assessment are being addressed.	All	-
11	WORK PROGRAMME The following items are scheduled for discussion at the meeting of the Panel to be held on 7 July 2009. Parking at St Marks and King Edward VII Hospital The Provision of Public Services to People with Learning Disabilities Service Monitoring Report Work Programme	All	-
12	LOCAL GOVERNMENT ACT 1972 – EXCLUSION OF THE PUBLIC To consider passing the following resolution:- “That under Section 100(A)(4) of the Local Government Act 1972, the public be excluded from the remainder of the meeting whilst discussion takes place on items 13-14 on the grounds that they involve the likely disclosure of exempt information as defined in Paragraph 3 of part I of Schedule 12A of the Act"	-	-

 Meetings 090505 Acshosc Medical Records Presentation

Information and Consultation Process
5th May to 13 July 2009



Proposed process for the Information and Consultation process for changes in acute medicine services in east Berkshire

Contents Page

1 Purpose of document 2

2 The engagement process so far 3

3 Consulting Organisation 3

4 Information and Consultation Period 3

5 Documents 3

6 Web-sites 4

7 Public meetings 4

8 Engagement Plan 4

9 Independent specialist support 5

10 Quality assurance 5

11 Contingency plans 5

12 Information and Consultation closure and report 6

Date		Time	Location
Tue	26 May 2009	10.00 am	Bracknell
Wed	27 May	7.00 pm	Windsor
Thur	28 May	2.00 pm	Ascot
Wed	3 June	2.00 pm	Slough
Tue	9 June	7.00 pm	Ascot
Thur	18 June	2.00 pm	Windsor
Thurs	25 June	7.00 pm	Bracknell

	Title	Realisation event	Timing	Control	Risk	Contingency plan
1	People wish to influence the consolidation of emergency services at Wexham Park	Public meetings	May to July	Preparation and briefing	High	Implementation on plan
2	External local Eg media			Communication	Low	Additional meetings/briefings
3	Parallel process risk with staff consultation	Complaint about predetermined decision	May to July	Communication	Med	Explain no option to change only to implementation
4	Questions without full answers	Public meetings	May to July	Preparation and briefing	Med	Additional meetings/briefings
5	Challenge	OSC referral,	May to July	OSC engagement	Med	Temporary implementation
6	Challenge	Judicial review	May onwards	OSC engagement	Med	Temporary implementation

Process Document Version 1.5
Prepared by:
Antony Rodden
30 April 2009

Date: 5 May 2009

Member Reporting: Councillor Simon Dudley

Contact Officer(s): Chris Thomas 01628 796091

Wards Affected: All wards affected.

1.1 The Supporting People Strategy is a requirement of each local authority by the Department of Communities and Local Government. This is to set the overall vision and objectives of the Supporting People programme locally.

1.2 Supporting People teams commission housing related support for vulnerable people from a wide variety of client groups. The support enables them to live independently within the community, to engage in activities and seek training and employment opportunities. The strategy includes a number of key areas and these are detailed below:

1.2.1 The National, Regional and Sub-Regional Context: this includes the National Supporting People Strategy – Independence and Opportunity 2007, the Strategic Housing Role for Local Authorities Sept 2008 and the role of the Homelessness Directorate 2008 in ensuring essential services are maintained for supporting homeless people.

1.2.2 The Corporate Context: this strategy helps deliver the aims of the Borough’s Community Strategy 2007 – 2013. In particular it supports the strategic priorities of the council which are: putting people first; providing value for money and equipping ourselves for the future.

1.2.3 Links to Other Strategies: this strategy helps deliver the strategic aims of the Borough and our partners and links to: the Berkshire East Primary Care Trust Strategic Plan 200811, the Thames Valley Probation Strategy to Reduce Re-Offending 2006, the Adult Plan 2008 – 20, the Children & Young People’s Plan 2008/11 and many others.

1.2.4 Drivers for Future Strategic Direction: these include Local Government Reform, Local Area Agreements, National Indicators, the removal of the ringfencing of Supporting People Grant from 1 April 2009, the economy, the housing crisis and the Transforming Social Care agenda.

2. RECOMMENDATION:

That: the Overview & Scrutiny Panel endorses the Supporting People Strategy 2009/11.

3.1 Background

3.1.1 The Supporting People programme went live on 1 April 2003. This brought together traditional legacy funding streams which had provided supported housing. As different agencies had sourced funding and developed new services there was no overall plan in any local authority area to ensure there was an appropriate balance of service provision and that all gaps were filled. Supporting People was introduced to put all the funding sources together into one and a body was set up to oversee the future strategic planning of service delivery.

3.1.2 The Supporting People Commissioning Body was a grant condition requirement originally to oversee the delivery of the local programme. It is made up of commissioning managers from the Administering Authority (RBWM), Berkshire East Primary Care Trust and Thames Valley Probation. The Commissioning Body have agreed the wording of this strategy.

The Supporting People Programme Grant, which funds housing related support services, is £1,723,056 for 2009/10 and the Borough provides additional funding to supplement this grant to the value of £374,560. The Supporting People Administration Grant, which funds the team and overheads, is £101,160 for this year.

3.1.4 Supporting People services locally are provided as sheltered and floating support to older people, supported housing and floating support for people with learning disabilities or mental health problems or young people at risk, supported housing and floating support for homeless people or those threatened with homelessness and there is a small service for people with a physical disability. The Borough’s home improvement agency, Repair with Care, is also a Supporting People service.

4. OPTIONS AVAILABLE AND RISK ASSESSMENT

4.1 Options

	Option	Comments	Financial Implications
	1. Endorse the Supporting People Strategy 2009/11	If agreed the strategy would be published formally on the Borough’s website and this would demonstrate the Borough’s commitment to continuing support services to vulnerable people. This is the preferred recommendation.	This will demonstrate the commitment to continue Supporting People services until 31 March 2011. There may be opportunities to increase funding via bids to the Community Partnership.
	2. Endorse the Supporting People Strategy 2009/11 with amendments	Members may wish to amend parts of the strategy. However, if these amendments materially affect the strategy, then this may require further consultation and delay.	This would depend on the scale of the amendments – if there were to be a direct impact to a service then the financial impact could be considerable and the future provision for vulnerable people would be likely to bring increased costs.
	3. Not endorse the Supporting People Strategy 2009/11	This would leave the council without an up to date strategy. There would not be a clear steer for local vulnerable people, their families, local service providers and the community at large.	Some vulnerable people may need to have most costly interventions to meet their needs. There could be an increase in crime due to the nature of some of the client groups which would have a cost implication

4.2.1 The risk of not endorsing the strategy are considerable. If support services were not to continue vulnerable people would not have appropriate support or supported accommodation and may be at personal risk within the community or pose a threat or risk to others.

5. CONSULTATIONS CARRIED OUT

5.1 This strategy has been developed using a partnership approach which has included representatives from Berkshire East Primary Care Trust, Thames Valley Probation, Adults Services and Children and Young Peoples Services from within the Borough, service providers, voluntary organisations and feedback from service users.

5.2 The draft strategy has been sent to all key stakeholders, was discussed in detail at Housing Forums in December 2008 and February 2009. It is available for comments on the Supporting People website. All comments have been included wherever possible.

6. COMMENTS FROM OVERVIEW AND SCRUTINY PANEL

6.1 Text.

7. IMPLICATIONS

The following implications have been addressed where indicated below.

 Meetings 090505 Acshosp Supporting People Strategy

 Meetings 090505 Acshosp Supporting People Strategy Appx1

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Date: 23 April 2009

Member Reporting: Councillor Hilton

Contact Officer(s): Andrew Brooker, Head of Finance, x6341

Wards affected: All

1. SUMMARY

1.1 This service monitoring report provides a monthly update on service delivery with emphasis on the impact on the council’s financial position. Whilst we are now past the year end, the reported position is projected as year end debtors and creditors are still being processed.

1.2 Services are currently projecting expenditure of £86,039k (down £409k since last month’s £86,448k). The approved estimate is £86,466k (up £139k from last month’s £86,303k, mainly as a result of additional provision for pay awards now being incorporated in service budgets). The expected under spend is therefore £427k (last month: overspend of £145k). See section 3 for more details.

1.3 General balances at year end are projected to be £ 5.245m (last month £4.676m) before carrying forward balances of £237k to 2009-10 – see section 4 for more details.

1.4 The approved capital programme has decreased by £1.792m since last month to £25.921m, which is funded by grants and contributions. Variances are £148k, slippage is £3.494m. See section 5 for more details.

2. RECOMMENDATION: That:

i) The provisional revenue and capital outturn figures in Appendices B and C be noted.
ii) The budget variations contained in sections 3.4 to 3.6 be approved.
iii) The capital programme variances and slippage identified in Appendix C be approved.
iv) The Leader, the Lead member for Children’s Services and the Director of Children’s Services be delegated to review and approve the carry forward of budget to 2009-10 of up to £237k as included in section 4 of the report.

3.1 Background

3.2 As at 31^st March 2009, total service expenditure for 2008/9 is expected to be £86,039k (down £409k from last month’s £86,448k).

3.3 Summaries of the Council’s provisional outturn Revenue and Capital financial reports are contained in Appendices A and B respectively. The revenue report includes income and expenditure statements together with a short Directorate report drawing members’ attention to key activities affecting the current and future years.

3.4 Learning & Care reports that its 2008-9 costs are projected to be under spent by £289k (down £352k from last month’s predicted overspend of £63k) on its approved estimate of £48,759k (an increase of £45k on last month’s approved estimate of £48,714k). The budget has been increased to allow for redundancy costs (£35k) and £50k for the recommended 0.3% for pay awards, as agreed at the March 2009 Cabinet meeting, and reduced by £40k from under spends on 2 grant-funded projects (£10k Pump-Priming Grant for Improving Carers Quality of Life, and £30k LPSA Reward Grant for Support to Concessionary Fares), which will be available for reallocation next year.

Children’s Services are expected to be overspent by £192k, a decrease of £276k on last month. Of this, an estimated £50k arises from recovery of staff costs from the General Sure Start Grant, and most of the rest relates to under spends on three Area Based Grant budgets – notably Child and Adolescent Mental Health Services.

Adult Social Care is expecting to under spend by £568k (down £168k from an expected under spend last month of £400k). The change mainly relates to projected under spend on 2 grant-funded projects – Transforming Social Care (£75k) and Stroke Care (£82k). This is offset by reduced application of ring-fenced Government grant which will be carried forward to be allocated next year.

3.5 Community Services reports a projected under spend of £65k (down £160k from last month’s anticipated overspend of £95k) from the approved estimate of £22,705k (down £105k from last month’s approved estimate of £22,810k). The budget has been increased because of a £23k Area Based Grant for climate change and £54k for the recommended 0.3% for pay awards. The Licensing Services budget of -£180k has transferred to Community Services from Corporate Services.

There have been some small increases in costs in several areas. The overall saving has mainly been achieved by further reductions in tonnages to landfill, a rate rebate for the Waste Transfer Station and increased licensing income.

3.6 The Chief Executive reports that Corporate Services expenditure is expected to be £14,929k, which is £73k lower (last month: £13k lower) than the approved estimate of £15,002k (increased by £223k since last month’s £14,779k). The budget for Licensing Services has transferred to Community Services (-£180k) and £40k has been added to allow for the approved 0.3% increase on salaries, per the decision at March cabinet.

Increased costs in the Coroner’s Service (£40k), Local Land Charges (£35k), Benefits Fraud (£30k), HR (£9k) and Corporate Performance & Development (£7k) have been more than offset by underspends in Legal Services (-£44k), Exchequer Services (-£20k), Pension Fund (-£43k), Members’ Allowances (-£35k) and Corporate Human Resources (-£12k).

4. OVERALL POSITION

Appendix A shows projected year-end reserves to have increased by £569k to £5.245m from the previous month’s £4.676m, before the commitment to carry forward balances of £237k to 2009-10. There has been an increase in service budgets of £163k, and additional under spends of £572k have been identified this month (see 3.4 to 3.6). The provision for increased salaries of £200k has now been accounted for in the service budget lines, and the contribution from earmarked reserves have been reduced by £40k re. LPSA and PPG grant under spends (see 3.4).

The commitment to carry forward £237k of balances to 2009-10 relates to three grant-funded areas under spent within Learning & Care: CAMHS (£156k), Teenage Pregnancy (£25k) and Extended Services (£56k).

5. CAPITAL

5.1 Capital Budget Movements Since Budget Report

Total capital expenditure for 2008/9 is expected to be £22.575m, which is £3.346m below the approved budget. This is made up of £148k variances and £3.494m slippage and is summarised as follows:-

Exp Inc Net
£'000 £'000 £'000
Approved Budget March 25,921 -15,266 10,655
Variances identified 148 -12 136
Slippage to 2009/10 -3,494 1,948 -1,546
Projected capital programme 2008/2009 22,575 -13,330 9,245

5.2 Projected Capital Variances and Slippage

Community Services reports that the capital budget is likely to be overspent by £11k, with slippage of £1.962m

Learning & Care expect a net underspend of £85k, with slippage of £1.338m

Resources expect a net overspend of £222k, with slippage of £194k.

Further details can be found in Appendix C.

5.3 Overall Programme Status

The project statistics show the following position as at the end of March 2009:

Number of Schemes in Programme 469
Yet to Start 6%
In Progress 34%
(Of which Ongoing Annual Programmes 6%
e.g.. Disabled Facilities Grant)
Completed 46%
Devolved Formula Capital Grant schemes 14%
(Data not available on budgets devolved to schools)

6. OPTIONS AVAILABLE AND RISK ASSESSMENT

6.1 Options

	Option	Comments	Financial Implications
	1. Accept the report	Directors have a responsibility for managing their Services within the Budget approved by Council. Cabinet has limited power to vary those budgets within the overall budget and policy framework or to re-define the priorities agreed when the budget was approved. Cabinet does however have responsibility for considering the impact on future year’s budgets of the decisions taken.	Revenue Capital
	2. Reject the report	This is not an option as The Local Government Act 2003 requires the Royal Borough to monitor its financial position	Revenue Capital

Risk assessments are carried out as a matter of course for the delivery of individual services. The main financial risks are included on the Council’s Risk Register. Paragraphs 3.8 to 3.15 discuss the risks associated with the current economic downturn.

The Councils Financial Strategy outlines the measures available to it in the event of a series of events that lead to significant projected budget variances being reported.

7. CONSULTATIONS CARRIED OUT

No specific consultation is carried out as this is a regular monitoring report

8. COMMENTS FROM THE OVERVIEW AND SCRUTINY PANEL

Relevant components of this report will be considered by each of the four scrutiny panels as part of their next round of meetings.

IMPLICATIONS

9. The following implications have been addressed where indicated below.

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 Meetings 090505 Acshosp Service Monitoring Appx5

Title: SAFEGUARDING ADULTS

Date: 5^th May 2009

Officers Reporting: Ed Thompson, Joint Commissioning Manager (01628 683614) Andy Iddiols, Safeguarding Adults Co-ordinator (01628 683710)

Wards affected: All

RECOMMENDATION: That the Panel:

a) notes the Annual Report;
b) consider any areas they wish to recommend for further work;

An RBWM Safeguarding Adults Partnership Board has been established
Recruitment of an Independent chair for the board
Recruitment to a new full time Safeguarding Adults/Dols Manager (interviews 12^th May 2009)
A new Safeguarding Adults Module on our IT system (PARIS) to improve investigations and statistical reports
Officers have gave presentations to a considerable number of groups raising awareness and promoting the message that safeguarding adults is ‘Everyone’s Business’
A week of Safeguarding events and promotion is being planned to coincide with the Action on Elder Abuse Day on 15^th June 2009

These items will be looked at in more detail in the body of the report.

The number of Safeguarding Adult referrals recorded by RBWM for the above period was 117 which compares to 99 last year, 69 in 2006/7, & 74 in 2005/6

95% of these were RBWM Service Users compared to 91% last year and 97% for 2006/7

5% of these were non-RBWM Service Users, but were within the RBWM area.

3 cases were recorded as Self Funded & 2 as Health Funded.



The table below shows the number of safeguarding investigations during 2008/09 to March 2008 with a comparison to the previous year:

The figures overall reflect increased safeguarding activity in relation to vulnerable adults. This can be related to a greater awareness of adult abuse and improved reporting of alleged abuse within partner agencies and community organisations.

A copy of the full Safeguarding Adults Annual Report is attached as an appendix to this report.

Background Papers:

Annual Report - attached

 Meetings 090505 Acshosp Safeguarding Annual Report

 Meetings 090505 Acshosc Annual Performace Assessment Presentation