Agenda and minutes

Venue: Council Chamber - Town Hall - Maidenhead

Contact: Andy Carswell 

Items
No. Item

98.

Apologies

To receive any apologies for absence.

Minutes:

Apologies for absence were received from Cllrs Majeed and Carroll.

99.

Declarations of Interest pdf icon PDF 217 KB

To receive any declarations of interest.

Minutes:

There were no declarations of interest received.

100.

Minutes pdf icon PDF 64 KB

To approve the minutes of the meeting held on June 20th 2018.

Minutes:

RESOLVED UNANIMOUSLY: That the minutes of the meeting held on June 20th 2018 be agreed as an accurate record.

101.

Improving Quality in Care Homes pdf icon PDF 186 KB

To receive a presentation.

Minutes:

The Head of Commissioning – Adults and Children informed Members that there were 24 care homes within the Royal Borough, accounting for 1,217 beds; of these, more than 900 were in homes that had nursing provision capable of providing for patients with complex needs. Two more homes, in Windsor and Ascot, were in the process of being built and this would create an additional 150 beds. There was a clear focus on ensuring residents of the Royal Borough had the best quality of care in a safe and caring environment.

 

Members were told that amongst residents of care homes in the Royal Borough there had been improvements in the length of time for them to become medically fit following a stay in hospital, and there had been a small but significant reduction of seven per cent in the number of non-elective admissions to hospital in 2017-18 compared to 2016-17.

 

The Head of Commissioning – Adults and Children informed the Panel that staff from the Royal Borough and Optalis had been working through health and social care partnerships across a wider area into Bracknell Forest and Slough, which had the benefit of providing them with greater shared knowledge and expertise. These partnerships included working with Healthwatch and the Care Quality Commission, in addition to NHS partners across Berkshire. Members were informed that these partnerships enabled information about registered care providers in the Royal Borough to be collected, and for targeted support to be given to those providers and managers who had been identified as requiring improvement. Examples of the information to be collected might be a safeguarding issue, or a specific issue relating to a certain practice. It had been proposed to introduce a questionnaire amongst care home residents to ask about satisfaction levels of where they resided and the quality of care they received, in order to identify any issues more quickly.

 

Members were told that the majority of the Quality Improvement projects were funded by the East Berkshire Better Care Funds and the Frimley Health Integrated Care System. The partnership approach had highlighted data regarding the main reasons for non-elective admissions to hospital, which had led to evidence-based practices being implemented. These included a hydration and nutrition programme, which has won awards, and the implementation of a trusted assessor scheme, where an assessor would be assigned to a patient while they were in hospital and would liaise with their care home manager. Members were told that this, combined with the introduction of a ‘Red Bag’ scheme to highlight that a hospital patient was a care home resident, had led to a reduction in the number of instances of patient lost property being reported.

 

Members were told that a new NHS email service was being introduced, which would allow care homes to receive emails with patient details directly from hospitals, and also part of the patient’s NHS records. Additional coaching and mentoring for care home staff, and the implementation of the National Early Warning Score, had also been introduced and  ...  view the full minutes text for item 101.

102.

Delayed Transfers of Care from Hospital pdf icon PDF 178 KB

To consider the contents of the briefing note.

Minutes:

The Head of Commissioning – Adults and Children introduced the item and explained that delayed transfers of care happened when it was not possible to discharge from hospital someone who was medically fit to do so. This practice was commonly referred to as ‘bed blocking’ in the media, and affected waiting times for other patients waiting to access NHS services. Members were told that it was important for patients to be discharged from hospital at the right time, as unnecessarily long stays resulted in lower morale and motivation, along with the increased risk of infection. Being discharged at the appropriate time also reduced the chances of patients needing to be readmitted to hospital.

 

The Head of Commissioning – Adults and Children informed Members that reducing delayed transfers was a key focus for all local authorities, and the Department of Health had set the target of no more than 3.5 per cent of hospital beds nationally to be occupied by a patient who was subject to a delayed transfer. The Royal Borough’s individual Health and Wellbeing Board had been set the target of no more than 15.3 delays per day on average; this had just been missed, as the average for last year was 15.7 days. For the current year this target had been reduced to 11.2 delays per day. The Head of Commissioning – Adults and Children informed Members that each delay would be ‘coded’ against the body responsible for the delay. For example if a person who was eligible for Local Authority funding was not able, for whatever reason, to be placed in a care home, the delay would be coded as a Local Authority delay; if the person was not eligible for Local Authority funding, then it would be coded as an NHS delay.

 

Rachel Wakefield informed Members that a number of schemes and projects had been implemented to reduce delayed transfers. These included greater collaborative working with community hospitals, hospices and local authorities, and the introduction of a weekly ‘transfer list’ so individual patients’ needs could be continually assessed. Some delays were caused by a lack of available transport; this had been partially remedied in the winter by an investment in private transport for patients. It had been noted that a need for additional specialist equipment was a regular cause of a delayed transfer. Members were informed that over the last year there had been two exceptional cases where it had been difficult to assess the appropriate location for the patient, which had resulted in two patients taking a bed for a combined 400 days between them. Vernon Nosal informed Members that there was a dedicated hospital social work team that was capable of carrying out patient assessments in the community, thereby reducing the need for patients to visit hospital.

 

Mark Sanders stated that Healthwatch were aware of three separate incidents where carers had been to visit a patient, only to find they had been discharged and were waiting to be picked up. Rachel Wakefield stated that  ...  view the full minutes text for item 102.

103.

DASH Charity Safeguarding Recommendations pdf icon PDF 22 KB

To consider the recommendations made by DASH regarding Adult Safeguarding, in light of the LGO complaint regarding Ms C discussed at the previous meeting.

Additional documents:

Minutes:

The Director of Operations – Optalis informed Members that the Council was confident that it could adopt the recommendations made by DASH, and that an action plan was in the process of being drawn up. It was agreed to defer the item to the next meeting, when the action plan could be discussed by Members.

104.

Work Programme pdf icon PDF 25 KB

To review the ongoing Work Programme.

Minutes:

The Chairman reminded Members to contact the clerk if they had additional items that they wanted to be raised at future meetings.

 

Mark Sanders informed Members that the Healthwatch Annual Report was now available, and stated that Councillors should have received email notification of this. Reports on Learning Disability Week and the national MENCAP scheme relating to hospital care were both due to be published imminently.

 

The Deputy Director Strategy and Commissioning informed Members that it was hoped that the new Chief Executive of the Frimley Health Trust would be available to give a presentation at the next Panel meeting.