To receive any apologies for absence.

Apologies for absence were received by Councillor Majeed.

To receive any declarations of interest.

There were no declarations of interest received.

To approve the part I minutes of the meetings held on July 18^th 2018 and September 20^th 2018.

RESOLVED UNANIMOUSLY; That the minutes of the meeting held on the 20^th September 2018 be agreed and noted.

ACTION- To schedule the DASH charity item for the next overview & scrutiny panel.

To receive a presentation on support in the community for people with a learning disability.

Presentation: OPTALIS

Vernon Nosal, Assistant Director for Statutory Services gave a presentation on the provisions available through Optalis for individuals with learning disabilities. It was outlined that the Community Team for people with learning disabilities was an integrated health and social care team that provided a holistic service response to approximately 320 people. Members were told that social care staff assessed individuals for eligibility as defined under the Care Act, these practitioners would then work with the individuals and their families to agree a plan to meet the needs of that person. Members were informed that currently 81 individuals live in residential care homes, 128 individuals live in supported living, 61 individuals were living within their family settings, 11 individuals were living independently with support, 5 individuals live in shared lives accommodation, 4 individuals were in placement at residential college and 12 individuals were in receipt of direct payments whilst living independently or within supported living accommodation. Member were told that this did not include figures for Continuing Health Care funded people or those individuals who received no funded support. Supported living offered greater security and control to individuals over their lives because they hold secure tenure with housing providers and care is provided by a different agency. The average cost of a residential care bed was estimated at £1598 and the average cost of a supported living placement was £846. Member were informed that RBWM and Optalis CTPLD had worked proactively with housing providers to build good quality flats which included, Ronald Young Court (8 flats), Shaw Court (11 flats), Park House (8 flats) and Catherine House (11 flats). The Panel were told that Housing Solutions was currently building Brill House for move on supported living accommodation for six people living in poor quality residential housing with five additional flats (totalling 11 flats). Members were then told of how CTPLD had helped a client who previously lived outside of the borough, but had moved to Windsor and had benefitted both socially and independently.

Presentation: Affinity Trust

Penny Lamb, Divisional Director (South) of Affinity Trust gave a presentation on the above titled item. Affinity Trust was set up in 1991 and was a values led registered charity. Over 1000 people had been supported across 35 local authority areas including Maidenhead. Affinity act as a specialist provider of support for people with learning disabilities and autism, who may also have disabilities or complex physical or mental health needs. The Panel were informed that Affinity helped individuals in supported accommodation, residential care, working with commissioners and landlords to source and develop bespoke properties and providing opportunities for inclusion, activities, employment and celebrations. Support was also provided to children and young people through transitional support when moving into supported living. Innovative positive behavioural support was provided through Bradford MDC and a social investment partner; intensive support for the child and their school; dedicated PBS psychology Lead; detailed functional assessments and payments by results on preventing admission to residential care. Specialist services in four  ...  view the full minutes text for item 114.

To note the contents of the report.

Jo Jeffries, Consultant in Public Health gave a verbal presentation on the above titled item. It was highlighted that as part of the commissioning arrangements for adults, the service had been commissioned to deliver a national programme under the s.718 specific duty to commission public health. The screening programme identified healthy people who have had an increased chance of developing an illness. General Practitioners offer testing and advice. The most prominent screenings as assessed and determined by the National Screening Committee were for breast, cervical and bowel cancers. Work on individuals with diabetes was underway and eye health was being monitored to try and reduce the risk of retinopathy. It was highlighted that immunisations reduced the number of transmissions which had seen better results and a decrease in the spread of illnesses. In Windsor and Maidenhead (latest data published as of 2017) there had been 78.8% breast screening uptake, 58.3% bowel screening, 73.5% uptake of cervical screening. It was noted that the uptake for certain screenings was affected by individual’s knowledge of the programmes and the benefits and it was also found that in areas of high deprivation there was relatively lower uptake of screenings.

Members were told that in some cases there was a reduced uptake as the screenings were seen as less palatable and could be off-putting to some individuals. It was reported that there was a national reduction in the trend for younger women and the uptake of cervical cancer and that work was being carried out which focussed on the positive messaging of screening. A new provider had been commissioned for diabetic eye screening and it was noted that this would be taking place across several locations. AAA screening was less than the national average and emphasis upon giving advice earlier to men to target this issue of reduced uptake. Shingles vaccine was at 46.1% uptake (48.3% national uptake) and it was highlighted that there were challenges nationally to lower the eligible age for the vaccine and to ensure that there was clearer and simpler information available regarding eligibility. Members were told that the uptake for flu vaccine for 2017 was higher than the previous year and was reported as 70.9% (72% national average). It was noted that there was work to be done with clients who had long standing illnesses to ensure that sign posting was done at specialist clinics where these patients received care as opposed to the traditional GP signposting.

There were plans for new bowel cancer testing (FIT testing) which would be more sensitive to the needs of the individual and would be rolled out nationally. Scope testing would be piloted at Heatherwood Hospital and the contract for diabetic eye screening had been awarded to Health Intelligence to carry out. Positive feedback had been received regarding the new CCG website. Plans to work systemically with the ICS to increase uptake across the borough were underway. Councillor Lenton queried whether there was an upper limit on age for vaccinations and it was confirmed  ...  view the full minutes text for item 115.

To consider the contents of the report.

Tessa Lindfield, Strategic Director of Public Health outlined the above titled report. Members were told that it was a requirement for local councils to publish an independent annual public health report from their Director of Public Health. The annual report was the Director of Public Health’s views on the health and wellbeing of the local community and outlined opportunities to improve the public’s health. The report looked at reconnecting professions, communities and landowners and highlighted opportunities for collaborative work to support public health through the creation and maintenance of accessible high quality green spaces and natural environments. The report outlined information and evidence that could support placed based strategies and the potential of green and natural spaces for the health and wellbeing of local residents and communities. It was highlighted that there were working examples of how local communities were using national environments to stay health and to improve the health and wellbeing of local residents.

It was highlighted that the natural environment could be used as a wider determinant of health and presented an opportunity to improve health and wellbeing, both physically and mentally. The report focussed on green and blue spaces, green spaces included open fields and forests and blue spaces included the sky, river and lakes. Members were told that both spaces could be utilised for exercise, time in nature, leisure and relaxation. It was noted that there was evidence to show that the natural environment was beneficial to having a positive influence on both physical and mental health. The report outlined four recommendations and ways in which the Royal Borough had committed to making progress in the following areas;

·         Make the most of natural space available to improve mental health, physical activity and strengthening communities.

·         Improvement of existing green spaces and design developments with green spaces and active travel in mind.

·         Planning guidance for new developments to specifically consider the use of green and blue space to improve health and wellbeing.

·         Fostering new relationships with organisations aiming to improve the natural environment and its use.

Members were told that there were a range of determinants that affect individual health. It was outlined that at the wider population level that there were a diverse range of economic, environmental and social factors that affected individual health and influenced their choices and lifestyles. At the conclusion of the verbal report, Councillor Mills queried whether there would be an extension of open spaces in hospices, intensive care units and specialist units and that there were plans for outdoor wards. It was confirmed that there would be a benefit to increased accessibility to open spaces and that there was much evidence to support speedier recovery with the use of green space. Councillor Lenton commented that the extension could be made in hospices and that this would be an increased benefit to wellbeing. It was also noted by Councillor Lenton that the writing within the report should be amended as green was not an accessible colour to read for many.

Members felt  ...  view the full minutes text for item 116.

To note the contents of the report.

 Nikki Craig, Head of HR and Corporate Projects, outlined the above titled report. The annual report covered the period from 1^st April 2017 to 31^st March 2018. The report included all compliments and complaints that were made by, or on behalf of, customers and that were investigated under the formal corporate complaints policy and statutory adults and children’s complaints policies. It was highlighted that local authorities were not required to produce an annual report on complaints relating to corporate activities but that they were required under statute to report complaints submitted on adults and children’s services. It was noted that the corporate complaints team produced an annual report that captured all compliments and complaints and this in turn allowed the Council to assess how residents experience the Council. It was noted that the Royal Borough had received 203,000 phone calls, 20,000 emails and 15,000 face to face enquiries. There had been over one million visits to library with 7,000 new library members. It was highlighted that there were five million waste and recycling collections, 13,000 streetlights which had been upgraded to LED, 275 children’s safeguarding referrals, 57 families supported by the Intensive Family Support Team, 141 adult transfers into long term care, 2,254 support plan reviews, 1,157 adult safeguarding concerns and enquiries investigated and 1961 determined planning applications. It was highlighted that engagement with 98.3% of residents and 98.8% of businesses to collect tax and rates.

Members were told that in 2017/18 that the Council had received 463 compliments compared with 192 received in 2016/17. There had been 644 complaints received and that though there had been a slight decrease from the previous year there was an ambition to reduce the complaints further. Members were informed of the different stages of complaints which included, the council processes (which contained two stages), Adult process (contains one stage) and children’s process (contained three stages). It was highlighted that the Council’s complaints procedure aimed to ensure that every opportunity for resolution was sought through dialogue or local resolution before a complaint was submitted. It was outlined that where agreement was not achieved the customer had a right to complain and that the complaints process was dependant on the area of service under which the complaint came under. Complaints were recorded by email, phone call, letter or face to face and all of these were captured along with comments, compliments on the complaints database (JADU). It was highlighted that the council’s complaints process was managed through one team and that the team were independent of the adult and children’s services which ensured independence and removed the possibility of conflict of interest.

Members were told that there were 54 Local Government Ombudsmen complaints where a decision was found. 18 of these were referred back to the council as they had not been through the complaints process, 4 were deemed incomplete or invalid and were investigated, 19 were closed after initial enquiries, 4 were investigated and not upheld and 9 were investigated and upheld.  ...  view the full minutes text for item 117.

To review the ongoing Work Programme.

It was noted that there were a significant number of items proposed for the January Panel and it was agreed that the Deputy Director Strategy and Commissioning would work with officers to realign the work programme.  In addition, members of the Panel asked for the following items to be added or amended as per the work programme:

·         Include the ‘DASH’ agenda item for the next meeting

·         Include the ‘Finance update’ for the next meeting

·         That the ‘Long term funding’ item be postponed to March’s meeting.

·         That the response from the CCG in relation to flash glucose be provided at the next meeting.

ACTION- That Hilary Hall circulate the financial update to all members ahead of the next meeting.