Verbal update from the Strategic Director of Social Care, Lisa Redfern.
Minutes:
The Strategic Director for Social Care provided a verbal update.
Scene setting, Vision, Achievements and Challenges
ASC provided services for 3,100 people with 234 staff, and Lisa Redfern outlined how the H&F vision was to support residents who were vulnerable to be enabled to live independently. Co-production of services offered real choice and control over residents’ own lives.
Quality
The Care Quality Commission (CQC) rated two H&F provided services as “outstanding”: The Community Independence Service, (CIS), and the Riverside short breaks service. Lisa Redfern explained that they were very proud of these achievements as this meant that they were offering high quality services to H&F’s residents. Ofsted and CQC had rated H&F SEND services as very good.
ASC was committed to improving quality of care, working more with primary care to prevent hospital admissions. The special disabilities service (Transitions) with the transfer to adult services commencing from 14 years and upwards was rated as “good”.
Home Care
ASC continued to work very closely with all three main agencies and robustly manage and monitor provision. Quality was variable.
Performance
ASC performance on delayed discharges both for acute and non-acute service is very good. We address any quality issues through our quality assurance work and forums, including the Safeguarding Adults Board.
Budget
ASC achieved a balanced budget again for 2018/19, however, the social care budget continued to face significant challenges.
Sovereign Borough Progress
All social care services have been fully disaggregated We have two services, the hospital discharge and emergency duty services which continue to be shared.
The Borough’s Safeguarding Adults Board was launched in September 2018 and was well attended by all relevant agencies and appeared to be working very well.
A weekly Footcare service/clinic was established. The cost for toenail cutting was heavily subsidised at £16.00, rather than £60.00. The option of a home visit was also being considered with a possible charge of £32.
The new direct payments service had been co-produced, and the new service was about to be launched.
Councillor Richardson thanked the Strategic Director for her overview and its emphasis on community provision and asked why the NHS did not engage more in similar provision. Councillor Coleman briefly provided context to the establishment of the footcare clinic, how following consultation the CCG had limited the provision of podiatry services to only those who had acute or severe medical conditions. Feetfirst had contacted the Council and this had been supported by the Strategic Director and the Mayor. Councillor Coleman felt that this was something that the CCG should have been able to pursue in partnership with the Council.
Footcare was important as it helped to prevent serious trips and falls and helped those who were too embarrassed about being unable to cut their own toenails. Councillor Kwon suggested that the availability of the service be highlighted to local diabetes charities and community groups as good footcare could help prevent amputations. Good footcare was essential, not just about grooming or appearance, but was much broader than this. Councillor Kwon also suggested that it might be possible to identify those who were not eligible for NHS podiatry services and it was noted that those with diabetes remained eligible.
Jim Grealy commented that the CCG needed to be reminded that health services were for residents and that how their provision impacted on residents. He asked if data could be provided by Feetfirst and hoped that this area of work could spark a conversation with people if they were already in receipt of hospital care. Good footcare was preventative medicine which could potentially save money and improve health and wellbeing.
Victoria Brignell enquired about annual surveys and whether the data and results were published. Lisa Redfern confirmed that these were undertaken each year and that the most recent results would be analysed with the results published soon.
ACTION: Strategic Director to provide this when it became available
Victoria Brignell asked about the proportion of people in receipt of direct payments. Lisa Redfern confirmed that approximately 500 people in residential and nursing care received direct payments.
In the context of homecare, Jen Nightingale asked if there was a correlation between pay and the quality of staff. All carers received a London Living Wage (LLW) however, Lisa Redfern explained that this was only one aspect as had been indicated by recent CQC and ADASS (Association of Directors of Social Services). It was important to recruit carers with the right attitude, who were caring and compassionate.
Councillor Lloyd-Harris reported that she had received complaints from residents about the poor quality of the home care that they had received and asked at what stage did the Council intervene. Lisa Redfern responded that the Council had significantly improved home care monitoring over the past year and that his was also being closely monitored through Councillor Coleman’s weekly member briefing meetings.
Councillor Caleb-Landy suggested that it might be possible to identify pinch points through cross-departmental working where residents who have experienced anti-social behaviour or environment concerns could be further supported. He asked if there were plans to have further engagement and dialogue with residents. Lisa Redfern explained that there were several cross-cutting, strategic and operational service boards. Lisa Redfern outlined how the Public Services Reform agenda was to challenge siloed thinking and advocated new ways of working. Formal boards such as the Safeguarding Adults Executive Board, and, the learning disability and mental health executive boards had also been established.
Councillor Caleb-Landy enquired about short breaks and was one of the first services to go but also one of the most important. Lisa Redfern responded that the Council continued to fund short breaks, breaks for carers, day services, direct payment for carers and a range of other options. Councillor Coleman commented that there had been a programme of ring-fenced funding for disabled children services. This had been removed by the Conservatives (in power at the time). Financial challenges had worsened but the Council still provided the service. There were also charities such as Family Fund that were able to offer support. Further information about this was provided at ASC Lunch and Learn sessions which members were invited to attend.
ACTION: Strategic Director to send information to Cllr Caleb-Landy; and to confirm for members details of Lunch and Learn sessions
Councillor Richardson commented on the physiotherapy consultation which had been scrutinised by the Health, Inclusion and Social Care Policy and Accountability Committee (HISPAC). The consultation had concluded, and Professor Tim Orchard and Imperial colleagues would consider the feedback provided by HISPAC. Members would receive a further update following Councillor Coleman’s next meeting with Imperial. A paper on physiotherapy and hydrotherapy had been requested from the CCG for the Health and Wellbeing Board (HWB). It was acknowledged that this may be a CCG funding or contracts issue and Councillor Caleb-Landy suggested that it would be helpful to obtain data about which physiotherapy services can be provided, with a view to further scoping this at HWB.
RESOLVED
That the update provided by the Strategic Director was noted.