Minutes of the virtual meeting held on Thursday 2 December 2021 at 10am.
County Councillor Karin Sedgwick in the Chair.
County Councillors: Eric Broadbent, Mike Chambers MBE, John Ennis, Caroline Goodrick, Helen Grant, Stanley Lumley, Roberta Swiers and Cliff Trotter.
In attendance:
County Councillor Michael Harrison (Executive Member) and Caroline Dickinson (Older Peoples Champion)
De Sue Proctor (Independent Chair NYSAB)
Officers: Ray Busby (Principal Scrutiny Support Officer) Shelia Hall (Head of Engagement and Governance, Health Integration), Anton Hodge (Assistant Director- Strategic Resources HAS, Strategic Resources) and Louise Wallace (Director of Public Health
Apologies:
County Councillors: David Jeffels, Andrew Jenkinson, John Mann and Robert Windass.
Co-opted Members: Jill Quinn (Dementia Forward) and Mike Padgham (Co-opted Member - Independent Care Group)
Copies of all documents considered are in the Minute Book
262. Minutes
That the Minutes of the meeting held on 20 September 2021 having been printed and circulated, be taken as read and be confirmed and signed by the Chairman as a correct record.
263. Declarations of Interest
There were no declarations of interest to note.
264. Public Questions or Statements
The committee was advised that no notice had been received of any public questions or statements to be made at the meeting.
265. Chairman’s Remarks
The Chair mentioned the members seminar held on 10 November regarding mental health first aid. Feedback to her suggested members were very engaged in the topic. She intended to undertake the more detailed two day course and encouraged others to consider the same.
266. Portfolio Holder Statement
Verbal overview by County Councillor Michael Harrison, Executive Member for Health and Adult Services, including health and wellbeing board, health integration, extra care.
Cllr Michael Harrison offered his perspective on the stresses on the workforce across the social care sector. The sector is running a high level of vacancies as providers face fierce competition in the recruitment of care staff. There are unparalleled problems with the supply of labour and the availability of resources in the care market, making this winter probably the most challenging for social care in a generation.
The directorate is responding to these pressures, in part, by diverting resources to the areas of greatest need whilst recognising there is an impact to doing so.
Cllr Harrison highlighted support for people discharged to social care from hospital settings, the volume of which has increased significantly. As an employer, we are already diverting resources to cover these gaps, to cover care package contracts - for example by redeploying staff from our services.
Instances of provider failure has also had an impact. Cllr Harrison reported the work being undertaken by our turnaround quality improvement schemes, equipped to step in to assist struggling providers.
He acknowledged that this workforce crisis might seem a bleak picture – especially the reduction in reablement, day care services and respite capacity, but he reassured members that the directorate has plans and a range of initiatives well in hand to deal with these problems.
One such approach under consideration is evaluating care packages taking a strength based approach – for example, can we still meet people’s needs whilst reducing the package of care, thereby freeing up some resource to help more people? Members agreed that as thinking on this develops, this is something the committee would want to be properly informed about.
Cllr Harrison encouraged members to support recruitment into the sector by promoting the make care matter website, a shared resource offering a wide range of jobs in adult social care and opportunities for career progression.
That the report be noted
267. Director of Public Health Overview and Update
A verbal update by Louise Wallace, Director for Public Health
Louise updated on public health activity in relation to the pandemic. She outlined current case rates across the county, which were – at least for the present – above the national average; but signs were numbers were reducing.
The picture seen was that infection rates were high in school-age children. Work was ongoing with partners to provide effective support for schools.
Government advice and precautionary measures were anticipated in the light of the spread of the new Omicron variant. No cases of this variant had, however been notified or identified in North Yorkshire at the time of reporting.
Louise highlighted the success of the local vaccination programme.
In terms of broader public health matters, her Annual report was shortly to be considered by the Executive. It would be brought to this scrutiny committee as soon as possible after that. Its content reflects back largely to 2020, and therefore recognises Lincoln Sergeant’s leadership during a good part of this period covered.
That the report be noted.
268. HAS Financial Pressures
Report of the Assistant Director - Strategic Resources, Central Services highlighting the current financial position facing HAS as at September 2021, summarising the changes being proposed by government regarding charging for social care and also providing some feedback on the changes introduced by NYCC in the last two years.
Anton gave the local a perspective on financial pressures, especially as affected by Covid, and share some of the national issues in relation to and affecting social care.
Half way through the current financial year a break-even position was reported but that only being possible because of council allocated growth money and continued reliance on Better Care Funding.
Covid costs had been significant in the previous year, mitigated in part by reductions in costs associated with some services not operating at full capacity under covid restrictions. That situation was changing with service costs returning to pre pandemic levels as “business as usual service activity returned to “normal“ levels, indeed in some cases exceeding those levels.
The agreed Business Recovery Plan, around better gatekeeping for example, and previously reported to this committee, was still in place but timescales and targets had been inevitably compromised by Covid pressures.
He also updated on charging, particularly local issues around the changes put in place a couple of years ago. Implementation of revised charges for these individuals requiring two carers present had been successful, with support offered to individuals affected and minimal complaints received. The other change brought in related to the charging for transport costs for day services. The impact of that had been difficult to assess because few day services had been in operation during the pandemic. Activity will start to increase again making assessment of impact more reliable, so it would be sensible to come back to committee sometime in the future.
Anton also covered the proposed changes recently announced by the Government in relation to the cost for care. The details are being worked through on that. It would inevitably bring more people into the scope of the authority who currently are self-funders. Again, it would be sensible to return to scrutiny in the new year by which time the position should be significantly clearer.
That the report be noted.
269. Annual Report of the North Yorkshire Safeguarding Adults Board
Dr Sue Proctor, Chair of the Adults Safeguarding Board introduced the Annual Report of the North Yorkshire Safeguarding Adults Board (NYSAB) for the financial year 2020-21, and outlined the future areas for development by the Board
Sue explained that the majority of the Board’s work, and that of its partner agencies over the 2020-21 period, had been focused on the response to the Covid pandemic. Whilst the pandemic had brought pressures to bear on all services, all partners had continued to demonstrate unbending commitment to safeguarding adults across North Yorkshire.
Partners within the North Yorkshire Safeguarding Children’s Partnership (NYSCP) and the Community Safety Partnership (CSP) are working on themes that are relevant to all three Boards/Partnerships such as Modern Slavery & Human Trafficking, County Lines, Suicide Awareness and Domestic Abuse to have a joined up approach and message to raise awareness.
Members supported the focus on collaborative working with the NYSCP and CSP on a joint engagement and communication strategy to outline how we want to engage and communicate with people across North Yorkshire.
Members expressed interest in the planned review looking specifically at the transition period from children’s to adult services, mental health involvement as well as the impact of adverse childhood experiences, self-harm and substance misuse.
The overriding conclusion was that that the council and its partners are discharging their statutory duties in relation to safeguarding effectively.
That the report be noted.
270 Work Programme
The report of the Scrutiny Team Leader on the Work Programme.
Ray Busby explained that the agenda for the next meeting included:
· Director of Public Health Annual Report.
· Local Account.
· All Age Autism Strategy
That the work programme be agreed.
The meeting finished at 12.05pm