Minutes of the meeting held on Thursday 23 June 2022 at 10am.
County Councillor Karin Sedgwick in the Chair.
County Councillors: Joy Andrews, Karl Arthur, Eric Broadbent, Andy Brown, Caroline Dickinson, Robert Heseltine, Nigel Knapton, Pat Marsh, Heather Moorhouse, Andy Paraskos (as substitute for Andrew Lee), Jack Proud, Roberta Swiers, Angus Thompson,
Co-opted member - Jill Quinn (Voluntary and Community Services)
In attendance: Cllr Michael Harrison
Officers: Ray Busby (Principal Scrutiny Support Officer), Dale Owens (Assistant Director of Commissioning & Quality, Health and Adult Services), Victoria Turner (Public Health Consultant), Louise Wallace (Director of Public Health).
Apologies:
County Councillors: Phillip Barrett and Andrew Lee.
Co-opted Member: Mike Padgham (Independent Care Group)
Copies of all documents considered are in the Minute Book
1. Minutes
That the Minutes of the meeting held on having been printed and circulated, be taken as read and be confirmed and signed by the Chairman as a correct record.
2. Declarations of Interest
There were no declarations of interest to note.
3. 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.
4. Chair’s Remarks
The Chair welcomed everyone to the meeting.
She congratulated Dale Owens on his recent appointment to another
authority and wished him every success in this new part of his
working life. She thanked him for his support and professional
advice over recent years to both her as Chair and to the
committee.
5. Overview and Scrutiny at North Yorkshire County Council
Report by the Scrutiny Team Leader providing a summary of how overview and scrutiny is undertaken at the Council, the way in which subjects for scrutiny are identified, why it is important and what role committee Members play.
Presentation by Louise Wallace, Director of Public Health on the experience of the Covid -19 pandemic from a public health perspective and where we are now in terms of a “Living with COVID-19” plan
Louise and Victoria Turner, Public Health Consultant, highlighted
· Move from government mandate to individual responsibility on key measures including isolation, testing, wearing face coverings etc.
· Routine contact tracing and legal requirement to isolate ended 24th February
· End of (most) free COVID-19 testing for general population 1st April
· Latest figures on Infection and patients admitted in England
· Vaccination uptake
Looking forward to Winter, we were currently at the expected height of Omicron, experiencing over 180 care settings with cases.
Victoria explained that Public Health had reviewed ways of working and managing cases, for example by building a prioritisation framework (to reach the most in need soonest), and more detailed ‘Red Status Dashboard’ to give oversight and reporting of cases to reduce need for calls to settings pushed for time to carry out the previous surveys.
Due to the high number of outbreak-related care home closures, there were impacts on hospital discharges; in this regard a multi-agency admissions panel had been set up to review urgent admission requests into closed homes.
In answer to a member’s question, Victoria advised that withdrawal of free symptomatic testing - other than for hospital patients or when it is required for their care and to people living or working in “high-risk settings”, such as care homes and prisons – would mean infection rates would be estimations. Furthermore, it was known that whilst people are still testing, the proportion of people then reporting the results is significantly lower.
6. North Yorkshire Adult Social Care Market Overview
Presentation and Report by the Assistant Director Prevention and Service Development, Commissioning and Quality (HAS)
Dale explained that adult social care is a complicated mix of state-funded and privately financed care, provided by many different organisations, most of which are independently owned businesses, at prices determined by local market forces and the funding available to local authorities.
There are now very low nursing and residential home vacancy rates with limited capacity across North Yorkshire. The authority faces considerable challenges with sourcing home care particularly in Selby and Scarborough and in some cases where people require very bespoke/specialist support. And significant workforce issues, pressures and shortages existed across health and care sector locally, regionally and nationally.
Overall, sustainability of the care market remains a high priority for the directorate, with significant and immediate issues relating to financial stability and workforce recruitment and retention.
In the face of all these pressures, Dale emphasised that the council has well established working relationships with the care market, voluntary and community sector and health are all committed to working together as a local health and care system.
Intervention measures to support the care market ranged from funding initiatives - for example to assist and promote recruitment and retention, regular engagement with new and potential new providers, working with homecare providers and stronger communities to identify opportunities to sub-contract non-regulated care, and a wider transformation plan incorporating national health and care reform.
That the report be noted.
7. Adult Social Care Charging Reforms
Report and Presentation by the Assistant Director for Prevention and Service Development, Commissioning and Quality (HAS)
Dale explained that while the Health and Care Bill goes through Parliament, social care is preparing for the changes it will bring – as part of wider government reforms – to financial assessment and funding regulations. In particular, this includes the introduction of a cap on what self-funders must pay towards their care before they become eligible for state-funded care. This will be a significant challenge to address the changes. From October 2023, no eligible person starting adult social care will have to pay more than £86,000 for personal care over their lifetime.
The reforms mean more people will qualify for local authority assistance than previously which will have significant implications across all our services.
NYCC has agreed to become one of five national trailblazer sites which will implement the reforms in January 2023. Dale and the portfolio holder, Cllr Michael Harrison stressed that this decision is not without risks for the council – especially in financial terms.
North Yorkshire has some aspects that make it very different from many of the other Trailblazers. We have high numbers of providers, high number of self-funders and have remote rural and coastal communities. Being a trailblazer gives us the opportunity to re-design some of the ways we go about our business generally and how we manage this local mix.
Members recognised the argument that as the council will ultimately have to implement this change, why not do so early but with direct support and the opportunity to influence how the new scheme works. Cllr Harrison added that if it works well, then early implementation will bring benefits to the population of North Yorkshire earlier than elsewhere.
a) That the report be noted.
b) Members welcomed the extent of the work the directorate has undertaken to prepare, whilst recognising the scale of the work ahead and the tight timeline in which to be ready for what is going to be a huge task.
c) Given the self-evident significance of this initiative, the committee indicated it would wish to keep a “weather eye” over activity towards implementation and then monitor its progress and effect.
8. Work Programme
The report of the Scrutiny Team Leader on the Work Programme.
For the next meeting in September, Richard Webb has agreed to give a strategic overview of the state of adult social care in North Yorkshire, including the financial pressures upon the service.
That the work programme be agreed.
The meeting finished at 12.05pm