North Yorkshire County Council
Care and Independence Overview and Scrutiny Committee
Minutes of the meeting held on Thursday, 22nd September, 2022 commencing at 10.00 am.
County Councillor Karin Sedgwick in the Chair. plus County Councillors Caroline Dickinson, Bridget Fortune, Heather Moorhouse, Roberta Swiers, Andy Brown, Joy Andrews, Pat Marsh, Robert Heseltine, Jack Proud, Eric Broadbent (Vice Chair) and Phillip Barrett.
Co-opted member: Jillian Quinn (Voluntary and Community Services).
In attendance: County Councillor Michael Harrison.
Officers present: Richard Webb (Corporate Director, Health and Adult Services), Anton Hodge (Asst Director, Strategic Resources) and Diane Parsons (Legal and Democratic Services).
|
Copies of all documents considered are in the Minute Book
|
|
1 |
Welcome and Introductions
The Chair welcomed everyone to the meeting. Apologies were noted from Councillors Arthur, Thompson and Knapton.
|
|
2 |
Minutes of the meeting held on 23 June 2022
Resolved –
That the minutes of the meeting held on 23rd June 2022, having been printed and circulated, be taken as read and confirmed and signed by the Chair as a correct record.
|
|
3 |
Any Declarations of Interest
There were no declarations of interest to note.
|
|
4 |
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.
|
|
5 |
Chair's remarks - Any correspondence, communication or other business brought forward by the direction of the Chair of the Committee.
The Chair encouraged Members to seek clarification on any points or to ask her or senior officers any questions as needed, recognising the level of change underway nationally and the wide brief of the committee.
Members were advised that climate change will be placed on the agenda for the committee meeting in March 2023 due to lack of capacity on the December agenda. The Chair encouraged all Members in the meantime to undertake the online learning package on the Learning Zone entitled “An Introduction to Climate Change”.
The Chair also wished to note her thanks to Diane Parsons for providing support to the meeting in Ray Busby’s absence.
|
|
6 |
Adult Social Care in North Yorkshire
Considered –
The report presented by Richard Webb, the Corporate Director, Health and Adult Services, providing an overview of the key focus and challenges for adult social care and Public Health.
Richard was asked why hospital admissions caused by deliberate or unintentional injuries in children are 15.3% higher in North Yorkshire than nationally. It was agreed that the reasons behind this would be explored further.
Members highlighted that more funding needs to be directed into tackling social isolation. Members were recommended to speak to their locality Stronger Communities Manager on local initiatives and that the Locality Budgets are a useful pot to direct into improving recreational facilities.
Members also discussed the need to ensure availability of specialist accommodation for the care market. Richard advised that work has been underway with district and borough councils on new housing developments to be able to be creative around Extra Care and supportive housing.
It was identified that more locality working on health and wellbeing programmes would be beneficial and that the leisure offer isn’t always consistent across the county. Richard highlighted that a proposal will be brought to the Executive in November around a countywide review of the delivery of leisure.
Richard provided further detail for Members on challenges faced by the care market. It was explained that there is currently huge pressure on hospitals and post-pandemic there are now large queues for people discharged from hospital in need of a social care package. Richard and Cllr Harrison have tried to influence nationally and in the media around the need for a decent level of pay for care workers but it is difficult to compete with other sectors and staff vacancies pose a significant issue. Additionally, a number of care homes are struggling, with particular depletion in available beds in Scarborough and Selby areas in the last few years. The service has had to intervene at points to ensure the continuation of homes and there are increasing applications from homes for hardship funding.
Members discussed the impact of large housing developments on the capacity of local hospitals. Richard highlighted that while the council is limited in its lobbying of the NHS on such matter, North Yorkshire lends itself to doing more around using technology in community care.
The committee also considered the difficulties of providing a competitive wage for care workers and welcomed the efforts of Councillor Harrison and Richard Webb in lobbying at a national level and in local media around better pay.
Members considered climate change implications in relation to care homes, along with the cost of heating homes, and whether the council can and does ask providers to review practices around sustainable warmth. Councillor Harrison advised that environmental requirements have been enhanced in contracts when procurement is underway, but that with domiciliary care providers it is more around reminding about practices which help the environment and save money and capitalising on things like doing remote meetings more often. Richard advised Members that there are climate changes leads in adult social care and Public Health, looking at electric cars as an option for home care workers and also looking at cycling pilots. The directorate is conscious of the need to keep this under review and to tighten up where possible.
In relation to the adult social care charging reforms Trailblazer, Richard outlined that no formal decision has been made to jump into this at an early stage but that there is an opportunity to shape development from a rural perspective. The service wants to see the funding gap properly identified nationally and addressed, along with a realistic timeline. There are also issues around IT and data. The directorate will continue to push on all of these issues.
Resolved –
That the committee:
(a) Notes the report provided; (b) Receives further information on why hospital admissions caused by deliberate or unintentional injuries in children are 15.3% higher in North Yorkshire than nationally; (c) Receives further detail on the number of homes operated by SMEs in the county.
|
|
7 |
Health and Adult Services Financial Pressures Update, including impact of ASC Charging Reform (The Care Cap")
Considered –
The report of Anton Hodge, Assistant Director of Strategic Resources (HAS) in relation to financial pressures within Health and Adult Services, including the impact of charging reforms for adult social care.
In terms of the current financial pressures, Anton highlighted that the following key issues:
· The directorate had been expecting significant pressures moving out of Covid in relation to increased discharges from hospitals. However, the situation has been compounded by the government having ended temporary funding around this. · Inflationary pressures had been predicted but it hadn’t been anticipated that these would get quite so high so quickly. · The service has not seen the impact of the re-procurement of the approved provider list but it was noted that this needs to be re-done and will consequently drive up costs. · The Fair Cost of Care and Trailblazer will also bring other costs. · Overall, the service was well placed by having predicted many of these additional pressures, although there is a risk of overspend. · Some work was undertaken in the directorate a few years ago to tighten up financial management so now there is better gate-keeping, a more robust scheme of delegation and better working together among managers and teams. The directorate is doing as much as it can to manage as efficiently as possible.
Anton provided an overview of the charging reforms for adult social care (the “care cap”). It isn’t possible, currently, to calculate what the costs of this will be to the authority. Anton highlighted that what the government has indicated it will give to the council is unlikely to cover all of the costs incurred as a consequence of the cap.
There is continued engagement with DHSC. Members were advised that a financial modelling working group has been set up. Even if NYCC is not a Trailblazer, it will still need to adopt the reforms next year so the work behind this to manage it still needs to be done.
Members discussed costs and profit in the care sector; particularly whether a different model could be adopted by the council to reap profits, as are achieved in the private care market. Richard and Cllr Harrison highlighted that there are different rules for NYCC in terms of making a profit and that the council is almost a provider of ‘last resort’. A provider development post is being put in place within the service and they are looking at other interventions that can be taken. It was also highlighted to Members that the sector per se is very expensive to run, particularly where some individuals need a high staffing ratio for their care.
Members also sought reassurance from the directorate that quality of care is being maintained when recruiting for carers from overseas and that those joining the service from other countries are appropriately housed. Richard highlighted the linkages with the Stronger Communities team and the efforts made to locate carers together in larger towns so that they have an accessible support network. It was noted that carers do also need to be able to easily serve more rural areas.
Resolved –
That the Committee notes the report provided.
|
|
8 |
Work Programme
Considered –
The report of the Scrutiny Team Leader on the Work Programme.
Diane Parsons noted that the next meeting will be on 1st December 2022 and will be held in person. Members’ attention was drawn to the range of high priority items identified for the committee at the recent mid-cycle briefing. Members were reminded that the Older People’s Champion will bring a report to the next meeting and that a couple of areas highlighted at Appendix 1 would probably need to be taken next time due to ongoing interest/urgency and/or the fact that they are annual reports. It was suggested that the committee look to take a brief update on Trailblazer progress, the Annual Safeguarding Adults Board report and the two reports from the Director of Public Health (Local Account and Annual Report).
It was identified that mental health is not on the forward programme. The Chair referenced the need to schedule suicide prevention and also social prescribing in to a future agenda.
In relation to the proposed item on climate change for March 2023, the Chair invited Cllr Brown to be propositional about the specific areas he would like the committee to consider.
Resolved –
That the Committee agrees its work programme.
|
|
9 |
Other business which the Chair agrees should be considered as a matter of urgency because of special circumstances.
The Committee were advised that no urgent business had been notified.
|
The meeting concluded at 12.05 pm.