NORTH YORKSHIRE COUNCIL
17 May 2023
STATEMENT OF CHAIR
CARE AND INDEPENDENCE AND HOUSING OVERVIEW AND SCRUTINY COMMITTEE
The committee agreed to consider the directorate’s response to Cllr Andy Brown’s line of enquiry in relation to Health and Adult Services directorate activity on Social Care, Public Health and Climate Change, inviting a response at this committee meeting. This covered:
· How are we working to reduce emissions through Procurement and commissioning options, Market Shaping and working with providers to embrace change to an environmentally sustainable agenda.
· for example, remote working, business travel for our staff and care service users.
Digital options – remote collaboration working, online assessments etc. promoting work with partners around tech care.
· The role of Public Health and the social and environmental determinants of health.
· Keeping people healthy; green agenda; Air quality/pollution - What opportunities are there in terms of the wider Culture and Leisure agenda.
A detailed response was considered, one that included the draft HAS Climate Action Plan which, when finalised, will form the basis of the directorate’s contribution to the overarching NYC strategy. Highlights included:
· Climate change & sustainability is a recognised part of HAS work plan.
· Identified leads for climate change for adult social care and public health since 2019.
· Climate change key issue highlighted in 2019 HAS Summer Conversations.
· Lots of work ongoing – in light of (draft) NYC climate strategy the directorate is pulling all current and planned work together into HAS climate action plan.
· Lots of crossover between climate and public health agendas – specific public health action plan to supplement HAS plan.
The Climate Action Plan follows nationally accepted guidance from the Local Government Association. This includes a series of commitments about what we will do and how we will do it. Also, HAS intends to include commitments around additional pieces to support implementation of the action plan:
· HAS Climate Board
· Climate literacy training
· Development of service level plans
· Climate in all policy approach
In relation to public health, there are significant commitments to:
· Develop the evidence base and data for the climate impact within North Yorkshire.
· Address the wide range of health impacts of climate change.
· Strengthen the climate resilience and environmental sustainability of the local health system, commissioned services, strategies, and interventions.
· Promote the health co-benefits of climate change mitigation in other areas.
The committee remarked favourably on the comprehensive nature of the draft plan. Although it may not address directly the specific questions raised in the line of enquiry, the service issues Cllr Andy Brown raised were properly and rightly incorporated in the scope and narrative of the draft plan.
Whilst the committee does not intend, in the short term at least, to look again at the draft plan, once the overall strategy is adopted the commitments within it will be a key element of how the committee chooses to scrutinise service performance and developments.
Once every year the committee considers the Health and Adult Services Local Account - the annual statement of HAS performance in delivering adult social care. Given that the Local Account ought to be an honest assessment of social care performance, it is helpful that, before it is published, members can review, pass comment and make suggestions for any amendments.
1. The time period covered for this Local Account is 1st April 2021-31st March 2022.
Whilst the main focus is adult social care, it is both helpful and important that the account also references in some detail public health activities.
For this Local Account, we liked that the format has been adapted to introduce the HAS Plan 2025 and better support the Directorate’s work to prepare for the new CQC assessment framework for council’s adult social care (reported in my last statement). In addition, we could see evidence of the intention to make the report more user-friendly and accessible.
We supported the way the format has been amended so that future Local Accounts can be aligned to the CQC self-assessment and showcase performance improvement in an engaging and accessible way.
As in previous years, the committee found the Local Account to be a high-quality document, well written and accessible. It has passed what for members has been the pivotal test: it is self-reflective rather than self-congratulatory.
When we review service updates on chosen topics, care market information is also made available as it is crucial if we are to assess whether we are supporting vulnerable adults effectively. But we decided it was time to reflect more generally on care market matters and gain a fuller picture of the pressures throughout the care sector. We wanted to be in the best position to determine where our key areas of focus should be for the coming year.
We learned that the key headlines, the areas of the greatest pressure, are:
· Workforce issues across the health and care sector
· Increased number of hospital discharges
· Unsourced packages of home care, particularly in Whitby, Craven and Ryedale
· Cost of care continues to rise, particular issues resulting from economic pressures
· Limited care home capacity, with deregistration of nursing homes
· Sustainability of the care market remains a priority, issues relating to financial stability and recruitment and retention
Unsurprisingly, all these elements were, in one way or another, part of our work programme. However, because of what we heard, we will escalate them as topics for regular monitoring and review. Our initial thoughts are that will entail looking closely at:
· the significance and impact of unsourced packages of care and if some areas of the county were more affected than others, what does this mean for equity.
· The complications and financial implications to providers and the authority resulting from the sector running high occupancy rates.
· The details, findings and conclusions of a pilot scheme in Harrogate on changed terms and conditions for the social care workforce.
· How we work to prevent but, when required, respond to market provider failure.
We were all pleased to see that Jill Quinn, who represents the community and voluntary sector on the committee, who founded Dementia Forward 10 years ago and now works as the Chief Executive, was made a Member of the Order of the British Empire (MBE) for services to people with dementia.
Jill facilitated an excellent informal session with committee members, covering how her organisation has developed and grown, the prevalence of dementia in the county, and local and national initiatives.
The committee agreed to hold an informal session to help it understand how it might carry out its expected new responsibilities around housing. A meeting between the Chair, Vice Chair and the AD for housing has been arranged for an initial discussion.
For the next meeting in June, we will be looking at:
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Extra Care - next generation |
Update on progress and statement on ambition to see Extra Care in all key towns by 2023. |
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Unpaid Carers – support for Carers |
Overview item to help assess the support provided to adult carers of adults in North Yorkshire. |
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Direct Payments |
Revisit how NYCC is ensuring that Direct Payments enable more choice and control over the support people receive and how their social care needs are met |
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Living Well |
Update on service activity |
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Digital Lives |
Introduction to Technology enabled care, online care, financial assessment and brokerage. Tech Enabled Care –supporting and enhancing the experience of people and their independence in their own homes. Activity, Initiatives etc
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Intermediate Care/Discharge to Assess |
Discharge arrangements and current position throughout the county. This may include a briefing on introduction of Pilot scheme for short-term care beds. |
COUNCILLOR KARIN SEDGWICK
2 May 2023