Agenda and draft minutes

Apologies were received from Councillors Karin Sedgwick and Roberta Swiers.  Councillor George Jabbour substituted for Councillor Karin Sedgwick.

Resolved – That the Minutes of the meeting held on 28 March 2024 be taken as read and confirmed by the Chair as a correct record.

All Members are invited to declare at this point any interests they have in items appearing on this agenda, including the nature of those interests.

There were no declarations of interest.

Members of the public may ask questions or make statements at this meeting if they have given notice to Melanie Carr of Democratic and Scrutiny Services and supplied the text (see contact details below) by midday on Friday 14 June 2024, three working days before the day of the meeting.  Each speaker should limit themselves to 3 minutes on any item.  Members of the public who have given notice will be invited to speak:

·            at this point in the meeting if their questions/statements relate to matters which are not otherwise on the Agenda (subject to an overall time limit of 30 minutes);

·            when the relevant Agenda item is being considered if they wish to speak on a matter which is on the Agenda for this meeting.

If you are exercising your right to speak at this meeting, but do not wish to be recorded, please inform the Chairman who will instruct anyone who may be taking a recording to cease while you speak.

No public questions or statements were received.

a)    Introduction from Councillor Michael Harrison: Portfolio Holder

b)    Presentation from Richard Webb, Corporate Director for Health and Adult Services

Considered – A presentation on Health and Adult Social Care performance.

The Executive Member for Adult Social Care, Councillor Michael Harrison introduced the presentation providing an overview of the scale of the Directorate and what it covered.

Richard Webb, Corporate Director for Health & Adult Services went on to provide his annual state of the nation update which provided an overview of:

·          The leadership team;

·          The scale of the Directorate and its four main roles i.e. Public Health, Adult Social Care, Supported Housing and working with the NHS;

·          500+ Commissioned Services

·          The significant in-house provision of social care and smaller scale in public health;

·          The make-up of primary care across the county i.e. the seven NHS Trusts and integrated Care Board

·          The HAS 2025 Plan and its 3 priorities i.e. ‘Opportunities for everyone, everywhere’, ‘My time and experience are valued’, and ‘My home, my community, my choice’;

·          The current issues i.e. budget and demand pressures, migration and social care, the outcome of Adult Social Care Assurance, the refurbishment/ replacement of 3 remaining council run care homes, the long term plan for social care reform, supporting the SEND generation into adulthood, and future pandemics/outbreaks;

·          The current financial position and the action plan underway to mitigate cot pressure risks and deliver the necessary MTFS savings;

·          Operational pressures in ASC and the care market, and areas for improvement; 

·          The position in regard to NHS Health Checks, Public Health healthcare, adult weight management, smoking cessation services, sexual health services and substance use;

·          The three main priorities for Public health i.e. ‘Best Start in life’, ‘Getting people moving more’, and ‘Healthy ageing’;

·          The seven main priorities for ASC i.e. ‘Direct payments’, ‘Carers’, ‘Home First’, ‘Waiting well’, ‘Reviews’, ‘Reablement’, ‘People with complex life’, and ‘Circumstances’;

·          Recruitment – a significantly improved picture in terms of vacant posts across key frontline services during 2023/24;

·          The work of the Quality Team;

·          Customer involvement, including the development of guidance and a toolkit;

·          Assurance and inspection – CQC ASC Assurance expected in next two years, and Public Health peer review in 2025;

·          The three phases of a recent Peer Review undertaken in preparation for the expected CQC Inspection – an overview of the draft findings to be presented at the committee’s next meeting;

·          Delivery Plans for ASC and in Public Health up to 2027 and beyond;

·          The 10 steps for Public Health and Social Care reform

·          The year ahead i.e. getting the basics right, transformation and foundations e.g. structural changes, ASC Assurance and evaluation and learning;

Members noted the update and raised the following:

·          The savings made through switching from residential care to home care and the need to be careful to ensure no unintended consequences;

·          Issues around short stay placements;

·          The reduction in living well referrals, thought to be as a result of the pandemic;

·          The need for a pre-planned approach to reablement following elective surgery;

They also requested a more detailed update on substance use.

The Chair thanked Cllr Harrison and Richard Webb for the update, and it was

Resolved  ...  view the full minutes text for item 5.

Considered – A presentation on service development and the transformation plan for the Adult Social Care market.

The presentation provided by Abigail Barron, Assistant Director for Prevention and Service Development, gave a detailed overview of:

·          The vision for adult social care and public health services moving forward;

·          The key market objectives for 2024-25;

·          The workforce;

·          The quality of care across social care services in North Yorkshire;

·          The recent Care Quality Commission ratings for care home provision and community-based care providers;

·          Market sustainability;

·          Care staff data – number of vacancies etc;

·          The plans for market shaping and ‘Home First’, including the planned navigator pilot for the Nidderdale and Washburn Valley Service to manage/reduce demand for commissioned services;

·          The proposed direction of travel for residential, intermediate and dementia care;

·          The planned full needs analysis and review of current service gaps to inform future commissioning of specialist and complex care;

·          The planned delivery of a refreshed Shared Lives Model and the establishment of a network of county wide care service providers and partners, to encourage collaboration and the sharing of best practice;

Members noted the presentation and in response to their queries, officers confirmed the following:

·          There was no evidence to suggest that ASC staff were leaving to go work for the NHS.  In regard to external care provider staff it was more likely they would move to hospitality/retail work.

·          Not many county residents were choosing cross border extra care, and those that did were not choosing it as a result of a lack of extra care in the county.

·          There had been some small pockets of market failure due to issues with international workforce, but the service was working closely with the Home Office and Care Market group to address it.  Where there had been provider failure, officers had work quickly to ensure care provision and where possible that had involved the care worker going with the patient to ensure continuity of care.

·          The allocation of young people’s care direct payments was not based solely on price but also on the patient’s needs.

·          Direct payments not only delivered value for money but also a more focussed person specific care package.

·          There was no evidence of a clinical reason for the national increase in early on set dementia but an increase in awareness has been seen.  Understanding was important has it helped to manage longer term trends.

The Chair thanked officers for the update, and it was

Resolved – That

i.          The presentation be noted;

ii.          A detailed update on Direct Payments be provided at a future meeting

Members considered the planned work programme for the remainder of meetings in the 2024/25 municipal year.

Having noted the discussions at the meeting it was

Resolved – That the Committee’s work programme be updated to reflect the following:

·          An update on the 3-stage ASC Assurance peer review, and a report on Substance Use for the committee’s next meeting on 26 September 2024

·          A detailed overview on Direct Payments for the committee’s meeting on 5 December 2024

·          Any further changes to the work programme to be agreed at the next mid cycle briefing