Agenda and minutes

To receive any declarations of interest.

There were no declarations of interest received at this point in the meeting.

The minutes of the Adult Social Care and Services Scrutiny Panel meeting held on 7 September 2022 were submitted and approved as a correct record.

The Director of Adult Social Care and Health Integration will provide the panel with a verbal update regarding the integration of health and social care.

The Director of Adult Social Care and Health Integration provided Members with an update regarding the integration of Health and Social Care; the following points were made:

• The transition to the new Integrated Care System (ICS) had progressed significantly.
• The Integrated Care Board (ICB) had been established and held its first meeting (the Board was responsible for the allocation of funding across the large geographical area that the North East and Cumbria ICS covered).
• Membership of the ICB was outlined to the panel and it was explained that this was driven by statute.  The role of the Local Authority representatives to offer perspective and contribute to the reflection of the area’s overall demographic was noted.
• The Integrated Care Partnership (ICP), which was the tier below the ICB, was responsible for health and wellbeing within the area.  This provided opportunity for statutory and non-statutory organisations to come together and convey their views for their respective areas.  The ICP had held its first meeting, although the finalised chairmanship arrangements were still to be determined.
• Below the ICP tier and unique to the North East and Cumbria ICS were four integrated sub-partnership boards, which reflected the complexity of the geography.  The structure of these was currently being determined, i.e. whether or not a formal Committee structure would be most appropriate, but work was currently ongoing.
• The Director outlined his position/involvement in each of the tiers.
• An initial objective was to have a health and wellbeing strategy for each area set in place, by the end of the current financial year.  At present, this was in a draft state, but issues relating to the size of the geographical area had been raised.

During the discussion that followed, Members queried several points with the Director – the following information was provided in response:

• There was a great deal of work required for the Director in terms of being involved with all three tiers, but he felt this was both manageable and beneficial for consistency; there was no conflict between the various levels of the ICS.  A flow chart of the ICS would be provided to Members when available.  Publication/availability of minutes of meetings would be determined (the panel noted that the ICB was a Committee of the NHS).  Owing to the size of the ICS’s geography, Members recognised the diverse needs of people from Cumbria to Northumberland, and the importance of conveying the five Tees Local Authorities’ needs to the ICB.
• As work progressed, matters would be reported to the Health Scrutiny Panel in conjunction with this panel; the relevant Democratic Services Officers would circulate information as required.
• Regarding Joint Strategic Needs Assessments (JSNAs), these were currently being reviewed (Adults JSNA was to be reviewed by December 2022).  The ICB required that a shape/strategy be devised.  Reference was made to a presentation delivered by the Association of Directors of Adult Social Services (ADASS) at the first ICP meeting in relation to current work and strategy development, which would be considered by all partners in line  ...  view the full minutes text for item 22/15

Officers will be in attendance to provide the scrutiny panel with a general overview and introduction to the topic.

The investigation will focus on matters including:

·        The impact of increased costs on care home and home care provision;

·        Government funding and the impact of increased costs on Adult Social Care funding / budgets; and

·        The impact of winter pressures.

The panel will be asked to consider the information provided and next steps for the review.

It was agreed at the last panel meeting that an additional topic would be added to the work programme, i.e. ‘The Impact of the Energy and Cost of Living Crises on Caring for Vulnerable Adults’.  The Overview and Scrutiny Board had subsequently approved the addition of this item at its meeting on 21 September 2022 (as part of the Scrutiny Chairs Update).

The Director of Adult Social Care and Health Integration and the Head of Strategic Commissioning and Procurement were present at the meeting to deliver a presentation to Members.  The information was presented in two parts.  The first part focused on ‘The Cost of Living Impacts on Adult Social Care’, and the second part focused on the risks and potential impact of the crises on both Adult Social Care and the wider directorates of the Council.

In terms of ‘The Cost of Living Impacts on Adult Social Care’, the following matters were raised:

-        By way of background, Members were advised that some of the issues experienced had recently been addressed by the government’s Mini-Budget, which was delivered on 23 September 2022.  However, some independent sector organisations that delivered services to vulnerable adults, and who continued to face pressures, had verbalised these to officers within Adult Social Care.

-        Homecare consisted of domiciliary care providers delivering services in clients’ own homes and in residential care settings.  Supported Living and Extra-Care Housing facilities were predominantly shared housing with care providers visiting; residents had their own tenancies in place and therefore faced the same pressures as other Middlesbrough residents, i.e. increased bills.  Mention was made of the Welfare Strategy discussed at the last panel meeting in assisting support recipients.

-        In terms of current issues being faced by providers, these were identified as follows:

       Homecare

-        A number of external factors had caused significant issues in respect of fuel, which had created an almost ‘perfect storm’.  In terms of the pandemic, the price of crude oil had fluctuated around the lockdown periods, and demand changed as businesses closed and then reopened.  Reference was made to the ongoing war in Ukraine, and the decreasing value of the pound versus the (oil costed) dollar.

-        Adult Social Care had five approved business providers for the delivery of domiciliary care; approximately 13,000 hours of homecare was commissioned per week.  An element of this was delivered by local staff able to walk and cycle to their clients’ homes, however, due to workforce pressures, there was an increasing reliance on drivers.  The viability of care work had decreased for many people, predominantly due to the rise in the cost of living and competition from other industry recruiters, such as retail.  It was indicated that a wider strategy around recruitment was required, as it was difficult to compete with organisations paying a higher wage.

-        In the period December 2021 to August 2022, fuel had increased by 26%.  When tendering for homecare contracts, providers needed to consider care workers’ hourly rate, which took into account insurance, registration  ...  view the full minutes text for item 22/16

The Chair will provide a verbal update on matters considered at the meeting of the Overview and Scrutiny Board held on 21 September 2022.

The Chair provided a verbal update on the matters that were considered at the Overview and Scrutiny Board meeting held on 21 September 2022.

In order to enable Members to access the minutes of the respective Overview and Scrutiny Board meeting(s) directly, a Member queried the possibility of adding links onto future panel meeting agendas.  The Democratic Services Officer would look into this. 

AGREED that the request regarding panel meeting agendas and links to OSB minutes be looked into.

DATE OF NEXT MEETING – 2 NOVEMBER 2022

The next meeting of the Adult Social Care and Services Scrutiny Panel had been scheduled for Wednesday, 2 November 2022 at 10.30 a.m.

NOTED