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 30 November 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 advised Members that, to enable staff to focus on winter pressure issues being experienced at hospitals over the Christmas period, integration work had recently been paused.

Details were provided in relation to two financial packages that had been provided to the NHS prior to Christmas, which would help facilitate hospital discharge arrangements in Middlesbrough. 

The first fund provided the NHS with £500m, of which Middlesbrough would receive circa. £600,000.  This would provide additional capacity around hospital discharge over the period, of which previous concerns had been raised.  Following agreement with the ICS, a scheme had been implemented and continued to operate currently.  Related performance was reported to the Department of Public Health on a fortnightly basis.  In terms of the second fund, Middlesbrough would receive a share of £200m allocated nationally, which would assist with the purchase of additional bed spaces within care homes and other provider space.  It was indicated that both funds were to be fully utilised by the end of March 2023, which was felt to be particularly unrealistic in terms of resolving any deeper issues.

The Director highly commended the work that the teams had carried out over the Christmas period.  A seven-day presence was provided, with discharge being driven on those days.  Flow from hospital to domiciliary care had been maintained and managers very happy with performance.  It was indicated that an end to activity was being approached, though there was awareness of industrial action taking place within the NHS.

In terms of continuing with integration work, the Director would be meeting with ICS colleagues on 9 February 2023 to discuss progress and next steps.  It was felt that the operational stage would commence shortly.

During discussion, Members discussed the £600,000 of funding awarded to Middlesbrough and the potential to spend this effectively within the required four-month period.  It was felt that if this could have been extended to cover the longer term, it may have provided longer term sustainability. 

Consideration was given to discharge arrangements from hospital to both care home and own home environments, and how the additional funding from both funds was able to assist with this.  The Director explained that the second block of funding was effectively concerned with locating beds for individuals, whereas the first block was a little more open.  For example, a small number of beds were reserved specifically for end-of-life care.  A specific amount of money was also reserved for reablement to enable individuals to return to their own homes and receive support.  Details around expenditure and regular monitoring of it were required by the Government.

A Member queried the development of a hospital in Stockton-on-Tees and whether this laid within the ICS arrangements.  In response, the Director explained that a diagnostic centre was being planned, but no further details were available at present.  It was felt that the relationship between North and South Tees would become closer, with a local dimension being developed through partnership.  It was  ...  view the full minutes text for item 22/35

Following the scrutiny panel’s 2022 review, Members will receive an update from the Director of Adult Social Care and Health Integration in respect of the panel’s recommendations and the action undertaken in response.

In respect of the scrutiny panel's 2022 review of The Recruitment and Retention of Staff Within Adult Social Care, the Director of Adult Social Care and Health Integration provided an update on the progress made with the implementation of the agreed recommendations / actions.  The following points were made:

• Work in the department had progressed quite significantly since the investigation had taken place, and things had changed.
• Following preliminary work and a paper being considered by the Leadership Management Team (LMT) around recruitment and retention support for staff, a change of direction followed to avoid the situation of a total loss of experience and only new experienced staff being in situ.  This involved changing the way in which Social Workers were able to progress through the ranks, and allowed more Social Workers to progress to more complex case handling without them needing to wait until such respective staff had left the organisation and effectively provided a vacancy.  This provided stability around core of workers.
• Recruitment issues did continue to present themselves as work became increasingly complex, preparing for CQC inspections, etc.
• In reflection of Children’s Services and work being undertaken in that area to reduce the use of agency staff, including the introduction of a recruitment and retention payment, a report would be submitted to LMT later this month with a proposal to incentivise potential staff to join Middlesbrough Council and remain for their career.  It was acknowledged that this incurred cost and therefore all recommendations would be scrutinised vigorously, with funding being provided through the budget and Medium-Term Financial Plan.  The service still operated with too many gaps in Social Worker complement and required a medium-term plan to fund it.  An update would be provided at a future meeting.
• In terms of awareness raising, a fair amount had been undertaken, with Teesside University for example.  It was anticipated that the online learning module would be progressed in the coming months; this had been delayed due to staff being involved with CQC work and assessments.

During the discussion that followed, Members considered the role of agency staff, of which Adult Social Care did not currently use.  It was explained that a small team had been employed in the latter stages of the pandemic to assist with completing a small piece of work, but these had since left.  The market for Adult Social Care Social Workers was not the same as it was for Children’s Social Workers, therefore the supply was not comparable.  In addition, when agency staff were appointed, this often increased pressure on existing permanent team members because agency staff needed training up.  The Director explained that it had been a calculated position to not require agency staff.  Further, the service wanted to avoid the situation of not being able to deliver duties solely by permanent staff because, if this could not be achieved, CQC direction towards agency support would impact budgets.

The panel discussed the available routes into the social work profession, with reference being made to apprenticeships  ...  view the full minutes text for item 22/36

The Chair will present a verbal update on the matters that were considered at the meetings of the Overview and Scrutiny Board held on 13 December 2022 and 12 January 2023.

The Chair provided a verbal update on the matters that were considered at the Overview and Scrutiny Board meetings held on 13 December 2022 and 12 January 2023.

NOTED

The next meeting of the Adult Social Care and Services Scrutiny Panel had been scheduled for Wednesday, 29 March 2023 at 10.30 a.m.

NOTED