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 July 2021 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.  Particular focus was given towards work currently taking place nationally around the transformation of NHS structures; the following points were made:

• Locally, Tees Valley Clinical Commissioning Groups (CCGs) would be dissolved and a new Integrated Care System (ICS) implemented next year.  Middlesbrough would fall under the North East and Cumbria ICS, a much larger geographical footprint than at present.  It was highlighted that this presented opportunity and very good relationships with partners had been developed to date.  Reference was made to a recent multi-agency meeting that had been held to discuss potential operation of the system across the Tees Valley area once implemented.  It was highlighted that the appointment of the Chair of the ICS had had a very positive impact on opening up improved communications with partners.
• Work on the local footprint and determining the most appropriate operational methods was paramount.  This work, which would look at key governance arrangements, would be undertaken with partners across the Tees Valley.  Meetings were being established by the Managing Director of Redcar and Cleveland Council in supporting this work.  The key question for Local Authorities and partners to ask concerned the types of issues where control, at local level, would be most sought.  Additional work, looking at such matters as work force, finances, etc., was taking place in parallel to this.

During the discussion that followed, Members raised a number of queries with the Director.  In response, the following information was provided:

• In terms of the types of issues that Local Authorities would wish to exert control, it was explained that there was a little uncertainty around this at present.  Consideration had been given to economies of scale and the operation of services as part of a wider geographical footprint.  It was felt important to retain as much control as possible over the direction of funding locally.  Reference was made to preventative work and ensuring sufficient investment within this area in order to build resilience and tackle long term challenges.  Ensuring a good and formal relationship with the Primary Care Network (PCN) was also a key objective.  Some matters would be determined statutorily by Ministers and others at ICS level.  The importance of ensuring a collective position and voice for the Tees Valley with negotiations / the ICS was highlighted. 
• In terms of Member representation on associated Boards / Committees, the Panel was advised that there would be discussion regarding Local Authority representation in due course.  It was commented that working relationships with the Directors of the CCGs was excellent and the success of this initiative would depend on the quality of relationships going forward.  Negotiations were currently taking place, but the feeling locally was that progress had been positive.
• With regards to local representation on a regional scale and ensuring that the ICS was representative of all areas of the North East, it was unknown at present as to  ...  view the full minutes text for item 21/10

The Director of Adult Social Care and Health Integration will provide the panel with a verbal update regarding adult day care services / provision.

The Director of Adult Social Care and Health Integration provided Members with a verbal update regarding adult day care services / provision; the following points were made:

·        The Council operated a number of forms of day care, which was a purposeful activity provided in response to identified / assessed social care needs. 

·        Day care for younger individuals acted as a dual function in that it provided purposeful activity for the individual, whilst also providing respite for parents / carers to allow them to attend work, etc.

·        Two streams of day care were currently operated: in-house day care and specialist provision.  In-house day care was delivered by Local Authority staff in Local Authority facilities and there were three aspects to this:

–       Community Inclusion – support was currently provided at Cumberland Resource Centre (learning disability provision), the Pavilion at the Park (learning disability provision) and Sandringham House (autism provision);

–       The Orchard, which was a partnership between the Local Authority and Tees, Esk and Wear Valley (TEWV) Mental Health Trust, provided specialist day care primarily for younger adults; and

–       North Ormesby Resource Centre, which provided an older persons day centre and a dementia focused day centre.

·        With regards to the private sector, the Council currently contracted ten providers to support individuals, predominantly in respect of learning disability provision.

In terms of service provision and the impact of COVID-19, the following points were made:

·        During the initial stages of the pandemic and upon entering the first spike in cases, decisions concerning the closure / suspension of day care services were taken in response to the statistics provided by the government.

·        Since this time, all efforts have been made to remain as flexible as possible.  For example: in instances where individuals could not enter day care services, staff provided support in domestic settings to ensure that both purposeful and social contact was maintained.

·        There had been periods of opening / closing facilities in line with government directives, but day care provision had now resumed and was operating well.  Reference was made to the progress achieved in terms of operational changes, including in relation to risk assessments, PPE, operation of bubbles and lateral flow and PCR testing, which had been implemented with assistance from infection control experts, Contracts and Commissioning officers and others.

·        In some of the units, operating capacity had reduced relatively slightly.  Some individuals had opted not to return to day care; others had sadly passed away during the period, although this was largely related to the turnover of individuals utilising day care and dementia and older peoples’ units, as opposed to necessarily being a direct consequence of COVID-19.

·        The next step would be to resume services for those individuals living in residential care and attending day care in different settings.

·        In terms of statistics, it was highlighted that there had been a marginal reduction in the number of individuals on the roll accessing day care across community settings.  Prior to the pandemic there were 259 people on the roll; this  ...  view the full minutes text for item 21/11

The Chair will provide a verbal update on matters considered at the meeting of the Overview and Scrutiny Board held on 28 July 2021.

The Chair provided a verbal update on the matters that were considered at the Overview and Scrutiny Board meeting held on 28 July 2021.

NOTED

The next meeting of the Adult Social Care and Services Scrutiny Panel had been scheduled for 13 October 2021.

NOTED