Agenda item

The Mayor and Executive Member for Adult Social Care and Public Health will be in attendance to provide an update in his capacity as portfolio holder for Adult Social Care and Public Health.

 

The Mayor was in attendance at the meeting to provide the Board with an update regarding his portfolio in relation to Adult Social Care and Public Health.

 

The Mayor provided a detailed presentation covering the following areas of responsibility within his current portfolio, which he anticipated to be of most interest to the Board due to their scope and capacity:-

 

·         Connect Service

·         Sensory Drop In

·         Levick Court

·         Homelessness

·         Health on the High Street

·         Relationship between health and wealth in Middlesbrough

·         Three conversations approach

 

The Mayor advised the Board that a new Executive Member would be appointed in the near future to take over this particular portfolio due to the Mayor’s extensive range of commitments.

 

Connect Service

 

The Board was advised that the Connect Service in Middlesbrough currently supported 3,600 people to live independently by providing on-call emergency assistance twenty-four hours a day, seven days a week, via a personal alarm.

 

The Service was available to anyone in Middlesbrough over the age of 18 who might feel vulnerable or unsafe at home; have a disability or medical condition.

 

Between April 2023 and March 2024, the Service had answered 98,148 calls and had responded to 2,432 emergency calls (1,505 of which were falls).

 

The Connect Service used a range of technology to support individuals, including fall sensors, GPS trackers and property exit sensors, epilepsy sensors and activity monitoring systems.  This technology was a key factor in enabling people to remain living independently in their own homes.  They Mayor hoped that in the future technology would evolve further to a point where the Service would be commercially viable to offer support to others within the Tees Valley.

 

Members were provided with an example case study outlining how an Assistive Technology Assessor, Social Worker and Occupational Therapist had worked collaboratively to assess a service user for their support needs.  Technology, including a voice-activated alarm, had resulted in the number of overnight calls from the service user being reduced – restoring their dignity.  The Occupational Therapist had supported the service user with single-handed care, reducing the need for carers for a significant amount of the day and this had resulted in a £100,000 a year saving.

 

Sensory Drop-In

 

The Sensory Support Service provided advice and support to Middlesbrough residents with hearing or sight loss or dual sensory loss.  The Mayor stated that many areas no longer offered such support and considered it to be a vital service in Middlesbrough.

 

The Service would move from the Livewell Centre located in Dundas Arcade to the new facility in the Cleveland Centre once it was completed.

 

A monthly drop-in service was launched in 2021, with 30 drop-ins held so far.  Around 289 individuals attended each month which provided a sense of community and social outlet whilst supporting individuals to access sensory assessments, equipment, health and wellbeing activities and digital inclusion.  Again, the services provided helped to promote independent living.

 

Levick Court

 

The Mayor advised that Levick Court was a 16-bed facility, currently operating at half capacity, which was a valuable provision to the Adult Social Care assessment service.

 

Due to operating at low capacity and the financial pressures that the Council was under, work had been ongoing with relevant partners to explore the re-provisioning of Levick Court in order to fully utilise the building. 

 

Staff consultation was ongoing regarding two potential options to re-purpose the unit via working with the NHS and a viable operating model was close to being identified. 

 

Homelessness

 

Sadly, there had been a rise in homelessness in Middlesbrough and the Mayor provided information regarding several initiatives within the Homelessness Service that provided support.

 

·         Single Homelessness Accommodation Programme (SHAP)

 

This was a Government-led scheme providing capital and revenue funding aiming to supply good quality accommodation to address gaps in homelessness pathway provision.  SHAP targeted two groups – those with long histories of rough sleeping or complex needs, to help them recover from rough sleeping; and vulnerable young people (aged 18-24) at risk of, or experiencing, rough sleeping.  The focus was to provide longer-term accommodation.

 

In Middlesbrough, joint bids with three local housing providers and Middlesbrough Council had been made to secure funding to purchase and renovate a number of properties for this purpose.

 

·         New Temporary Accommodation

 

It was recognised that more family homes/family-focussed units were needed to avoid reliance on hotels and hostels, particularly as Newport and Penrith Road hostels tended to continually be at full capacity.  There would be a focus on bringing as many empty properties as possible back into use.

 

·         Front Door, Community Interventions and Housing Solutions Teams

 

The Housing Solutions Team provided help and support to those who were homeless.  Amongst the range of support available, the service would help to find accommodation through the Tees Valley Home Finder, (shortly to be joined by Thirteen Housing bringing all providers together in one place) and drop-in sessions were available.

 

·         Open Door

 

This was a twice-weekly drop-in session undertaking preventative work with those that had ‘leave to remain’ status.

 

·         Pathways

 

This service offered support to care experienced young people leaving care.  It provided, amongst other things, support in long term planning for independent living.

 

·         Tees Valley Home Finder Common Allocation Policy

 

This Policy was to be reviewed with a briefing for Members and consultation due to commence in late summer.  Changes to the policy would aim to address unfairness in housing allocation as there was currently no priority for rough sleepers over housed individuals.

 

·         Rough Sleepers Action

 

Attendance from multiple agencies had grown in strength to address rough sleeping.

 

Health on the High Street

 

The Mayor updated the Board in relation to the Health on the High Street Initiative.

 

There had been a decline in traditional retail in Middlesbrough town centre and a decision was taken to relocate the Live Well Centre from the Dundas Arcade into empty units within the Cleveland Centre.  Existing services would be moved across once refurbishment was complete as well as other services including NHS Services, pop-up hubs by Teesside University and dedicated youth and family space.  It was anticipated that the health offering would include dentistry which would relocate from the currently under-utilised service at the University.

 

The benefits of relocating the existing and new services to the Cleveland Centre included:-

 

·         Revitalising the High Street – through increased footfall, diversification and a community hub.  There would also be a significant cost saving to the Council as it owned the Cleveland Centre.

·         Improving public health and addressing social detriments of health– increased accessibility, greater prevention and early intervention, promoting healthy lifestyles.

 

In terms of the relationship between health and wealth in Middlesbrough, the Board heard that breaking the cycle of health inequalities in Middlesbrough to reduce the impact of poor health was crucial. 

 

Three Conversation Approach

 

As part of Middlesbrough Council’s Transformation Programme – Recover, Reset and Deliver - Adult Social Care would adopt the Three Conversations model which was a ‘strengths based’ person-centred approach.

 

The model had been used in other local authorities including Blackpool who, after a thirteen-week period, reported staff feeling less frustrated with the inflexibility of previous processes and more empowered to make decisions as well as service users responding well to being listened to differently.

 

This approach worked by:-

 

1.    Listening to the individual and understanding what really mattered to them then connecting them to resources and supports that would help them to get on with their chosen daily lives independently.

 

2.    Working intensively with people in crisis, putting together an emergency plan with colleagues to help individuals regain control of their lives by making urgent changes.

 

3.    Building a good life – finding out what a ‘good life’ looked like for the individual and identifying what resources, connections and support would enable them to live their chosen life.

 

In order to deliver the Three Conversations model, two teams would work as they wished, using the approach, from innovation sites created for a 13-week period.  One team would work with existing cases and the other would work with new cases.

 

Going forward, in terms of practice improvement to ensure better outcomes and savings, prediction into prevention would be developed using AI.  For example prediction of frailty and knowing at what point intervention was required to prevent detrimental impacts on individuals.  Prediction work was used by GPs and this could be integrated with Adult Social Care to prevent escalation.  The software used would match against care plans and health records.

 

During the course of discussion, the following issues were raised:-

 

·         In response to how to access the dentistry service at Teesside University, it was explained that patients generally needed to be registered with an NHS dentist and referred, however, there was scope to take some allocation without a referral.

 

·         A Panel Member raised the issue of housing allocations and the current banding system which appeared to be unfair.   The Mayor stated that the banding system was being reviewed and that currently not a high enough priority was given to those who were sleeping on the streets.

 

·         A Member asked what impact Government proposals to abolish Section 21 ‘no fault’ evictions might have.  Section 21, or ‘no fault’ evictions, allowed a landlord to evict a tenant by giving them two months’ notice without a reason.  The Mayor responded that Section 21 notices were difficult for local authorities to deal with and blanket bans were not the way to deal with problem tenants.  Even if Section 21 was abolished immediately it would not solve the housing waiting list problems.

 

·         Reference was made to the Connect Service and it was queried whether there was a direct charge to the resident.  It was confirmed that this was the case and that the cost started from £6.40 per week for the alarm and 24/7 response package.  Packages could be tailored to suit each individual’s needs and those in receipt of certain benefits may be eligible for help towards the cost.

 

·         A Board Member asked whether there was any update in relation to Adult Social Care spending.  Members had previously been advised that approximately 83% of the Council’s total budget was spent on Adult and Children’s Social Care.  The Director of Adult Social Care and Health Integration responded that last year’s Adult Social Care revenue budget was £50,000 but the figure for the current year was not yet available.  The Service’s total gross spend (including salaries, communications etc) was £109,000.  Last year, there had been a slight underspend on one of the budgets.  The Association of Directors of Adult Social Care had stated that in 2023/24, 72% of Councils had overspent.  Part of the spring survey on Adult Social Care showed that the national figure for Adult Social Care spending was 37.2% of a Council’s total spend.  This had risen from 36% the previous year.  Middlesbrough had spent up to 2.8% more on adult social care than the national average, however, Middlesbrough’s health profile and demographics needed to be taken into account.

 

·         In relation to the Three Conversations model, the Director explained that this particular model was being used by 50 local authorities and would transform the way in which adult social care services were delivered.  It would introduce a framework to ensure Social Workers had a consistent approach and could build up good relationships with individuals by finding out what their priorities were and what help they needed, rather than referring them to providers for services and care that they did not want.  It would also enable Social Workers to work with more people, all of which would result in cost reductions.  It was hoped that this approach would encourage better working within communities and with community organisations, such as MVDA.  The Chair highlighted that the Chief Executive of MVDA was in attendance to observe the meeting and would attend a future meeting of OSB to provide an overview of the organisation.

 

·         A Member referred to comments made by the new Government Health Secretary that the CQC was not fit for purpose and it was queried whether the Director accepted those comments.  The Director responded that there were several things happening at the moment with the CQC.  One, it continued to provide a framework to carry out assessments of care providers which was a ‘well-oiled’ process with regulatory visits.  The Council had worked to improve its relationship with the CQC.  Two, it had undertaken a rapid review of NHS mental health services but had struggled to deliver this.  Considerable pressure had been put on the CQC to accelerate this.  The Director stated he had no opinion as yet regarding the Health Secretary’s comments.

 

·         In response to a query regarding the Reablement Team, it was confirmed that they were employed by the Council with some funding provided by the NHS.

 

·         Reference was made to elderly care and the increased use of technology which led to less face-to-face contact and it was queried how loneliness was being approached.  The Mayor responded that part of the Cleveland Centre remodel provided social spaces for people to meet.  In addition, some technology could positively help with social isolation and this was part of a menu of options available.

 

The Chair thanked the Mayor and the Director for their attendance and the information provided.

 

AGREED that the presentation provided be noted.