Agenda item

The Chair invited the Executive Member for Adult Social Care and Public Health to deliver her presentation. The presentation outlined the service structure in Adult Social Care which included Head of Prevention; Provider and Support Services; Access and Safeguarding and Specialist and Lifelong Services.

 

In terms of Access and Safeguarding; the presentation listed a range of services that were operated within the service which acted as a front-door for service users. Some of those services included:

 

·         East and West locality teams which between them had received more than 9000 service users.

·         The service also included a hospital team that assisted patients when they were being discharged.

·         The Deprivation of Liberty team undertook best interests’ assessments and offered advice and guidance regarding the Mental Capacity Act.

 

In terms of Prevention, Provider and Support Services this service provided support to help people stay at home, safely and independently. Services within this area included:

 

·         The staying put agency

·         Sensory loss

·         Community Reablement

·         Community inclusion services

·         Levick Court.

 

In terms of Specialist and Lifelong Services, this area included services such as:

 

·         Older person’s mental health team

·         Forensics Social Care Team

·         Learning disability and Transitions team

 

Members were advised that other dedicated teams from commissioning and finance also worked across the portfolio area.

 

The Chair thanked the Executive Member for her presentation and invited questions from Members.

 

A Member queried if the Sensory Loss team was restricted to sight and hearing loss. Members were advised that the team was small but growing and provided a very important service. The team worked with people who had lost one of their senses, and an example was provided of a lady who, through the help of the team had reduced the number of support carers from four to zero. It was also noted that Redcar and Cleveland Council had also referred people to the service. It was also asked if the team could be grown. It was clarified that it hoped the service could be commercialised so the service was available to a wider cohort of people. This would be one of the main priorities of the new Director of Adult Social Services.

 

In regard to the Community Inclusion Service, a Member queried if the there was a waiting list for this service and it was available to those with autism. It was clarified that the Community Inclusion Service did not cover such assessments. However, it was possible that support could be provided to those people on waiting lists. It was also clarified that waiting list length was not in the remit of the Council but was determined by central government.

It was also asked if the Sensory Loss team would teach people who had lost their hearing how to use sign language. It was confirmed that this was the case and that there were a range of options available to provide support for those that had lost one of their senses.

 

Regarding the promotion of the handy person’s service, it was clarified that while some publicity was available on the Council website, there was also an element of word-of-mouth publicity from social care professionals. It was important to maintain this balance due to potential over subscription of the service. It was also commented that the charges for the service were very reasonable.

 

A Member queried if Social Care related accommodation was being considered as part of new housing developments. It was clarified that available housing included sheltered housing, housing with extra care as well as residential and nursing housing. Social Services spoke with the Planning Service and developers where appropriate, but the Council would look at the issue of housing on a strategic level.

 

A discussion took place about the mechanisms in place for communities to provide feedback about community need. It was clarified that while Social Care was primary focussed on the needs of individuals, there were links with neighbourhood working and a view to move to locality working. Doing this would allow the service to better understand the needs of communities which, in turn, would benefit care to individuals. The situation for Social Care was more reactive in nature at the moment.

 

A Member queried the remit of the Staying Put Agency which was clarified as being assessments of minor adaptations to people’s houses, such as the installation of grab rails, that helped individuals live independently at home.

 

A conversation took place about the cost implications of community working during which it was noted that moving to a community based model of working could result in a more efficient way of service delivery. This approach also provided a much better level of service for users.

 

A conversation took place about new homes requiring relevant adaptions and how, in any circumstance, adaptation was always the best approach. It was also commented there should be a more joined up approach to housing needs.

 

A Member asked if any training was available for staff and Members regarding sign language. It was clarified there was a training programme for staff, but Members suggested there may be a need for Members to undertake a similar course.

 

It was commented that approximately 10 years ago the sensory support team was larger and was shared with Redcar and Cleveland Council. However, while the service had been diminished there were several innovative approaches that helped keep the service effective. There was also a need to invest further in this service which would complement sign language courses.

 

The Chair stated Adult Social Care was one of the largest spenders in the Council, and that the Transformation programme was proactive rather than reactive and wondered what Transformation looked like for Adult Social Care. It was highlighted that while the budget for Adult Social Care was large, this was supplemented by contributions from service users. Some of the initiatives, as part of the Adult Social Care Transformation programme included working more closely with the ICB who were also facing budget cuts. It was also important that a different style of conversation namely, about providing advice and guidance rather than based on want which led to dependency. Doing this could lead to reduction in demand. Other initiatives included a more community-based approach as well using technology such as Artificial Intelligence. Ultimately, there was a move to help people to help themselves.

 

The Chair invited the Executive Member to present the Public Health element of her portfolio. The presentation included the following information:

 

·         The challenges across the South Tees including that despite improvements, Middlesbrough had a lower average life expectancy than the rest of England. There were also significant differences across different areas of the town.

·         The different roles within the Public Health service that was spread across the South Tees.

·         The programme approach to Public Health, which included five programmes, four core approaches and three levels of intervention.

·         In terms of Healthy Environments, the intention was to implement a system led approach to creating places that promoted healthy eating and moving more. The healthy weight declaration has been agreed to assist with this.

·         There was also an initiative to protect health which involved a number of priorities to protect the population of South Tees from the spread of communicable disease. It was noted there had been an increase in the cases of syphilis in the South Tees and an action plan had been created to tackle this.

·         There was a need to reduce the inequalities in population health through early detection of disease. Significant work had been undertaken at James Cook Hospital to try and reduce Did Not Attend rates with the example of maternity DNAs reducing from 15% to 3.4% due to focussed work.

·         There was a drive to reduce vulnerabilities at a population level, and this would be possible when there were sufficient facilities in place to do this.

 

A Member queried the issue of preventing ill health. In other countries health checks were undertaken with certain individuals. It was clarified this was available in the UK via the NHS health check for individuals between the ages of 40 and 74 and could be accessed via GPs. It was also clarified this was available to all people in that age range but that take up rates were dependent on demographic profile.

It was also clarified that GPs differed in their approach of inviting individuals for their health check. Going forward Public Health would try to understand why there was such variability.

 

A Member queried about Mental Health provision. It was clarified that the Joint Strategic Needs Assessment (JSNA) was available online and contained much of the information relating to this. It was further queried how success was measured in relation to such things as substance misuse. It was clarified this type of performance was managed through a national framework. It was commented that, in terms of Public Health support to different cultural groups, the service had an officer that managed the relationship between Public Health and BAME communities.

 

In relation to the School Activity programme, a Member suggested that improvements could be made by encouraging parents to walk their children to school rather than drive them. It was confirmed that this, along with several other initiatives, would contribute to the Active Schools programme.

 

In relation to improving health environments, it was highlighted certain areas of the town had more elderly people and that infrastructure was not suitable, such as footpaths. It was clarified that when footpath infrastructure improvements were made it made more sense to target those areas where there was a higher risk of falls.

The Chair thanked the Executive Member for Adult Social Care and Public Health, as well as the Directors of Adult Social Care and Public Health for their attendance.

 

AGREED that

 

1. Statistics relating to NHS Health Check take up be provided to the Board and where possible these be on a ward basis.
2. That the information presented to noted