The Executive Member for Adult Social Care, Public Health, Public Protection and Digital Inclusion, Cllr David Coupe, was in attendance to update the Board on his aims and aspirations, progress made to date and to highlight any emerging issues relating to his portfolio.
The Director of Adult Social Care and Health Integration, the Director of Public Health (South Tees) and the Director of Legal and Democratic Services were also in attendance. The Executive Member opened by thanking the Board for the invite and advised that he would highlight some of the key areas he had been working on, as well as some of the emerging issues relating to his portfolio. During the presentation the following key points were made:-
· In terms of the broader context it was advised that it was becoming an increasingly challenging local environment for staff within these service areas, as they were dealing with increasingly complex “chaotic” users of services, the impact of the increasing cost of living and the on-going impact of COVID-19. They were managing these challenges in the context of the current financial restrictions for both the Council and for partner organisations. There was also uncertainty around the impact and resourcing of central government’s reforms of Adult Social Care (charging reforms and changes to the ways in which care providers are funded – would they go ahead and how would they be funded?).
· It was advised that plans were in place for the commencement of CQC inspections of Adult Social Care from 2023 and the Council was connecting into the emerging Integrated Care Board (ICB) work programme in order to support the delivery of shared aspirations to reduce health inequalities and improve population health. In addition the delivery of the national drugs strategy “From harm to hope: A 10-year drugs plan to cut crime and save lives” was also high on the agenda.
· The Executive Member highlighted the on-going work and key current issues in which he was involved and all of the issues were detailed in his PowerPoint presentation, which had been shared with Members and was available via the modern.gov system.
Following the presentation Members of the Board were afforded the opportunity to ask questions and the following queries were raised:-
· In response to a query regarding the monies received by the Council during the pandemic for the provision of workforce support in Care Homes it was advised that the Council had developed a mechanism to disperse the funding, which had been monitored through the contracting and commissioning teams. The Member was advised that if the question could be submitted in writing a detailed response in respect of the figures could be provided.
· In terms of the way in which the Council and its partners were responding to the cost of living crisis it was advised that a multi-agency response was in place and the cold weather plan would also soon come into effect. The Council was working with the NHS to identify those at particular risk of being unable to heat their homes and community warm spaces across the town had been identified. Efforts were also being made to understand the offer from the Revenue and Benefits Team and where any professional went into a cold home personalised advice would be provided. The Live Well Centre in central Middlesbrough would ensure that people were also supported to connect into other opportunities. It was about looking at what else could be done to support the individual – addressing loneliness for example. The Sport England programme funding was being used to support the initiative to ensure that warm spaces were not simply a place to go to be warm but that would lead to ongoing connections.
· In response to a query it was confirmed that the substance misuse service had been brought back in-house.
· Reference was made to the ending of the Heroin Assisted Treatment (HAT) programme in Middlesbrough and Members of the Board expressed the view that the decision by the Police and Crime Commissioner to withdraw his funding had been really disappointing. The Executive Member advised that he was extremely supportive of the programme and still backed it 100 per cent. Unfortunately the Police and Crime Commissioner had struggled to make the case to fund it, stating that it was a health issue, and although the Council had funded it for a short period it was unable to sustain the funding. It was advised that the current patients, of which there were approximately 10, would continue to be supported and safely transitioned onto another form of treatment.
· The Board expressed dismay that a great service had been lost at a time when there was an increase in the number of drug related deaths due to overdose. The Executive Member advised that he would love to find another way to source the programme and was happy to push as hard as he could for it to be funded. Reference was made to the funding contributed by Middlesbrough Council to Cleveland Police to increase the number of Police Officers and whether the PCC’s office could therefore be asked to contribute to the scheme by the Board.
· A Member of the Board advised that the Health Scrutiny had had a similar discussion at its recent meeting and had determined that it wished to write to the PCC, along with the Health Secretary and the Home Affairs Select Committee. Representatives from the Home Affairs Select Committee had recently visited the HAT scheme in Middlesbrough and had appeared on national television on 11 October 2022 praising the effectiveness of the scheme in terms of the savings generated in court time and Police time. The Executive Member advised that he would certainly be supportive of such action and having previously been Vice-Chair of the Health Scrutiny Panel during its undertaking of a review on Opioid Dependency all of the evidence he heard had persuaded him that it was an excellent scheme and he would be very keen to see it continue.
· Reference was made to the food hygiene star system and the recent press coverage in relation to a small number of premises. In response it was advised that there were over 1000 eateries in Middlesbrough and only a very small percent had any problems identified. Whilst undertaking visits Environmental Health staff did on occasion experience situations whereby they would need to close a business. However, Environmental Health staff worked to a legislative framework and depending on what they found appropriate action would be taken. It was advised that if a premises received zero stars it was obvious that improvements had to be made and support would be provided to ensure the premises was brought up to standard. The Director of Adult Social Care advised that he would be happy to arrange an all Member Briefing on the Food Hygiene Star System.
· In response to a query regarding digital roll out it, it was advised that City Fibre had recently attend a local community council meeting and advised that it planned to cover great pockets of the area, although the south of the town was more complicated. It was anticipated that 5G coverage would be ongoing until 2025 and would cover as much of Middlesbrough as possible.
· A query was raised in respect of telephone access to the Registrars Service and the Monitoring Officer advised that this information would be sought and fed back to Members following the meeting.
· In response to a query on the issue of bed blocking it was advised that this was an issue that had occupied the most management time over the last 10 years and one which obscured the complexity of the issue. The sheer volume of people attending A&E and the availability of resources in the community at the point of discharge meant it was a multifaceted issue. The Director of Adult Social Care advised that the Council was working very closely with the Integrated Care System (ICS), as there was a need to ensure that we worked hand in hand with GP’s and the ambulance to prevent people ending up in hospital. It was acknowledged that there was a whole discussion to had on this issue.
The Chair thanked the Executive Member for Adult Social Care, Public Health, Public Protection and Digital Inclusion for his comprehensive presentation and contribution to the meeting.
AGREED as follows:-
1. That a letter be written to the Police and Crime Commissioner highlighting the concerns of the Board in relation to the ending of the Heroin Assisted Treatment (HAT) programme in Middlesbrough.
2. That an all Member Briefing on the Food Hygiene Star System be arranged by the Director of Adult Social Care Services.