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City of York Council |
Committee Minutes |
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Meeting |
Health and Adult Social Care Policy and Scrutiny Committee |
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Date |
9 February 2021 |
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Present |
Councillors Doughty (Chair), Cullwick (Vice-Chair), Hook, Heaton, Perrett, K Taylor and Wann (substitute for Cllr Waudby) |
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Apologies |
Councillor Waudby |
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7. Declarations of Interest
Members were asked to declare, at this point in the meeting, any personal interests not included on the Register of Interests or any prejudicial or discloseable pecuniary interest that they might have in respect of the business on the agenda.
None were declared at this point but whilst discussing Agenda Item 4, Covid Update, Cllr Wann declared a personal non prejudicial interest in that he worked at the University of York and had used the lateral flow testing site.
8. Minutes
Resolved:
(i) That the minutes of the previous meeting of the committee held on 10 November 2020 be approved with the following amendments and signed at a later date.
· Under minute item 4, Verbal update on how GP practices are coping with the Coronavirus emergency, first bullet point on page 3 include the word ‘rated’, so the first sentence reads, ‘The City of York was fortunate in that they had a service which was rated good or better, which was important in the context of discussions of patient expectation’.
· Under minute item 5, 2020/21 Finance and Performance First Quarter Report Health and Adult Social Care:
§ change 202/210 to 2020/21
§ change the heading ‘Delayed transference of care’ to ‘Delayed Transfers of Care’ and under this heading change the word ‘customer’ to ‘patient’ in the last sentence.
(ii) That the response from officers regarding the projected overspend at Haxby Hall be emailed around Committee Members.
(iii) That officers liaise with the Clinical Commissioning Group (CCG) regarding an update on the development of the new mental health workers.
9. Public Participation
It was reported that there had been no registrations to speak under the Council’s Public Participation Scheme.
10. Covid Update
The Director of Public Health attended the meeting to provide a presentation on the latest Covid-19 data relating to the Outbreak Control Plan, epidemiology, settings, testing and contract tracing and key issues emerging.
Some key points raised:
· The current Outbreak Control Plan was approved by the Outbreak Management Advisory Board in June 2020 and would be refreshed by April 2021.
· The 7 national themes in the Outbreak Control Plan covered
§ Care homes & schools
§ High risk places, locations & communities
§ Local testing capacity
§ Contact tracing
§ Data integration
§ Local Boards
· This latest peak had shown increases in numbers across the 35 to 49 age group but trends across all age bands were now falling in York.
· As at 4.2.21 the Positivity rates (Pillar 2 only) for York showed 263 positive cases out of 4,104 lab based (PCR) tests and 43 positives out of 9,684 rapid (lateral flow) tests.
· The 7 day incidence rates per 100,000 showed how York’s figures were decreasing below the regional and national average.
· Westfield, Strensall, Hull Road and Dringhouses and Woodthorpe Wards had a statistically significant fall in rates compared with 7 days ago.
· There had been an increase of hospital admissions in January but figures were decreasing.
· There had been 140 excess deaths in York since the start of the pandemic (using the 2015-19 weekly average number of deaths as the comparator).
· As at 9.2.21 there were 5 care homes in the City of York Council area with confirmed Covid-19 infection.
· The new UK (Kent) variant had become the predominant variant and had been the reason for the spike of cases in York.
· A community daily hub met daily to review anti-social behaviour across the city and the Covid Marshalls were interacting with businesses, patrolling the city, supplying face masks and had picked up 735 discarded face masks.
· The Covid vaccination program was progressing extremely well with all care homes being offered the vaccine.
The Director summarised the ongoing key issues as being the expansion of testing to businesses with more than 50 employees; enhanced contact tracing; compliance with social isolation and any future roadmap out of national lockdown.
Members questioned the Director on a range of issues and she confirmed that:
· Other respiratory diseases, such as flu and norovirus cases, were lower than normal due to the current infection control measures in place and a higher take up of the flu vaccine.
· York was in a better position regarding care home outbreaks compared to other local authorities within the region. Care home staff were tested weekly and residents tested monthly and where they were any particular concerns, the care home was supported to ensure good practices were in place.
· Nimbuscare were managing the vaccination sites in York and there were currently no concerns regarding vaccine supply.
· Nimbuscare were considering measures to ensure the vaccination sites would operate safely when footfall increased due to the first and second dose overlap. All vaccination sites were Care Quality Commission (CQC) registered and had to comply with the national standard operating procedures.
· School and University data was regularly monitored and work with larger businesses would be the next focus.
· York St John University, The University of York and the Community Stadium were currently being used as lateral flow testing sites.
The Director agreed to email Members the intensive care capacity figures at York Hospital and further specific information relating to the activities of the Covid Marshalls.
The Chair thanked the Director for all her continuing efforts and those of her team.
Resolved: That the presentation be noted.
Reason: To ensure that the Committee were aware of the current situation in York relating to Covid-19.
11. Commissioning update on the care market, and capacity requirements for the coming period
Committee Members considered a report that provided a commissioning overview of the care market in York, with a particular focus on the needs of older people and to describe the council’s approach to the challenges of the next few months.
The Assistant Director of Joint Commissioning was present to provide the update and with the Corporate Director of People, answer Members’ questions.
She stated that:
· The latest Care Quality Commission (CQC) ratings showed that 74% of residential and nursing home settings were good, 8.6% outstanding and 17.1% required improvement and that since the report had been written, for community settings, including supported living, one provider had shifted from ‘inadequate’ to ‘requires improvement’.
· A complex network of partners continued to work together to support the care system and ensure the right range of services were available to enable people to live as independently in their own homes for as long as possible.
· A new Market Position Statement was in the process of being co-produced with the sector for publication in 2021.
· The Council sets a standard weekly fee rate for its placements, known as the Agreed Cost of Care (ACOC), with higher costs by exception.
· In 2019 a capacity and demand exercise was commissioned to better understand the pathways relating to urgent and unplanned care.
· The Coronavirus Act 2020 created a new financial mechanism as well as new service models and requirements, allowing care providers to build on the strategic agreement that Home First is York’s default, supported by the Hospital Discharge Service Requirements.
· Care providers in York had been supported by the CCG and Council teams to fully implement the Capacity Tracker, which had supported communication about available capacity and the status of services in relation to risks.
· The Adult Social Care Action Plan and the Winter Plan continued to be developed and it included the establishment of a designated residential care setting at Peppermill Court for patients who had tested positive for Covid-19, to enable safe discharge from hospital and a unit at Haxby Hall for people who had come in contact with the virus but tested negative.
· After the initial wave of infections in the earliest phase of the crisis, providers had implemented excellent infection prevention and control, with no outbreaks for a long period of time.
· All local care homes were receiving the vaccine.
The Assistant Director noted that a range of services had to be extended or created to manage the steep rise in demand and she thanked staff and partners for their dedication. She commended the partnership working and integrated commissioning approaches that had made great progress in response to the pandemic.
In answer to Members questions, the Assistant Director confirmed:
· A temporary care home setting was a good asset to have in the system for those who required short term care when discharged from hospital.
· The findings from the independent exercise, that had been jointly commissioned to update the ACOC model, was currently being considered, including any implications of the changed circumstances linked to Covid-19. When the document was publically available Members could be updated at a future meeting.
· Individual care providers do have the ability to breakdown their weekly costs and the sector does have an understanding of the expected profit margins.
· Recruitment was continuing and there was a range of resources to ensure new staff were supported and encouraged to continue in the field once the immediate crisis was over.
· Voluntary organisations, service users, families and previous users were all included when surveys were issued, to ensure a wide response was received
The Assistant Director and Corporate Director of People answered a specific question raised regarding the selling of a council asset that was designated as a health and social care building and the transparency around this. They stated that the council had a strategic overview of all their assets in the city and that officers ensured they had sufficient types of buildings for the whole range of care services. Overtime these requirements could change and if a particular building was no longer required it would revert back to being a council asset to potentially be used in a different way.
The Assistant Director agreed that any future monitoring reports could include past data to enable the Committee to compare how the inspection framework had developed and improved over the last few years.
The Assistant Director was thanked for her update and for the tremendous work achieved throughout the pandemic.
Resolved: That the report be noted.
Reason: To keep the Committee updated on the care market in York.
12. Work Plan
The Committee noted that that the Chair and Vice-Chair of Customer and Corporate Services Scrutiny Management Committee were still coordinating business for all scrutiny committees, whether forums or public meetings, through the corporate work planning process.
The Committee considered its draft work plan and agreed to receive:
· at the Forum meeting on 13 April 2021, following a referral from the Chair of CCSSMC, the Future of Health and Social Care in York report that was due to be considered by Executive on 18 March. The Executive Member for Health and Adult Social Care could also be invited to attend.
· at a future meeting, an update on the dementia provision in York, including the dementia strategy and dementia action alliance.
Although some Members raised their concerns and frustrations regarding the reduction in scrutiny and hoped for a more rigorous process to resume soon, they were appreciative of the work of officers in Democratic Services.
Resolved: That the work plan be approved, subject to the above amendments/additions.
Reason: To keep the Committee’s work plan updated.
Cllr Doughty, Chair
[The meeting started at 5.30 pm and finished at 8.28 pm].