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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 |
21 February 2023 |
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Present
In Attendance
In Attendance Remotely |
Councillors Doughty (Chair), Hook (Vice-Chair), Barnes, Vassie, Cullwick and Wells
Peter Roderick, Consultant in Public Health Ruth Hine, Public Health Specialist Practitioner (Advanced) Maxine Squire, Assistant Director of Education and Skills David Barf, North Yorkshire Police Andrew Simpson, North Yorkshire Police Sharon Stoltz, Director of Public Health Cllr Runciman, Executive Member for Adult Social Care and Public Health [Between 6:05pm and 7:24pm] Terry Rudden, Strategic Support Manager, Adults and Public Health Steve Tait, Finance Manager, Adult Social Care
Jamaila Hussain, Corporate Director, Adult Services and Integration |
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Apologies |
Councillor Heaton |
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30. Declarations of Interest (6:03 pm)
Members were asked to declare at this point in the meeting any disclosable pecuniary interests or other registerable interests they might have in respect of the business on the agenda, if they had not already done so in advance on the Register of Interests.
Cllr Vassie declared a personal non prejudicial interest in agenda item 5, 2022-23 Finance and Performance Q3 Monitor Report, in that his father was a client of Be Independent.
No further interests were declared.
31. Minutes (6:05 pm)
Resolved: That the minutes of the previous meeting held on 14 December 2022 be approved as a correct record and be signed by the Chair.
32. Public Participation (6:05 pm)
It was reported that there had been no registrations to speak at the meeting under the Council’s Public Participation Scheme.
33. Local Plan of Action for Drugs and Alcohol in York (6:05 pm)
Members considered a report that highlighted the Local Plan of Action for Drugs and Alcohol in York.
The Consultant in Public Health set out the background to the report, where it was noted that the York Drug and Alcohol Partnership, established in 2022, had created a live and evolving local plan of action, which was aligned to the national strategy.
The action plan was presented to Members at the meeting and was attached as a supplement to the published agenda. The presentation provided an action plan overview and informed Members of:
· The scale of the challenge;
· The 10-year ambition;
· The plans to break drug supply chains;
· How treatment and recovery systems would be delivered;
· How a generational shift in the demand for drugs would be achieved.
During discussion of the item, and in answer to questions raised, officers stated that:
· Hospital admissions data for alcohol related issues was recorded through several categories. The data received was specifically linked to York residents. In addition, the Integrated Care Board (ICB) would be considering trends linked to age and ward areas.
· There were various funding streams available to support the outcomes and these were regularly reviewed by the Drug and Alcohol Partnership.
· Increased referrals into treatment would be incorporated to support a national initiative to intervene, protect, divert and support individuals to not fall into the criminal justice system.
· Operation Chill had been designed to enhance relationships between the police and young people. It looked to identify young people who may be subject to a criminal environment to enable the police and partners to intervene at an early stage.
· The York Drug and Alcohol Service had recently been rated outstanding by the Care Quality Commission (CQC), and the service would be supported to meet the growth in capacity to keep officer caseloads at a manageable level.
· York in Recovery was a peer-support, and peer led recovery group. The charity provided an exceptional service and offered a safe space, activities, and connections for members of the York Community who were in recovery.
· The overall effectiveness of the service was evaluated through a set of standard national measures. These measures were considered by officers on a quarterly basis. Statistics were also available on the public health data collection fingertips website https://fingertips.phe.org.uk/.
· Breaking drug supply chains and achieving generational shift in the demand for drugs would be evaluated through a new set of metrics issued by the government, and any smaller projects or initiatives would also be assessed.
Members noted the evidence base solutions for treatment, intervention, and prevention. They understood that funding constraints would be a challenge to achieve a world-class treatment and recovery system but welcomed the strong working partnerships already attained to deliver an exceptional service.
Members thanked officers for their report and
Resolved:
(i) That the update on the Local Plan of Action for Drugs and Alcohol in York be noted.
(ii) That the report be shared with the Chairs of the council’s scrutiny committees, particularly Children, Education and Communities Policy and Scrutiny Committee and Housing and Community Safety Policy and Scrutiny Committee.
Reason: Scrutiny members’ comments would help shape this emerging action plan and strengthen the actions and work on reducing the harm caused by drugs and alcohol in the city.
34. 2022-23 Finance and Performance Q3 Monitor Report - Health and Adult Social Care (7:15 pm)
Members considered a report that provided a detailed view of the outturn position for Public Health (PH) and Adult Social Care (ASC) for 2022/23.
During discussion of the item, Members raised questions regarding; the performance analysis in ASC; pressures on the workforce; the overall satisfaction of people who use the adult social care service; breastfeeding; smoking in pregnancy; sexual health; Be Independent; Yorkcraft, and future budgetary forecasts.
Officers confirmed that:
· The continued ambition was to reduce the use of agency staff and build strong performing teams within ASC. The right recruitment and retention packages were in place to increase the social work cohort and all vacant ASC Heads of Service had been filled, which would support the next recruitment drive during Social Work Week in March 2023.
· Following the recruitment of a Head of All Age Commissioning, that team was now more robust and would support delivery of future budget savings.
· Yorkcraft were considering their business plan to achieve more commercial sales.
· Be Independent was a key part of the council’s preventative offer. Further work was required to stabilise the organisation, and support the underachievement on the sales income budget.
· The number of Adult Safeguarding concerns reported had risen and structures were in place to manage the impact on staff.
· Following the Adult Social Care User Survey, an additional survey had been issued to customers who had identified they were not satisfied with the service, and officers were working on the identified pockets of dissatisfaction. Officers were also collaborating with Healthwatch York to ensure the needs of our customers were being appropriately met.
· Smoking in pregnancy was a high priority and additional resource had been achieved to try to encourage pregnant smokers to quit.
· Additional funding had been obtained from the Humber and Yorkshire Integrated Care Board (ICB) to support the breastfeeding agenda. The aspiration in York was to become a breastfeeding friendly city and to progress community services to achieve baby friendly status.
· The budget set for 23/24 would be sufficient and mechanisms were in place to enable a more balanced budget next year.
The Director of Public Health informed Members that the percentage data highlighted within the final sentence of paragraph 53 of the report was inaccurate. It was reported, following the meeting, that the data had been checked for accuracy and the correct figures for April to September 2022 were:
· 87% (over 90% originally reported) of clients who set specific health goals have achieved at least one of the goals and 69% (over 70% originally reported) of all the health goals set have been achieved.
Members noted that a Care Quality Commission (CQC) assessment was expected to take place within ASC and they thanked officers for the report and update.
Resolved:
(i) That the report be noted.
Reason: To update the Committee on the third quarter financial and performance position for 2022-23.
(ii) Statistics relating to the York Sexual Health service to be included within future finance and performance monitor reports.
Reason: To keep the Committee updated.
(iii) That an update be received at a future meeting on the improvements implemented to address the dissatisfied outcomes identified in the Adult Social Care User Survey.
Reason: To ensure the needs of our customers were being appropriately met.
[An adjournment took place between 7:43 pm and 7:48 pm]
35. Adult Social Care Reform: Cap on Care (7:48pm)
Members considered a report that provided an update on Social Care Reform particularly around cap on care costs, following the government’s announcement in September 2021 to implement the cap on care cost by October 2023.
The Corporate Director of Adults and Integration set out the background to the reform and explained that the cap of care implementation date had been delayed until 2025. Members were informed that the cap would be set at £86,000 and the reform proposed a point at which a person was eligible for local authority means-tested support. This more generous means-testing limit meant that more people would be eligible for some state support towards the cost of care earlier, and would reduce the amount that people would pay for their care each week.
The Finance Manager of Adult Social Care confirmed that the ringfenced funding for the loss of income to the council had been redirected to pay for the cost of care exercise, which was currently being undertaken, and he also stated that the Health and Social Care Levy had been reversed.
Members acknowledged the implications and shared their concerns. Officers stated that the delay would enable all Local Authorities to complete planning to enable robust modelling and a clearer understanding of the required resource to support the reforms on an ongoing basis.
Members noted the significant challenges faced, particularly without additional resource to support the implementation, and they welcomed an update at a future meeting.
Resolved: That the update be noted and a report be considered at a future meeting following the publication of the white paper: People at the Heart of Care.
Reason: To keep the Committee updated on Social Care Reform, particularly around cap on care costs
36. Work Plan (7:59 pm)
Members considered the draft work plan for the Committee.
Resolved: That the following additional items be included for consideration during the 2023/24 municipal year.
· An update following the Care Quality Commission (CQC)assessmentin Adult Social Care.
· An update on the developments of the Integrated Care Board (ICB).
· An update on the Social Care Reform, particularly around the cost of care exercise and cap on care costs, either before or following the publication of the white paper: People at the Heart of Care.
· An update on the improvements implemented to address the dissatisfied outcomes identified in the Adult Social Care User Survey.
Reason: To keep the Committee’s work plan updated.
Cllr Doughty, Chair
[The meeting started at 6.02 pm and finished at 8.02 pm].