Agenda and minutes

Apologies for absence were received from Cllrs. Anne Cyron and Gerard Hargreaves.

Any member of the Council who has a disclosable pecuniary interest in a matter to be considered at the meeting is reminded to disclose the interest to the meeting and to leave the Chamber while any discussion or vote on the matter takes place.

Members are also reminded that if they have any other significant interest in a matter to be considered at the meeting, which they feel should be declared in the public interest, such interests should be declared to the meeting. In such circumstances Members should consider whether their continued participation, in the matter relating to the interest, would be reasonable in the circumstances, particularly if the interest may give rise to a perception of a conflict of interests, or whether they should leave the Chamber while any discussion or vote on the matter takes place.

No declarations of interest were made.

The minutes of the Meeting of the Adult Social Care and Health Select Committee  held on 30 November 2023 are submitted for confirmation. The action tracker is also enclosed.

The minutes of the meeting held on 30 November 2023 were confirmed as a correct record.

The purpose of this paper is to update the Select Committee on the Public Health and Communities teams’ new proposal of a three-year Voluntary and Community Sector (VCS) development investment programme of £2.35m, and to invite the Select Committee’s questions on it.

Appendix C – Key Decision Report (to follow)

At the Chair’s invitation, Cllr Josh Rendall, Lead Member for Adult Social Care and Public Health, and Cllr Sarah Addenbrooke, Lead Member for Communities and Community Safety, supported by Anna Raleigh, Bi-Borough Director of Public Health, Callum Wilson, Strategic Director of Grenfell Partnerships, Communities and Transformation, and Muskaan Khurana, Head of Health Equity and Engagement, introduced the report and raised the following points:

1.     This was the best way to improve health outcomes in certain wards, by working with voluntary and community sector (VCS) partners who know the communities best.

2.     The programme would also involve offering training to VCS partners in the future.

3.     Acknowledged the importance of VCS organisations and the reach that they have to communities who may not engage with the NHS and Council services.

4.     The Council had a lot more data on this area now and officers had looked at the data and thought about why existing interventions had not worked. It was a three-pronged approach.

The Committee discussed the report and:

1.     Asked for a timeline of the programme and what success would look like. The officers explained that the first phase would start towards the end of March/April 2024. This would include continuing conversations with VCS partners and communities. Market warming would take place and a co-produced journey will be curated to map out some of the community-based referral pathways into NHS and Council services. The second phase would take place around September 2024 and this would be the bidding stage. When organisations bid, they would be required to commit to joining a network and providing a training offer. The Council would work with them in depth over the three-year period. Success would include improving the referral rates into services such as cancer screenings and immunisations. It would also be about providing a culturally competent offer to try and improve health outcomes for certain demographics. There would be a dashboard which would include the indicators.

2.     Noted that lower health outcomes in North Kensington had been known for over five years and questioned what would be done differently this time to get better outcomes. In response, officers explained that they would take learnings from Together for Grenfell, which was culturally appropriate, and apply it to this. The Council was aware that it was not trusted by a lot of people and that was why finding the right organisations was important.

3.     Enquired about the role of the community champions. The Lead Member for Communities and Community Safety explained that they provided information about services and raised awareness in a volunteer capacity, they did not deliver health checks.

4.     Noted the lack of resources in the north of the borough, particularly for sexual health services. The Lead Member for Communities and Community Safety responded that the programme would ensure that the right services were available in the right places. In addition, the officers would have discussions with the NHS, VCS partners and integrated care teams about providing public health services in known community  ...  view the full minutes text for item 4.

The report provides an update to the Select Committee on the development of the Council’s Learning Disability Plan 2023-2026.

Appendix A – Learning Disability Plan 2023-2026 (to follow)

The Lead Member for Adult Social Care and Public Health, Cllr. Josh Rendall, was invited to introduce the report, supported by Seth Mills, the Bi-Borough Director of Learning Disabilities and Provided Services, and informed the Committee that:

1.     It built on the Learning Disabilities Big Plan 2018 and aimed to support those with learning disabilities to lead their best lives by meeting their needs.

2.     There were seven key priorities and the Plan aimed to pull together the work completed by the Council and a range of partners. There were a variety of workstreams included which would deliver the priorities of the Plan.

The Chair then invited Sue Redmond, the Joint Chair of Full of Life, to share her experiences with the Committee, which included:

1.     Informed the Committee that she was a parent of a 33 year old daughter with complex disabilities and drug-resistant epilepsy.

2.     Noted that many parents of children with learning disabilities will be life-long carers and often they were not seen as such. Their sleep would average at four and a half hours per night due to caring responsibilities.

3.     Shared that Full of Life employed 121 support workers and staff in 2022/23 which equated to £541,000 in pay, of which £164,000 went to HMRC. They also contributed £13,000 to pensions. Thus, there were significant financial contributions to the community.

The Committee then ask questions and raised the following points:

1.    Asked whether the feedback from focus groups was a valuable experience for those who attended, and that they felt that their feedback influenced change. The officer emphasised the importance of having a feedback loop, and shared that the forum was co-chaired by himself and Sue and included residents, parent carers, representatives from health and education. It created a strategic discussion, as well as specific actions about how to improve things. Sue Redmond added that a mapping progress was crucial to see the difference, and Full of Life was not willing to be involved in the process unless they started to see a change, which she believed the Plan provided the steps to achieve. Sue shared that her goal was to know that the system would look after her child when she would pass away.

2.   Enquired how the Council and other organisations engaged with employers regarding opportunities for those with learning disabilities. The officer responded that it was a work in progress and the challenge was sustaining paid employment. However, the percentage of people with disabilities in work was double the London average. They encouraged all employers to be disability friendly and inclusive. Sue Redmond added that every employer should be able to demonstrate their outreach work to those with learning disabilities. It was also important to remember that those with very complex needs would never be able to participate in paid employment and they should not be forgotten. Those individuals were often bordering on being admitted to assessment units if not appropriately supported.

3.   Questioned whether there was confidence that the Council could  ...  view the full minutes text for item 5.

The purpose of this report is to update the Select Committee on the development of the Carers Strategy.

At the Chair’s invitation, the Lead Member for Adult Social Care and Health, Cllr. Josh Rendall, explained that this Strategy was for adults who provided care in the community for free. It had been co-designed with carers. The ambition was to identify carers early, ensure carers were valued for their role, and to inform people about the support available to them.

Gareth Wall, Bi-Borough Director of Integrated Commissioning, and Brian Jones, representing the Carers Network, were also in attendance for the discussion.

During the discussion, the Committee:

1.   Queried how vital the one-to-one sessions were in terms of engaging carers in the process, and whether carers were reluctant to voice concerns. The officer explained that those sessions were for contributions to the development of the Strategy. Brian Jones shared that there was no hesitancy from carers when sharing their thoughts. They operated a number of carers’ forums, and no cohort was quiet.

2.   Asked about the financial support for carers, including employers being more understanding of employees with caring responsibilities. Brian Jones explained that benefits were means tested and only applicable to certain people, for example, you were ineligible if you worked full time. Some local authorities also provided a grant which carers could apply for. The support available was dependent on somebody’s individually assessed needs. 88% of carers were deemed eligible for some form of support. The officer added that the Council was good at supporting carers at work, however, wanted to understand the current picture better and deliver in the gaps.

3.   Enquired about the specific interventions available to support carers’ own wellbeing and physical health and what could be improved. Brian Jones shared that they had a great relationship with the commissioners at the Council. The Carers’ Network provided a range of support services above the statutory function such as yoga classes. However, some just wanted to receive the assessment. In terms of feedback, carers shared that they want to be able to tell their story once, and that the system could be complicated to navigate. The officer added that there were 970 carers on their records, however, they estimated that the number was closer to 9,000 based on the census. Some individuals did not recognise themselves as a carer and found the label offensive. There would always be some groups where it will be more difficult to find the right offer for them.

4.   Queried whether information on carers was recorded effectively. Brian Jones responded that they kept a record on their system of any interactions they had. The officer confirmed that the Council also kept a record of carers, however, they did not record those who sought advice but did not get an assessment.

5.   Asked what was planned to address housing issues. The officer explained that there were six actions related to housing in the Strategy and it also included a section on what had been done well to achieve the action.

6.   Noted that coffee mornings predominately existed in the north of the  ...  view the full minutes text for item 6.

The purpose of this report is to provide the Select Committee with an update on the Adult Social Care Annual Complaints Report 2022/23.

The Lead Member for Adult Social Care and Health, Cllr. Josh Rendall, provided some opening remarks and then the Chair invited the Committee to discuss the report. Seth Mills, Director of Learning Disabilities and Supported Services, and Louise Butler, Head of Adult Safeguarding, Quality Assurance and Engagement supported the Lead Member. The Committee:

1.  Enquired about the plans to improve timeliness of complaints and asked what caused the low score. The officers explained that complaints came under the remit of the Head of Adult Safeguarding, Quality Assurance and Engagement in September 2023 and since then, a performance management approach had been taken with weekly updates on complaints. Complaints provided an opportunity to learn when things went wrong. There had been dramatic improvements in completion time, with a 100 per cent rate since November 2023. The officers explained that complaints was not in the most appropriate team but now there was a tight governance structure in place.

2.  Queried why 100 per cent of complaints made to the learning disabilities team, and a high percentage of those made to the hospital team, were upheld. The officers explained that they could be caused by a range of things, such as a care provider arriving late. They worked with partners to manage services and ensure issues were not repeated. There was a strong learning culture within the quality assurance team.

3.  Asked about the proportion of agency and permanent staff and the training of staff. The officers explained that under 10 per cent of staff were agency workers. There was training for staff on listening skills and being sensitive and patient. As well as ongoing mentoring. The complaints team was neutral and supported residents through the process. The team also reflected on every complaint regardless of whether it was upheld and empowered residents to challenge. A no blame culture was promoted within teams.

4.  Enquired about the complaints regarding quality of care and whether this pointed to a wider problem. The Lead Member explained that there were always things that could be improved. Complaints sometimes involved other areas of the Council or partners. Staff were very committed and passionate about their work.

5.  Noted that there were 92 complaints from 79 people and asked whether it was normal for some individuals to make multiple complaints. The officers responded that there were some residents who complained on a multiple basis, so it was about understanding where those issues came from. The number of referrals from complaints was reducing and the quality assurance process was much tighter now.

This report is an update on the Select Committee’s development of the work programme for the municipal year 2023/24.

The report was agreed as tabled.