Agenda and minutes

There were no disclosable pecuniary or other relevant interests declared.

The minutes of the meeting held on 2^nd April, 2014 were signed as a true record. Further to Minute 63 concerning ‘Referral by Healthwatch Coventry – Commissioning of Patient Transport Services’ the Chair, Councillor Thomas reported that a copy of the letter sent to Coventry and Rugby CCG outlining the Board’s recommendations would be forwarded to Healthwatch Coventry by the end of the week. With reference to Minute 65 headed ‘Local Care Data Programme’, Councillor Thomas informed that the letter to University Hospitals Coventry and Warwickshire requesting information about patient data for acute care would be circulated by the end of the week.      

Presentation by Coventry and Warwickshire Partnership Trust

Josie Spencer, Deputy Chief Executive and Director of Operations and Roisin Fallon-Williams, Director of Strategy and Business Support, Coventry and Warwickshire Partnership Trust have been invited to the meeting for the consideration of this item.

The Scrutiny Board received a presentation from Josie Spencer, Deputy Chief Executive and Director of Operations and Roisin Fallon-Williams, Director of Strategy and Business Support, Coventry and Warwickshire Partnership Trust, detailing the outcome of the recent Care Quality Commission (CQC) Inspection of the Partnership Trust. This inspection was a pilot, the first of a new type of process used by the CQC and the Trust had put themselves forward. Councillor Gingell, Cabinet Member (Health and Adult Services) attended for the consideration of this item.

The presentation provided an overview of the Trust which served a population of 1,053,000 with a budget of over £200m. Mental health, learning disability and community health services were provided and the Trust operated from 70 sites. 

The inspection reports included 13 location reports and 1 provider level report, all of which identified areas of good/notable practice and some acknowledging exemplar practices. Examples of good feedback from across the Trust were given along with examples of good practice that had been observed.

The inspection had also identified a number of areas which required improvement which had resulted in 1 enforcement action and 5 compliance actions. Each Directorate already had its own action plan that reflected these actions and the monitoring arrangements were detailed. Reference was made to each of areas which required improvement and to the proposed actions in response. Particular attention was given to the enforcement issue, to ‘ensure that planning and delivery of care meets people’s individual needs, safety and welfare’.

The Board were informed of the system issues; the wider learning from the inspection feedback; and the next steps to taken by the Trust. The presentation concluded with a summary of what the inspection meant for the Foundation Trust application. 

The Board questioned the representatives on a number of issues and responses were provided, matters raised included:

·  The importance of working with both the staff and patients to be able to understand dementia patients’ needs and concerns

·  Whether the increased training and awareness of the Mental Capacity Act would be available for temporary as well as permanent staff

·  The rates of pay for bank staff

·  Concerns about 17 year old patients being placed on adult wards

·  Concerns about the CQC findings relating to patients being denied access to bedrooms and communal rooms

·  The increased therapeutic activities for patients, would they meet individual needs as well as group needs

·  Concerns about the lack of beds for young mental health patients with very complex needs

·  How would the Trust ensure that any changes to culture would happen at all of their 70 locations

·  How did the service cope with language barriers

·  Were all the criticisms in the CQC’s findings justified

·  Did the Trust have any concerns that the CQC didn’t pick up on

·  Did the CQC comment on the work around the community support that was provided when a diagnosis of dementia was made

·  Did the Trust have the opportunity to feed back to the CQC on their pilot inspection.

RESOLVED that the  ...  view the full minutes text for item 71.

Briefing Note of the Deputy Director, Early Intervention and Social Care

The Scrutiny Board considered a briefing note of the Deputy Director, Early Intervention and Social Care which provided an overview of the Care Bill and Coventry’s preparations for implementation when this became legislation. Councillor Gingell, Cabinet Member (Health and Adult Services) attended the meeting for the consideration of this issue.

It was expected that the Care Bill would receive Royal Assent in 2014 and from April, 2015 Local Authorities Adult Social Care Services would be legally required to work to this new legal framework. The Bill focused on putting the wellbeing of individuals at the heart of care and support services and would replace many pieces of existing legislation.

The Care Bill set out key proposals for reforming the way in which adult social care was funded. Consequently much of the discussion and analysis had been in relation to the proposed Care Cap, which limited the lifetime costs an individual had to pay for their care, and the infrastructure required to manage this. The Bill would also impact upon the duties and functions of adult social care services and processes and practices needed to be reviewed to ensure compliance and delivery.

The briefing note provided a summary of the key requirements and timescales for implementation.

Members of the Board questioned the officers and responses were provided, matters raised included:

·  A concern about the financial implications in light of the continuing reductions in the Council’s budget and the potential to be able to support less elderly residents

·  Whether interest would be charged if payments were deferred on the £72,000 care cap

·  If there had been any indications that the Council would receive additional funding

·  The potential for reductions in the quality of care

·  If someone required care would the nature of care remain consistent once the £72,000 limit had been exceeded or would the support be different

·  The responsibility upon the Council if people didn’t have resources to pay for their care

·  Whether the nature of support differed depending if people made contributions or not

·  If the Council’s two criteria for support, critical and substantial, might need to change.    

RESOLVED that a progress report be submitted to a future meeting of the Board in six months including information on the financial implications.

Report of the Deputy Director, Public Health, considered by the Coventry Health and Well-being Board at their meeting on 7^th April, 2014  

Councillor Gingell, Chair of the Health and Well-being Board has been invited to the meeting for the consideration of this item

Dr Jane Moore introduced the report of the Deputy Director, Public Health concerning the draft work programme for the Health and Well-being Board for the 2014/15 municipal year. The report had been considered by the Health and Well-being Board at their last meeting on 7^th April, 2014. Councillor Gingell, Chair of the Health and Well-being Board attended the meeting for the consideration of this item.

The work programme had been established to reflect the following principles:

(i) Responsibility for delivering the key elements of the Health and Well-being Strategy rested with the responsible partnership or group and regular updates on progress would be submitted to future meetings.

(ii) Informal Board development sessions would be scheduled alongside formal Board meetings including joint sessions with Warwickshire’s Health and Well-being Board.

The work programme was a live document and would be continually updated as new work areas developed and additional reports needed to be considered by the Board. Frequency of Board meetings had recently been increased and the Board would now be meeting every two months.

Members discussed the problems associated with the availability of GP appointments and the issue of good quality primary care.

RESOLVED that:

(1) The Board to continue to work with the Cabinet Member (Health and Adult Services) and the Health and Well-being Board during the next municipal year.

(2) Consideration to be given to the inclusion of the following in the Scrutiny Board’s new work programme for 2014/15:

a) The joint initiative to develop an integrated model of care that keeps older people out of hospital

b) Good quality primary care including the availability of GP appointments.

Report of the Executive Director, People

The Board noted a report of the Executive Director, People concerning the National Children’s and Adult’s Services conference which was held in Harrogate from 16^th to 18^th October, 2013. The report detailed the benefits of attendance and how this would inform the work of the People Directorate over the next year.

Outstanding issues have been picked up in the Work Programme

The Board noted that all outstanding issues had been included in the work programme, Minute 76 below refers.

Report of the Scrutiny Co-ordinator

The Board noted the completed work programme for 2013/14. Members discussed potential items for the new work programme.

RESOLVED that:

(1) Items still to be considered to be prioritised for inclusion in the new work programme when planning for 2014/15.

(2) A report on the new pharmacy arrangements at the hospital to be included on the agenda for the first meeting in the new municipal year.

(3) A progress report on the interim arrangements for patient transport services to be submitted to a future Board meeting.

(4) University Hospital Coventry and Warwickshire Trust be invited to attend a future meeting of the Board, once their decision on whether to appeal has been determined, to discuss the spending of £10m on the Dr Raj Mattu case.

Report of the Scrutiny Co-ordinator

The Board considered a briefing note of the Scrutiny Co-ordinator that reviewed the work of the Scrutiny Board carried out during the course of the 2013/14 municipal year and sought to identify priorities or issues for consideration when planning 2014/15 work programme.

The Board had met on ten occasions during the year and the work programme had been used to prioritise issues for consideration. There was an acknowledgement that some issues were not covered during the year and some areas of the Cabinet Member portfolio were not addressed.

RESOLVED that arrangements be made for Members of the new Board to have a briefing session on social care early in the new municipal year.

Any other items of public business which the Chair decides to take as matters of urgency because of the special circumstances involved

The Chair, Councillor Thomas, thanked members for their support and contributions during the course of the year. Members also congratulated Peter Barnett, Scrutiny Co-ordinator, on his new appointment as Head of Libraries, Advice, Health and Information.