Agenda and minutes

There were no declarations of interest.

The minutes of the meeting held on 5^th October, 2016 were signed as a true record. There were no matters arising.

Briefing Note of Joan Beck, Chair of the Coventry Safeguarding Adults Board

The following representatives have been invited to the meeting for the consideration of this item:

Liz Kieran, University Hospitals Coventry and Warwickshire

Jayne Phelps, Coventry and Rugby Clinical Commissioning Group

Chris Evans and Tracey Wrench, Coventry and Warwickshire Partnership Trust 

The Board considered a briefing note of Joan Beck, Independent Chair of the Coventry Safeguarding Adults Board which informed of the progress made in relation to the three Safeguarding Adult Reviews (SARs) published in 2015 and the outstanding actions completed by the Coventry Safeguarding Adults Board (CSAB). Liz Kieran, University Hospitals Coventry and Warwickshire (UHCW), Jayne Phelps, Coventry and Rugby Clinical Commissioning Group (CCG), and Chris Evans and Tracey Wrench, Coventry and Warwickshire Partnership Trust (CWPT) attended the meeting for the consideration of this item and provided an update on the actions undertaken by their organisations in response to the three SARs.

The briefing note indicated that the three SARs related to incidents which took place in 2013 and 2014 and related to fire death, septicaemia and pelvic abscess, sigmoid perforation and fractured vertebrae. There have been no furthers SARs in Coventry.

As a result of the SARs a series of actions were agreed by the CSAB which included:

·  Improving awareness of and response to fire safety risks

·  Establishing protocols for professionals to work together on a case

·  Working towards making safeguarding more personalised

·  Reviewing pressure ulcer policies and information.

Significant progress had been made in delivery of these actions including:

a)  Events had taken place to disseminate learning and promote person-centred practice

b)  There had been a strong emphasis across the partner agencies on outcome-focused work with people with care and support needs and agencies had developed their training

c)  West Midlands Fire Service had supported and delivered fire health and safety intervention training to a range of agencies and a comprehensive fire safety guidance handbook had been produced for professionals and carers who worked with adults with care and support needs

d)  Pressure ulcer guidance had been revised with a focus on notification and referral process; agencies had delivered further training; and a ‘React Red’ scheme which aimed to prevent pressure ulcers had been set up. Accreditation was given to care homes that demonstrated best practice in all areas of pressure ulcer prevention

e)  Coventry and Rugby CCG, UHCW and CWPT all reported that more robust and effective discharge planning processes were in place.

The Board were informed that on the SAR action tracker, three actions remained incomplete, all relating to quality assurance and consistency of safeguarding training. A plan had been agreed to complete these actions by the end of March, 2017.

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

·  Further information about how initial meetings and case conferences involving individuals and their families worked when abuse or neglect was suspected

·  How a case would be tackled if abuse was reported by a third party and the individual concerned didn’t want to pursue the matter

·  Further information about training for carers

·  More details about the React Red scheme and the accreditation of care homes

·  Clarification about whether all the partnership work on prevention was maintainable in the light of current austerity cuts

·  A suggestion that  ...  view the full minutes text for item 32.

Briefing Note of the Executive Director of People

Further to Minute 3/16, the Board considered a briefing note of the Executive Director of People detailing the progress made since the Adult Social Care Peer Challenge in February 2016 following a review visit held on 10^th October, 2016. This concluded the peer challenge process.

The briefing note indicated that on 10^th October, 2016 the peer challenge lead, Mr Keith Skerman and a colleague from Improvement and Efficiency West Midlands revisited Coventry to review the progress made. The findings from the visit were set out in a letter which was set out at an appendix to the briefing note. A second appendix set out the action plan which detailed the progress made to date.

The feedback identified that the improvement journey had made good progress; the impact being made by the senior management team was acknowledged; and there was a desire to improve services and performance at pace. Specific areas of key progress included:

·  The development of an Adult Social Care vision to ensure that staff, partners and stakeholders were aware of the department’s objectives and strategic approach

·  A stakeholder reference group was now in place to provide an additional mechanism for people with care and support needs and carers to input and shape the work of Adult Social Care

·  An online social care assessment which allowed people to receive individually tailored information and advice

·  Staff development sessions and the establishment of a practice development forum

The Board were informed that there had been an acknowledgement that substantial change and improvements would take time. Some further suggestions had been made which included:

·  Working with Elected Members to manage expectations and promote alternatives to long term care

·  Building corporate awareness of the needs of older people and people with learning disabilities

·  Engage with ICT to co-produce technical innovations

·  Focus on presenting the evidence base for preventative services

·  Build a narrative that celebrates the successes of Adult Social Care.

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

·  Further details about the on-line social care assessment

·  Additional information about the Stakeholder Reference Group and the personalisation champions

·  Clarification about some of the suggestions arising from the review visit including working with elected members to assist them to manage community expectations; building on the cultural change; and engaging with ICT

·  Whether the time spent on the Peer Review process was adequate for an in-depth Peer Review and whether officers were satisfied with the depth and robustness of the review

·  The costs to the City Council of this Peer Review and the anticipated date of the next Review

·  A suggestion for the future that it would be appropriate to provide feedback to groups and stakeholders who had taken part in the process.

RESOLVED that:

(1) The outcome of the review of the Peer Challenge chair be noted, which concludes the requirements of the Peer Challenge process.  

(2) Feedback be given to groups and stakeholders involved in any future Peer Reviews.

Briefing Note of the Executive Director of People

The Board considered a briefing note of the Executive Director of People which outlined the role that home support played in the delivery of effective social care and provided an overview of the service changes expected as a result of the forthcoming tender agreed by Cabinet at their meeting on 1^st November, 2016.

The briefing note indicated that adult social care provided personal and practical support that helped people live their lives. It was an area where it was possible to have a hugely positive impact on individuals, their family and carers. The City Council supported approximately 950 people each week through home support, with approximately 12,000 hours of support at an approximate cost of £8.4m for 2016/17. Approximately 100 hours a week of this supported children with disabilities living at home at a cost of £0.1m.

The Board were informed that the majority of adults in receipt of long term support were aged over 75 with almost 40% aged 85 or over. The current arrangements for the provision of home support in Coventry was based on a contract let in 2010 through a city-wide contractual framework, with 40 organisations on this framework. Organisations who evidenced the best quality and the best price were given the opportunity for any new work. Since 2010 a number of factors had influenced the operation of home support including the impact of austerity in local government; increased costs of delivery; increasing levels of complexity of people referred for support; and challenges in offering contracts of employment that were attractive to staff.

At their meeting on 1^st November, 2016 Cabinet approved the re-tendering of home support. The process was scheduled to commence in December 2016 with new providers and contracts commencing during June 2017. The Board were informed that the retender would seek to achieve a more sustainable and secure provider base through offering larger contracts of 1200 – 1500 hours per week for five years, with the option of extending by a further two years. This would support provider sustainability allowing for margin reductions to be compensated for by increased volume of business and enable providers to employ more staff on contracted hours, improving retention. These larger and longer contracts would also give the greater security required for providers to invest in delivering good quality services, for example investing in staff completing the Care Certificate.

The Board noted that currently 23 organisations were contracted, post tender this would reduce to 9. They also noted that a number of people would be supported by a different provider. In terms of wider improvements expected as a result of the tender, the service specification had been updated to reflect the wellbeing and prevention elements of the Care Act 2014.

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

·  How confident were officers that it would be possible to secure the services of 9 companies who could deliver the necessary quality support to approximately 950 individuals

·  Further  ...  view the full minutes text for item 34.

Report of the Scrutiny Co-ordinator

The Board considered a report of the Scrutiny Co-ordinator which detailed the approach being taken on the progress, outcomes and responses to recommendations and substantial actions made by the Board at their previous Scrutiny meetings.

The Board were informed that Simon Gilby, Coventry and Warwickshire Partnership Trust had informed that he was currently considering how he would be reporting back to the Board on the action plan in response to the Care Quality Commission (CQC) Inspection and the Trust’s Improvement Plan. He had also indicated that the update on the proposals for working with patients during the transition period from childhood to adulthood would be incorporated in the Child and Adolescent Mental Health Services Transformation Agenda Update due to be considered by the Board at their meeting on 1^st March, 2017. Members indicated that they were still interested in receiving the additional information about the anticipated future savings on Agency Staff.

RESOLVED that:

(1) The report and the verbal update on the responses from Simon Gilby, Coventry and Warwickshire Partnership Trust be noted.

(2) Officers to continue to request a response from Simon Gilby for information on the anticipated future savings on Agency Staff.

Report of the Scrutiny Co-ordinator

The Board noted their work programme for the current municipal year which included the addition of an extra meeting on 7^th December, 2016 to consider the Sustainability and Transformation Plan.

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

Members placed on record their thanks to the Chair, Councillor Gannon for initiating the excellent visit to Warwick Medical School on 21^st November.