Agenda and draft minutes

Apologies were received from Councillors Gallagher, Clarke, Croft, Nargund.

There were no substitute members.

There were no declarations of interest.

RESOLVED:

This item was deferred to the next meeting.

The Chair informed the Committee members that the scrutiny visit to Mildmays Extra Care Scheme had been conducted on the 7^th of January 2025. The Chair thanked those who attended and mentioned that notes had been drafted and circulated to the members who attended. He asked for members to review and report back with any comments or additions. It was advised that the final version would be submitted to the Committee for noting at the next meeting on 20^th of March 2025.

The Chair reminded members that an additional meeting had been arranged to receive evidence from Islington and Shoreditch Housing Association. This would be a virtual meeting and was scheduled for the 27^th of February 2025 at 6:00pm.

Finally, the Chair informed the Committee that a focus group meeting had also been arranged and was incorporated in the Let’s Talk Peer Event on the 20^th of February 2025. The event would be taking place at 222 Upper Street from10.45am - 1.30pm. As the Chair had sent his apologies for this event, it was noted that Cllr Croft had agreed to lead on this on the day of the event.

In regard to the discussion items, the Chair agreed to vary the order of business with Item B2, Adult Social Care Budget Report, as the first item.

There were no public questions.

John Everson, Director of Adult Social Care and Shakeel Yasin, Assistant Director of Finance provided the Committee with a presentation on the Adult Social Care budget overview for 2024/25 and summarised key points to the Committee.

The following main points were noted in the discussion:

• It was noted that the gross expenditure budget for 2024/25 was £163m. This was the amount the Adult Social Care have spent on various services including home care, residential care and staffing.
• The Gross income budget was £106m. This was the amount expected to receive from various income streams including client contributions and money from the NHS.
• The Committee noted that the net budget was £57m. This was funded from the Remediation Support Grant from the government and the Council Tax re-raise.
• Adult Social Care Funding for 2024/25 was £163m. The majority of the funding came from various income streams which included Central Government Grants, Client contributions, NHS income, Revenue Support Grant and Council Tax.
• In terms of Adult Social Care Gross Expenditure for 2024/25, around 73.4% was spent on placements which provided front line provision of care for vulnerable residents in Islington.  The next highest expenditure was around 9.5% being spent on staffing for Adult Social Care.
• In relation to placement expenditure, it was noted that large amount was spent on residential care and homecare for people with learning disabilities and for people that required memory & cognition and physical support. The Council placed a lot of importance for individuals to receive care at home as this promoted independence and also increased the chances of enabling them to get better. The Committee noted that in total around £120 million was spent on placement in Adult Social Care.
• In relation to budget forecast, pressures & risks for quarter 2, it was highlighted that the pressure from Care UK was caused by the fact the beds were unavailable for several years resulting in the need to place service users in spot provision at an additional cost to the council which was around £2.4 million. Once the beds became available at the end of 2023/24, the process to reoccupy started with some criteria having to be met. There were limits on the number of service users that should be placed each week, to support safe & effective transfers and also had to ensure a match in the level of need of the individual to the specific support available in the placement bed. It was also added that once the homes are filled this pressure will not carry into 2025/26.
• Some of the potential future financial risks included additional demand due to NHS, Community pressures, increase in the acuity of need to exiting clients exceeding budgeted allocation, NHS funding changes, Children transitioning to Adult Social Care, delays in the opening of Adults Social Accommodation and Savings Slippage. The plans and mitigations for these potential risks & pressures were outlined on page 21 of the report pack.
• In terms of Adult Social Care savings, it was noted that for 2024/25, there was a  ...  view the full minutes text for item 60.

Sakiba Gurda, Head of Planning, Policy and Development Viability Services provided a presentation to the Committee on Islington’s Local Plan and summarised key points to the Committee.

The following points were noted in the discussion:

• The Committee noted that the Local Plan provided statutory framework for making decisions on planning applications.
• One of the key priorities for Genuinely Affordable Housing was that there was a strategic target for 50% of additional housing to be affordable and to have 10 or more homes required to deliver affordable housing on site.
• In terms of policies for specialist accommodation, it consisted of a Planning Policy on meeting the needs of vulnerable older people and another Planning Policy on Supported Housing (working age adults).
• In regard to Planning Policy on meeting the needs of vulnerable older people, the need for accommodation for older people would be met primarily through the delivery of conventional residential accommodation designed to be adaptable to changing needs over time. Different levels of care may be delivered in conventional accommodation which meant there was likely to be a lesser need for certain specialist forms of older persons housing, in particular market extra care housing. In addition, it was also noted that there was some local need for affordable one and two-bed extra-care units. This specific type of specialist older persons accommodation may be acceptable on certain schemes, but only where the Council’s Adult Social Care service considered that the proposed accommodation would meet a defined need.
• The Committee was informed that specialist older people’s residential accommodation, such as care homes and extra care facilities, would only be suitable where there was evidence of local unmet need for specialist older people accommodation or it would contribute to meeting the London Plan benchmark figure of 900 dwellings over the plan period. It was highlighted that this was an aspirational figure where the aim was to have 60 homes per year for each London Local Authority over the 15 years.
• The Committee followed up and queried that due to the shortage of land available in the borough, would there be a possibility to decrease the target of 60 homes for Islington as a borough, in response to this follow up question, Officers advised that the Council’s obligation was to only ensure that the overall housing target for the borough was met, which was 775 homes per year. It was noted that this target was relatively lower than targets set for other London Local Authorities. Officers added that the Mayor of London had started the process for the new London Plan and all the figures were being reviewed. The review would also consider land availability for housing. This would then form the new targets for each London Borough.
• In regard to Planning Policy on Supported Housing for other vulnerable adults, it was noted that the Council would support the provision of new supported housing where it would meet an identified need. Additionally, it should also be suitable for the intended occupiers in terms of  ...  view the full minutes text for item 61.

Victoria Nestor, Deputy Director Operations for Adult Social Care, introduced the report. The Deputy Director summarised the performance against targets in Quarter 2 2024/25 for measures relating to Health and Independence as detailed in the report.

The following main points were noted in the discussion:

• Performance targets were set based on benchmarking and trend data. Targets were reviewed and updated each year. The next set of targets would be reviewed in April 2025.
• It was noted that of the residents who received reablement in quarter 2, 77% were reabled and did not require long term support from adult social care. The target of 78% was the latest London average performance figure from the December 2024 Adult Social Care Outcomes Framework publication.
• In terms of new admissions to nursing or residential care homes, it was highlighted that inn Q2, there were 84 new admissions to care homes. There have been slightly more admissions compared to Q2 last year where there were 74 new admissions. However, performance had still met the target of having no more than 100 admissions in quarter 2. It was also noted that Islington had a lower rate of new admissions to a care home per 100,000 of the population compared to London and England.
• In regard to the percentage of Adult Social Care service users receiving long term support who had received at least one review, in Q2 2024/25, 36% of the service users who had been receiving services since the beginning of the year had received a support plan review. In addition, the Committee was informed that the Quarter 2 performance had reached an all-time high, driven by increased activity and enhanced data capture. End of year projections estimate performance would exceed the 52% target.
• In relation to the percentage of service users receiving services in the community through Direct Payments, it was noted that 30% of Islington service users receiving services in the community were supported via a Direct Payment. Performance for this indicator had improved compared to last quarter which was 29%. Benchmarking from the latest published statistics in the Adult Social Care Outcomes Framework (ASCOF) 2023/24 shows Islington was performing better than, London and England.
• In terms of Making Safeguarding Personal (An individualised approach to safeguarding that focusses particularly on what the resident would like the outcome of the safeguarding to be), 96% of service users reported that their desired outcomes were fully or partially achieved and Quarter 2 performance had exceeded the target.

RESOLVED:

That the Quarter 2 Performance Report be noted.

Councillor Flora Willaimson introduced the Adult Social Care Annual Report and summarised key points to the Committee.

The following points were noted in the discussion:

• One of the highlights over the last 12 months was the launch of the Carers Strategy which was co-produced with local health and social care organisations from the Islington Borough Partnership and outlines commitments to improving carer outcomes and ensuring that carers receive the necessary support. The strategy highlighted the significant contribution of unpaid carers to society, emphasising their role in preventing the need for statutory services and supporting people to live independently at home.
• The Committee also noted that the Integrated Front Door Service in Islington was another highlight over the last year which launched in October 2024. This was a new health and care model that was developed jointly by Whittington Health and Adult Social Care. The service was designed to act as a single point of access for all Adult Social Care, urgent community health and hospital discharge referrals for Islington residents.
• In terms of the Challenges over the last 12 months, the Committee noted that the sustainability of the care market continued to be a challenge for the Council with providers increasing costs and expressing concerns about their financial sustainability. It was noted that this was a national issues. To mitigate these issues, significant improvements were made to the uplift process, there was a review of the structure of the Brokerage function, and a new Quality Assurance Framework was implemented.
• The Committee noted some of the priorities for the next 12 months, which included reviewing the CQC inspection findings and implementing any changes needed, working with the Islington Food Partnership to ensure that the Council was supporting the delivery of the food strategy, opportunities from the Labour Government’s with a renewed focus for delivering health care in the community, and a review of the future of Adult Social Care and developing the locality profiles and integrated ways of working, alongside the new NHS Neighbourhood Health for London model.
• In addition, another priority was capitalising on the opportunity presented in the government's legislation on Tobacco and Vapes to achieve a smokefree generation in Islington. The Committee stressed the importance of ensuring that people stopped smoking in their homes, particularly in flats and apartments.
• It was also noted that Public Health and Adult Social Care teams had been combined under one directorate with John Everson as the Corporate Director for Adult Social Care and Public Health together.
• A member of the Committee stated that in terms of ASCOF areas of success, the report mentioned 46% overall satisfaction for carers and if this should be classed as a success. In response to this it was mentioned that this was a positive outcome as the bench-marking figures for London was 33% and 37% for England.
• The Chair raised concerns that the aging population in the borough were not receiving adequate support and had suggested to negotiate funding for Adult Social Care.
• The Chair also asked  ...  view the full minutes text for item 63.

RESOLVED:

That the Committee to note the report.