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Agenda and minutes

Contact: Peter Moore  020 7527 3252

Items
No. Item

81.

Introductions

Minutes:

The Chair introduced Members and officers to the Committee

82.

Apologies for Absence

Minutes:

None

83.

Declaration of Substitute Members

Minutes:

None

84.

Declarations of Interest

If you have a Disclosable Pecuniary Interest* in an item of business:

§  if it is not yet on the council’s register, you must declare both the existence and details of it at the start of the meeting or when it becomes apparent;

§  you may choose to declare a Disclosable Pecuniary Interest that is already in the register in the interests of openness and transparency. 

In both the above cases, you must leave the room without participating in discussion of the item.

If you have a personal interest in an item of business and you intend to speak or vote on the item you must declare both the existence and details of it at the start of the meeting or when it becomes apparent but you may participate in the discussion and vote on the item.

 

*(a)Employment, etc - Any employment, office, trade, profession or vocation carried on for profit or gain.

 (b)Sponsorship - Any payment or other financial benefit in respect of your expenses in carrying out

  duties as a member, or of your election; including from a trade union.

 (c)Contracts - Any current contract for goods, services or works, between you or your partner (or a body

 in which one of you has a beneficial interest) and the council.

 (d)Land - Any beneficial interest in land which is within the council’s area.

 (e)Licences- Any licence to occupy land in the council’s area for a month or longer.

 (f)Corporate tenancies - Any tenancy between the council and a body in which you or your partner have

  a beneficial interest.

 (g)Securities - Any beneficial interest in securities of a body which has a place of business or land in the council’s area, if the total nominal value of the securities exceeds £25,000 or one hundredth of the total issued share capital of that body or of any one class of its issued share capital. 

 

This applies to all members present at the meeting.

 

 

Minutes:

None

85.

Minutes of the previous meeting pdf icon PDF 106 KB

Minutes:

RESOLVED:  

That subject to the inclusion of the words ‘ to look at which Council’s operate in house services’ in the SID, in minute 78 - the minutes of the meeting held on 11 June 2019 be confirmed and the Chair be authorised to sign them

86.

Chair's Report

87.

Public Questions

For members of the public to ask questions relating to any subject on the meeting agenda under Procedure Rule 70.5. Alternatively, the Chair may opt to accept questions from the public during the discussion on each agenda item.

Minutes:

The Chair outlined the procedures for filming and recording of meetings and the procedure for Public questions, and fire evacuation procedures

88.

Health and Wellbeing Board Update

Minutes:

None

89.

Scrutiny Review Adult Paid Carers - Witness evidence - verbal pdf icon PDF 42 KB

Minutes:

Jess McGregor and Jon Tomlinson, Adult Social Services were present for discussion of this item, and introduced the following witnesses to the Committee, Colin Angel, Caleb Atkins, Ian Hadingham and Sayeda Ahmed

 

A revised SID was laid round for Members incorporating the amendments made at the previous meeting

 

All of the above witnesses made presentations to the Committee, copies interleaved, during which the following main points were made –

 

Colin Angel –UK Homecare Association Policy Director

·         The numbers of people affected by state- funded market failures has shown a significant number of contracts handed back or provider ceased training, in both the residential and home care services sectors

·         UKHCA Minimum price for homecare – the methodology used is verified by experienced finance directors from different organisations

·         The minimum price for homecare April 2019-March 2020 is £18.93 per hour, based on compliance with flat rate NMW/NLW

·         The current practice for the majority of Councils/high use of zero hours contracts by employers. To achieve economically efficient guaranteed hours contracts Councils would need to recognise and pay the full costs of contact time, travel time and costs and down time. Councils must pay the employer the costs of the entire span of the workers’ duty and worker receives the agreed wage for the entire span of their duty and travel costs. Councils also need to commission services in a way which increases workforce utilisation, e.g. by zoning areas, and moving away from framework agreements to contracts with guaranteed purchase

·         Perspectives on employee contract arrangements – Flexible/Zero hours contracts – Workers - popular with majority of workforce, even when given option of guaranteed hours, enables people to combine work and other responsibilities, income less predictable. Providers – responds to peaks and troughs in demand for services, maximises ability to recruit workers who want flexible or unsocial working hours, and higher risk of short notice of cancellations from workers, if not managed well. Councils – Councils are able to achieve purchase care at lowest hourly rate achievable, and there is a negative public perception of zero hours contracts

·         Guaranteed Hours contracts – Workers – Predicable income, easier to obtain mortgages and credit, harder to flex with personal commitments, less choice (worker must accept all arrangements). Providers – generally more attractive to younger recruits, may increase staff loyalty, provider bears risk of financial loss if Council’s purchasing pattern changes. Councils – More politically acceptable to elected Members, increased cost as Council pays all downtime

 

Caleb Atkins - City and County Healthcare Group

 

·         The number 1 healthcare provider in the UK, providing 50000 hours of care a day. It has 12500 care worker staff at 170 locations, and operates in all homecare segments, home care, extra care, live in, supported living, complex care, and temporary staffing (agency). It has a diversified contract base across more than 250 contracts with LA’s and CCG’s

·         The current landscape – there is a financially challenging environment, there is an Ethical Care Charter Commitment which is contractual, there is poor integration with  ...  view the full minutes text for item 89.

90.

Camden and Islington Mental Health Foundation Trust - Performance update pdf icon PDF 141 KB

Additional documents:

Minutes:

Dean Howells and Simon Africanus-Rowe, Camden and Islington Mental Health Foundation Trust were present for discussion of this item, and made a presentation to the Committee, a copy of which is interleaved

 

During discussion of this item the following main points were made –

 

·         The key focus of the Trust is the safety and quality of care delivered – key domains – Patient safety, Clinical Effectiveness, Patient Experience

·         Patient Safety Priority 1– an overall trend on the number of incidents suggests continuing reduction. The proportion of restraints that are prone restraints are being kept to a minimum. The use of seclusion continues to decline, and demonstrates the Trust is achieving least restrictive practice in this area

·         It is recognised that sustainability is a key factor to the longer term success of this intervention. Further progress on this priority will be monitored through the Safe Wards project, and Positive and Proactive Air Group as priorities in 2019/20

·         Patient Safety Priority 2 – Provide comprehensive risk – a randomised audit  was undertaken between December 2019-January 2019 – evidence of timely risk assessments and risk formulation. The scores range from 80% to 100%. A rapid inpatient enquiry conducted in February 2019, following a serious incident, highlighted inconsistencies in recording risk assessment on EPR and populating care plans. The Task and Finish Group has achieved initial policy review, and identified documentation and training requirements, and is aligning this work with an STP-wide suicide prevention initiative

·         Patient Safety Priority 3 – Ensure mandatory targets are achieved – overall core skills compliance has reached 88>9%, which is higher than at any point in the last 12 months. CPR and Information Governance remain below the required levels. Weekly reporting has been introduced. Trajectories will form part of this reporting, in order to highlight any issues, and manage supply and demand for face to face programmes. Commissioning of courses will aim to flatten spikes caused by periods of concentrated high demand

·         Clinical Effectiveness Priority 4 – Engage service users/staff in suicide prevention strategies. A risk assessment and suicide prevention group established. This works in collaboration with the Public Health Crisis Concordat. Local strategy implementation delayed due to the complexity in having a local strategy while at the same time working with other stakeholders

·         Clinical Effectiveness Priority 5 – Better involvement of service users in developing and reviewing their care plans. Randomised documentation audit – care plans are co-produced, services users are receiving copies of their care plans, physical care needs are identified and care plans are up to date. The scores for these indicators range from 78% to 95%

·         Clinical Effectiveness Priority 6 – Improving Physical Health – Physical health screening is now embedded, and training covers a wide range of physical interventions. The Physical and Healthwellbeing policy has been comprehensively revised, and is ready for relaunch is June 2019

·         Patient Experience – Priority 7 – Learning from Deaths and serious incidents – Learning from Deaths policy embedded. Trust Mortality Review Group meets on a weekly  ...  view the full minutes text for item 90.

91.

Work Programme 2019/20 pdf icon PDF 43 KB

Minutes:

RESOLVED:

That the report be noted