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Agenda and minutes

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No. Item




The Chair introduced Members and officers to the meeting


Apologies for Absence




Declaration of Substitute Members




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 of the previous meeting pdf icon PDF 136 KB



That the minutes of the meeting of the Committee held on 21 November be confirmed and the Chair be authorised to sign them


Chair's Report


The Chair stated that the items would be taken in agenda order


The Chair added that she had had discussions with the CCG about the proposals around Walk in Centres and that she felt that Members of the Committee should be updated at the March or April meeting of the Committeee


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.


The Chair outlined the procedure for Public questions, and the Fire Evacuation procedures


Health and Wellbeing Board Update - Verbal







Scrutiny Review - Adult Paid Carers - Witness evidence - Verbal


Stephen Day, Head of Service IDLP, and Nicola Martinez –Herrera, Team Manager, Direct Payments were present, and gave witness evidence to the Committee


During the evidence the following main points were made –


·         A personal budget is the amount of money the Council will pay towards any social care and support a service user needs. The personal budget is determined following an assessment of needs under the Care Act. The assessment will confirm what kind of care and support is needed, how much it will cost, how much the service user is able to afford to contribute following financial assessment

·         A personal budget can be paid to the service user or carer, to enable them to make more decisions about how it is spent. This is known as a Direct Payment

·         Direct payments have been in use in adult care and support since the mid 1990’s. The Care Act 2014 confirms personal budgets in law for people with eligible assessed needs and carers, including the right to direct payment. In order to ensure that people are supported to use and manage the payment appropriately, local authorities must provide relevant and timely information about direct payments

·         Direct payments give individuals greater choice and control over the support they receive and how it is provided. For example, one could choose to hire care workers or personal assistants who are always the same people and available when needed, speak the same language, have experience working with a person’s care needs, or is a specific person that has been recommended

·         There are many ways service users could choose to spend the money. A person can make a choice as long as the personal budget is spent on things that meet their needs, and are detailed in their support plan

·         Benefits of Direct Payments – choice and control, flexibility, empowerment, consistency, person centred, creative, can have specialist support, savings to LA which makes more funds available to service clients, local job creation, improved service provision, less prescriptive care, variety of sources of service provision

·         Currently 22% of all Islington community care and support is provided through Direct Payments. This figure has decreased almost 10% since 2017. Feedback from the 2018 service user survey continues to show that DP recipients felt that they had the most choice, and control, over their care and support services, and had the highest percentage of those extremely, or very satisfied, with their service

·         Improving the offer – Personalisation is a key stream of the Adult Social Care Plan 2019-22. Building on evidence from research, the aim is to improve the offer to people who choose a Direct Payment. The aim is to increase uptake to make it the default choice, and are looking at how the market can meet the needs of those who choose Direct Payments. Processes and policies are being reviewed, and work is taking place across departments, and the CCG, to ensure an integrated and co-ordinated approach to personalisation. The aim is to develop a new training  ...  view the full minutes text for item 137.


Local Account pdf icon PDF 58 KB

Additional documents:


Councillor Janet Burgess, Executive Member Health and Social Care, was present for discussion of this item


During consideration of the report the following main points were made –


·         Noted that Adult Social Services are facing increasing pressures, with reductions in funding, at a time when the numbers of frail older people are increasing. There is a high incidence of people with long term mental health conditions, along with a population of people with physical and learning disabilities, who require specialist services

·         In 2019/20 to help meet these challenges – there is a need to build on strengths, focusing on work, and helping people overcome barriers which are preventing them from reaching their potential, and having the best possible lives they can. Also a need to provide support to carers of people receiving adult social care through the provision of direct payments, advice and information, respite care, support groups, special events, and the Flexible Breaks Fund service. Also work is being carried out to reduce social isolation, by broadening the number of social contacts through innovative schemes with the voluntary sector, so that people are better connected to things that can engender a sense of wellbeing, and greater quality of life. There is also support for independent living through direct payments, and self-directed support, and by supporting service users to make their own informed decisions, and choices

·         Discussion took place as regards care homes and sheltered accommodation and it was stated that this was an area that the Committee may wish to carry out a scrutiny/mini scrutiny review in the future

·         A Member stated that she had a neighbour who had a substantial package of care and his elderly wife did not have any, and enquired the reasons for this. Councillor Burgess stated that she would investigate this if details were provided




The Chair thanked Councillor Burgess for attending


Executive Member Health and Social Care Annual Report pdf icon PDF 557 KB


Councillor Janet Burgess, Executive Member, Health and Social Care, was present at the meeting, and made a presentation to the Committee


During consideration of the presentation, the following main points were made –


·       Since 2006-2008 life expectancy has increased in Islington for men, and women. Life expectancy at birth for men in Islington is 79.6 years, an increase of 4.4 years since 2006. However, this is below the London average. For women in Islington life expectancy is 83.3 years, which is statistically significantly lower than the London average, 84.5 years of age

·       Healthy life expectancy – In Islington men and women spend on average the last 17 and 20.7 years of life in ill health, statistically similar to London and England

·       The Health and Wellbeing Board has set priorities for 2017/20 – ensuring every child has the best start in life, preventing and managing long term conditions to enhance both length and quality of life, and reduce health inequalities, plus improving mental health and wellbeing

·       Key achievements long term conditions – these include projects funded by the National Diabetes Transformation Funding, development of an NCL wide programme of work to improve Atrial Fibrilation management, cervical screening social marketing campaign to increase uptake of cervical screening. Proactive Islington has developed and agreed a new physical activity action plan with partners. Islington Food Poverty Action plan developed – Islington has been recognised as best performing borough in London 2019 food poverty profile. Behaviour change includes NHS Health Check offer, pre-diabetic residents referred onto NHS Diabetes Prevention programme, stop smoking initiatives, and adult weight management

·       The top 3 contributors to premature mortality in Islington are cardiovascular disease, cancer and respiratory illness

·       Looking forward, the coming year will see increased work with partners across NCL STP to support improvements in long term conditions

·       Key achievements mental wellbeing – 5148 people entered IAPT treatment in 2018/19 in Islington, this is approximately 17.4% of those estimated to have a common mental health problem. Public health funded mental health promotion services include mental health awareness training. There has been a downward trend in suicide rates in Islington, and Islington is leading the commissioning of an NCL Support after Suicide Service to provide support for those affected by suicide, who themselves are at increased risk of suicide. Training in suicide awareness for non-clinical frontline staff in the borough has proved very popular

·       Workplace mental health and wellbeing continues to be a focus for Public Health. 5% of Islington’s older population have a diagnosis for dementia, and Islington has been recognised as having an exemplar clinical model

·       There is a relationship between poor mental health outcomes and deprivation/social disadvantage. Community and Mental Wellbeing service in Islington aims to promote awareness of mental health and wellbeing. Physical health and mental health are inextricably linked. Life expectancy is lower among people with some mental health conditions, and this is largely attributable to long term physical conditions. Older adults are one of the fastest growing population groups, and the number of people  ...  view the full minutes text for item 139.


Performance update - Quarters 1/ 2 pdf icon PDF 175 KB


Councillor Burgess, Executive Member Health and Social Care, was present at the meeting and outlined the report


During consideration of the report the following main points were made –


·         Delayed transfers of care – noted these are at 5.6 beds per day at quarter 2, over the target of 5 beds per day. To improve the rate of delayed transfers of care, processes have been reviewed and support strengthened within the local system. There are also weekly heads of service, AD escalation meetings chaired by the Local Authority with the Whittington, UCLH, and St. Pancras to ensure cases are resolved, and there is a strategic approach in identifying themes and recurrent issues to be addressed and resolved

·         Discharge to home or community setting – at the end of 2018/19, 95% of people discharged from hospital into enablement services were at home or in a community setting 91 days after discharge, meeting the target of 95%. Work is taking place with acute partners to co-ordinate hospital discharges, and ensuring full utilisation of all pathways

·         Direct Payments – in Quarter 2 24% of all Islington Community Care and support is provided through Direct Payments, compared to 24% at this point last year. The total number of service users continues to show that direct payments recipients felt that they had the most choice and control over their care and support services. Personalisation is a key work stream of the Adult Social Care Plan 2019/22. Work is taking place with Children’s Services to ensure the offer is consistent, and allows a clear and supportive transition for young people moving into adulthood. Work is also taking place with partners in health to ensure a co-ordinated approach to personalisation, and the sharing of knowledge, and expertise. Work has taken place to reform the Direct Payments Forum, so that people using Direct Payments and their carers can discuss issues arising with Council staff, and make suggestions for improvements

·         Admissions into residential or nursing care – the aim is to keep the number of permanent placements as low as possible, supporting more people to remain in the community. To maintain the same target rate per 100000 residents aged 65 and older as 2018/19, the target is 134 new placements for 2019/20. At the end of Quarter 2 there had been a total of 51 new placements of people aged 65 or older. This places it on target, and a reduction from the same period last year

·         In the year to date, at end of Quarter 2, there have been 510 placements in nursing or residential care homes for service users, aged 65 or over. New admissions have accounted for 15% of these placements. There are an additional 1062 placements with long term homecare services for service users, aged 65 or over, in the year to date

·         Reducing social isolation – results from the 2018/19 Social Care survey show an increased percentage of working age adults known to Adult Social Care feeling that they have adequate, or better social  ...  view the full minutes text for item 140.


Work Programme 2019/20 pdf icon PDF 48 KB





That, subject to the addition of a report on Walk in Centres update to the March or April meeting,  the report be noted