Agenda and minutes

The Chair welcomed everyone to the meeting and members and officers introduced themselves. Fire safety, webcasting and microphone procedures were explained.

Apologies were received from Councillor Gilgunn.

There were no substitute members at the meeting.

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.

There were no declarations of interest.

RESOLVED:

That the minutes of the meetings held on 5th October and the 14th November 2023 be confirmed as an accurate record of proceedings and the Chair be authorised to sign them.

The Chair highlighted that information regarding a consultation on proposed changes to maternity, neonatal and children’s surgical services in North Central London had been circulated to the committee and that demonstrations would be taking place outside of Whittington Hospital at 5pm on Wednesday 20th December 2023 if anyone wished to attend.

Following a previous update on the overspend in Adult Social Care the Chair reassured members that he was continuing to work with officers to discuss improvements.

The Chair informed members that the council had hosted a seniors Christmas party in the Assembly Hall on Tuesday 12^th December. Guests aged over 70 from across Islington were invited to attend, and enjoyed a Christmas lunch, bingo, and entertainment from Pearly King and Prince of Finsbury.

The Chair requested that presentations and questions be concise so the meeting could finish on time. Too enable guests to speak first items 11 and then 10 would be taken first before proceeding through the rest of the agenda in order.

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 advised that any questions from the public should relate to items on the meeting agenda and that members of the public would be given the opportunity to ask their questions once councillors had spoken.

The Independent Chair of the Safeguarding Adults Board gave an update on the Islington Safeguarding Adults Board Annual Report. 

The Chair asked about the reduction in reported adult abuse and neglect. It was explained that it could be related to improved signposting and early intervention.

A member asked about a particular case where a man was being abused by his cousin who used drugs. The man was able to be rehoused by the Council using the duty to refer homelessness as it was not his house, and his accommodation was deemed an unsafe environment. It was highlighted that more could be done to pursue perpetrators.

The Chair asked how safeguarding incidents were monitored by the Council. It was explained that safeguarding incidents could come in from anyone and would be recoded primarily by the safeguarding unit. Incidents would then be reported to the Safeguarding Adults Board who received a report each quarter that flagged any safeguarding concerns. Partners were also responsible for providing data to the Board and it was an area they hoped to improve to help prevent, recognise, and respond to abuse.

The Chair asked whether assessments over the phone rather than by social workers visiting homes would cause difficulty in identify self-neglect. It was explained that purely relying on social workers would not provide a full picture and it was important to work with partners to assess individual needs. 

The Committee considered the data the Board received, including the significance of better reporting in by partners and the security of individuals personal data.

A member of the public raised concern that there was factually incorrect information in the report under Liam SAR. They said there was no evidence care was refused or access by the fire brigade and the coroners review found there was gross negligence and manslaughter, and this was omitted from the report. It was explained that the report was written prior to the inquest to ensure the learning from the incident was assimilated as soon as possible.  They would speak privately to the individual concerned and update the information on the website.

It was then raised that Snowball Care UK Ltd, the agency involved in the Liam SAR case was still used by Islington Council. A senior officer explained that they were no longer a provider of choice and there was ongoing work to ensure those who received care from them were transferred to other providers. It was highlighted that the owners had been opening other agencies. This would be investigated.

A member of the public raised concern that the Council did not have adequate oversight of social workers who could not provide information related to their relative’s care plan, did not respond to requests for information from the police and who they felt were overstepping boundaries related to their legal powers in regard to financial abuse and theft. The Independent Chair of the Safeguarding Adults Board said the Local Authority did have powers that could help them uncover information that could trigger police  ...  view the full minutes text for item 19.

The Executive Member for Health and Care gave an update. It was highlighted that there had been a celebration of Adult Social Care workers, with a turnout of 80 people, who worked for Islington and cared for those in need. It was explained that Islington had many good social care workers. The complaints made by the residents at the meeting would be investigated.

The executive member explained they would be campaigning to keep the maternity services open at Whittington Hospital.

The executive member presented his annual report to the committee.

A committee member highlighted that 66% of residents said they were satisfied with their adult social care service and asked what could be done to improve satisfaction further. It was explained that resident feedback was key, and the indicators had improved from 62% in the previous year. Islington was performing well compared to other councils in London and a comparison could be provided to the committee.

The Committee received evidence from the Care Quality Commission (CQC) for its scrutiny review of access to health and care services in England. The CQC explained that they were doing specific work on access to GP’s as there was a requirement for people to be able to make appointments and get onto waiting lists.

A committee member asked the CQC to provide examples of how they were reviewing and assessing Islington’s ability to meet its care duties. It was explained that the CQC were building relationships with Healthwatch and were looking at ways to get the patient voice.

A committee member asked if there were mechanisms for residents to flag concerns if the CQC considered an issue was not within its legal powers. It was explained that sometimes the system was not clear, and it was important to listen to people to ensure concerns were picked up. Organisations should also have a culture of learning and not be defensive.  

A committee member asked what could be put in place to ensure the service users voice was heard. The CQC said their inspections methodology included looking at the organisations feedback and talking to people about their experiences. The CQC were asked whether they logged the number of complaints per organisation. The CQC would look at complaints, but it was important to look at them in a qualitative way as the numbers could be misleading. The Deputy Director of Assurance Strategy and Improvement said in Adult Social Care they used a range of tools to capture the voice of people who used their services and their families such as service user group and, complaints analysis.

A committee member who worked in healthcare highlighted that all hospitals had to write a learning from deaths reports, provided learning from serious incidents and the number of complaints and the learning and outcomes from complaints to the CQC. All deaths were also reviewed by a medical examiner, who was separate from the team that cared for the person, and they would speak to the family and ask them if they had any concerns. It was highlighted that it was important to have a clear pathway for people with concerns.

The Chair asked how often services were assessed by the CQC. The CQC would do an annual assessment based on the data they held for each service. They would also do inspections based on that data, e.g. if there was missing information or an identified risk.

The Chair asked how people reported their complaints to the CQC, particularly those from ethnically diverse backgrounds.  The CQC explained they worked with Healthwatch and other organisations who had links with those communities, they had different languages and formats available on their website and were able to use translators to speak to people one on one.

The Deputy Director of Public Health presented the Public Health Performance report for quarter one.

Following an update on the healthy start scheme, which provided free multivitamins to pregnant women and young families, a committee member asked if Omega 3s’ were included in the scheme and whether they could also be provided. The Director for Public Health said they would check what was offered but the offer could be subject to the national model.

A committee member asked about the 2022-23 data on substance abuse. This was available in the quarter 4 report but as the indicators had changed and were not directly comparable were not shown in the current report.

A committee member highlighted that there had been an increase in adults accessing services for substance misuse and asked why the increase in those seeking support for opiate misuse was relatively lower than in other areas. It was explained that this was a new breakdown of data, and it was hoped that a better picture of the issues would emerge over time. There was also ongoing work to improve access to services by those who misused opiates.

The committee considered health checks, although Islington Council were ahead of their targets, they would be looking at a breakdown of the demographics to see how uptake could be improved. Some outreach work was carried out.