Agenda and minutes

Apologies were received from Councillors Chowdhury, Burgess and Staff.

None.

None.

RESOLVED:

That the minutes of the previous meeting held on 8 July 2024 be agreed as a correct record and the Chair be authorised to sign them.

The Chair advised that the order of business would be revised to consider item C3, the Adult Social Care performance report, as the first item of business.

Item C2, the HealthWatch Islington Annual Report, would be considered as the second item of business.

None.

Victoria Nestor, Deputy Director Operations for Adult Social Care, introduced the report. The Deputy Director summarised the performance as detailed in the report. Councillor Williamson, the Executive Member for Health and Social Care, also commented on the performance data, noting that most indicators were in line with target, and Islington compared favourably to London and national comparators.

The following main points were noted in the discussion:

·        The Committee noted those placed in care settings outside of the borough and queried how decisions were taken on placements outside of Islington. In response, it was advised that the majority of those receiving care were placed locally within London; some of those receiving care were placed elsewhere, and often this was a choice, to allow them to be closer to family. A review was undertaken last year, which sought to bring those placed elsewhere back into the borough, and a higher percentage than expected declined to move. In circumstances where care outside of the borough was considered, then the council did consult with the individual and their family to best meet their needs and wishes.

·        It was noted that, when a resident was placed in care accommodation outside of the borough, Islington Council retained responsibility for that individual.

·        In relation to the cost of care placements outside of borough, officers commented that care was often less expensive outside of London.

·        Following a question on the financial status of Adult Social Care and the link to performance data, it was advised that keeping residents living healthy and independent lives in their own home for longer was more cost effective than residential care placements. However, the most important aspect was the health and wellbeing of those receiving care, and ensuring their needs were met.

·        It was noted that the Chair of the Committee met regularly with the Executive Member and the Director of Adult Social Care to consider the financial challenges facing the service. It was queried if further information on the financial challenge could be appended to the quarterly performance report in future. The Executive Member indicated that this would be raised with the Chair and officers.

·        A member queried the challenges associated with data collection and ensuring quality data. It was advised that a management dashboard had been developed which was now assisting with data collection; this was considered to be more reliable than saving data on spreadsheets.

RESOLVED:

That the quarterly performance report be noted.

Emma Whitby, Chief Executive of Healthwatch Islington, introduced the report. The following main points were noted in the discussion:

·        The Committee noted Healthwatch’s key achievements over the 2023-24 year. Over 800 people had shared their experiences of health and care services and 12,000 had approached the organisation for advice and information. In particular, the Committee noted the way in which Healthwatch supports those with long term conditions, helping them to receive quality advice from medical professionals on how best to manage their condition.

·        Healthwatch Islington had been working with Somali and Turkish communities to encourage take up of cervical screening, and to understand the reasons why these communities had relatively lower rates of take up. This information then allowed services to better target information, providing accurate advice and addressing any concerns.

·        Ms Whitby praised the volunteer team at Healthwatch for their work in providing support and advice to residents.

·        It was noted that Healthwatch Islington was no longer able to provide the Digital Inclusion service due to a shortfall in funding; however the importance of digital inclusion and ensuring services are accessible was emphasised. While it has been difficult to measure impact of the programme, those working on the scheme knew the significant impact of supporting residents to access online services.

·        Following a question, it was advised that the digital inclusion work was funded through various organisations, and while digital inclusion was a significant priority during the pandemic, other issues had since taken priority for those funders.

·        Following a question, it was commented that having a variety of contact options for health and care services was crucial as not everyone could access online services. Organisations also had to avoid stereotypes about the digital skills of older and younger generations; digital skills were varied among all age groups. It was also commented that having an easy-to-use online interface was crucial. It was reported that some health service websites were difficult to use, even for those with high levels of digital literacy. 

·        Healthwatch had worked with the council to seek feedback on the home care service, holding interviews with service users, next of kin and staff.

·        It was noted that Islington was behind other London Boroughs on childhood immunisations and Healthwatch had attended various community events to speak to residents about the barriers to and benefits of immunisation.

·        Ms Whitby commented on the positive working relationship with the council and welcomed the council’s Evidence Islington programme, as well as Islington’s focus on addressing the wider determinants of health and health inequalities.

·        Healthwatch had worked with residents to understand the barriers to accessing mental health services; this identified the importance of building trust between services and service users, ensuring consistency in staffing, and the importance of diversity and inclusion in services.

·        Healthwatch had used the Challenging Inequality toolkit to identify any areas for development in their own service; as a result, Healthwatch was seeking more board members aged over 45, as they currently had a very young board. 

·        The Committee asked how  ...  view the full minutes text for item 19.

(a)   Approval of Scrutiny Initiation Document: Adult Social Care Accommodation

Jodi Pilling, Director of Strategic Commissioning and Investment, and Nikki Ralph, Assistant Director – Strategic Commissioning, introduced the scrutiny initiation document. Councillor Williamson, the Executive Member for Health and Social Care, also commented on the document and welcomed the scrutiny review, noting the importance of care services providing the right support, at the right time, in the right way.

The Committee approved the SID, with the caveat that the list of witnesses could develop over time. In particular, the committee was keen to hear from residents, and also community organisations working with those receiving care services. It was also suggested that receiving evidence from the council’s workforce could provide an interesting perspective.

It was commented that evidence from an expert in digital inclusion and innovation in care may be helpful.

Officers also commented that the order of evidence received may need to be revised depending on the availability of witnesses.

RESOLVED:

       i.          That the Scrutiny Initiation Document be approved;

      ii.          It be noted that the list of witnesses was not exhaustive and further witnesses may be identified through the review.

(b)   Scrutiny Review: Introductory Presentation

Jodi Pilling, Director of Strategic Commissioning and Investment, and Nikki Ralph, Assistant Director – Strategic Commissioning, presented to the committee. The presentation set out the principles and challenges of the council’s approach to adult social care accommodation. The following main points were noted in the discussion:

·             Islington’s approach to adult social care accommodation had developed over time. The service always sought to engage with residents and co-production was crucial to ensuring that accommodation met the needs of service users.

·             The service faced several challenges; while national challenges around funding for social care were significant, it was also recognised that Islington was a small and densely populated inner London borough with limited options for developing new care accommodation. Islington would have to take an innovative approach to ensure it had sufficient accommodation for service users in future.

·             Demand for care services had increased over the past decade, and would continue to increase as life expectancy increased and the demography of the borough changed.

·             It was also noted that Islington had the highest prevalence of severe mental illness in London. This presented challenges in terms of providing appropriate care support and accommodation.  

·             The Committee noted the range of accommodation types available. The service sought to support people’s independence as far as possible, and also provided accommodation to those with very specific and complex support needs.

·             The Committee commented on the importance of early intervention to support independence. Following a question on support for those with mental health issues, officers summarised the local services available and joint working with Camden and Islington NHS Foundation Trust and the North Central London Integrated Care Board.

·             A member asked if there was a specific part of the accommodation strategy that would benefit the most from member scrutiny. In response, it was commented that the ambitions around innovation would be useful to  ...  view the full minutes text for item 20.

Noted.