Agenda and draft minutes

Apologies were received from Councillors Clarke and Staff.

There were no substitute members

There were no declarations of interest.

RESOLVED:

That the minutes of the previous meeting held on 15 October 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 B3, Quarter 1 Performance Report – Adult Social Care as the first item of business.

There were no public questions.

Victoria Nestor, Deputy Director Operations for Adult Social Care, introduced the report. The Deputy Director summarised the performance as detailed in the report.

The following main points were noted in the discussion:

• In Q1, there were 37 new admissions to care homes. There had been slightly more admissions compared to Q1 last year, however performance had still met the target of having no more than 50 new admissions each quarter.
• As of Q1 2024/25, 20% of the service users who had been receiving services since the beginning of the year had received a support plan review. Quarter 1 performance had reached an all-time high, driven by increased activity and enhanced data capture. It was noted that the end of year projections estimated performance would exceed the 52% target.
• Regarding Adult Social Care accommodation costs, a greater proportion of residential care costs were on spot purchased services compared to other types of accommodation. The Committee noted that the service had tried to reduce the number of people going into care homes, however, for some, a care home was the best and safest option. It was noted that the Council tried to procure services in-borough via "block" contracts, however, to meet demand, the Council had also procured accommodation-based services on an individual spot basis, sometimes within Islington but mostly out-of-borough.
• In response to a question on targets for new admissions to nursing and residential care homes, it was advised that targets were set through reviewing trends over a period of time, and this had changed since the Covid pandemic. The targets were reviewed every year and re-set according to trends.
• In response to a question regarding reviews for Adult Socia Care service user, it was noted that the reviews were carried out in person and virtually. However, the preference would be to carry out the reviews face to face as part of the assessment would be to see how the individual was functioning in their environment. Risk assessment would always be carried out beforehand for any virtual reviews.
• The Committee queried about the percentage of service users receiving services in the community through Direct Payments, in response it was noted that Direct Payments were being encouraged, however, there had been some challenges which included individuals struggling to manage the Direct Payments as it was seen as overwhelming. To tackle this issue, there were a number of Direct Payments user and carers forums and working groups that had been commenced that were focussing on improvements to processes that would simplify the Direct Payment process.

RESOLVED:

That the Quarter 1 Performance Report be noted.

Jeremy Porteus, CEO & Founder, Housing Learning and Improvement Network and Ian Copeman, Business Director summarised the presentation as set out at pages 55-76 in the agenda pack.

The following main points were noted in the discussion:

• The Committee queried about accommodation availability in the borough and it was advised that there had been a trend towards vertical living and introduction of new schemes on housing above shops. It was noted that a key priority from a GLA perspective was around fire egress. There was also importance given to access to amenities, NHS facilities community hubs, green space, public transport and social connectivity.
• The Committee noted that a lot of the sheltered housing was built in the 1960-1980, often at relatively low densities and in urban boroughs it was important to look at existing specialist and supported assets, particularly in terms of affordable housing in the borough. It was also stated that another London borough had introduced a new strategy to demolish some of their sheltered housing schemes introduced in 1970s, that were very low density on prime sites and redeveloped social housing and created new and additional housing for their older citizens.
• In response to a question on funding for sheltered accommodation, it was noted that sheltered accommodation was being repurposed into supported living and there was a diverse range of provisions. In terms of accommodation choices for people with complex needs, often sheltered housing was a last resort, which puts a lot of pressure on providers in terms of managing people who were vulnerable with more complex needs. It was added that there was still a demand for good quality sheltered housing and the commercial sector, private sector and housing associations had been exploring this.
• In response to a question regarding the National Planning Policy Framework changes, it was stated that issues around housing for older people were more explicit and would like to see a guidance given for local authorities to look at Use Class Orders and to also make sure that there was supplementary planning guidance that can be created at a local level to reinforce planning intentions of local authorities. The Committee noted that there were currently debates on whether there should be a dedicated Use Class Order for Extra Care housing and if this was sufficient.
• In response to a question regarding intergenerational housing and affordable housing in Islington, it was advised that there would be new allocations for Extra Care and Supported Living Housing within new developments in the borough. Premises that were being developed prioritised in being age friendly so they could be adapted at a later time to meet the needs of the individuals. It was also noted that intergenerational housing and communities would create healthier living across generations, as well as increasing community resilience for relational care and support.
• The Committee asked about culturally appropriate care facilities for people from different ethnic minority backgrounds, in response it was stated that there had been work carried out with the South Asian Community  ...  view the full minutes text for item 39.

Jodi Pilling, Director of Strategic Commissioning and Investment, and Nikki Ralph, Assistant Director – Strategic Commissioning, presented the Adult Social Care Accommodation cost to the Committee.

The following main points were noted in the discussion:

• The Committee queried about how accommodation costs had changed over the years, in response officers advised that costs have increased and the Council was supportive of adult social care in term of budgets. The service also had a robust approach in maintaining healthy relationships with providers and maintaining payments in line with inflation.
• The Committee noted that there had been changes in ownership and the Council had been working to create a more balanced market that ensured local providers were being empowered and enabled to bid for the contract. 
• Officers stated that the cost of spot placement depend on the level of need and support of the individual. Overall spot purchases were more expensive than the block purchases commissioned by the Council.
• The Committee noted that the service had a process in place for new builds where they liaise very closely with Planning and New build colleagues. There were bi-monthly meetings where colleagues from different departments discuss any projects that were in the pipeline for Adult Social Care.

RESOLVED:

That the report to be noted.

RESOLVED:

That the Committee to note the report.