Agenda and minutes

There were none at this meeting.

RESOLVED – That the minutes of the Safe and Strong Communities Select Committee held on 8 November 2018 be confirmed and signed by the Chairman.

Report of the Deputy Leader and Cabinet Member for Health, Care and Wellbeing

Quality assurance of care homes had been undertaken by the Care Quality Commission (CQC) and Healthwatch. Over the last five years this had evolved to include the work of the in-house Quality Assurance Team (QAT). The QAT collated data from across the health and social care economy for care homes and monitored all registered provision in Staffordshire.

The County had a large and diverse market, with 252 care homes, and were the second largest local authority for nursing beds in relation to their comparators. A joint health and social care risk matrix was used for the adult social care market which the QAT managed and used to track and assign levels of risk of care providers. Risks were reviewed and monitored through the monthly multi-agency Quality and Safeguarding Information Sharing Meeting (QSISM), with the level of risk the determinant for subsequent actions. Local Authority Quality Assurance visits were targeted at risk services with an emphasis on quality assurance. Members were informed that there remained some pockets of inconsistency but pro-active work was being undertaken to improve consistency across the County.

Staffordshire had on average 10% (25 care homes) more services outside the expected quality standards compared to West Midlands and national averages for the whole market. However Staffordshire performed better than both the regional and national averages for community services. The number of good services had seen an increase over the past two years from 55% to 72%. Staffordshire had also seen an improving picture regarding provider failure, with a multi-agency standard operating procedure in place which outlined how agencies would respond.

Healthwatch were a partner of QSISM and carried out visits to care homes through their “Enter and View” powers. However their role was different to both that of the CCG and the County’s Quality Assurance Team, focusing on the customer experience.

The Select Committee received details of the actions taken to improve services and the introduction of the Quality Improvement Process (QIP), which was a multi-agency approach focusing on proactive intervention at an earlier stage.

The QAT was made up of seven quality assurance officers, an information analyst and a team manager. The Team worked closely with two lead nurses from the CCGs and a range of other part time nurses. When necessary Commissioners would also work with the Team on specific projects. Required actions, where care homes presented a risk, would be taken as appropriate depending on the risk rating. Where necessary action could be taken within a day, at other times within a month, depending on the nature and urgency of risk.

A multi-agency standard operating procedure was in place which outlined how agencies would respond. This evolved as lessons were learnt and included very detailed information to ensure residents were kept safe and retained their dignity whatever the outcome for the care home, drawing upon the wider capacity of the Council where necessary.

Details of quality assurance were made public to enable transparency for Staffordshire residents. The Select Committee applauded this transparency. They heard that  ...  view the full minutes text for item 37.

Report of the Scrutiny Support Officer

The Select Committee had set up an Inquiry to consider children on the edge of the care system. The Inquiry presented its final report to the Select Committee on 3 September 2018, where it was endorsed for submission to the Cabinet Member for Children and Young People for his Executive response.

Members now received the Executive Response setting out the 10 recommendations, the proposed action, lead officer and deadlines. The Inquiry Group Chairman thanked the Cabinet Member for his response and the Officers for their involvement in the Inquiry. He raised the issue of the need for Members to receive current data to help in this kind of work. Whilst up to date data was available on a weekly and monthly basis this was not verified and could not be used as a comparator with other local authorities.  Data was published in November for the previous year, with data for March 2017-March 2018 recently having been published.

Inquiry Group members congratulated Officers on the excellent, proactive work they were doing to prevent children and young people from coming into the care system. Members heard that the Courts had given more time to care proceedings and therefore were now managing the timeliness of proceedings better. Members also heard that there was no current concerns over referrals from schools. The Dedicated Schools Grant (DSG) money for early help family support was taking shape and Members requested that details of this work be brought to the Select Committee in 12 months time to evidence progress made.

Members queried the number of unaccompanied asylum seekers who wrongly claimed to be under 18, referencing recent concerning figures at Liverpool City Council. Whilst this did happen in Staffordshire there was a very experienced team dedicated to unaccompanied asylum seekers, who had specialist training in age assessments. Where appropriate this Team had challenged age assertions made, with some individuals taken to court. Staffordshire was compliant with legislation and thorough in their care and their challenge, where necessary. Those unaccompanied asylum seekers who were under 18 were looked after with the same care, rights and responsibilities as any other Staffordshire young person in the care system. However difficulties remained in delays by the Home Office in dealing with requests to stay in Britain, which could result in a young asylum seeker unable to claim benefits and therefore result in the cost of their continued care falling on the County Council.

RESOLVED – That:

a)    the Executive to the Inquiry Group report and recommendation be noted; and

b)    a report be brought in 12 months time on progress made with the early help family support contract.

Report of the Scrutiny Support Officer

The Elective Home Education (EHE) Review had taken its final report and recommendation to the 8 June 2018 Select Committee. At that meeting Members had endorsed the report and recommendations for submission to the Cabinet Member for Learning and Employability, for his response.

The Select Committee now received the Executive response, setting out the proposed action for each of the four recommendations, the lead officer and deadline. The Cabinet Member was in broad agreement with the recommendations made, including challenging schools where coercion rather than parental choice had been the reason for removing a child from a school. He was hopeful that Lord Soley’s Bill would go through and that new legislation would ensure a registration system would be introduced. However there would be a need to ensure funding was available to implement this.

Recommendation 3 had set out the Review Group’s concerns over the significant rise in work load of the EHE officer and the need for further support and resource in this area. Whilst the Cabinet Member had sympathy with this recommendation there was no further resource currently available. It could be possible to involve serving teachers in some of this work and it was also hoped that where a child was removed from a school, the funding be stopped immediately rather than at the end of the school year.

The Cabinet Member thanked the Review Group for the work they had undertaken. He felt that EHE was an example of where the focus on people’s rights had overtaken wider responsibilities and that this needed to be addressed.

RESOLVED – That the Executive Response to the Review of EHE be received.

The Select Committee received a copy of their current work programme. Members agreed the following additions:

·         Health visiting and midwife contracts from a safeguarding point of view (the contracts were currently within the remit of the Health Scrutiny Committee );

·         Changes to anti natal visits and the work of the Family Improvement Board, with a suggestion that Natasha Moody and Alexandra Birch be invited to the Select Committee to discuss the East Staffordshire pilot;

·         Children’s Mental Health Strategy; and

·         Alternative education provision, eg pupil referral units.

Some of the proposed additions to the work programme were within the remit of other Select Committees and the Scrutiny Manager agreed to look at how best to undertake this work.

RESOLVED – That the amendments be made to the work programme.

The Chairman to move:-

“That the public be excluded from the meeting for the following items of business which involve the likely disclosure of exempt information as defined in the paragraphs of Schedule 12A (as amended) of the Local Government Act 1972 indicated below”.

Part Two

(All reports in this section are exempt)

RESOLVED - That the public be excluded from the meeting for the following items of business which involve the likely disclosure of exempt information as defined in the paragraphs of Part 1 of Schedule 12A of the Local Government Act 1972 indicated below

The Committee then proceeded to consider reports on the following issues:

(exemption paragraph 4)

Presentation of the Cabinet Member for Children and Young People

(exemption paragraph 5)

Oral Briefing of the Deputy Leader and Cabinet Member for Health, Care and Wellbeing