Agenda and minutes

To note the Committee’s terms of reference as set out below:

1.    To scrutinise matters relating to health, public health and adult social care and to hear the views of local residents, with a view to improving health/care services, reducing health inequalities and improving the health/care of local residents.

2.    To scrutinise the impact of the Council’s own services and of key partnerships (including the Health and Wellbeing Board) on the health of its population.

3.    To respond to consultations by local health trusts and by the Department of Health.

4.    To consider whether changes proposed by local health trusts amount to a substantial variation or development and, if so, to take appropriate action including appointing members to any joint committee where proposals cover more than one local authority’s area.

5.    To undertake all statutory health scrutiny functions.

6.    To receive and respond to referrals and reports from Healthwatch relating to health services in the area of Camden.

7.    To receive and respond to referrals and reports from the Local Involvement Network relating to adult social care services in the area of Camden, in accordance with the Local Government and Public Involvement in Health Act, 2007 regulations and guidance.

RESOLVED –

THAT the Committee’s terms of reference be noted.

Apologies for absence were received from Councillors Anna Burrage and Nasim Ali. Councillor Kemi Atolagbe substituted for Councillor Burrage.

Members will be asked to declare any Statutory Disclosable Pecuniary Interests, Compulsory Registerable Non-Pecuniary Interests and Voluntary Registerable Non-Pecuniary Interests in respect of items on this agenda.

Councillor Lorna Greenwood declared for transparency that she worked for a not-for-profit arts and health CIC in Suffolk.

Broadcast of the meeting

The Chair to announce the following: ‘In addition to the rights by law that the public and press have to record this meeting, I would like to remind everyone that this meeting is being broadcast live by the Council to the Internet and can be viewed on our website for twelve months after the meeting. After that time, webcasts are archived and can be made available upon request.

If you have asked to address the meeting, you are deemed to be consenting to having your contributions recorded and broadcast, including video when switched on, and to the use of those sound recordings and images for webcasting and/or training purposes.’

Any other announcements

Broadcasting

The Chair announced that the meeting was being broadcast live by the Council to the Internet and could be viewed on the website for twelve months after the meeting. After that time, webcasts were archived and could be made available upon request. Those who were seated in the Council Chamber or participating remotely were deemed to be consenting to having their contributions recorded and broadcast and to the use of those sound recordings and images for webcasting and/or training purposes.

Requests to speak at the Committee on a matter within its terms of reference must be made in writing to the clerk named on the front of this agenda by 5pm two working days before the meeting.

There were no deputations.

There were no items of urgent business.

To approve and sign the minutes of the meeting held on 25 April 2023.

RESOLVED –

THAT the minutes of the meeting held on 25^th April 2023 be approved and signed as a correct record.

Report of the Executive Director, Adults and Health.

The paper gives an overview of the recent peer review of Camden’s Adult Social Care services organised by ADASS (Association of Directors of Adult Social Care). Specifically, it introduces the work that is being done to develop an action plan from the feedback of the peer review team, as well as the reflections of Camden staff and partners.

Consideration was given to the report of the Executive Director, Adults and Health, which was introduced by Avril Mayhew, Head of ASC Operations.

In response to questions about the co-production framework and its planned finalisation in November 2024, Chris Lehmann, Head of ASC Strategy and Commissioning, explained that the co-production framework was developed alongside residents to ensure that services being delivered were person-centred and co-produced with colleagues in commissioning and Adult Social Care teams. Meaningfully co-producing a framework took time. A co-production lead was working with the voluntary and community sector, providers and resident groups but they were also reaching out to residents who were seldom heard and were not engaged with to the level that Adult Social Care would like. It was confirmed that disabled people were very involved in the co-production framework development.

It was queried whether the culture of quality improvement was embedded just within Adult Social Care teams or more broadly across the council, particularly with regard to sharing the assurance plans of the Safeguarding Adults Board more widely. The Head of ASC Operations confirmed that the work of the Peer Review was focused on Adult Social Care but the findings would be shared with the Safeguarding Adults Partnerships Board which had a broad membership and with other fora and groups. As safeguarding lead, the department would want to be assured of safeguarding activity across the partnership.

Anna Wright, Cabinet Member for Health, Wellbeing and Adult Social Care, highlighted that the Peer Review found co-production to be a key strength of Adult Social Care in Camden. Finalisation of the framework was not required before co-production could start. It simply formalised and embedded existing systems. The Peer Review had also asked detailed questions about safeguarding being everybody’s business and was pleased with how the Safeguarding Adults Partnership Board was working but stressed the need to spread and normalise the work of that Board. The Chair noted that, at the informal work planning session of the Committee, more regular updates on safeguarding work was requested.

It was confirmed that the service had not been waiting for the Peer Review to put in place improvement. A quality assurance framework had been agreed with an Adult Social Care Quality Board that met quarterly and a monthly quality action group that carried out the work on the action plans. A review of case file audits was underway and a set of recommendations being implemented immediately. Allegra Lynch, Camden Carers, and Monica Riveros, Age UK Camden, confirmed that their organisations had been involved in the Peer Review.

It was explained that AMHP refers to Approved Mental Health Professionals.

There was a request for a diagram setting out the interaction between the various boards referred to during the meeting.

ACTION: Senior Policy and Project Officer

RESOLVED –

THAT the report be noted.

Report of the Cabinet Member for Health, Wellbeing and Adult Social Care

This report sets out the proposed commissioning strategy for Mora Burnet House, an extra care service which offers 35 flats in Swiss Cottage for residents with a wide range of support needs. It is recommended that the care provision for Mora Burnet House is insourced. Evidence suggests that this strategy offers the best outcomes for residents, staff and the wider extra care network.

The report is coming to Cabinet for approval in line with Contract Standing Orders due the financial implications and potential Transfer of Undertakings (Protection of Employment) (TUPE) requirement associated with the recommended commissioning strategy.

Consideration was given to the report of the Cabinet Member for Health, Wellbeing and Adult Social Care, introduced by Chris Lehmann, Head of ASC Strategy and Commissioning.

The Cabinet Member for Health, Wellbeing and Adult Social Care commented that the proposal to insource care provision for Mora Burnet House was an exciting opportunity arising from the provider with the current contract not being able to provide the quality required at the price they offered. The proposal offered the prospect of better outcomes for residents.

In response to the Chair’s query whether Mora Burnet House would follow Charlie Ratchford Court in having a mix of ages and disabilities, it was agreed that the same model would be adopted over time but that there were already a number of residents living at Mora Burnet House who would continue to live there.

Clarity over the proposed integration with the community was requested. Officers confirmed that the same approach at Charlie Ratchford Court was intended with local residents and organisations being brought into the building and going into the community.

It was suggested that there needed to be close monitoring of maintenance by Origin Housing. Officers noted that there were ongoing concerns but many issues had been dealt with during the Enhanced Monitoring process and commissioners had built a strong relationship with Origin Housing. A Service Level Agreement would be agreed and commissioners would continue to monitor closely.

In response to a question from Allegra Lynch, Camden Carers, on whether an unpaid carer could at times be accommodated with a resident, officers agreed to look at the possibilities.

ACTION: Head of ASC Strategy and Commissioning

Concern was raised for staff at Mora Burnet House and the need for ongoing engagement and support during a period of change. Officers confirmed that there were ongoing discussions with staff. Commissioners and provider services were present. Relationships had been built and risks were being managed.

RESOLVED –

THAT the report be noted.

Report of the Chair of Health and Adult Social Care Scrutiny Committee.

The paper sets out the proposed terms of reference for a potential Health and Adult Social Care scrutiny panel as requested by the Chair of that Scrutiny Committee. The purpose of the Panel would be to investigate available screening and prevention programmes in Camden to determine which programmes should be prioritised, create an understanding of the barriers to up-take and develop recommendations for how to improve up-take in Camden.

Consideration was given to the report of the Chair of Health and Adult Social Care Scrutiny Committee, introduced by Councillor Judy Dixey.

It was suggested that health screening and ill-health prevention take-up be scrutinised through a lens of health inequalities.

The Cabinet Member for Health, Wellbeing and Adult Social Care supported the proposed scrutiny panel and agreed that health inequality was key to the investigation giving examples of people not being able to take time off work or afford transport to a clinic. A routine mammogram had recently saved the Cabinet Member’s life, evidencing the value of screening.

RESOLVED –

THAT a scrutiny panel be set up, in line with the terms of reference and membership in Appendix A to the report, to investigate health screening and ill-health prevention take-up.

Report of Executive Directors of Supporting People, Supporting Communities and Corporate Services.

This report focusses on Quarter 4 (Q4) 2022/23 and an overview of performance of the whole financial year, using a broad range of measures from each directorate and divisions across the organisation. Individual services have provided a narrative covering key performance challenges and areas of positive improvement in their service areas.

This report is divided into two main sections, namely:

-         A strategic summary which highlights challenges and anticipated pressures coming in 2023/24, as well as featuring any systemic issues and risks that are considered relevant to our organisational health.

-         A detailed summary of core service delivery for quarter 4 and the year 2022/23 as a whole across each of our three Directorates.

Taken together, these sections are intended to provide Camden Management Team (CMT) with a picture of performance across the Council and enable CMT to take decisions about any further remedial or improvement activity required over and above activity already underway in services. 

This report includes expanded data on a range of organisational health measures (staff turnover, sickness, complaints etc) by directorate (and division for some measures).

Consideration was given to the report of the Executive Directors of Supporting People, Supporting Communities and Corporate Services, introduced by Piers Simey, Assistant Director for Public Health.

Officers agreed to provide detail on the sectors that trainees on Mental Health and Wider Determinants had come from eg private sector, voluntary and community sector.

ACTION: Assistant Director for Public Health

While the increased take-up of Long-Acting Reversible Contraception was commended, the lag on data was noted.

It was noted that a KPI on weight management services had been requested at a previous meeting for the next financial year. Officers confirmed that weight management services had been remobilised, with a new provider in place since the start of the year. The data would be provided for the next financial year. In response to a question, it was confirmed that there was a variety of programmes with some focused specifically on diabetes prevention, some linking diabetes and weight loss, and also general weight loss programmes with benefits that include reducing the risk of diabetes. It was highlighted that there was an inequality whereby men were significantly less likely to attend weight loss programmes. A scheme that had been recently introduced in Camden had been successful in supporting men to lose weight.

Officers agreed to investigate and feed back to the committee on why the KPI ‘tracking adult social care outcome for individuals (admissions/re-admissions)’ had no data.

ACTION: Head of ASC Operations

In response to concern about reduced numbers accessing Making Every Contact Count (MECC) training, officers suggested that the total number of participants across the lifetime of the training contract was a more helpful perspective. However, it was noted that more targeted promotion and course availability would be addressed. It was also suggested that specific training could be offered to the Committee.

ACTION: Assistant Director for Public Health

Allegra Lynch, Camden Carers, confirmed that staff in her organisation had accessed the training.

RESOLVED –

THAT the report be noted.

Report of the Executive Director Adults and Health.

This paper sets out the Committee’s work programme for 2023-24 and tracks actions from previous meetings.

Consideration was given to the report of the Executive Director, Adults and Health, introduced by James Fox, Senior Policy and Project Officer who highlighted that the work plan would be updated following the recent informal work planning session.

In response to queries about a previous request from the Medical Director at Great Ormond Street Hospital to update the Committee, officers commented that as a Children’s Hospital it fell outside the remit of Health and Adult Social Care Scrutiny Committee.

The Senior Policy and Project Officer confirmed that visits to care homes were being arranged for the committee.

RESOLVED –

(i)             THAT the work programme for 2023-24 be noted; and

(ii)            THAT the Committee’s Action Tracker be noted.

There was no urgent business.