Agenda and minutes

Members are asked to declare any interests in the items under consideration and in doing so state:

(1) the type of interest concerned; and

(2) the nature of the interest concerned

If any member requires advice on declarations of interests, they are advised to contact the Head of Democratic Governance in advance of the meeting.

Councillors Kath Benson and Chris Ryan declared personal interests in Item 9 ‘Blackpool Teaching Hospitals Foundation Trust: CQC Inspection’, the nature of the interests that they were employees of the Trust.

To agree the minutes of the last meeting held on 4 February 2016 as a true and correct record.

The minutes of the meeting held on 4 February 2016 were signed by the Chairman as a true and correct record.

To consider any applications from members of the public to speak at the meeting.

The Committee noted that there were no applications for public speaking on this occasion.

The Committee to consider the Workplan, together with any suggestions that Members may wish to make for scrutiny review.

The Committee considered the report and agreed:

1.      To approve the Committee Workplan.

2.      To note the update on the implementation of the Committee’s recommendations/actions.

The Committee to consider the content of the Council’s Forward Plan, April 2016 – July 2016, relating to the portfolio of the Cabinet Secretary.

The Committee considered the items contained within the Forward Plan, April 2016 – July 2016 and queried who the responsible officer would be for the ‘Headstart Round Three Funding Bid Result and Future Action’ following the departure of the Deputy Chief Executive from the Council. Mrs Del Curtis, Director of People advised that the Chief Executive would be the responsible officer with the delivery arm, if the bid was successful, forming part of Children’s Services. In response to a further question, Mrs Curtis advised that a decision on the funding bid was due in May 2016.

The Committee to consider the Executive and Cabinet Member decisions within the remit of the Resilient Communities Scrutiny Committee. 

The Committee considered the Executive Decisions taken since the last meeting and noted that PH25/2016 ‘Blackpool Schools Funding Allocation 2016/2017’ would be considered in detail during the course of the Education Scrutiny Panel.

To update the Committee on progress made since Child Sexual Exploitation was last considered by the Committee to allow effective scrutiny. 

Ms Philippa Holmes, Awaken Team Manager advised that in the six months since the Committee had previously considered Child Sexual Exploitation a large amount of progress had been made. She reported that the capacity of the team had been doubled and that partnership working had been improved. She further advised that a Multi-Agency Sexual Exploitation (MASE) approach had been developed to consider the young people with the highest risk of being exploited.

Ms Tracy Poole-Nandy, Service Manager reported that children ‘missing from home’ was currently an important issue in Blackpool. She added that a consideration of Ofsted inspection readiness had demonstrated that not enough work was being undertaken with regards to children who were missing from home and that measures had been put in place to address the concerns.

In response to questions, the Committee was informed that the key concern was data collection and evidencing the work undertaken. Ms Poole-Nandy advised that processes were being rewritten to filter information and to clearly identify issues in order to address the concern.

Members queried the degree to which different areas in the country worked together to locate children missing from home. In response, Ms Poole-Nandy advised that the Police coordinated the approach to any child reported as being missing. She added that Police intelligence was shared daily across borders and was also shared with the relevant local authority where appropriate.

In response to further questions, Ms Holmes reported that a large amount of training had been undertaken on Child Sexual Exploitation and children ‘missing from home’ with frontline Police Officers in order to change the internal culture. She added that the multi-agency response to Child Sexual Exploitation had been proven to work in Blackpool and that emphasis must be placed upon prevention and understanding of the situation.

The Committee discussed the Child Sexual Exploitation Action Plan and noted that there were a number of targets that had not been met. Ms Poole-Nandy advised that the action plan was a Pan Lancashire Action Plan and that actions could not be marked as complete if they had not been implemented across the whole area.

Members questioned the potential timescale for inspection and were informed that Ofsted could undertake the inspection at any time. Additionally, it was noted that the inspection would be carried out on an area basis and therefore it might not take place in Blackpool. The Committee was also informed that an internal audit was being undertaken to measure progress made in Blackpool.

The Committee agreed to receive an update report once the Ofsted inspection had been undertaken.

The Committee to receive an update on progress made with implementation of the New Models of Care Approach to allow effective scrutiny. 

Mr Roy Fisher, Chairman of the Blackpool Clinical Commissioning Group and Mr David Bonson, Chief Operating Officer introduced the Blackpool Clinical Commissioning Group (CCG) report on New Models of Care and highlighted the progress made since the Committee had previously considered the item.

Mr Bonson advised that the New Models of Care approach aimed to improve integration of care and reduce admissions to hospital. He reported that the extensive care service at Moor Park had been operational since July 2015 and that initial outcomes were positive. He further advised that the CCG was awaiting the outcome of the funding bid to NHS England to allow continued implementation of the approach.

The Committee queried whether the different approach to provision of equipment to patients had increased or reduced costs. Mr Bonson advised that he understood that the closure of the equipment store had resulted in an initial reduction in costs. Following further discussion, it was agreed that a comparison of costs between the new approach and the equipment store would be circulated to Members following the meeting.

In response to a question, Mr Bonson advised that the majority of referrals to the extensive care service would be made by GPs, due to the specific criteria a patient must meet to be eligible for the service. He added that a carer could request that a GP consider referring a patient if they felt the service would be appropriate.

Members discussed the Enhanced Primary Care model and noted the importance of integration of health services with social services and third sector organisations. During the discussion, Mr Fisher advised that a key target of the model was to reduce social isolation.

The Committee queried how the practicalities of integrating teams would be overseen, noting the different organisations and management structures in place for different teams. In response, Mr Bonson acknowledged that different management structures were a complicating factor and that there would be no change to the employment of staff. He added that ultimately GPs would be responsible for patients and would have an oversight of all care provided to a patient.

Mr Bonson further advised that the Lancashire Patient Record Exchange Scheme was currently being developed and would enable improved and appropriate access to patient records for a wide range of organisations including nursing homes. In response to questioning, Mr Fisher advised that further upgrades to Information Technology provision would be undertaken during the summer allowing progress on the scheme to be made.

The Committee queried if any evidence could be provided that the new approach was reducing the number of emergency admissions and was advised by Mr Bonson that there was evidence of an early impact on emergency admissions in addition to a reduction in elective admissions. However, he added that increased levels of participation over a longer time period were required for detailed analysis and complete evidence of impact.

Members requested that the CCG attend a further meeting in approximately six months to present additional patient stories including examples from  ...  view the full minutes text for item 8.

To brief the Committee on the Care Quality Commission (CQC) follow up inspection to Maternity Services and Accident and Emergency Services on 21^st and 22^nd September 2015 to allow effective scrutiny of the Trust.

Ms Marie Thompson, Director of Nursing, Blackpool Teaching Hospitals Foundation Trust reported that in January 2014 the Trust had received a full inspection with the outcome ‘requires improvement.’ She advised that each individual service had also received a separate rating with maternity services rated inadequate. 

Ms Thompson advised that the key reasons for the Maternity Service’s previous inadequate rating had included a small cluster of large post-partum haemorrhages resulting in hysterectomies, which had not been fully investigated at the time of the inspection. In addition, a new staffing model had been introduced. The Committee was advised that due to the ongoing investigation it had been agreed that the Maternity Service would be re-inspected swiftly.

Members were informed by Ms Thompson that the re-inspection had taken place in September 2015, which had resulted in a ‘good’ rating. It was noted that the re-inspection had found that the investigation into the cluster of post-partum haemorrhages had provided assurance and that the Service was performing within expected benchmarks. Ms Thompson added that the new staff model had also provided assurance, however, the inspection had repeated concerns regarding equipment cleanliness and maintenance.

The Committee was advised that in addition to Maternity Services, the Accident and Emergency Service had also been re-inspected. In January 2014, the Service had received a rating of ‘requires improvement’ and the re-inspection in September 2015 had delivered the same outcome. Ms Thompson advised that the key concerns relating to Accident and Emergency included the constraints of the physical environment and the checking of equipment. She added that the inspection had also raised concerns relating to the time to mental health assessment.

Members discussed the health economy as a whole in relation to mental health and noted that concerns regarding mental health services had been previously considered. Ms Thompson advised that a task group had been established with representatives from Blackpool Clinical Commissioning Group, Blackpool Teaching Hospitals Trust and Lancashire Care Foundation Trust meeting on a monthly basis to work on improvements for mental health patients.

In response to a question, Ms Thompson advised that winter pressures had had a significant impact on the Accident and Emergency Service and that the four hour target had not been met during the 2015/2016 winter.

The Committee noted the significant improvement to the inspection outcome of Maternity Services and expressed concern that the same improvement had not been made in relation to Accident and Emergency Services. Members challenged Ms Thompson as to when an improvement to the Service would be made. In response, Ms Thompson advised that a series of actions had been developed from the inspection to which the Trust was required to regularly report progress on to the Care Quality Commission. She added that the task group was already working to achieve better outcomes for mental health patients.

The Scrutiny Committee is invited to offer their views as to progress made on the Business Plan and priorities for the year ahead.

Mr David Sanders, Chairman of Blackpool Safeguarding Children’s Board introduced the Business Plan for the Board 2015/2017. He highlighted the priorities within the Business Plan and reported to the Committee where progress had been made. He also highlighted the actions where progress had not been made and informed Members of key concerns including recording of data, which was a high priority of the Board.

In response to a question, Mr Sanders advised that the majority of taxi drivers had received training on Child Sexual Exploitation and the relevant Sub Group of the Board was currently considering how to provide similar training to hoteliers.

The Committee agreed to receive the Annual Blackpool Safeguarding Board Report at a future meeting.

To inform Scrutiny Committee of the work undertaken by Adult Services on a day to day basis to allow effective scrutiny of services.

Mrs Del Curtis, Director of People presented the Adult Services Overview Report and the Chairman invited questions from the Committee.

Members noted that one care home had been suspended to new placements whilst improvement work was undertaken and sought assurance that the existing residents of the home remained safe. Mrs Curtis provided assurance and advised that social workers and commissioners were working with the home to make improvements and that appropriate reassessments of all residents in the home had been undertaken.

The Committee went on to note that there had been a significant increase in the number of safeguarding alerts from the Harbour and queried how the increase was being addressed. In response, Mrs Curtis advised that a meeting had been sought with Lancashire Care Foundation Trust’s Safeguarding Team and reported that patients at the Harbour had extremely complex needs and were more likely to pose a risk to themselves or to others.

Following a discussion regarding delayed discharges, the Chairman highlighted the improved performance of Adult Social Services and requested that the relevant NHS organisations be invited to a future meeting of the Committee in order to discuss discharges that had been delayed as a result of the NHS.

In response to a question, Ms Lynn Gornall, Principal Social Worker and Head of Safeguarding advised that following the implementation of the Care Act 2014, entitlements to respite had been reassessed. Councillor Cross, Cabinet Member for Health Inequalities and Adult Safeguarding added that the Act had also resulted in minor changes to charges and reported that a consultation with service users had been undertaken.

Members expressed concern that the implementation of the living wage would impact upon the ability of the care sector to continue to provide adequate levels of care to residents and queried the support that was being given to providers. In response, Mrs Curtis advised that a number of ‘in kind’ offers to homes such as training courses would continue to be provided. She added that key performance indicators including finance related indicators for care providers were considered by the commissioning and contracting staff to allow early intervention if any provider became financially unstable.

In response to further questions, Mrs Curtis advised that fast track payment processes for care providers were being considered in order to assist with cash flow and that support was also offered in obtaining fees from self-funders where appropriate.

The Committee agreed to invite relevant NHS organisations to a future meeting in order to discuss discharges that had been delayed as a result of the NHS.

To inform scrutiny of the work undertaken by Children’s Services on a day to day basis and to update on the progress and implementation of developments within the area to allow effective scrutiny of services.

Mrs Del Curtis, Director of People presented the Children’s Services Improvement Report and the Chairman invited questions from the Committee.

The Committee queried the relationship with schools and was informed by Mrs Curtis that engagement from schools had improved significantly since the introduction of the Blackpool Challenge Board. She added that the level of funding provided to the authority for school improvement reduced each time a school converted to academy status and she highlighted the Government’s announcement that every school would become an academy by 2020.

Members noted that 303 contacts had been received from the Multi Agency Safeguarding Hub with only 42 converted into referrals and questioned why so few had converted. In response, Ms Josie Lee, Service Manager, Children’s Social Care advised that the Performance Review Group had requested a full report to analyse the contacts and any trends, a copy of which would be circulated to the Committee when completed.

In response to questions, Ms Lee advised that all children who had been on Child Protection Plans for more than 18 months would be reassessed to determine if the plan was still appropriate. She added that agencies were often unsure of taking children off plans and more work was required to manage the agencies’ concerns.

The Committee noted that the report highlighted that the number of Our Children (Looked After Children) had increased due to increased demand and a number of serious injuries to young children and requested further information. Ms Lee advised that a number of large families had been accommodated since December 2015 and that four instances of serious injuries to young children had occurred within one month, all of whom had been taken into care.

Members discussed the funding received to provide therapeutic support to young people who had been sexually abused. In response to questions, Mrs Curtis advised that the therapeutic support would link to HeadStart and that the funding received was a one-off and the results of the pilot would be analysed to identify impact.

Members went on to consider the increase in the number of children who had been removed from mainstream education to be educated at home. Mrs Curtis advised that an initial visit was undertaken in each instance in addition to an annual review. She added that the Blackpool Education Registers Attendance (BERA) Panel tracked all young people including those educated at home. The Committee sought further assurance that young people in receipt of home education were safe and received an adequate education, however, Mrs Curtis informed Members that although the authority had no power to monitor the standard of education any safeguarding concerns would be escalated following recognised procedures.

The Committee noted the significant improvements made to the reoffending rates of young offenders and reducing first time entrants to the youth justice system and queried how the improvements had been achieved. Mrs Curtis advised that the Youth Offending Team Service had been redesigned and had moved out of special measures. In order to continue improvements, the Youth Offending  ...  view the full minutes text for item 12.

To note the date and time of the next ordinary meeting as Thursday 12 May commencing at 6pm in Committee Room.

To also note the date and time of the two special meetings of the Committee  as Wednesday 6 April and Thursday 14 April both commencing at 6pm.

The Committee noted the date and time of the next ordinary meeting as Thursday 12 May 2016 commencing at 6pm in Committee Room A and also noted the date and time of two special meetings of the Committee as Wednesday 6 April 2016 and Thursday 14 April 2016 both commencing at 6pm.