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 either a

(a) personal interest

(b) prejudicial interest

(c) disclosable pecuniary interest (DPI)

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.

Councillor Hobson declared a personal interest in the Health and Wellbeing housing priority detailed in the ‘Public Health Directorate - Overview Report’ as he was the Chairman of Blackpool Housing Company. 

Councillor L Williams declared a personal interest in the ‘Adult Social Care Regulated Care Services – Overview Report’ as her husband worked for the Council’s Commissioning Team.

To agree the minutes of the last meeting held on 24 January 2018 as an accurate record.

The Committee agreed that the minutes of the Adult Social Care and Health Scrutiny Committee meeting held on 24 January 2018 be signed by the Chairman as a correct record.

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

The Committee noted that there were no applications to speak by members of the public on this occasion.

To consider the Executive and Cabinet Member decisions within the remit of the Adult Social Care and Health Scrutiny Committee. 

The Chairman explained that there was one Cabinet Member decision which was covered in more detail under the Adult Social Care Regulated Care Services – Overview Report later on the meeting agenda.

The Committee agreed to note the Cabinet Member decision.

To present an update on the first year of the integrated Drug and Alcohol Treatment Service to support adults.

Ms Karon Brown, Head of Integrated Services, Delphi Medical Consultants Limited presented an update on the first year of the integrated Drug and Alcohol Treatment Service to support adults. Also in attendance were Ms Nina Carter, Commissioning Manager; Ms Judith Mills, Public Health Consultant; and Dr Arif Rajpura, Director of Public Health.

Ms Brown explained that the Service provider was Horizon (part of Delphi). She outlined the background to the current service.

The Care Quality Commission had been critical that all support was provided in one building. Horizon recognised that it was important for clients to see a clear pathway of treatment progress to enable them to see their lives were moving forward.

It was report that first-line support (including outreach services to hostels and other places) was provided at the Dixon Road building and focused on community detox models involving key workers supporting clients. Most clients then moved on to Winston House where specialist support was offered, e.g. with mental health workers. Clients were often struggling with alcohol, drug, mental health and other problems such as smoking. They were initially supported with the first condition that they presented but most did have emotional and mental health issues. Staff included a psychologist and family worker to recognise that people were part of families suffering pain and loss. GPs were involved with meetings too. Ms Mills added that people presented with complex conditions but the services were well embedded to support them.

Ms Brown added that death rates were high with particular risks associated following the period immediately after finishing detox so support needed to be wide, including managing drug withdrawal, peer networks, art groups. It was a challenge supporting people with serious addictions to fully recover. She referred to a YouTube link within the report which featured examples of success stories.

Members accepted that the first year involved transitional change but were concerned that the recovery rates at the end of January 2018 were well short of end-year targets (end March 2018). The number of people recovering from opiate use was at 104 with a target of 200, non-opiates at 44 (target 200) and alcohol recoveries at 226, with a target of 500. They queried if the targets would be met or if they were unrealistic and how many people were waiting for treatment.

Members also queried the percentage of people entering treatment against those successfully completing treatment and it was agreed that a written answer would be provided following the meeting.

Ms Nina Carter explained in-depth analysis had been undertaken and the figures did not show the complexities involved, e.g. people often had a primary substance which they had recovered from but used other secondary substances. People also used drugs and alcohol making recovery challenging.

Ms Brown added that the previous service had been clinically focused, i.e. if people were identified as ‘drug-free’ then that counted as a successful completion. However, people were now supported for much longer periods, e.g. over six months to ensure that they achieved sustained  ...  view the full minutes text for item 5.

To present an update from the Public Health Directorate on the following work areas: New model for 0-5 year olds’ public health services; Due North; and the Health and Wellbeing Strategy.

Arif Rajpura, Director of Public Health presented an update from the Public Health Directorate on the following work areas: New model for 0-5 year olds’ public health services; Due North; and the Health and Wellbeing Strategy.

He explained that the new model for 0-5 year olds’ public health services offered eight structured visits (previously five) from a Health Visitor for mothers during pregnancy and until their children had reached 3.5 years old. The key aim, based on research, recognised the importance of early life development with increased opportunities for early help support to ensure children were prepared for starting school.

The Lottery funded Better Start Programme (2015-2025) also involved a significant investment over ten years of £45million for families and children particularly in deprived areas. He added that Blackpool Teaching Hospitals was on the Better Start Board and the maternity workforce was being developed appropriately.  He emphasised that over time it would be possible to ‘break the cycle’ of deprivation.

The new health visiting model would be launched on 1 April 2018.

Councillor Cross added that Public Health England had commended the new model. She added that breastfeeding was part of the new Health Visiting service and volunteers had been trained to offer peer support for mothers.

Members agreed with the importance of good early development for children and ensuring that they were ready to start school although not all parents were proactive. Members also supported the £1.6million investment in local parks and green/open spaces. Dr Rajpura re-iterated that the Better Start Programme also aimed to develop parents to better support their children.

Dr Rajpura referred to the Due North Report (2014) which had reviewed health inequalities and aimed to:

·         Tackle poverty / economic inequality in the North (and with the rest of England)

·         Promote healthy early childhood development

·         ‘Share’ power for resources / public able to influence spending (improve health)

·         Health sector to promote health equity (fairness)

Members queried whether health inequalities had improved over the last four years. Dr Rajpura reported that the inequality gap had not narrowed in the last four years. Life expectancy was a key inequalities measure and had been going up across the country including Blackpool but increases had been faster elsewhere. This year had been the first drop in life expectancy for some years.  For babies born in Blackpool now, life expectancy was five years less than some other areas.

He referred to the wider determinants of health such as poverty, employment and housing. Transience was a significant issue with access to cheap quality housing. Councillor Cross agreed that access to quality housing was a key priority.

The Chairman referred to councils who had used planning policies to restrict the number of fast-food takeaways in areas where a ‘saturation’ point had been reached of these outlets. Councillor Cross acknowledged the issue and options. She explained that alcohol premises could be restricted through licensing laws where there were alcohol related issues. Licensing could not be used for limiting the number of fast-food premises but  ...  view the full minutes text for item 6.

To provide an update on the current status and developments in the regulated care sector for Blackpool (including residential and nursing provision and care at home services). 

Ms Karen Smith, Director of Adult Services presented an update on the current status and developments in the care sector for Blackpool. The update included residential and nursing provision, regulated placements, care at home services and other ongoing work and plans.

She referred to the Care Quality Commission, the national regulator responsible for inspecting health and social service providers including care homes and care at home. The Commission had rated Blackpool well against regional and national peers for residential and nursing provision and also care at home in February 2018.

The Commission provided monthly feedback and was impressed with the support provided, for service providers, especially by the Council’s Quality Monitoring Team.

The Team aimed to ensure that providers did not run into difficulties and encouraged providers to seek help early, e.g. managing limited resources better for a quality service. Structured support could include training opportunities, effective recruitment and feedback from families could be used to help improve services.

Enforcement action was taken if providers did not improve, e.g. they could be suspended from taking on new packages or clients and if necessary contracts were withdrawn.

Some case studies of work had been included which showed the challenges and effective range of action taken.

Ms Smith referred to the current re-tendering exercise for ‘care at home’ provision. The exercise had involved a range of professionals, e.g. social workers and health staff considering needs and options to design a new specification. A realistic practical approach was being developed working with care providers. She reported that a new Extra Care Housing provider had been awarded the contract for this service.

Ms Smith referred to regional benchmarking of Adult Social Services and reported that Blackpool had performed well particularly with people feeling that they could easily access good support.  There were a few areas where performance was less good compared to others such as people being admitted to homes on a ‘permanent’ basis and delayed transfers of care from health services to social care.

Some of these were national issues but were being looked at with various initiatives, e.g. extra staff investment over the Christmas period. She added that this had meant no people were waiting for packages of care but there were growing challenges such residential beds for people with challenging behaviour with dementia.  She referred to integrated work between social care and health services, New Models of Care (through neighbourhood hubs housing a range of professionals working together) and the Better Care Together fund.

Ms Smith highlighted that the focus was on preventing people needing to go to hospital in the first place and promoting independent living.

Ms Smith referred to fee rates for Adult Social Care contracts. Work had taken place closely with providers to ensure that best value was secured. 

Members noted that care at home provision had been rated highly by the Care Quality Commission and Ms Smith clarified that all seventeen providers had been rated as good. Members queried what was being done to promote improvement at  ...  view the full minutes text for item 7.

To consider the Adult Social Care and Health Scrutiny Committee Workplan 2017-2018, together with any suggestions that Members may wish to make for scrutiny review topics.

Members were advised that the Work Programme was as presented with the new smoking reduction service item having moved to the May 2018 meeting.

In response to a question, Members were advised that their previous recommendation for a ‘zero suicide’ target was on the Action Tracker with Public Health due to raise it at a Pan-Lancashire meeting later that week.

The Committee agreed:

1. To approve the Scrutiny Workplan 2017-2018.
2. To note the ‘Implementation of Recommendations’ table.

To note the date and time of the next meeting as Wednesday, 9 May 2018 commencing at 6pm in Committee Room A, Blackpool Town Hall.

The Committee noted the date and time of the next meeting as Wednesday 9 May 2018, commencing at 6pm in Committee Room A, Blackpool Town Hall.