Agenda and minutes

          The Minutes of the meeting held on 27 November 2018 having been printed and circulated were signed as a correct record.

          The Board was advised that no public questions had been received.

The minutes from the Health and Wellbeing Board’s meeting of 3 October 2018 were presented to the Board for information.

HWB11 – Transitions in Care – Transition Team – it was hoped that the Named Social Worker (NSW) project would be continued in Halton and support was being gathered for this.  It was however subject to additional funding being available so a decision would be made in June 2019.

RESOLVED:  That the minutes be noted.

The Board received the Halton Safeguarding Adults Board (HSAB) Annual Report for 2017-18 (1 April 2017 to 31 March 2018) and welcomed Audrey Williamson – the Independent Chair, who presented the report.

It was reported that the Annual Report fulfilled one of the HSAB’s three core statutory duties; detailing how effective their work had been.  

The Board was advised that all safeguarding partners had submitted their annual summary of work activity, the focus of which addressed HSAB’s priorities as identified from the 2016-2017 Annual Report Performance Framework and Strategic Plan (2016-2018), in addition to acknowledging local and national safeguarding adults emerging issues / trends / policies throughout the year.

Further, the report also provided a summary analysis of the data gathered from HBC Safeguarding Adults Collection and highlighted that what this information revealed informed the work priorities for 2018-2019; this could be found at paragraph 3.4 of the report.  The addition of two case studies within this year’s report was highlighted and it was agreed they provided a valuable insight into the diversity of support needed to help safeguard an adult at risk.

The Board was advised that following analysis of the previous year’s data and work activity and consultation with Members, HSAB partners, sub groups and service user groups, the following 3 priorities were agreed for 2018-2019:

·       Priority 1 – Quality Assurance;

·       Priority 2 – Learning and Professional Development; and

·       Priority 3 – Co-production and Engagement.

          In response to one Member’s query, it was commented that the increase in Acts of Omission was mainly due to medication not being given or not being given on time.  The Board requested feedback from the one GP practice that acted as the pilot for NHSE’s (National Health Service England) online virtual college; this would be sought.

RESOLVED:  That the report be noted.

The Board welcomed Colin Scales, Chief Executive Officer from Bridgewater Community Healthcare NHS Foundation Trust (BCHFT), who provided an update on the position of the Trust in relation to Quality Surveillance by National Health Service England (NHSE).  They also provided the results of the Care Quality Commission (CQC) inspection September 2018. 

          The Board was advised that due to concerns raised by CCGs and NHSE, BCHCF received a three month Enhanced Surveillance Notice and commenced a comprehensive programme of work to improve safety and quality of care using a Quality Risk Plan (QRP).  A review of this took place on 7 September 2018, where the Trust provided significant evidence of improvement which was subjected to further scrutiny by commissioners.  Following a further review on 24 October 2018, it was agreed to remove the enhanced surveillance and further scrutiny of the outstanding actions would be carried out via the Collaborative Commissioning Forum (CCF) rather than directly by NHSE.

It was explained that the actions within the QRP relating to Woodview Child Development Centre were removed and included in a separate plan for Woodview.  The scrutiny of the remaining actions of the Woodview plan were now undertaken by the CCG.  It was announced that there had been significant improvements, which included staff engagement in developing services and greater involvement with families.

The report provided further detailed information and the following was clarified following Members’ queries:

·       The Woodview plan was still ongoing and parents were encouraged to share their concerns with the Trust directly;

·       CQC feedback was still awaited regarding the Quality Risk Plan;

·       the Royal College of Paediatrics and Child Health had been commissioned to carry out an external review on Woodview.  Their findings would be shared with the Board once finalised; and

·       Healthwatch Halton would be hosting a feedback event on the improvements made at Woodview on 26 March 2019.

Members were asked to note the position in relation to quality surveillance and the CQC, and acknowledge the improvements made by the Trust.

RESOLVED:  That the updates are noted.

The Board was presented with the Halton’s Draft Homelessness Strategy 2019-2024 and the Homelessness Strategy Delivery Plan 2019-2024.  Both were appended to the report.

Members were advised that in accordance with the Homelessness Act 2002, it was a statutory requirement for each Local Authority area to produce a five year strategy.  This Strategy superseded Halton’s Homelessness Strategy 2013-2018.  The action plan would be reviewed annually, to ensure it remained current and reflected economic and legislative changes.   Since the previous Strategy was implemented it was noted that the Homelessness Reduction Act 2017 had come into force, so this had been incorporated and complied with into the new Strategy.

          The following additional information was provided following Members’ queries:

·       Housing Solutions worked with Nightstop at the moment around training and accommodation referrals.  However, Housing Solutions had not been notified of the new model and how it would be delivered.  It would be necessary to look at their model in detail to determine how a partnership could develop further.  This would be addressed by the Local Authority’s service commissioner;

·       Concerns were raised over the level of support for ex-Armed Services personnel who found themselves homeless and with mental health issues such as Post Traumatic Stress Disorder (PTSD); Halton had signed up to the Cheshire, Halton and Warrington Community Covenant which  encouraged support for the ex-Armed Forces Community working and residing in these areas; the Board would be provided with details of the Cheshire Armed Forces Covenant and the progress to date;

·       The Housing Solutions Team employed a Landlord Accreditation Officer and a Prevention Officer to ensure that privately rented properties in the Borough were maintained to an acceptable standard;

·       The Chair suggested that ‘zero hour contracts’ and ‘tenants leaving properties due to refurbishment’ be added to the causes for homelessness; and

·       Member training was taking place on 11 March 2019, at 5.30 pm in the Council Chamber to cover the Housing First Programme which would be facilitated by a Combined Authority Officer.

RESOLVED:  That the report be noted and comments made be considered before the Homelessness Strategy 2019-2024 is finalised.

The Board received an update from Dr Andrew Davies – NHS Halton CCG and Nicky Ambrose-Miney – Senior Commissioning Manger Urgent Care, NHS Halton CCG, on the development of the Borough’s two Urgent Care Centres (UCC) into Urgent Treatment Centres (UTC).   

Members were advised that Urgent and Emergency Care (UEC) was one of the national service improvement priorities.   It was noted that the clinical review of the current UCC model stated that neither UCC was fully compliant with NHSE expectations for UTC’s for the reasons stated.

The report outlined the core standards for UTC’s and how this would apply to Halton residents.   Officers advised that to ensure the two local centres met the needs of the population, NHS Halton CCG were conducting a consultation on the model, including the CCG’s proposal to reduce the opening hours by two hours a day. 

The Board was advised that a pre-consultation engagement was held from 24 October to 12 December 2018.  Its purpose and the main themes that came out of the consultation were discussed in the report.  Following this a formal eight week public consultation commenced on 7 January 2019 and would run until 3 March 2019.   The consultation process was discussed in detail which included how the public would be engaged in the process.

Members were also advised that from 1 October 2018, GP led cover at Widnes and Runcorn UCCs for 6 hours per day (12 noon – 6 pm, 7 days per week) had been implemented.   The impacts of this were described in the report.

The following points were added in response to Members’ queries:

·       The procurement process for the UTC’s was a formal process prescribed by national guidance;

·       Although there was interest initially with private providers, these had not continued with the process in Halton;

·       Once the UTC’s had been implemented, the onsite GP’s service would be negotiated with the new provider but the requirement would be for more than 6 hours per day;

·       The pre-consultation document questions were available and would be shared with the Board;

·       Patient online appointment bookings were still being encouraged;

·       Members’ comments regarding the improvements needed at ‘front of house’ in dealing with patients in the UCC’s were noted; and

·       Once the UTC’s were implemented; patients attending the Centre would have access to free parking.

The Chair requested that the Officers return in September with an update.

RESOLVED:  That the Board

1)    notes the outcomes of the pre-consultation engagement;

2)    notes the procurement timetable; and

3)    notes the impact of standardised GP cover in the Urgent Care Centres.

The Board was presented with the final Scrutiny Topic Group report on Care Homes – Future Sustainability, and its accompanying appendices.

It was noted that the Scrutiny Topic Group identified seven recommendations as part of the review which were detailed throughout the main report, as well as at the end of the report in a table for easy reference (appendix 4).

Members agreed that the topic group had proved to be enlightening and enjoyable to be a part of.  On behalf of the Board the Chair thanked the staff involved with the Topic Group and the Members of the Board for their input.    She also paid recognition to those Elected Members who visited care homes on a regular basis as part of their constituency work.

It was also confirmed that as part of Member involvement in the current business planning process, a range of topic areas had been identified for consideration for scrutiny during the municipal year 2019-20.  The priorities for Adult Social Care for 2019-20 were agreed by Members in December 2018; these were confirmed as:

·       Reablement pathway, including review of recruitment issues in community services;

·       Safeguarding Unit;

·       Deprivation of Liberty Safeguards (DoLS); and

·       Finance.

The Board discussed these priorities and agreed that the topic for the Scrutiny Review for 2019-20 would be Deprivation of Liberty Safeguards (DoLS).

RESOLVED:  That the Board agrees that

1)    the report be approved; and

2)    the topic for the Scrutiny Review for 2019-20 be Deprivation of Liberty Safeguards (DoLS).

The Board received the Performance Management Reports for quarter 3 of 2018-19.

Members were advised that the report introduced, through the submission of a structured thematic performance report, the progress of key performance indicators, milestones and targets relating to Health in quarter 3 of 2018-19.  This included a description of factors which were affecting the services.

The Board was requested to consider the progress and performance information and raise any questions or points for clarification; and highlight any areas of interest or concern for reporting at future meetings of the Board.  

The following highlights from the report were noted:

·       Additional funding had now been provided to refurbish the upstairs floor at Oak Meadow Care Home which would increase beds by 11;

·       The Complex Care pool budget was forecast to balance as advised by CCG;

·       A task and finish group would be established with Children’s Services to review the issues related to direct payments; and

·       With regards to the delivery of equipment and adaptations to patients homes and the returning of equipment by patients; a revised service specification for the Community Integrated Equipment Service would be developed during 2019-20.

RESOLVED:  That the quarter 3 2018-19 priority based report be received.