Agenda and minutes

            The Minutes of the meeting held on 29 June 2021 having being circulated were signed as a correct record, subject to noting that Mr Dave Wilson, the Healthwatch Co-optee was in attendance.

The minutes from the Health and Wellbeing Board meeting held on 24 March 2021 were attached for the information of the Board.

The Director of Pubic Health and Protection provided the Board with an update on the Public Health response to Covid-19 Coronavirus.  

The update and accompanying presentation included the most recent Covid-19 figures and data for Halton; how the Halton Outbreak Support Team were working to successfully identify and manage local outbreaks; and gave details of the most recent information on testing and vaccination for people in Halton.

Responses to Members questions were provided and it was agreed that a summary of the information, as it stood today, would be prepared for the Board and sent following the meeting.

            RESOLVED:  That the update be received.

The Board considered a paper from the Strategic Director – People and the Chief Commissioner, NHS Halton CCG.  The report provided a position statement in relation to (a) One Halton and the development of the One Halton Integrated Care Partnership (ICP) and (b), the development of Cheshire and Merseyside Health and Care Partnership as an Integrated Care System (ICS).

The report also included latest information and relevant updates in relation to the White Paper and considered any impact for Halton.

It was reported that since the publication of this report, some progress had been made and the formal governance structure and legal framework was now in place; these updates would be included in a report for the next Board meeting in November.   Comments made by the Chair were noted and it was confirmed that Halton would not see any reductions in services, no additional costs and there would be no cuts to budgets resulting from the ICP or the ICS.

RESOLVED: That the report be noted.

The Board considered a report from the Strategic Director – People, which provided details of the risks associated with the recent Government legislation published on the need to vaccinate people working or deployed in care homes.

It was reported that the regulations must be implemented by 11 November 2021 and although this legislation was expected to reduce the health risks to care home residents and staff, it would introduce a number of consequential risks, which threatened the operation of local health and care systems.  The report explained these risks and the immediate actions that would be needed to prepare for workforce reductions that were expected to arise because of this legislation.

Members were advised that in the 11 days since the publication of this report, the information had changed considerably and the number of staff across the whole sector that were not vaccinated had reduced from 200+ to just 33.  Nonetheless, the risks associated with non-vaccination of care home staff was still present, as described in the Statement of Risks (paragraph 3.4) and the subsequent impact assessment carried out against these risks (paragraph 3.5).

Further to Members’ questions, the following information was noted:

·         In-house care homes were almost full at the moment but there were no staff reductions;

·         Those staff at risk of losing their jobs were being supported with finding other roles and contact with agencies had been made;

·         Since the pandemic some care homes had shut parts of their building and these may or may not re-open;

·         The recruitment and retention of staff in the care sector was challenging – it was noted that some work was being carried out by the Liverpool City Region in this area;

·         Some staff were unvaccinated due to being exempt – they were subjected to rigorous testing prior to being in contact with residents; and

·         Vaccination of domiciliary care staff was not yet mandatory; they were also subject to rigorous testing and use off PPE.

The Board requested an update on the situation at a future meeting.

RESOLVED:  That the report and comments made be noted.

The Board received a report of the Strategic Director – People, which provided an update on implementation of a new model for the delivery of Intermediate Care and Frailty Services in the Borough, since the last update report presented to the Board in February 2021.

As outlined previously, one of the key aspects of the new service would be the introduction of a Single Point of Access (SPA) and the integration of the previous frailty service provided by the Halton Integrated Frailty Service (HIFS), with the ability to provide a Community Rapid Response within 2 hours, if assessed as necessary.   The key objective of the SPA therefore, was to ensure the seamless, safe management of referrals for people requiring Adult Community Services, to either potentially prevent an admission, support early discharge, or co-ordinate care closer to home.

Members were referred to Appendix one which provided further detailed information on the model and Appendix two, which displayed the pathway into the new ICFS.

Further to a request from the Chair, an update would be provided at a future meeting.

RESOLVED:  That the Board notes the report and appendices.

The Board received the Halton Safeguarding Adult Board (HSAB) Annual Report for 2020/21 and accompanying presentation, and was requested to approve this for publication.

            It was noted that the HSAB was developed in conjunction with HSAB partners to ensure the report encompassed a multi-agency approach.  The report included performance data and comparisons between years, achievements in the year and highlighted some of the good practice in the Borough.

RESOLVED:  That the HSAB Annual Report be approved.

The Board considered a report of the Strategic Director – People, which provided an update on and highlighted key issues with respect to Quality Assurance in care homes and domiciliary care.

It was reported that during the pandemic both the Care Quality Commission (CQC) and Halton’s Quality Assurance Team had to amend the way that they supported the sector undertaking a risk assessment approach and alternative arrangements for assessing and monitoring and only ‘crossing the threshold’ in relation to serious safeguarding issues.  This had significantly reduced intelligence and notifications received by the services, which also had an impact on reporting of ratings.  It was noted that the Quality Assurance Team had now started to undertake safe and well visits and the CQC had resumed inspection activities.

The report provided Members with the care home ratings for July 2021 and the domiciliary care ratings for July 2020.  It also discussed the sustainability of the care sector and challenges faced since the onset of the pandemic and highlighted the Lessons Learned and Home First approaches.

Further to a query the Board was advised that vacancies in care homes were only at 3% presently so they were filling up, but it should be noted that the closure of some units within care homes had affected their capacity.

RESOLVED:  That the report be noted.

The Board received the Performance Management Reports for quarter one of 2021/22.

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 one of 2020-21.  This included a description of factors, which were affecting the service. 

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. 

Updates were provided to ASC 04, ASC 15 and ASC 18.  It was noted that ASC’s 17, 19, 20, 21, and 22 would not be available this year. 

RESOLVED: That the quarter one Performance Management reports be received.