Agenda and minutes

9.1       The Committee RESOLVED to agree the minutes of the meeting held on 18 June 2015.

10.1     Apologies for absence were received from Councillor Charles Clark. It was also noted that Councillor Bill Bentley, Lead Member for Adult Social Care, had sent his apologies.

Disclosures by all members present of personal interests in matters on the agenda, the nature of any interest and whether the member regards the interest as prejudicial under the terms of the Code of Conduct.

11.1     Councillor Trevor Webb declared a personal non-prejudicial interest as a member of the East Sussex Health and Wellbeing Board.

Notification of items which the Chair considers to be urgent and proposes to take at the appropriate part of the agenda. Any members who wish to raise urgent items are asked, wherever possible, to notify the Chair before the start of the meeting. In so doing, they must state the special circumstances which they consider justify the matter being considered urgent.

12.1     There were none.

13.1 Cllr David Elkin (Deputy Leader), Cllr Sylvia Tidy (Lead Member for Children and Families), Becky Shaw (Chief Executive), and Keith Hinkley (Director of Adult Social Care & Health) were present for the Reconciling Policy, Performance and Resources (RPPR) item.

13.2     Cllr Elkin told the committee that the council had already made savings of £64 million in recent years, but would be required to find an additional £70-90 million over the next three years. These figures are based on current projections, and the final total may well be greater. The scale of the savings required means that there are no ‘red lines’ – no services are exempt from challenge. Planning has been in line with the council’s four key priorities and with a ‘one council’ approach.

13.3     Becky Shaw told members that, in addition to Government funding reductions, the council also had to deal with growing demographic pressures, particularly in terms of our ageing population. The council was still assessing the implications of the July budget statement, of the decision to delay the implementation of the cap on care costs, and of the introduction of a National Living Wage. The Government’s Comprehensive Spending Review will be published on November 25^th, although the details of the Local Government settlement will be considerably later; so much so that there may be pressure on council to meet their budget deadlines.

13.4     Keith Hinkley told the committee that it was important to bear in mind that this was not the beginning of the savings process: council budgets have been reducing for a number of years, meaning that many of the most readily achieved savings have already been taken. Further integration with NHS partners does offer significant opportunities. However, the NHS is itself struggling with funding levels, and there is some uncertainty as to how much future NHS funding will be routed through Clinical Commissioning Groups (CCG), our main partners in integrating services. There are likely to be further changes to the Better Care Fund, but this will probably not include any more direct transfers of funding to Local Authorities.

13.5     In response to a question from Cllr John Ungar on what the council was doing in terms of lobbying Government about the demographic pressures we face, Becky Shaw told members that there was ongoing dialogue via ADASS (Association of Directors of Adult Social Services), the LGA, SE7 and the County Council Network. However, many other councils face similar pressures to East Sussex.

13.6     Keith Hinkley added that ADASS had told the Government that its members have reduced confidence in their ability to continue to meet local government commitments to adult social care (ASC). The South East Adult Social Care Lead Member group had also been active in lobbying on demographic pressures, but also on problems of pay and recruitment which are particularly acute in the region. CCG partners have also expressed their concerns to Government about adult social care pressures. There will be some additional funding for winter pressures this year, and the  ...  view the full minutes text for item 13.

14.1     The Committee considered a report by the Director of Adult Social Care and Health containing the Safeguarding Adults Board Annual Report 2014/15 and Safeguarding Strategic Plan 2015-18.

14.2     In response to questions raised by Members, officers provided the following additional information:

• The East Sussex Safeguarding Adults Board (SAB) has now appointed Graham Bartlett as its Independent Chair. Due to the fact that Mr Bartlett is the Chair of the Brighton & Hove SAB and Brighton & Hove Local Safeguarding Children’s Board (LSCB), and there are already pan-Sussex safeguarding policies and procedures in place, this appointment is expected to deliver economies of scale.
• The SAB has recorded a reduction in safeguarding referrals from GPs for 2014/15 and is working with the CCGs to understand why this is the case. SAB believes that working with the CCGs to raise awareness of safeguarding issues amongst GPs will have a greater impact than contacting GPs directly. This is because CCGs already have oversight of and influence on GPs (as their membership is derived from GPs) and they are obliged to ensure that there are suitable safeguarding arrangements in place amongst GPs. SAB is aiming to create an environment within CCGs where GPs who sit on the CCG boards understand that safeguarding is a priority, cascade this message down to GP surgery level, and put a monitoring regime in place.
• The reason for the change in policy for reporting pressure ulcers – which explains the reduction in safeguarding alerts in 2014/15 – is that they are no longer automatically flagged as a safeguarding issue unless there is a suspicion of neglect.  Prior to 2014/15, all safeguarding referrals due to pressure ulcers were being flagged as examples of neglect as part of a response to historic underreporting. However, the reporting policy changed in 2014/15 to a more proportional response that focusses on raising awareness of pressure ulcers amongst staff in residential and community settings. Under the new system, if an initial safeguarding alert is raised, then the Quality Team will intervene to provide advice and guidance. However, if there are repeated and systemic safeguarding alerts then it is likely that it could be investigated as a case of neglect.
• SAB collects incident reports from multiple sources to ensure that they are as accurate as possible. These include incident reports produced by the CCGs and the reporting procedures that the Care Quality Commission (CQC) follows when it inspects care homes. There is no absolute guarantee that incident reports will tell the whole picture, so the SAB remains proactive in developing qualitative and quantitative information as well as looking out for anecdotal safeguarding issues.
• In the 7% of cases where there was action under safeguarding arrangements and risk was not reduced or removed – usually because the victim wanted to maintain a relationship with the family member who was the source of the risk – SAB continues to work with the victim.
• The SAB identifies areas where there may be issues in the reporting of safeguarding issues and works  ...  view the full minutes text for item 14.

15.1     The Committee considered a report by the Director of Adult Social Care and Health providing an update on the Care Act implementation priorities for 2015/16.

15.2     In response to questions about the impact of the Department of Health’s decision to defer the implementation of the care cap to 2020, officers explained that:

·         The care cap was due to be implemented in April 2016 so significant work had already been carried out in anticipation, including the development of new policies and systems to deal with the new responsibilities, for example, the deferred payment scheme. Development of and recruitment for these new systems has now had to stop.

·         The postponement of the implementation of first party top-ups will have no effect on clients as the current care system does not offer this service.

·         The postponement removes significant risk from the ASC budget; however, this is likely to be offset by the introduction of the national living wage.

·         The Department of Health has not yet indicated whether it will continue to provide local authorities with the payment for implementing the care cap and other measures. The July and August tranche of the payment has been made, and it is unlikely that this money will be clawed back.

15.3     The Committee RESOLVED to note the report.

16.1     The Committee considered its work programme for future meetings.

16.2     The Committee RESOLVED to request a report at its March 2016 meeting on the impact of the change in the method of providing Meals on Wheels.

The Forward Plan for the period to December 2015. The Committee is asked to make comments or request further information.

17.1     The Committee considered the latest edition of the Council’s Forward Plan covering the period 1 September to 31 December 2015.

17.2     The Director of Adult Social Care and Health advised the Committee that an additional item had been added to the Forward Plan relating to a decision due to be taken on 13 October 2015 to relocate the Learning Disability Service that is currently provided from Sandbanks in Hailsham to an alternative Council building, namely Grangemead in Hailsham.

17.3     The Committee RESOLVED to agree that the Forward Plan should be the first substantive item at future Adult Social Care and Community Safety Scrutiny Committee meetings.