Agenda and minutes

Please note that this meeting may be filmed or recorded by the Council for live or subsequent broadcast via the Council’s internet site or by anyone attending the meeting using any communication method. Although we ask members of the public recording, filming or reporting on the meeting not to include the public seating areas, members of the public attending the meeting should be aware that we cannot guarantee that they will not be filmed or recorded by others attending the meeting. Members of the public participating in the meeting (e.g. making deputations, asking questions, making oral protests) should be aware that they are likely to be filmed, recorded or reported on. 

By entering the meeting room and using the public seating area, you are consenting to being filmed and to the possible use of those images and sound recordings.

The chair of the meeting has the discretion to terminate or suspend filming or recording, if in his or her opinion continuation of the filming, recording or reporting would disrupt or prejudice the proceedings, infringe the rights of any individual or may lead to the breach of a legal obligation by the Council.

The Chair referred Members present to agenda Item 1 as shown on the agenda in respect of filming at this meeting, and Members noted the information contained therein’.

Apologies for absence were received from Cllr Felicia Opoku and Ali Amasyali.

Apologies for absence were also received from Cllr Lucia das Neves, Cabinet Member for Health, Social Care and Well-being.

The Chair will consider the admission of any late items of urgent business (late items will be considered under the agenda item where they appear. New items will be dealt with as noted below).

Dominic O’Brien, Scrutiny Officer, said that the terms of reference and protocols for the Overview & Scrutiny Committee and its Panels and the non-voting co-opted Members on the Committee/Panels had been tabled as an item of urgent business. This included the policy areas/remits and the membership for the Committee and each Panel for 2023/24. These documents were for noting.

The report also required the Panel to approve its non-voting co-opted Members for 2023/24. The Panel was permitted to appoint a maximum of three members. There had been two members during 2022/23 (Ali Amasyali and Helena Kania) and no additional applications had been received.

RESOLVED: That Ali Amasyali and Helena Kania be appointed as non-voting co-opted Members of the Adults & Health Scrutiny Panel for 2023/24.

A Member with a disclosable pecuniary interest or a prejudicial interest in a matter who attends a meeting of the authority at which the matter is considered:

(i) must disclose the interest at the start of the meeting or when the interest

becomes apparent, and

(ii) may not participate in any discussion or vote on the matter and must withdraw from the meeting room.

A member who discloses at a meeting a disclosable pecuniary interest which is not registered in the Members’ Register of Interests or the subject of a pending notification must notify the Monitoring Officer of the interest within 28 days of the disclosure.

Disclosable pecuniary interests, personal interests and prejudicial interest are

defined at Paragraphs 5-7 and Appendix A of the Members’ Code of Conduct.

Cllr Pippa Connor declared an interest by virtue of her membership of the Royal College of Nursing.

Cllr Pippa Connor declared an interest by virtue of her sister working as a GP in Tottenham.

Cllr Thayahlan Iyngkaran declared an interest by virtue of his membership of the Royal College of Radiologists.

To consider any requests received in accordance with Part 4, Section B, Paragraph 29 of the Council’s Constitution.

None.

To approve the minutes of the previous meeting.

Cllr Connor updated the Panel on a previously agreed action from the Panel’s budget scrutiny meeting in December 2022 that dialogue with the finance officers about the 2023/24 budget scrutiny process be commenced as an earlier stage. A discussion had subsequently taken place on 19^th June 2023 involving Cllr Connor, the Chair of the Overview & Scrutiny Committee, the Director of Finance and others on the format of the budget scrutiny reports for 2023/24, with particular reference to the capital budget details. 

The minutes of the previous Adults & Health Scrutiny Panel meeting were approved as an accurate record.

RESOLVED – That the minutes of the meeting held on 13^th March 2023 be approved as an accurate record.

To provide an update on plans and solutions to support people with dementia in the Borough as part of the multi-agency Ageing Well Strategy.

Cllr Pippa Connor opened this item by highlighting three specific areas that the Scrutiny Panel would like to hear further information on which were a) details of the budget for the Ageing Well Strategy, b) which organisations received money from this budget, and c) the outcomes that were delivered and how these were measured.

Paul Allen, Head of Integrated Commissioning, then introduced the report on dementia services, noting that it provided an update to the previous report to the Panel at the December 2022 meeting and comprised of three main areas:

• Improving awareness-raising and progress towards a dementia-friendly Haringey;
• Improving diagnostic rates and onward connection to services;
• Improving services for people living with dementia.

On the first area around awareness-raising, Paul Allen said that actions taken since the last report had included appointing a dementia coordinator and relaunching the Dementia-Friendly Haringey Alliance, which had recently had a successful conference. The priority on support for under-served communities had included work through the community ambassador network to spread awareness about spotting the signs and symptoms of dementia and encouraging people to approach their GP for help earlier. An Ageing Well guide was also being developed and funding had been obtained for a training and awareness raising programme on ageing well with a specific module on dementia.

On the second area around diagnostic rates, Paul Allen said that actions taken had included working with GP practices and NHS Trusts to improve diagnostic rates by getting the basics right, including through initial screening. There had been some work with the Dementia Reference Group to develop a dementia chart which describes some of the things that people might expect in accessible language including advice on where to turn if problems escalate. An enhanced health and care homes model and collaboration between primary care community health and care homes had been worked on as around 70% of the care home population had dementia to some extent.

On the third area around improving services, Paul Allen said that support available at acute Trusts had been improved through initiatives such as an assessment unit for frailty. Support in the community was being improved through the ‘hub-and-satellite’ model set out in the report which involved the Haynes Dementia Centre, the Grace Organisation and other community resources.

Laura Crouch, Senior Services Manager for Community Provisions, Day Opportunities and Shared Lives, spoke about the ‘hub-and-satellite’ model explaining that the Haynes Dementia Centre was the centre for expertise for dementia in the Borough and that the aim was to develop that expertise elsewhere in the community. There were links developed by the dementia coordinator with Priscilla Wakefield House and other housing associations where dementia-friendly activities (knitting, drama, art therapy, etc.) were being held in the common room areas. They were also looking to expand the Singing for the Brain programme to other parts of the Borough as this was now oversubscribed at Alexandra Palace. There were conversations ongoing with Tottenham Hotspur Football Club about the possibility of obtaining some community space for  ...  view the full minutes text for item 7.

Report to follow.

Chris Atherton, Principal Social Worker and Head of Quality Assurance & Development for Adult Social Services, introduced the report for this item beginning with social care reform. Proposed measures on liberty protection safeguards and the social care cap had been pushed to the next Parliament. Changes to the Mental Health Act had been pushed back by a Parliamentary Committee which stated that it did not do enough to tackle inequalities and rising detention rates.

The new inspection regime for adult social services by the Care Quality Commission (CQC) was being slowly implemented with pilot work ongoing with five local authorities until September 2023 and then another 20 local authorities from then until March 2024. The aim was for all local authorities to be inspected and rated in the two years after that. The CQC had identified four themes for local authority assurance:

• How local authorities work with people – including assessment of needs, supporting people to live healthier lives and equity in experience and outcomes.
• How local authorities provide support – including market shaping, commissioning, workforce capacity/capability, integration and partnership working.
• How local authorities ensure safety within the system – including safeguarding processes/frameworks, reviews, safe systems and continuity of care.
• Leadership – Governance, management and sustainability. Learning, improvement and innovation. 

Chris Atherton said that, from their work with ADASS and the LGA, it was clear that the CQC would have a particular focus on recruitment, retention and development of staff. The redevelopment of the Council’s workforce strategy had therefore aimed to identify the key drivers that relate to its workforce, Haringey as a borough and its connection with the wider system. From this, workforce priorities had been developed including staff welfare and wellbeing, leadership and management traineeship, apprenticeships and career pathways.

He added that it was often difficult to get the workforce supply that was needed and so consideration had been given to developing capacity moving forward. Low vacancy rates improved outcomes for residents, improved service delivery and improved new models of practice. The Council’s new social work and occupational therapy officer roles would provide stability to the workforce and future proof services by ensuring a steady flow of social workers and occupational therapists into the service each year by providing clear pathways into professional qualifications.

Chris Atherton, Vicky Murphy and Beverley Tarka then responded to questions from the Panel:

• Helena Kania expressed concern about the extensive staff time taken up by preparing and responding to inspections. Vicky Murphy agreed that this was an issue and said that preparation was key, including the work that had already been done with the commissioning review and the workforce review. They had also joined the ADASS group for peer review and would obtain experience from contact and collaboration with other local authorities. Beverley Tarka added that ADASS had worked closely with DHSC (Department for Health and Social Care) over the development of the inspection framework and were pleased that these focused on people’s experience of care and support and the outcomes that people identify  ...  view the full minutes text for item 8.

Report to follow.

Introducing this item, Jon Tomlinson explained that a decision had been taken about a year ago to review the adult social care commissioning function and so the Local Government Association (LGA) had been approached who had suggested taking part in testing out an evaluation tool provided by the Public Services Transformation Academy. Haringey was the first local authority to use this tool and, over the course of three days in Sep/Oct 2022, engaged with teams across the Council, providers, service users and voluntary organisations. The Review which was then produced included eight different dimensions which were scored with areas highlighted where room for growth had been identified in areas such as relationships, co-production and innovation. From a commissioning perspective, Jon Tomlinson said that there was enthusiasm to drive change, challenge the market and achieve a high-quality level. There were therefore some areas of improvement work, including on strategic direction, data, communication with providers/service users and refreshing documentation to help plan the commissioning cycle. The direction of travel was to be user and outcome centred as set out on the ‘progress through the models’ slide.

Jon Tomlinson and Vicky Murphy then responded to questions from the Panel:

• Referring to paragraph 1.8 of the Executive Summary of the report, Cllr Connor noted the statement that there were “foundational resources that are lacking within the Adult Social Service Commissioning team” including an overall commissioning strategy, a clear vision about strategic commissioning, leadership and a contracts register. Vicky Murphy highlighted that the commissioning function was still in recovery from the impact of the Covid pandemic and Jon Tomlinson noted that the priority during the pandemic had been ensuring that residents had access to basic services which impacted on other areas of work, such as the commissioning documentation. In terms of other issues, he said that the churn in senior managers across the services would have caused some disruption, so the aim of the current approach was to establish a ‘foundation block’ and clarity of direction to enable consistency irrespective of who was leading commissioning. Cllr Connor observed that the language of the report suggested a lack of strategy and that there would have been a strategy in place prior to the Covid pandemic. Jon Tomlinson confirmed that there had been a strategy in place but said that it was now quite dated, particularly because commissioning had changed as a result of Covid. Various documents, such as the market position statement, and the overall direction of travel therefore needed to be updated. He added that the report had been quite honest about what the key issues were, which was important to enable these to be tackled.
• Cllr Iyngkaran welcomed the transparency of the report and noted that some of the issues highlighted were familiar ones such as silo mentality and poor communication. Asked by Cllr Iyngkaran about the positive points that could be taken from the report, Jon Tomlinson said that the staff being the strongest asset came out clearly in the report. He added  ...  view the full minutes text for item 9.

Dominic O'Brien, Scrutiny Officer, reported that evidence sessions for the Scrutiny Review on hospital discharge had been continuing, including a recent session with the discharge team at the Whittington Hospital and the Council’s sheltered housing team. A second Scrutiny Review on digitalisation and communications with residents was anticipated to begin in the Autumn. The next Panel meeting was scheduled to take place on 18^th September 2023 with the agenda items detailed in the work programme report. Cllr Connor noted that further input from Panel Members on the terms of reference for the second Scrutiny Review would be helpful ahead of the Autumn.

·         18^th September 2023 (6:30pm)

·         16^th November 2023 (6:30pm)

·         12^th December 2023 (6:30pm)

·         22^nd February 2023 (6:30pm)

·         18^th Sep 2023 (6:30pm)

·         16^th Nov 2023 (6:30pm)

·         12^th Dec 2023 (6:30pm)

·         22^nd Feb 2024 (6:30pm)