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, Cllr Sheila Peacock and Ali Amasyali.

Apologies for absence were also received from Cllr Lucia das Neves, Cabinet Member for Health, Social Care & Wellbeing.

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).

None.

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 referred Members of the Panel to the responses received so far on action points from previous meetings, noting that some responses were still outstanding and would be followed up with officers.

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 18^th September 2023 be approved as an accurate record.

To provide details of recent quality assurance activity carried out in Haringey.

Report to follow.

Jon Tomlinson, Senior Head of Service for Commissioning, Brokerage and Quality Assurance, introduced the report for this item which provided an annual update on the recent quality assurance work and the current challenges faced including upward pressure on costs, recruitment and retention, and increased acuity and demand. Regular meetings were held with both domiciliary care and residential care providers to discuss key issues and a new uplift process had been introduced to reflect the challenges faced by providers. He explained that the Council and the Care Quality Commission (CQC) worked closely with providers to develop action plans when issues had been identified through the quality assurance process. In Haringey, the majority of providers had been assessed as being in the ‘good’ or ‘outstanding’ categories and the general approach of the Council was not to commission providers that were assessed as requiring improvement, although there were cases where there were already residents using those services.

David Harris, Operations Manager for Islington, Camden & Haringey at the CQC, explained that his role covered a range of health and social care services and that, from January, there would be an allocated CQC inspector for adult social care in Haringey. With regard to the report, he concurred that there was a lot of pressure in the system at present and noted that there were particular concerns about the demand on ambulance services coming into the Whittington and North Middlesex hospitals.

Jon Tomlinson and David Harris then responded to questions from the Panel:

• Cllr Iyngkaran referred to Provider G in Table 1 in the report which was listed as having two open Safeguarding Adult Reviews and 30+ safeguarding concerns. He asked why the Council had lifted its suspension on further placements while the Integrated Care Board (ICB) had continued with a suspension. Jon Tomlinson responded that the Council had developed an action plan with the provider and that all of the required quality assurance actions had been complied with. The Council had a block contract with the provider and it was deemed appropriate to lift the suspension. Vicky Murphy, Service Director for Adult Social Services, added that the provider had 106 beds, 61 of which were for residential and lower needs nursing. She explained that there were also some intermediate care beds and that the ICB would also spot purchase beds for Continuing Healthcare (CHC). The requirements on CHC had been around intensive nursing support and changes were ongoing in this area. Further information was expected to be available on this in the coming weeks which could be provided to the Panel. (ACTION)
• Referring to Table 5 on page 8 of the supplementary agenda pack, Cllr Iyngkaran asked why nine of the Out of Borough placements were at uninspected premises. David Harris explained that not every adult social care service was inspected by the CQC (e.g. supported living) and that some services may have registered but not been inspected yet. When registering, they would have to go through a rigorous process including many of the same  ...  view the full minutes text for item 29.

To consider the annual report of the Haringey Safeguarding Adults Board for 2022/23.

Dr Adi Cooper, Independent Chair of the Haringey Safeguarding Adults Board (HSAB), presented the Board’s annual report for 2022/23 noting that it had continued to be a challenging environment for all partners in maintaining the good work being done in Haringey. The report set out the work that the board had done in terms of meeting statutory duties and priorities and there had been a major project in developing a revised strategic plan after the previous plan had come to an end, with support provided on the formal consultation and co-production from the Joint Partnership Board. The co-production work had aimed to work with representatives of different voices of people with lived experience in the borough to influence the direction of the plan from the beginning.

Dr Adi Cooper described the changing infrastructure below the Board which now included an engagement and partnership group, a practice improvement group and a reconfigured quality assurance group. Over the longer term there would be a greater priority on engagement to inform prevention work. There had also been deep dives on data including on safeguarding referrals from people in supported housing and on neglect and financial abuse. This had been initiated because of variations in the data but the deep dives had not suggested issues with the practice going on.

Other issues described in the report included the joint work with partners such as the regular meetings with the Children’s partnership, including on transitional safeguarding. Each year the Board undertook a self-assessment to ensure that it was still effective and that partners were all deliveries on their responsibilities.

Dr Adi Cooper then responded to questions from the Panel:

• Cllr Brennan described concerns about inadequate communication channels and support in relation to an individual case involving a resident in sheltered housing. Dr Adi Cooper said that, while she could not comment on individual cases, she would be happy to discuss this outside of the meeting to understand the concerns and the agencies involved. Asked by Cllr Connor whether there were any particular improvements that could be made around communications, Dr Adi Cooper said that most Adult Safeguarding Reviews typically identified communications as an issue at some point and also that communication between boroughs were sometimes not as good as could be expected in relation to cross-boundary cases. She noted that there had been an issue in Haringey in the past where communications back to people who had referred concerns to the local authority had been poor, but she felt that this had now improved. Another issue to be considered was the churn in staffing in the public sector which did not make for easy maintenance of relationships and communication. Cllr Mason commented that communications between boroughs could be a particular problem in domestic abuse cases when people moved boroughs.
• Cllr Mason raised concerns about homelessness and the safeguarding concerns associated with this, noting a recent increase in street homelessness cases coming in via the food bank in her area and that local homelessness agencies were  ...  view the full minutes text for item 30.

Report to follow.

Alexandra Domingue, Project Manager for Adult Social Care Commissioning, introduced the report noting that the Adult Social Care Commissioning Co-Production Board was being launched in November 2023 as a response to both the recent peer review and the Scrutiny Review on this issue. The Board was envisaged as a vehicle for Adult Social Care Commissioning to involve people in the development of projects that would affect them.

Alexandra Domingue added that the Joint Partnership Board had helped to shape the development of the new Board including the terms of reference. The vision was for the Board to take upcoming commissioning work and gain input and guidance on the development as part of a multidisciplinary group including residents who access adult social care services and carers. It would also involve providers and adult social care staff. Other issues such as quality assurance work or contracts may also be brought to the attention of the Board.

Alexandra Domingue then responded to questions from the Panel:

• Asked by Cllr Connor about the membership of the new Board, Alexandra Domingue said that invitations had been sent to reference groups, carers groups and residents. It was also expected that there would be sub-groups with people joining based on their areas of experience and expertise. Cllr Lucia das Neves would be attending the Board as the Cabinet Member for Health, Social Care & Wellbeing. It may also be appropriate to involve other Council Members on certain areas of work, particularly when related to certain localities. Cllr Connor suggested that information about this should be communicated to all Council Members so that they could have the opportunity to express their interest. (ACTION)
• Cllr Mason expressed support for wider engagement with local voluntary sector organisations and Alexandra Domingue said that any further suggestions of organisations that they could reach out to would be welcomed.
• Asked by Cllr Mason how success would be measured, Alexandra Domingue said that there would be various ways of doing this including the contract monitoring process and proactively obtaining feedback from service users. This could potentially happen through a resident audit team rather than directly through officers.
• Asked by Cllr Connor about support for residents in their co-production roles, Alexandra Domingue said that specification of the position of a Co-production Board member had been provided in the agenda papers and there was also some ongoing work with colleagues on the development of some formal training and ring-fenced support/debriefing. There had also been progress in bringing forward financial remuneration measures and references for future job applications and there were ongoing conversations about the most appropriate format for this.
• Helena Kania requested further details about the link between the Co-Production Board and the Joint Partnership Board. Alexandra Domingue responded that the role of Public Voice had been instrumental in sharing details about the Co-Production Board with its members and that she would welcome close working and updates between the two Boards. This could potentially include a representative of the Joint Partnership Board joining the Co-Production Board.  ...  view the full minutes text for item 31.

a)    To consider any additions or amendments to the Panel’s current work programme.

b)    To amend/approve the draft terms of reference for the proposed Scrutiny Review on Digitalisation and Communications with Residents.

Scrutiny Officer, Dominic O’Brien, informed the Panel that, in addition to the latest version of the Panel’s Work Programme, the draft scope and terms of reference for a new Scrutiny Review on Digitalisation and Communications with Residents was included in the agenda pack. Since publication, it was suggested that the terms of reference be amended to clarify that communications for residents presenting with complex needs involving a multidisciplinary team was one element to be included in the Review rather than the main/only element of the Review as a whole. Cllr Connor commented that one strand of the Review would include how residents, carers/families, other organisations were kept informed of developments in a case and another strand would look at how the digitalisation of the process would work. With these amendments added, the terms of reference for the Review were approved by the Panel.

Helena Kania suggested that work in the NHS on personalisation and the involvement of residents/carers in the plan and its progression could be considered as part of the evidence gathering and would provide some further details outside of the meeting. (ACTION) Panel Members were reminded to provide any further feedback on the Review, including possible witnesses, by email.

RESOLVED – That the terms of reference for the amended Scrutiny Review on Digitalisation and Communications with Residents be approved.

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

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

·         12^th Dec 2023 (6:30pm)

·         22^nd Feb 2024 (6:30pm)