Agenda and draft minutes

Jane Havergal

Verlyn Cowell

Liz Marnham

Lloyda Fanusie

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 at Item 11 below).

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A Member with a personal interest in a matter who attends a meeting of the authority at which the matter is considered must disclose to the meeting the existence and nature of that interest at the commencement of that consideration, or when the interest becomes apparent.

A Member with a personal interest in a matter also has a prejudicial interest in that matter if the interest is one which a Member of the public, with knowledge of the relevant facts, would reasonably regard as so significant that it is likely to prejudice the Member’s judgement of the public interest and if this interest affects their financial position or the financial positions of a person or body as described in paragraph 8 of the Code of Conduct and/or if it related to the determining of any approval, consent, licence, permission or registration in relation to them or any person or body described in paragraph 8 of the code of conduct.

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To approve the minutes from the meeting on 4^th February 2008.

Agreed

Papers to follow

The panel was taken through the PSSEX1 return; this is the information which is provided to the Department of Health by the Directorate on an annual basis.

Noted that it is difficult to compare 05/06 and 06/07 as what is included in each cost centre may have changed.  For example, Assessment and Care Management in 05/06 is shown as £3.6 million and in 06/07 it is shown as £6.7 million this is because the distribution of assessment costs was changed.

Over the past four years money has been incrementally moved from institutional based care to community based care, both internally and externally.  This has included a reduction in residential care placements of over 220.

At the same time the number of people being supported in their own home has increased.

It is difficult to move more services at once as there is no parallel funding available.  This is a challenge.

Out of a total spend of £40 million approximately only 5% if this is spent on preventative services.

Joint arrangements are those which are joint with the TPCT.

Points of discussion

The number of people receiving Meals on Wheels (MoW) has decreased.  This is because historically MoW was not FACs tested.  The decision to make this FACs tested was due to the increased cost of meals, for example kosher meals are more costly.  The Council’s contribution therefore doesn’t take long to become a budget pressure.  The use of FACs also ensures that the provision of the service is more transparent.

Equipment and adaptations are not costed to Older People’s services.  These sit under Physical Disabilities; some is also costed to Homes for Haringey, Housing Associations and the Disabilities Facilities Grant.  Therefore the costs which are incurred by Older People is not easily accessible due to the disparate sources.

Noted that the performance of equipment and adaptations has improved significantly.  At the same time the increase in the number of assessments undertaken has resulted in long waiting times, this is due to the finite resources.

Query as to why Home Care costs have not increased whilst the numbers in residential care have decreased.  Noted that there was an overall shift and the costs were incorporated into Assessment and Care Management.  However this is not apparent from the breakdown.

Other Services includes areas such as transport to and from respite care, deep cleaning of properties.  It also includes areas such as grants, e.g. for the Alzheimer’s society.

Part of this is budgeted for e.g. grants but some is based on need and therefore can not be predicted e.g. the deep clean service.

The reason for deep cleans varies – it can include homes which need the service as the tenant has had a quick onset of dementia and also in homes where there has been a choice not to clean and therefore the property has deteriorated.

Supporting People is for helping to maintain tenancies, services under Supporting People do not explicitly state this due to perceptions that this is only housing help.  ...  view the full minutes text for item 46.

Papers to follow

Looking at the TPCT spend on older people is complicated as the money is all within an adults budget and not separated for older people.

There is currently no system like Framework-I to enable figures to be pulled off and there is no single spreadsheet which keeps all over the information together.

Noted that the figures are not fully comprehensive due to the time of year and the resource pressures at the TPCT.

The spend on older people is approximately 9% of the total spend.  This correlates with proportion of the population who are over 65 years of age.

Foot health is not included in the figures, this will be supplied to the panel.

It is very difficult to get a breakdown on what is being spent on Dentists and GP’s, but this is being looked at.  At the same time the information would again be on adults and not broken down to older people.

Need to be careful when comparing costs and number of people that this cost represents as often the figures can be mis-read.  For example, the number of services can be mixed up with the number of people – one person may have more than one service.

The TPCT is moving to a more outcome based way of commissioning services.

Points of discussion

Handy Person project is an open access project.  People can self-refer, although a large amount of referrals come go through the Integrated Community Therapy Team. Figures on numbers of people using the service can be accessed from Age Concern.

Query raised as to whether Homes for Haringey benefit from the scheme if a person who accesses the project if in a HfH property.  This should be referred by the Handy Person Project should it be the case.

Noted that Acronyms need to be avoided.

HICES – Haringey Integrated Community Equipment Store

RNOH – Royal National Orthopaedic Hospital

List of approved traders?  Age Concern have this. 

Suggested that this should include not only traders, but also dentists, podiatrists etc.

Query as to whether this could be available on the Haringey information sites as may be seen to be favouring certain companies.

To consider the proportions of the older population who receive a social care assessment and subsequent service based on a proportion of the whole population.

Papers to follow

The Panel were shown 2 performance indicators:

E47 - Ethnicity of Older People receiving an assessment

E48 – Ethnicity of Older People receiving services following an assessment

The Older People’s service is comfortably within the top performing banding set by the Department of Health for both of these Performance indicators.

If the service notes any ethnic group where the numbers are not represented on a proportional basis then it looks to understand why this is the case.

An Equalities Impact Assessment was recently done which showed that Chinese people were under represented; this is now being looked at.

This is also the case where some ethnic groups are less represented in taking up Direct Payments.

The panel looked at assessment and service data from 06/07 and 07-Jan 08 in comparison with the proportion of the population from each ethnic group as shown on the 2001 census.

This is broadly representative throughout the data.

Points of Discussion

Noted that there may be variances in what people would class themselves as on a form and what people would class themselves as on a one to one basis with a professional e.g. British or Geek-Cypriot with British citizenship.

People are sometimes frightened to complain to social services as they fear that they will have their service withdrawn.

Approached by people in White Hart Lane to act as an advocate for older people, particularly those with literacy problems.

Believes that services are inaccessible for those people who are illiterate in all communities.

Concerns raised about those who do not meet the eligibility criteria who are passed to the voluntary sector and the services they receive then not followed through.  Also, concerns raised about the governance of these and that people do not know who they should complain to from these agencies.

Beliefs that there is a real need for independent advocates across the borough.

Noted that culturally specific services for all sections of the community are important.

Points of discussion

Issues raised about those who are directed to the voluntary and community sector but as not deemed as an emergency.  Potential for their situation to deteriorate in the mean time, especially with issues around arrears.

Assurance given that those who are in an emergency situation are not left to deteriorate on an interim basis.  This has on occasion included providing people with money to enable them to pay for heating and food until further assistance can be sorted.

Noted that services that are commissioned by the council are monitored under governance arrangements and are reviewed regularly.  Where there are found to be issues the services are de-commissioned.

With regards to complaints – the council is responsible for the services it commissions.  Local resolutions are the first step, after this there are additional steps within the complaints procedure.

Acknowledged that there is an issue with the perception that if someone complains there will be repercussions.  This is a real challenge within the service; however people are assured that their service will not be affected.

Some older people still perceive social care services as ‘Welfare’ and feel that they should be ‘grateful for what they are getting’.  This again is a challenge.

The Supporting People Partnership Board is accountable for the services it funds.

All options are considered when tendering for contracts and if third sector organisations within the borough bid for contracts they would be considered.

Unmet need is an area of concern.

Discussion on the best way forward for foot care.

Noted that the TPCT is currently looking at evidence and best practice in order to commission services from May 2008.

Agreed that all parties send Melanie Ponomarenko suggested recommendations for possible inclusion in the final report.  A further Panel meeting will then be organised to agree the final report.

Suggestions to be sent to:

Melanie.Ponomarenko@haringey.gov.uk

Tel: 0208 489 2933

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