Agenda and minutes

Adults & Health Scrutiny Panel
Thursday, 15th September, 2022 6.30 pm

Venue: Westbury Room - George Meehan House, 294 High Road, Wood Green, N22 8JZ

Contact: Dominic O'Brien, Principal Scrutiny Officer, Email: dominic.obrien@haringey.gov.uk 

Items
No. Item

13.

FILMING AT MEETINGS

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.

Minutes:

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’.

14.

Apologies for absence

Minutes:

Apologies for absence were received from Cllr Anna Abela and Cllr Felicia Opoku.

 

Cllr Abela had informed the Panel Chair that she was unable to attend due to a clash with a Corporate Committee meeting of which she was also a member.

 

15.

Items of Urgent Business

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).

Minutes:

None.

 

16.

Declarations of Interest

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.

Minutes:

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.

 

17.

Deputations/Petitions/ Presentations/ Questions

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

Minutes:

None.

 

18.

Minutes pdf icon PDF 379 KB

To approve the minutes of the previous meeting.

Minutes:

Cllr Connor referred to the action points from the previous meeting and requested that quarterly finance and performance briefings be set up for the data from Q2 of 2022/23 onwards. (ACTION)


In response to a query from Cllr Connor about the responses to the Panel’s Scrutiny Reviews on co-production and on sheltered housing, Dominic O’Brien, Scrutiny Officer, said that these were expected to be on the agenda of the Cabinet meeting in November 2022.

 

Cllr Connor welcomed the written response that the Panel had received in response to concerns about people with high needs being placed in sheltered housing schemes alongside older residents. She requested that further information be provided about what care the residents with high needs were receiving within sheltered housing. (ACTION)


With regards to the written update that the Panel had received about Canning Crescent, Cllr Connor asked if there were any complications relating to the work to establish a lease between the Council and Barnet, Enfield & Haringey Mental Health Trust. Gill Taylor, Assistant Director for Communities and Housing Support, confirmed that this work was a normal part of the process and that this was progressing well.

 

With regards to the written update about legal issues with Hospital Trusts over people with no recourse to public funds, Cllr Connor asked for clarification on the point that the only way to collate the data was to contact each local hospital separately. Gill Taylor confirmed that this was a live process with requests made. It was agreed that a further update would be provided to the Panel when this work had been completed. (ACTION)

 

With regards to the written update about inclusion health groups, Cllr Connor asked whether the recent Inclusion Health Needs Assessment conducted by NCL boroughs would be published. Gill Taylor said that it hadn’t yet been published but that she would check with NCL colleagues whether there were any plans to do so and report back to the Panel. (ACTION)

 

Cllr Peacock noted that the minutes referred to the aim to put in place a new LGBT IDVA (Independent Domestic Violence Advocate) in the Borough. Gill Taylor confirmed that this was going ahead and that this post would be delivered through a specialist community organisation.

 

The minutes of the previous meeting were approved as an accurate record.

 

RESOLVED – That the minutes of the meeting held on 21st July 2022 be approved as an accurate record.

 

19.

Aids and adaptations pdf icon PDF 3 MB

Report to follow.

Minutes:

Cllr Connor introduced this item and welcomed a number of local residents who had joined the meeting to explain some of the issues that they had experienced in getting aids and adaptations installed in their homes.

 

A couple spoke about the difficulties that they had in getting the right adaptations for their son who has disabilities. They explained that they had made two complaints against the Council to the Local Government and Social Care Ombudsman which had been determined in their favour. The first was on home adaptations and they stated that the main problems were that they were encouraged not to have all the adaptations that were needed, they felt that they had experienced hostility from staff members and that there had been poor communications and delays to the adaptations which had still not been fully completed. In particular, there had been concerned about delays to arranging replacement sides to their son’s bed as this represented a serious safety issue. Despite this, there did not appear to be provision within the system to prioritise actions that had urgent safety implications or any recognition of the seriousness of the need for such equipment.

 

The family had been housed with a specialist housing association by the Council and there had recently been an issue with a flooded toilet. They said that, despite contacting the housing association, the flooding continued for nearly a week until they eventually hired their own plumber at a substantial expense.

 

Another resident with significant long-term mobility issues following an operation, spoke about her experience of needing a ramp to be installed at her home and adaptations to a toilet. She said that a visit had taken place to take measurements for this but then there was no further contact for a significant period of time. A contractor then made changes to the bathroom but the standard of the work was so poor that she contacted the Council the same day asking them to inspect the work. However, this was not done. The toilet later started leaking with the water pouring downstairs requiring an emergency call-out. The ramp had been significantly delayed meaning that she had not been able to use her back garden for four years. She felt that lack of communication had been a problem in her case that required significant improvement in the service.

 

A resident who acted as a carer to a family member spoke to the Panel about their difficulties. They had experienced problems in obtaining a wheelchair after applying months previously and had experienced delays and poor communications which had led to the submission of a formal complaint. She added that the district nurses had been very helpful and had explained the assessment process clearly but, after the application had been made and measurements had been taken for the wheelchair, they did not hear anything further for months. She felt that the lack of a clear process and the lack of communications made this a difficult service for residents to use.  ...  view the full minutes text for item 19.

20.

Finance & performance update pdf icon PDF 949 KB

·         To receive an Adults & Health finance update for Quarter 1 of 2022/23.

 

·         To provide an overview on Adult Social Care throughput for each service area.

 

 

 

Additional documents:

Minutes:

Sean Huang, Business Partner, and Josephine Lyseight, Head of Finance (People), provided the Panel with a finance update with data from Quarter 1 of 2022/23. Adults and Health was forecast to spend £121.7m against a budget of £112.4m representing an adverse variance of £9.3m at Q1. Around £7.9m of this adverse variance was attributed to adult social care with the remainder to housing demand, mainly due to a loss of temporary accommodation units. The breakdown of adverse variance in adult social care was:

  • Older People - £2.701m
  • Learning Difficulties - £3.195m
  • Mental Health - £2.347m

 

Sean Huang explained that the main driver for this had been a substantial increase in demand including new high complexity clients coming into the system. The residual impact of Covid included worsening health conditions and frailty leading to greater demand and complexity. There was a risk around hospital discharge with an increase in the number of clients along with inflationary pressures.

 

In addition, there had been some slippage in savings delivery, although £4.8m of the £5.3m required savings were on target to be delivered. The areas that were not being achieved were mainly stretch targets that were projected to slip into future years due to demand pressures. However, there had been a one-off £1m recovery of aged debt which would contribute towards savings.

 

He continued that there was a very small overspend in adult commissioning and that public health spending was projected to break even.

 

Mitigations to address the budget shortfalls included:

  • A review into the top 30 high-cost learning disability and top 44 high-cost mental health packages.
  • An ongoing integrated care review to identify efficiencies, particularly on transition to long-term care.
  • Working with health partners to address hospital discharge funding and identify the correct pathways.

 

On capital spending there were a projected underspend of around £2.1m against an original budget of £13.2m for the current financial year. This was due to some delays to capital projects and so the funding would be reprofiled into future years.

 

Gill Taylor, Assistant Director for Communities and Housing Support, Sean Huang and Josephine Lyseight then responded to questions from the Panel:

  • Asked by Cllr Iyngkaran why there had been no spending at all on Capital Scheme 218 on Social Emotional & Mental Health Provision, Gill Taylor explained that this funding had been identified to improve services on a bespoke basis. However, the thinking had changed on how to use this funding and so new redefined capital bids in this area were in development.
  • Asked by Cllr Iyngkaran about the expected opening of the service at Canning Crescent (Capital Scheme 213), Gill Taylor said that there had been construction delays but that the service was expected to open in October 2022.
  • Helena Kania asked for further explanation about the comment in the report about ensuring that hospital discharge was appropriate and via the correct pathway. Beverley Tarka explained that this related to where people were discharged to, whether this be reablement at home or more supported bed-based rehabilitation  ...  view the full minutes text for item 20.

21.

Living Through Lockdown report - Council/NHS response pdf icon PDF 521 KB

To receive an update on the Council’s response to the recommendations of the ‘Living Through Lockdown’ report.

 

The report was published in August 2020 by the Joint Partnership Board and is provided in full in this pack.

 

Additional documents:

Minutes:

Gill Taylor introduced the update responding to the recommendations of the Joint Partnership Board’s (JPB) Living Through Lockdown report, highlighting some examples including the strengthening of the Council’s co-production activity and the recruitment of a Participation Lead, the establishment of a Digital Inclusion Network and the development of a Food Strategy. Helena Kania, also a Co-Chair of the JPB, welcomed the update and said that the JPB members appreciated the opportunity for the recommendations to be monitored by the Scrutiny Panel on an annual basis.

 

Gill Taylor then responded to questions from the Panel:

  • Referring to the section of the update on Housing and Sheltered Accommodation, Cllr Peacock commented that defibrillators should be more widely available in sheltered housing schemes. Gill Taylor agreed to take this query back for a response. (ACTION)
  • Asked by Cllr Connor about the ongoing restrictions on visitors to care homes, Gill Taylor said that measures still in place were due to some vulnerable residents shielding on a case-by-case basis rather than blanket bans on visitors. Vicky Murphy added that the number of visitors were restricted in some care homes and that, with winter approaching, measures could be subject to change but the aim was for at least one named person to be able to visit each resident in circumstances where restrictions are necessary.
  • Asked by Cllr Connor whether there were figures available on the take up for bereavement counselling specific to those with learning difficulties (Mental Health and Wellbeing section, point number 2), Gill Taylor said that she would provide this data to the Panel. (ACTION)
  • Cllr Connor queried how the inter-service referrals for mental health patients for extra support (Mental Health and Wellbeing section, point number 6) would be monitored. Gill Taylor responded that the number of referrals wasn’t being measured specifically but that the focus was on the new multi-disciplinary locality approach which enabled staff to better connect with local community services.
  • Cllr Connor queried whether any personal assistant capacity had been increased by commissioning through Disability Action Haringey (DAH) (Personal Budgets and Assistants section, point number 3). Officers agreed to provide a written response to the Panel on this. (ACTION)
  • Cllr Connor requested that further information should be provided to the Panel on the success or failure of e-consultations (NHS and Care Services section, point number 9). (ACTION)
  • Cllr Connor requested that further information should be provided to the Panel on the commitment to share information with the JPB on the strategy and vision for opticians and dentists (NHS and Care Services section, point number 12). (ACTION)
  • Cllr Iyngkaran asked whether there was any data on the number of toilets kept open in parks and how parks were being kept safer (Park and Recreation section, point numbers 4 & 5). Gill Taylor said that the engagement work with residents and user groups typically provided qualitative data on park safety. Helena Kania expressed concerns about park gates not being locked which led to anti-social behaviour at night. Data on park toilets could be  ...  view the full minutes text for item 21.

22.

Work Programme update pdf icon PDF 370 KB

To consider any additions or amendments to the Panel’s work programme for 2022/23.

Minutes:

Providing an update on the Work Programme, Dominic O’Brien, Scrutiny Officer, said that the Scrutiny Café consultation event was due to take place the following day (16th Sep 2022) and that the feedback from this along with suggestions previously received from Panel Members would be used to populate the Panel’s work programme for 2022-24. The next Panel meeting on 17th November 2022 would receive updates on the Haringey Safeguarding Adults Board (HSAB) annual report and an overview on CQC inspections. A joint meeting with the Children & Young People’s Scrutiny Panel on transitions between children’s and adult services was planned for Feb 2023 (date TBC). An update on integrated joint partnership working and co-production had been scheduled for the Panel’s March 2023 meeting.


Cllr Connor requested that an update on the safeguarding process for women and children staying in people’s homes (such as those recently arriving from Ukraine) be added to the HSAB annual report item at the November 2022 meeting. (ACTION)

 

Cllr Peacock highlighted the provision of dementia services in the Borough as an item that could be added as a future agenda item. Cllr Connor noted that it would be useful to receive a full list of existing dementia services in the Borough as part of this item.

 

23.

Dates of Future Meetings

·         17th November 2022 (6:30pm)

·         8th December 2022 (6:30pm)

·         13th March 2022 (6:30pm)

 

Minutes:

·         17th November 2022 (6:30pm)

·         8th December 2022 (6:30pm)

·         13th March 2023 (6:30pm)