Agenda and draft 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’.

There were no apologies for absence.

Four members of the Panel attended the meeting online: Cllr Mary Mason, Cllr Felicia Opoku, Cllr Sheila Peacock and Helena Kania.

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 as a consultant radiologist and a deputy medical director.

Helena Kania declared an interest as a co-Chair of the Joint Partnership Board.

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

A question was received from Nazarella Scianguetta on behalf of the Haringey Wheelchair User Group. Ms Scianguetta spoke about the accessibility difficulties that wheelchair users experienced in Haringey, particularly in relation to restaurants, cafes and shops. Problems included a lack of ramps to enable access when there were steps at the entrances and/or fire exits, obstacles in shop walkways and the layout of tables and lack of space for wheelchairs in cafes/restaurants. Ms Scianguetta queried what the Council was doing to improve accessibility for wheelchair users in Haringey and to enforce existing equality legislation.

It was noted that officers had not received advanced notice of the question and so a full response would need to be provided in writing. (ACTION)

To approve the minutes of the previous meeting.

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

RESOLVED – That the minutes of the meeting held on 14th November 2024 be approved as an accurate record.

To review progress against action points from previous meetings in 2024/25.

Dominic O’Brien, Scrutiny Officer, reported that an update had been received on Action Point 6 which related to Continuing Healthcare figures in Haringey. The full response would be circulated to the Panel. (ACTION)

To consider the appointment of a new non-voting co-opted member of the Panel.

Apologies had been received from Eve Trimingham so this item was deferred to the next meeting.

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

Report to follow.

Richmond Kessie, Specialist Commissioning Officer, introduced the report on this item and responded to questions from the Panel:

• Cllr Iyngkaran noted that 23 out of 86 in-Borough providers remained were not yet rated by the CQC and queried how the Council could be reassured about the quality of care being provided. Richmond Kessie clarified that the Council only commissioned with providers rated ‘Good’ or higher and that, should an existing provider fall below this threshold, a social worker would carry out a welfare visit to establish that clients were receiving good quality care. He added that, of the 23 providers referred to, around half were dormant and not currently providing any services and the Council was encouraging the CQC to inspect the others. He confirmed that Haringey did not commission from any of them. Cllr Connor and Cllr Brennan requested that clarification be sought from the CQC on when these providers would be inspected. (ACTION)
• Cllr das Neves, Cabinet Member for Health, Social Care and Wellbeing, commented that Council also had a quality assurance role with all providers. Richmond Kessie added that there were currently five providers rated as ‘Requires Improvement’ that the quality assurance team was working with and felt that they were ready for reinspection with a high chance of acquiring a Good rating.
• Cllr Iyngkaran expressed concern that the number of providers commissioned by Haringey had declined from 250 to 220 in one year. Richmond Kessie responded that there were enough providers available for the Council to be able to place clients. He explained that some providers had left the market because they felt that the previous uplifts provided by the Council were not sufficient for them to be able to provide a good enough service.
• Cllr Iyngkaran requested a written breakdown of the number of private sector providers and voluntary sector providers. (ACTION)
• Asked by Cllr O’Donovan whether the quality assurance team engaged with residents, Richmond Kessie confirmed that they did and that any issues of concern were fed back to the CQC and may also be addressed as part of an improvement plan.
• Asked by Cllr O’Donovan about the process for following up written complaints, Richmond Kessie explained that the quality assurance team could investigate concerns and could suspend any further placements with the providers if serious issues were proven. In addition, the care management team could review service users currently placed with that provider.
• Asked by Cllr Mason whether the public could access a full list of providers and ratings, Beverley Tarka, Director of Adults, Health and Communities, said that the CQC published this information on their website.
• Asked by Cllr Mason about the recording of complaints, Richmond Kessie confirmed that these were recorded and taken through right to the end, including by informing the complainant of any actions taken.
• Cllr O’Donovan noted the complaints against the Newham provider on page 9 of the report and asked about the support being provided to the Haringey resident placed there. Beverley Tarka said  ...  view the full minutes text for item 43.

To review the Savings Tracker 2024/25 (Q2) which includes details of previously agreed savings relevant to Adults & Health. This item was deferred from the previous meeting.

Cllr Connor reminded the Panel that this was an item that had been deferred from the previous meeting on the Budget. She commented that the format of the tracker had been improved since the previous meeting and was now much clearer.

Neil Sinclair, Head of Finance (People), and Jo Baty responded to questions from the Panel about the savings tracker:

AHC_SAV_001 – Improved practices and processes to ensure that residents receive the right level of care

• Cllr Brennan noted the comment on the tracker that this item was “forecasted red from the start as the target is so large” and queried whether the target was realistic. Jo Baty clarified that the improvements to processes and practices referred to the reviews undertaken by social workers and ensuring that support packages were proportionate to the needs of the resident. This item also included the changes with Continuing Healthcare funding. Beverley Tarka explained that this was due to how budget processes worked and the establishment of a narrative when the approach to savings was developed. As the year then progressed there was improvement of processes and practices in various different areas, which meant that there was some duplication in the tracker (specifically combined with AHC_SAV_011 – Continuing Healthcare & AHC_SAV_012 – Strength Based Working). It was not possible to change the original narrative from a finance perspective but it was all part of the same overall exercise. So while two of the three budget lines were red, the overall target for the three lines was £2.2m and this was on track to be achieved through AHC_SAV_011 as set out on the tracker.
• Asked by Cllr Mason whether these changes were reflected on a risk register, Beverley Tarka explained that there was regular monthly monitoring of the savings trajectory and the risk of delivery with mitigations identified where necessary. The tracker showed an overall risk of non-delivery of savings of around £2.6m and the Finance took all risks into consideration when publishing budget monitoring reports. Neil Sinclair added that the risks of non-delivery had an impact on the forecast of the overall position for the Council and that this was a consistent ongoing process.

AHC_SAV_004 – Contract Reviews

• Cllr Connor noted that the tracker referred to resource constraints within the Commissioning team and requested further detail on progress in this area. Beverley Tarka explained that there had been joint commissioners prior to the recent decision of the ICB to reduce their revenue costs by 30%. There were now local authority-based commissioners and the required restructuring had taken some time, leading to the challenge in delivering savings. Going forward, there was an invest-to-save proposal to enhance the commissioning resource as this was key to achieving a number of strategic sustainable outcomes over the course of the MTFS period. Jo Baty added that they were already thinking about what would be required next year to bring savings through and so some of the savings line would be rolled forward and adjusted next year as commissioning capacity was  ...  view the full minutes text for item 44.

An opportunity to question the Cabinet Member for Health, Social Care & Well-being, Cllr Lucia das Neves, on developments within her portfolio.

Cllr Lucia das Neves, Cabinet Member for Health, Social Care & Well-being responded to questions from the Panel on issues relating to her portfolio:

·         In the context of the current financial pressures, Helena Kania questioned the effectiveness of prevention initiatives such as on weight management. Cllr das Neves said that Haringey was one of the only London Boroughs that has a holistic service looking at people’s smoking, weight, psychological needs and other factors together. Will Maimaris, Director for Public Health, added that the new weight management service offered a 12-week course which included a series of sessions on the various factors mentioned. He clarified that the Council commissioned ‘Tier 2’ weight management services while the NCL ICB commissioned ‘Tier 3’ weight management services which could include prescription of weight loss drugs. There were currently some gaps in Tier 3 provision in NCL which the ICB was currently looking to address. Cllr das Neves suggested that some detailed data on outcomes could be brought to a future scrutiny meeting (ACTION) but that Haringey outcomes were broadly in line with or better than London averages. She also noted that much of the public health budget was ring fenced. On a specific case raised by Helena Kania, she suggested that further details could be provided outside of the meeting.

·         Cllr Mason expressed concerns about people with long-term health needs living in poor housing conditions. Cllr das Neves acknowledged the increasing difficulties of housing people in London and said that the Council was looking at a refreshed allocations policy. She added that issues such as exposure to damp and mould were also important to address as this could impact on long-term health and well-being. Sara Sutton, AD for Partnerships & Communities, explained that the intention was for the refreshed allocations policy to go out to consultation in the New Year and that there were some proposed changes that took account of the priority status that might be required for people with different types of complex health needs. Other relevant areas of the Council’s work in this area included:

o   The building of new homes including bespoke homes built around the needs of individuals.

o   The Housing Improvement Board which looked at issues including repairs, damp and mould.

o   A recently implemented Responsive Repairs Policy which prioritised vulnerable residents.

o   A Vulnerable Residents Policy which focused on cases involving greater need and complexity and how they are prioritised.

o   The work of the Private Rented Sector team and the licensing arrangements which aimed to raise standards in that sector.

o   The new Adults, Housing & Health Directorate would provide an opportunity to integrate areas of working, particularly where there was complexity and vulnerability.

o   A complex needs panel which took referrals from relevant social care teams and considered evidence about needs to inform recommendations on housing outcomes.

·         Cllr Iyngkaran raised the issue of the surge in RSV virus cases nationally and asked about the situation in Haringey including vaccine uptake. Will Maimaris said that the  ...  view the full minutes text for item 45.

To provide an overview of the 2024-26 work programme for the Panel and for any amendments to be proposed and considered.

Scrutiny Officer, Dominic O’Brien, informed the Panel that a key item scheduled for the next meeting on 10^th February was the Council’s response to the recent CQC inspection. The other main topics on the agenda were a report on preparedness for a future pandemic and an update on aids and adaptations. However, the CQC report was not expected to be available until the New Year and so it was now no longer anticipated that it would be possible to provide the Council’s full response in time for 10^th February. It was therefore proposed that the meeting be postponed until March.

The initial draft work programme for 2025/26 had been included in the agenda papers but there were still a number of vacant slots where topics could be allocated, including topics that had been suggested through the Scrutiny Café consultation earlier in the year.

Comments on possible topics for the Work Programme were made:

• Cllr Brennan suggested that the policy on self-neglect and hoarding that was discussed earlier in the meeting could be added to the Work Programme. Cllr O’Donovan added that the timing of this would be important so that any discussion fed into the development of the Council’s refreshed policy in this area.
• Cllr Mason proposed that a topic arising from the Scrutiny Café should be added to the agenda for the first meeting of 2025/26. She suggested that the topic could be either communications with residents or the impact of poor housing conditions on health & wellbeing.
• Cllr Connor noted that the Council’s Autism Strategy was another priority topic that had arisen from the Scrutiny Café. (ACTIONS)

·         10^th Feb 2025 (6:30pm)

·         31^st March 2025 (6:30pm)

NOTE: The meeting previously scheduled for 10^th February 2025 was postponed.