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 Gideon Bull and Cllr Eldridge Culverwell who both had clashes with other meetings. Cllr Bull attended part of the meeting online.

Apologies were also received from Cllr Sheila Peacock who was not able to join the meeting in-person but did join the whole meeting online.

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 Nick da Costa declared an interest by virtue of his ownership of a company working with the NHS, medical providers and healthcare practitioners on a variety of projects, none of which, to his knowledge, work in Haringey Borough though they do work in surrounding areas and with service providers across London.

Cllr Mahir Demir and Cllr Gideon Bull both noted that they were employed by the NHS.

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.

Following a query from Cllr da Costa, the scrutiny officer advised that there were a number of actions relating to further information required on the locality working item. It had been agreed with senior officers that the additional information would be presented to the Panel at a future meeting, which was most likely to be the meeting in November 2021.

The accuracy of the minutes of the previous meeting was agreed as an accurate record.

AGREED: That the minutes of the meeting held on 11^th March 2021 be approved as an accurate record.

To provide an update on the most recent commissioning and quality assurance activity carried out in the care sector by the Council and on inspections in the care sector by the Care Quality Commission (CQC).

Margaret Lynes, Inspection Manager at the Care Quality Commission (London Region), provided an overview of inspection work in Haringey Borough. There were 81 registered locations in Haringey, 32 of which were residential homes and 49 of which were community-based services. The Covid-19 pandemic had caused a dramatic impact on the number of inspections that could be carried out and so any on-site visits were carried out in response to risk. The number of these that were necessary in Haringey was low compared to some other areas.

The general approach during the early stages of the pandemic was a supportive one with service providers being contacted to ascertain how they were managing and flagging any particular concerns such as a lack of PPE. An Emergency Support Framework (ESF) was introduced to enable the targeting of local advice, guidance and support to providers and care staff.

After the initial support phase, a Transitional Monitoring Approach (TMA) was introduced, enabling more inspections to take place but doing so remotely where possible and limiting the physical presence of inspectors at premises. This was a more detailed approach than the ESF with more data required from providers and more intelligence gathered in order to more accurately assess risk.

An Infection Prevention and Control (IPC) methodology was developed to enable targeted inspections of practices relating to infection prevention and control in care homes. This was used to identify both good practice which could be shared and providers where services required improvement and could be given additional support and guidance. Around 500-700 of these inspections were being carried out per month and the IPC methodology continued to be included as part of care home inspections.

Margaret Lynes then responded to questions from the Panel:

• Asked by Cllr Connor what difference the changes in practice had made to the public reports following inspections, Margaret Lynes said that the purpose of the ESF was not to produce reports but instead to identify issues and provide advice and support where necessary. Reports that had been produced through physical inspections did not have as much service user voice as they would like due to the need to avoid close contact with residents. Inspectors also took additional precautions when visiting care homes including the use of PPE, weekly covid tests and a lateral flow test prior to the visit. As the methodology had developed, service user voice was being obtained through the use of ‘Experts by Experience’ and by contacting relatives’ representatives of service users.
• Asked by Cllr Connor about the guidance for visiting care homes, Margaret Lynes said that the CQC position was that service providers should follow government guidelines. The CQC had established that some providers had chosen to go beyond the government guidance and so the CQC had firmly said that providers should follow the government guidance unless there were very good reasons why they shouldn’t. She was not aware of any care homes in Haringey that had imposed their own restrictions.
• Cllr da Costa asked whether the limitations  ...  view the full minutes text for item 7.

This item is to receive a verbal 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 agenda pack.

Cllr Connor reminded the Panel that this item related to the report published in 2020 by the Joint Partnership Board (JPB) and that the Panel had previously backed the recommendations in the report and determined to monitor the Council’s response to them.

Helena Kania, a co-Chair of the JPB, said that the JPB was a group of reference groups which provided a forum which liaises with the Council over a wide range of issues. Representation on the JPB included representation from people groups including those who are carers, frail, autistic, with mental health problems or with learning disabilities.

Helena Kania said that she had recently liaised with Charlotte Pomery over this and had concluded that a lot of the recommendations related to long-term changes that would need to be embedded and monitored over a period of time. She estimated that by December it would be possible to see whether the changes were working and suggested that this be brought back to the Panel at around this point as a quick item. (ACTION) Charlotte Pomery added that she was keen to ensure that the report’s recommendations changed the culture and the way that the Council does things in a tangible way.

Asked by Cllr Connor if there was further detail available about the Council’s response to specific recommendations, Charlotte Pomery said that the report had been widely circulated within the Council, was very much part of the recovery and renewal work and there had been progress in various areas. This included communications with residents for example, but it was felt that the changes needed to become more embedded and that it was important to understand the shift in culture before coming back to the Panel on this.

Cllr das Neves added that the report had been mentioned in several different contexts since her recent appointment to the Cabinet and featured heavily in the policy debate in various areas.

To receive a presentation from the Director of Public Health about the health impact of the Covid-19 pandemic on the residents of Haringey.

Dr Will Maimaris, Director for Public Health, along with Jim Pomeroy and Eduardo Lopez Salas from the policy team, presented information about the broad impact on health and wellbeing caused by the pandemic in Haringey. Key points included:

• Since the beginning of the pandemic up to 11^th June 2021, 514 deaths had been registered in Haringey with Covid-19 on the death certificate.
• Haringey’s age-standardised Covid-19 death rate of 281 per 100,000 (Mar 2020 to Mar 2021) was slightly above the median for London boroughs and below the worst hit boroughs which were in excess of 400 per 100,000.
• Areas in the east of the borough, including Tottenham Green East, Bruce Grove South and Northumberland Park recorded the highest death rates. However, the East-West contrast was not without exception – Highgate Wood had one of the highest rates while Tottenham Lea Valley had one of the lowest.
• There was a moderate to strong correlation between higher rates of Covid-19 deaths and areas with a higher proportion of people from BAME backgrounds.
• 82.6% of Haringey residents over the age of 70 had received a first vaccination by the week ending 20^th June 2021. Of these, 95.1% had also received their second vaccination. There was a geographical disparity with 70+ vaccination rates of over 90% in several areas in the west of the borough and areas with only 75% in the east of the borough.
• 70+ first vaccination rates varied significantly by ethnicity. Rates for residents with Asian and White backgrounds were around 90%, but those from Black backgrounds were below 80% including people from Caribbean backgrounds at around 75%.
• 53.4% of Haringey residents over the age of 16 had received a first vaccination by the week ending 20^th June 2021. This was below the national average rate of 70.8%. A total of 32.5% of 16+ Haringey residents had received both vaccinations. Vaccination rates were higher in the west of the borough than in the east.
• Data from the CCG showed that, in the 12-month period from Apr 2020 to Mar 2021, there were around 45,000 secondary care referrals, a decrease of 30% from the 64,000 referrals of the same 12-month period the previous year. Completed treatments also declined by 36% from just over 450,000 in 2019 to under 290,000 in 2020/21. This was attributed to the measures required to manage the impact of Covid-19 and the increase in waiting times. The largest declines in treatments were in Ophthalmology, Trauma & Orthopaedics and Ear, Nose & Throat.
• There had been a decline in average life satisfaction in Haringey residents during the first 6 months of the pandemic, according to data from the Annual Population Survey. On a 10-point scale there had been a decline from 7.7 to 7.0, one of the highest declines in London. The NHS Mental Health Forecast Tool predicted a significant increase in demand for mental health services as a result of Covid-19.

Dr Will Maimaris, Jim Pomeroy and Eduardo Lopez Salas then responded to questions from the Panel:  ...  view the full minutes text for item 9.

To discuss items for the work programme for the Panel for 2021/22.

Cllr Connor updated the Panel on the Work Programme. Following discussions with officers, the terms of reference for the proposed scrutiny review on sheltered housing had been amended. Dominic O’Brien, Scrutiny Officer, outlined the new terms of reference which remained on broadly similar lines and focused on three key areas:

• Issues identified from various sources of information about the experience of residents living in sheltered housing. This should include any recent pilot projects, any recent co-production work or more general feedback from residents or other stakeholders.

• Support measures taken to address issues impacting on the quality of life of some residents, specifically:

o   Residents experiencing mental health difficulties;

o   Residents experiencing alcohol/drug misuse issues;

o   Residents reporting problems with anti-social behaviour.

• The wider care and support provided to residents living in sheltered housing, including:

o   Ensuring that residents know who to communicate with when they need to access help/support on a wide range of issues;

o   Measures with a preventative approach to potential health and social care issues;

o   Measures that promote aging well.

Dominic O’Brien informed the Panel that the next step would be to organise a meeting involved the Chair of the Adults & Health Scrutiny Panel, the Chair of the Housing & Regeneration Scrutiny Panel, officers from the Adults team and officers from Homes for Haringey to agree on the format for the evidence sessions and the information that the Scrutiny Panels would require.

Cllr Connor noted that a follow up report on the recommendations of the Panel’s previous scrutiny review on Day Opportunities was scheduled for the September 2021 meeting of the Panel.

The issue of delayed discharge was discussed and it was agreed that this could be considered at the September 2021 Panel meeting if pertinent lines of enquiry could be identified. It was agreed that Cllr Demir, Helena Kania and Dominic O’Brien would liaise on this topic and report back to the Chair. (ACTION)

It was also intended that another report on locality working would be provided to the November 2021 meeting of the Panel and it was hoped that visits to key sites in the borough relating to this work could be organised in prior to this meeting.

Cllr Connor noted that the Panel had been advised earlier in the meeting that further details on the Council response to the JPB’s Living Through Lockdown report would likely be available in December 2021. However, the Panel would be focused on the budget at that time and after that the next scheduled Panel meeting was not until March 2022. It was agreed that it would be preferable for this report to be received at the November 2021 Panel meeting it that were possible. (ACTION)

It was agreed that updates on Violence Against Women & Girls, Integrated Care Systems and CQC inspections should be scheduled for the March 2022 Panel meeting. (ACTION)

Cllr Demir enquired about Council House adaptations and whether or not this work was carried out in-house. Cllr Connor responded that the Panel had not scrutinised this  ...  view the full minutes text for item 10.

·         9^th September 2021

·         15^th November 2021

·         16^th December 2021

·         3^rd March 2022

• 9th September 2021
• 15^th November 2021
• 16^th December 2021
• 3^rd March 2022