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.

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).

Cllr Pippa Connor reported that the Cabinet’s response to the recommendations of the Adult & Health Scrutiny Panel’s Review on Adult Social Care Commissioning & Co-production had been discussed at the Cabinet meeting on 8^th November 2022. She noted that there was a lot of work unpinning the response and suggested that the Panel should receive a more detailed report about this at a later date. (ACTION) After a discussion with Beverley Tarka, Director of Adults, Health & Communities, about the likely timescales for this, it was agreed that this should be added to the work programme for the meeting in November 2023.

RESOLVED – That an update report on the response to the Scrutiny Review on Adult Social Care Commissioning & Co-production be considered at a Panel meeting in November 2023.

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.  

Cllr Thayahlan Iyngkaran declared an interest by virtue of his wife working for Barnet, Enfield & Haringey Mental Health Trust.

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 requested further details on the response to an action point which stated that there were currently no plans to install defibrillators in sheltered housing but that costs and installation would be explored by the service. Vicky Murphy, Service Director for Adult Social Services, said that a solution had not yet been found but that a housing related support group had recently been set up to look at issues related to supported living with input from residents and carers groups. This suggestion would be taken forward to the group which would be meeting for the first time over the next couple of weeks. Cllr Peacock said that, while she was aware of the potential costs involved in installing defibrillators and training staff to use them, she felt that this was essential as she was aware of numerous previous emergency situations in sheltered housing involving vulnerable people. It was requested that the Panel be kept updated on any progress. (ACTION)

Cllr Connor referred to the response to an action point stating that there was currently very limited information about the success of e-consultations and asked about timescales for further information to be obtained. Vicky Murphy explained that a provider forum had been set up as part of the new commissioning strategy as well as another forum for residents, service users and carers, which would be meeting for the first time shortly. This would help to improve input and develop understanding.

Cllr Connor noted that there were a large number of action points relating to the previous item on aids and adaptations and acknowledged that this would take some time to implement recommendations that were made. Vicky Murphy reported that a project manager had been aligned to this piece of work, addressing areas for improvement and strengthening processes. She was hopeful that some positive outcomes could be seen within the next 12-16 weeks so an update for the Panel was likely to be available for the March 2023 meeting. (ACTION) She also noted that she had visited some of the residents who had attended the Scrutiny Panel meeting in September 2022. In response to a question from Cllr Peacock about visiting sheltered housing schemes, Vicky Murphy confirmed that she had visited some of the schemes that the Council commissions with.

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

RESOLVED – That the Panel should receive future updates on the issues of defibrillators in sheltered housing and on aids & adaptations.

RESOLVED – That the minutes of the meeting held on 15^th September 2022 be approved as an accurate record.

To provide details of recent commissioning and quality assurance activity carried out by the Council in partnership with the Care Quality Commission (CQC), Integrated Care Board (ICB) and other local authorities.

Jon Tomlinson, Senior Head of Service for Commissioning, Brokerage and Quality Assurance, introduced the report for this item noting that there was a challenging environment currently for providers across the country. He informed the Panel that Commissioning for Adults had now been integrated into Adult Social Care with the team covering commissioning, brokerage and quality assurance. This was a relatively small team but they were looking to strengthen this with additional resource to help drive improvements.

Jon Tomlinson commented that, the more that people were able to participate in input, including friends and relatives, the better this was for maintaining high quality services and keeping people safe. This also required close working relationships with the Care Quality Commission (CQC), the Integrated Care Board (ICB) and other local authorities. He explained that there were some really good providers in Haringey but that some required additional work to get to Good or Excellent quality levels.

Jon Tomlinson and Richmond Kessie, Quality Assurance Officer, then responded to questions from the Panel:

• Cllr Peacock raised concerns about the quality of care in sheltered housing and how issues could be raised. Jon Tomlinson said that the role of Councillors was a good example of the input that could help with quality assurance and that referrals were taken very seriously. Depending on the nature of the concerns that were raised, a referral could lead to the setting up of a providers concern process and the monitoring of improvements. If improvements were not made to the required standard, then this could potentially lead to the Council stopping commissioning with that provider. In response to a question from Cllr Connor, Jon Tomlinson clarified that Councillors could make referrals through the Members Enquiries process.
• Cllr Brennan asked about the process of registering a care home with an outside body or regulator and whether there was a high level of complaints or problems. Jon Tomlinson explained that commissioners worked closely with regulators, including by sharing information and horizon scanning to tackle issues quickly and effectively. He added that the scale of issues in Haringey were not at a level then would raise serious concerns and that, with the challenges currently faced by providers, it was inevitable that there would be some slips. The role of his team was therefore to monitor and quality control with the safety and well-being of residents in mind.
• Cllr Iyngkaran raised the issue of whistleblowing as a theme across a number of cases and emphasised that staff must feel safe to raise concerns in order to maintain high quality services. Jon Tomlinson agreed and said that the team took such cases very seriously. He confirmed that there had been one whistleblower incident since he had been appointed to his post recently and that this had led to the organisation being challenged about the issues that had been raised. In such cases, evidence would be gathered about the concerns and then assurance would typically be sought with mitigations put in place until the required standards  ...  view the full minutes text for item 30.

To consider the annual report of the Haringey Safeguarding Adults Board for 2021/22.

Dr Adi Cooper, Independent Chair of the Haringey Safeguarding Adults Board (HSAB, introduced the Board’s annual report for 2021/22. She explained that the Board had a statutory responsibility to produce a plan and an annual report to explain how the plan was being delivered. The Board’s activities were delivered through a range of sub-groups and this included a Covid task and finish group which had met frequently during this period but had now ceased. However, there was a recognition that Covid had not gone away and so there was an open agenda item at the Board which enabled any Covid-related issues to be raised.

Dr Cooper explained that one of the Board’s statutory responsibilities was to commission Safeguarding Adults Reviews. One had been published during 2021/22 and the learning from previous reviews was continuing to be implemented. The thematic review from homelessness had continued and most of the action plan had been delivered. The cover report included an update on the issues that had been raised by the Panel in the previous year.

The report also demonstrated the actions against the strategic priorities for the previous year, the approach for which was to aim high with the recognition that not everything would necessarily be delivered. Partnership working was also set out, including the regular meetings between the HSAB and the Local Safeguarding Children Board (LSCB) to improve the way that the two Boards worked together, particularly on transitions between the two services.

Dr Cooper then responded to questions from the Panel:

• Cllr Connor requested further details on the nature of the safeguarding issues relating to the Homes for Ukraine scheme and what alternative accommodation was offered. Dr Cooper agreed to provide further details about this in writing. (ACTION)
• Helena Kania raised concerns about the risk of additional safeguarding issues causing by lack of resources. Dr Cooper said that she was equally concerned about this issue which would be included in the strategic plan for this year. It was also important to consider how this might translate, for example through financial abuse because of lack of financial resources or because of domestic abuse because of tensions between family members. This would then help to prioritise resources across the partnership.
• Helena Kania asked about safeguarding issues that related to how the police dealt with autistic people. Dr Cooper said that she had spoken to the Joint Partnership Board (JPB) earlier in the day about co-producing the safeguarding strategy for the next 3-5 years. She acknowledged that the issue of the police dealing with autistic people was a good example of an area of input from the JPB that hadn’t previously been raised through the HSAB but could be included in future strategies and was part of the complex area of debate about vulnerability and criminality.
• Asked by Cllr Iyngkaran about how robust the safeguarding training for the Police was, Dr Cooper said that this would be for Police colleagues to comment on the impact and effectiveness of the training as this  ...  view the full minutes text for item 31.

To provide an outline of the Council’s approach to Living Well with Dementia, including partnership work.

Paul Allen, Head of Integrated Commissioning (Integrated Care & Frailty) for the Council and ICB, introduced the report on this item which summarised issues around dementia, including the process of how a dementia diagnosis was made. This often started with the GP, but it was also important to engage with communities and residents on this as people didn’t necessarily always recognise when they have cognitive impairment. The report also highlighted the importance of listening to patients and residents and a number of areas for improvement that could be made around this. Post-diagnostic support was another area where improvement efforts would be made to develop a network of support so that people didn’t feel isolated after their diagnosis.

Paul Allen also highlighted some specialist areas including the multi-agency care co-ordination team to support people with frailty, including dementia, and enhanced support in care homes as around 70% of care home residents had some form of dementia.

Paul Allen then responded to questions from the Panel:

• Asked by Cllr Brennan why a greater proportion of BAME people suffered from dementia compared to white groups as stated in the report, Paul Allen explained that there was a genetic component which impacted on the likelihood of acquiring particular conditions. There was also less likelihood of people from some under-served communities coming forward for diagnosis and so a Dementia Co-ordinator had been funded to work with communities to raise awareness around cognitive impairment. A bid had also been put in for a Dementia Facilitator which was a different role working with GPs on diagnosis rates. Cllr Connor proposed that a further update should be received by the Panel at a later date on the progress with these roles. (ACTION) Cllr Brennan asked whether more details could be provided on the genetic component and it was agreed that a link to a relevant medical research study could be circulated. (ACTION)
• Cllr Peacock spoke about her experience of working with people with dementia suggested that swimming sessions could be made available for them as she had seen how beneficial this could be. Paul Allen acknowledged that, while dementia was progressive, it was possible for people to have a good quality of life for many years if they were diagnosed early and had access to the right treatment. This treatment was not just about medication but also about physical and mental activity and so there had been investment in community assets to support this. This included activities such as walking programmes, but he was open to other suggestions in this area. Helena Kania asked whether this offer on activities had been connected to social prescribing so that people were aware that these were available. Paul Allen said that the team were preparing an Aging Well training and awareness pack, an element of which was on dementia. An aim was to encourage the more than 170 social prescribers and community navigators in this space to come forward and learn more about dementia. This could involve some of them becoming dementia  ...  view the full minutes text for item 32.

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

The Panel noted the items scheduled on the work programme for future meetings.

Referring to the forthcoming Scrutiny Review on Access to Adult Social Care Services, Cllr Connor informed the Panel that evidence sessions with officers were expected in January so it would be useful to speak to groups in the community, such as carers, before then so that their feedback could be put to officers. She requested that any suggestions on groups to speak to should be emailed to the Scrutiny Officer.

·         8^th Dec 2022 (6:30pm)

·         13^th Mar 2022 (6:30pm)

·         8^th Dec 2022 (6:30pm)

·         13^th Mar 2022 (6:30pm)