Agenda and minutes

Please note that this meeting will be 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. 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, you are consenting to being filmed and to the possible use of those images and sound recordings

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’.

None.

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.

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 noted that at the previous meeting there had been a discussion on the Living Through Lockdown report by the Joint Partnership Board. The Panel had recommended that the response from officers to the report should be made first to the Joint Partnership Board and then later to the Adults & Health scrutiny panel. Cllr Connor requested that this be added to the minutes. (ACTION)

RESOLVED: With this amendment made, the minutes of the previous meeting on 21^st September 2020 were approved as an accurate record.

To receive an update on the impact of Covid-19 on the delivery of mental health services and on the drivers of mental wellbeing and illness in the population.

Tim Miller, Joint Assistant Director for Vulnerable Adults and Children for Haringey Council and North Central London CCG, and Andrew Wright, Director for Planning and Partnerships at Barnet, Enfield & Haringey Mental Health Trust, provided an update for the Panel on adult mental health.

Tim Miller noted that, in addition to the points about mental health services that were highlighted in the slides provided, there had also been a lot of recent work in primary care including the commissioning of a new primary care service for adults with severe mental illness with a focus on physical health. Many of the services had been targeting those at greatest clinical risk from Covid and from health and social inequalities, including BAME communities and areas of greatest economic deprivation. Safe Haven, a non-clinical crisis service, had been introduced as a virtual service with Mind in Haringey. A joint effort across partners in Haringey to support people experiencing homelessness during the Covid pandemic had been effective in reaching those at greatest risk.

Andrew Wright added that demand for mental health services had decreased during the first Covid wave and then increased quite significantly over the summer. There had been only a small reduction in demand following the second lockdown. Commissioners and providers were mindful of the longer-term implications of the wider economic and societal impact on people’s mental health.

Andrew Wright also provided a brief update on Blossom Court, the new mental health inpatient unit at St Ann’s Hospital. The unit had opened in August with a ceremony attended by Cllr Peacock in her capacity as the Mayor and he thanked colleagues at the Council for their support in getting to this stage as the benefits of the new facilities for patients and staff had been huge.

Tim Miller and Andrew Wright then responded to questions from Members of the Panel:

·         Cllr Brabazon asked how services deal with complex anti-social behaviour problems arising when a person with mental ill-health lives in shared accommodation or a block of flats. She noted that Members often found it difficult to obtain multi-agency action in such circumstances when dealing with casework. Andrew Wright responded that, as the local provider, the Trust was very aware of how difficult this type of situation can be for the individual, as well as for neighbours, families and friends. He said that the Trust works closely with colleagues in social care, housing services and other partners to seek to agree solutions with the patient and their families. Cllr Brabazon explained that, from the perspective of a local Councillor, it can be difficult to establish relevant facts in such cases due to confidentiality requirements making it more difficult to get action taken. Cllr Connor added that, in her view, a single point of contact for Councillors for such cases would improve the situation. Andrew Wright said that Councillors were welcome to contact him directly if they had a specific issue and that he would provide some contact details that could be used. Cllr Brabazon said  ...  view the full minutes text for item 18.

To receive an overview of changes made to the delivery of domestic abuse services following the implementation of lockdown arrangements in March 2020.

Chantelle Fatania, Consultant in Public Health, introduced a briefing on domestic abuse supported by members of the Violence Against Women & Girls (VAWG) team, Manju Lukhman (VAWG Strategic Lead), Catherine Clark (VAWG Coordinator) and Caterina Giammarresi (VAWG Coordinator).

Chantelle Fatania highlighted the following key points from the report provided in the agenda pack:

• During the first national lockdown there had been an increase in calls to the national domestic abuse helplines for victims, rising use of the Women’s Aid online support tool, an increase in calls and messages to the Respect perpetrator phone line and website and an increase in calls to the NSPCC from children experiencing domestic abuse.
• Locally, service providers and partners such as the Police also reported increased contacts compared to the previous year and there was a widespread recognition that domestic abuse victims faced additional barriers to reporting during lockdown and were less likely to be able to contact others for help.
• Since the start of the pandemic, Haringey Council had worked with partners and service providers to identify and support residents who needed help. All commissioned domestic abuse services continued to operate with some transitioning to additional online and telephone support and referrals continued to VAWG and domestic abuse providers as normal. All specialist services commissioned by Haringey Council had reported increased levels of risk, complexity and severity at the point of referrals during lockdown.
• The Independent Domestic Violence Advocacy (IDVA) service offers support to women experiencing domestic abuse who are at a high risk of serious harm or homicide. There is also a Floating Support service, provided by Solace Women’s Aid, which offers support to women experiencing domestic abuse who are at a medium and standard risk of serious harm or homicide. Both services had transitioned to operating online and by telephone.
• The IRIS service offers support to women experiencing domestic abuse who present to their GP. Their clients had reported that the lockdown had made it harder to leave or get space from their perpetrator, had caused an increase in childcare responsibilities, that perpetrators have been using the pandemic as an excuse to further control the victim and that clients were reporting a decrease in emotional wellbeing.
• The Multi-Agency Risk Assessment Conference (MARAC) is a meeting where all high-risk domestic abuse cases are discussed and actions to increase safety are agreed by multi agency partners. At the start of the first lockdown, the MARAC had to undergo a rapid transformation into a virtual format, resulting in a significant increase in workload.
• At the start of the first lockdown, the refuges provided by Solace (15 spaces) were already full. The Ministry for Housing, Local Communities and Government (MHCLG) provided additional resources such as hotel accommodation and the London Black Women’s Project was commissioned to provide 4 single BME refuge spaces, which were due to open soon. Personal Protective Equipment (PPE) was provided to refuges and weekly food/essential supplies packages were provided to families in refuges as part of the Council’s emergency food delivery scheme.  ...  view the full minutes text for item 19.

To consider the annual report of the Haringey Safeguarding Adults Board for 2019/20.

Dr Adi Cooper, Independent Chair of the Haringey Adult Safeguarding Board, introduced the Board’s Annual Report for 2019/20 which is one of the Board statutory duties. Dr Cooper said that the Board uses this report as an opportunity to promote awareness of safeguarding adults. The core purpose of the report was to demonstrate the progress that had been made against the plans that had been set by the Board the previous year through the work of the sub-groups and partnerships. The report also provided details of the Board’s statutory responsibility for Adult Safeguarding Reviews and, although no reviews were published in 2019/20, there was still significant activity in this area with cases and thematic areas being put forward to be examined.

Due to the Covid pandemic, the report was slightly scaled down compared to previous years because some agency partners were responding to the pandemic and were unable to contribute to the report in the way that they normally would. The Board had set up a Covid task and finish group which had been meeting monthly and monitoring the impact of Covid and the response of partner agencies to ensure that core safeguarding duties have been met.

Dr Cooper then responded to questions from the Panel:

• Cllr da Costa asked about the increase in Section 42 Enquiries by 17% overall with a significant rise in the home as an abuse type as set out in the report. Dr Cooper said that the increase in Section 42s was good news as Haringey had been low compared to the average so her interpretation of this was an improvement in practice. The increase in the proportion of abuse in the home this was reflected nationally, including because more people were being cared for in their own homes, more abuse in the home was now being reported and also there was potentially improved care standards in institutional settings.
• Cllr Brabazon asked about the processes used to monitor systemic change following the recommendations of a Safeguarding Adults Review (SAR). Dr Cooper said that the learning from the SARs aim to shift practice. All of the recommendations from the SARs have actions against them, some of which are for individual agencies and others for multiple agencies. These actions are all monitored, though it can be difficult to demonstrate long term impact. The recommendations from the SAR into the death of “Ms Taylor” in a fire had been responded to on aspects such as training and fire safety. There were certain areas of poor practice, including poor communication, that come up regularly in SARs so there was a significant challenge in ensuring that the recommendations do lead to real change in the interface between agencies. A workshop had been held earlier in the year to bring various agencies together to discuss this. However, a suitable mechanism which assesses whether improvements have been successfully embedded had not yet been established so this remained an ongoing objective though progress towards this had unfortunately been impacted by Covid.
• In  ...  view the full minutes text for item 20.

An opportunity to question the Cabinet Member for Adults & Health, Cllr Sarah James, on developments within her portfolio.

Cllr Sarah James, Cabinet Member for Adults and Health provided a short update to the Panel on developments within her portfolio. She said that the major preoccupation of services was obviously on the Covid outbreak and the second lockdown. Although case numbers did not seem to be as severe this time round so far, there was potential for infection rates to rise rapidly. There had been small numbers of cases in care homes this time so far but no major outbreak.

Cllr James said there had also been a lot of work on improving discharge from hospitals, getting autism services up and running again, supporting care homes, the launch of a new Carers Strategy, work on a Modern Slavery Strategy and also work on VAWG as discussed earlier in the meeting. The Connected Communities programme had been shortlisted for a pan-European award for the second year running, a mark of the ongoing work to support the community and keep people safe and healthy during difficult times.

Cllr James then responded to questions from the Panel:

• Asked by Helena Kania about the Joint Partnership Board’s ‘Living Through Lockdown’ report and when the Council’s response to this was expected, Cllr James said that the report was very helpful and was being discussed in meetings on a regular basis in terms of the response to the needs of the community caused by lockdown. Charlotte Pomery, AD for Commissioning, echoed this point, saying that the report was being used to help with the planning of services including on the themes such as communications. She and Rachel Lissauer had recently attended a meeting of the Joint Partnerships Board with next steps being shaped on working together with a number of people there. Charlotte Pomery indicated that they would be happy to return to a future meeting of the Board at their invitation. Cllr Connor suggested that after officers had met with the Joint Partnerships Board, they could then report back to the Adults & Health Scrutiny Panel as is currently pencilled in for February 2021. (ACTION) 
• Asked by Cllr Stone about progress towards the opening of services at Walthoef Gardens, Cllr James said that she had visited the site a couple of weeks previously and builders were on site to redevelop the interior of the site. The opening of new services was expected in the New Year, dependent on the situation with Covid. There are two buildings on the site, one of which would be used for a complex learning disability and autism service to be known as the Haringey Opportunities Project. The commissioning process had already been concluded with Centre 404 providing the services. The second building would be used for an autism hub which would focus on residents who are autistic but without a learning difficulty. The service had already been staffed and was already working as a virtual service.
• Cllr Brabazon asked about intergenerational housing projects, specifically two sheltered housing blocks in Tottenham. There had reportedly been some recent difficulties including a  ...  view the full minutes text for item 21.

To consider potential issues for inclusion within the Panel’s current work plan for 2020/21.

Cllr Connor introduced this item noting that the Panel’s budget scrutiny meeting would be held on 10^th December. There had been discussions on holding an additional informal briefing on finance in early December to ensure that Members had all the information required ahead of the main meeting, including information on the capital programme.

Items currently scheduled for the Panel meeting in early 2021 including the CQC overview, the Living Through Lockdown report and locality working in North Tottenham. The community commissioning model on mental health earlier in the meeting would now be added to the list. (ACTION)

Helena Kania suggested that the Panel could also look at the impact of the new expanded CCG which now covered the NCL area. Cllr Connor suggested that this could be added to the following year’s work programme. (ACTION)

On the unfinished scrutiny review on commissioning, Cllr Connor reported that she had been in discussions with senior officers who had said that, in the current circumstances, they did not have the capacity to help provide the evidence required to finish the review.

Cllr Connor reported that she had discussed with Cllr Ruth Gordon, Chair of the Housing & Regeneration scrutiny panel, the possibility of a joint meeting between the two Panels on the subject of supported housing.

·         Thurs 10^th December 2020

·         Tues 23^rd February 2021

·         Thurs 10^th Dec 2020

·         Tues 23^rd Feb 2021