An opportunity to question Councillor Arthur, Cabinet Member for Finance and Health, and Cllr Vanier, Cabinet Member for Adult Social Care and Culture, on their portfolios.
Minutes:
The Chair welcomed Cllr Jason Arthur, Cabinet Member for Finance and Health, and Cllr Bernice Vanier, Cabinet Member for Adult Social Care and Culture, to the meeting.
In response to questions concerning portfolio responsibilities for Corporate Plan Priority 2, Cllr Arthur explained that he was responsible for Public Health; Health Devolution Pilots; Health and Social Care Integration; and working with the CCG and NHS. Cllr Vanier confirmed that the following areas of responsibility related to her portfolio: Adult Social Care; Adults with Disabilities and Additional Needs; and Safeguarding Adults.
Cllr Arthur provided an update on issues relating to protecting Haringey home care workers. The Panel was informed that the Council had recently signed up to UNISON’s ethical care charter. It was noted that this set out a series of commitments to protect the rights of home care workers’. Cllr Arthur explained that under the charter, the Council was committed to replacing zero hours contracts with guaranteed hours, and to make full payment for travel time between home care visits. In response to questions, the Panel was informed that the new code would mean the commissioning of home care visits would always be shaped by what was best for the person being cared for and the care worker, not by the need to meet a certain quota of visits or complete care duties in a set timeframe.
Cllr Arthur went on to provide updates on a number of issues, including:
- The work that was taking place across Haringey to support “Stoptober”, a campaign, backed by Cancer Research and the British Heart Foundation, aimed at encouraging the nation’s 8 million smokers to give up.
- Sexual health services in Haringey and across London. The Panel was informed of recent improvements with information, advice, testing and treatment for a range of conditions available online 24 hours a day, as well as a host of services at clinics, pharmacies and GP practices.
- Better Care Funding, including details of an open letter, written in partnership with Islington Council, to Jeremy Hunt, Secretary of State for Health. Cllr Arthur explained he had submitted a letter, in partnership with Cllr Janet Burgess MBE, Islington Council’s Executive Member for Health & Social Care, to highlight the vital role played by the Better Care Fund and to raise concerns about a series of changes which had been made to the conditions attached to the release of the funding.
Cllr Arthur also provided an update on the Haringey and Islington Wellbeing Partnership, including work that was taking place to engage local residents, while issues were also considered in relation to the Sustainability and Transformation Partnership for North Central London.
Cllr Vanier provided an update on a number of issues, including:
- The Disability Related Expenditure Disregard Proposal. It was noted that a report would be considered by Cabinet in November 2017. It was explained that this report would set out the findings of the consultation and would contain recommendations with regards to the proposal to bring disability related expenditure disregard more in line with other London Boroughs by April 2018.
- The fact the Council was working with Haringey CCG to develop a draft respite policy. The Panel was informed that the policy intended to provide clarity for carers, service users and practitioners around a joint approach to respite care provision in the borough for children, young people and adults.
- An update concerning the Meals on Wheels Service. In response to questions, the Panel was informed that as set out in the Medium Term Financial Strategy, the Council was considering withdrawing subsidy from the Meals on Wheels Service. It was explained that a report would be considered by Cabinet in October 2017. This report would outline findings from the public consultation.
In response to questions, concerning savings and costs associated with day care closures, the Panel was informed that further information would be provided as part of the Panel’s special meeting on budget monitoring, scheduled for 16 November 2017. The Panel also received an update on a feasibility study, that was being prepared by Property Services, concerning the future use of the Haven Day Centre site.
The rest of the Q&A session was spent considering issues relating to the proposal to close Osborne Grove Nursing Home following concerns about the quality of care and safety of residents. It was noted the home provided accommodation, personal and nursing care for adults over 65 with complex health needs and had capacity for 32 beds across 4 units and that there were currently 18 occupants.
The Panel was informed that on 6 and 7 December 2016, a Care Quality Commission (CQC) inspection had highlighted serious concerns around the care of residents in Osborne Grove. These included but were not limited to the areas of:
- Medicine management and administration.
- Record keeping and documentation.
- The moving and handling of residents.
In response to questions, the Panel was advised that four enforcement warning notices had been issued against the council for breaches of the legal requirements relating to the quality of care and support with compliance deadlines of 17 February and 31 January. The following points were noted by the Panel:
- The council had developed a clear action plan to address areas of concern highlighted within the stated timescales.
- A number of improvement measures were implemented and a joint improvement steering group assembled to closely examine progress and compliance.
- Further CQC inspections on 22 and 30 March 2017 noted that despite the service improvement plans and interventions, the service had failed to meet compliance standards and progress has not been made at the pace that is expected.
In response to questions, the Panel was informed that consequently, on 20 June 2017, a decision was taken at a Cabinet Member signing to undertake a period of consultation with Osborne Grove residents, their families and carers on the proposal to close the nursing home.
In addition, it was noted that on 26 and 27 July, the CQC had conducted an unannounced inspection at Osborne Grove. The Panel was advised that significant improvements had been made since the last CQC inspection in March 2017. It was noted that Osborne Grove had complied with the following three of the four warning notices served:
- Safe care and treatment
- Meeting nutritional and hydration needs
- Good governance
The Panel agreed that they were happy to hear about these improvements and noted work that had been undertaken by both operational and corporate staff. However, the Panel was informed that whilst some improvements were being realised, as evidenced in the recent CQC inspection report, with the level of resourcing and management oversight required to achieve these, concerns remained that the pace and sustainability of these improvements remained a considerable risk moving forward. The following points were noted by the Panel:
- Although the home was no longer in special measures, it was rated ‘requires improvement’ in three of five areas covered by the comprehensive inspection, namely safe, responsive and well-led.
- The CQC rating for Osborne Grove fell below commissioning standards set by the council and staffing levels had not been reduced despite a reduction in occupancy of residents by almost 50%.
- The 2017/18 Quarter 1 Finance Report Cabinet paper reflected that the measures required to secure service improvements had come at a cost – with the projected overspend in excess of £700,000.
In response to questions, the Panel was informed, in light of the recent CQC inspection report, that the Council had agreed to extend the consultation period by one month. This was to ensure residents, their families and carers had sufficient time to make an informed decision on the proposals.
The Panel raised a number of concerns and were informed that the proposal to cease operating the home had not been arrived at easily. The Panel was informed that the Council expected residents in care settings to be treated with utmost professionalism and dignity at all times, and that standards at Osborne Grove were still below the high benchmark that was demanded.
During the discussion a number of issue were considered, including:
- A suggestion, from the Panel, that neighbouring authorities and partner authorities be asked to contribute to service improvements at Osborne Grove to help safeguard capacity for the local health and care economy across North Central London.
- In response to questions about the cost of beds, the Panel was informed that the cost per bed at Priscilla Wakefield House was lower when compared to Osborne Grove.
- The fact that various issues at the home were entrenched and linked to ineffective management and significant competency and performance issues.
- The importance of communicating the outcome of the consultation and Cabinet’s final decision on the proposal relating to Osborne grove to residents, their families and carers. The Panel was informed that Cabinet was expected to make a decision on the proposal before Christmas.
In response to questions, a brief update was provided on the proposals outlined in the 5 year MTFS for 2017/18 – 2021/22. This included an update on the options appraisal for Osborne Grove.
AGREED:
(a) That the update from the Cabinet Member for Finance and Health be noted.
(b) That the update from the Cabinet Member for Adult Social Care and Culture be noted.
(c) That update concerning Osborne Grove Nursing Home be noted and the commitment to carry out an options appraisal be supported by the Panel.
(d) That the Cabinet Member for Adult Social Care and Culture be asked to consider the concerns raised by the Panel (outlined in the minutes above) and the suggestion that further input be sought from neighbouring/partner authorities before Cabinet be asked to make a decision on the proposal to close Osbourne Grove Nursing Home.