Agenda and minutes

          The Minutes of the meeting held on 17 September 2019 having been circulated were signed as a correct record.

The minutes relating to the Health and Wellbeing Board from its meeting of 10 July 2019 were presented to the Board for information.

One Member queried why the proposals in relation to the Urgent Care Centres’ and the merging of Warrington and Halton CCGs’ did not appear on the Health and Wellbeing Board’s agenda; commenting that items of such importance should be.

The Chair advised that his comments would be fed back.

RESOLVED:  That the minutes be noted.

The Board welcomed Helen Featherstone, North of England Service Manager for Independent Living Services, British Red Cross (BRC) who provided a presentation to them on the Halton Support at Home Service, which is provided in the Borough by the BRC.

Members were advised that the BRC service supported people for a short period of time (up to 6 weeks) during the difficult transition from hospital to home.  The service was an important part of the discharge management process, helping to alleviate the pressure on beds as well as offering practical support to people when they were at their most vulnerable.   It was noted that the Service was also available to people in the community to help avoid hospital admission and operated Borough wide, between the hours of 9.00 am and 5.00 pm Monday to Friday.

The report and presentation provided details of the services, activities and interventions which may be provided to individuals whilst using the service.  It was noted that under the current contract, BRC provided information on a number of indicators relating to numbers of referrals and numbers of service users, as well as outcome information.

Further to Members queries the following additional information was provided:

·       The Health and Wellbeing Walk was praised and there was a similar walk in Runcorn, carried out by another organisation, the details would be sought and provided to the Board;

·       People were able to access the BRC services more than once, in fact this had happened already;

·       Referrals could come from family, friends and agencies; people were welcome to call the BRC in the first instance; and

·       Some referrals did prove challenging due to some clients having complex needs so these would be signposted to an additional service for help.

RESOLVED:  That the Board note the contents of the report and accompanying presentation.

The Chair, Councillor Joan Lowe, declared a disclosable other interest in the following item as her daughter in law worked for the domiciliary care provider.  She did not take part in the discussion of the item and handed the Chair to the Vice Chair, Councillor Baker, for the duration of the item.

The Board welcomed Kath Parker, the Chair of Healthwatch Advisory Board who presented the outcomes from Healthwatch Halton’s recent survey on Domiciliary Care Services in Halton.

It was reported that in 2016, Healthwatch Halton undertook a project to gather the views of people using Home Care Services (Domiciliary Care) in Halton.   Over 140 people took part in the survey, which concluded that the vast majority of service users were satisfied with their care but there were some issues that needed to be addressed and as such, the report made a number of recommendations.

It was noted that at the time the report was published, Halton Borough Council announced a review of provision of Domiciliary Care services across the Borough and following the review recommissioned home care services, with the contract being awarded to one main provider.  Subsequently, HBC were interested in how the new provider was performing against issues the previous report had raised and as such, Healthwatch Halton undertook an evaluation of the new service provision as well.   This report, published 24 October 2019, was appended to the report: Domiciliary Care Services in Halton – what people told us about their experiences.

          Members were pleased to receive the report and the consensus was that an 80% satisfaction rate overall was a very good figure.  They also recognised that there were consistent problems for the provider such as the continuity of carers; length of visit times; and high staff turnover for example. 

          The following points were discussed and noted following Members queries:

·       Vera’s Story and what would happen next in this scenario;

·       Some clients were not clear about the care options available to them;

·       The importance of independent advice for clients from other agencies and what could be done to improve this part of the service – it was agreed that this needed to be clarified;

·       Continuity of care was recognised as a huge issue for the provider and was being monitored on a monthly basis; and

·       A response to the survey had since been provided, a copy of which would be included in a future report to the Board.

RESOLVED:  That the Board notes the Healthwatch Halton report relating to domiciliary Care Services in Halton.

The Board received the Public Health Annual Report (PHAR) 2018-19, which was in the form of a short film which focussed on Workplace Health as its theme.

It was reported that since 1988 Directors of Public Health (DPH) had been tasked with preparing annual reports – an independent assessment of the health of local populations.  The annual report was the DPH’s professional statement about the health of local communities and was an important vehicle by which a DPH could identify key issues, flag up problems, report progress and thereby serve their local populations.

          It was noted that each year a theme was chosen for the PHAR so therefore it did not encompass every issue of relevance, but rather focused on a particular issue or set of linked issues.  Also, the PHAR was the DPH’s independent, expert assessment of the health of the local population and whilst the views and contributions of local partners had been taken into account, the assessment and recommendations made in the report were those held by the DPH and did not necessarily reflect the position of the employing and partner organisations.

As the Director of Public Health was unable to attend the meeting, the Chair requested that any queries from Members be directed to her for a response.

RESOLVED:  That the Public Health Report 2018-19 be received.

The Strategic Director People, provided Members of the Board an update on the work of the Transition Team, based within the Care Management Division of Adult Services.  It focussed on the continued use of the Named Social Worker (NSW) approach, following the provision of funding from One Halton for 2019-20.

As Members were already aware of the Transition Team and Named Social Worker pilot, they were provided with summary of this as a reminder.  The report continued, with an update on funding for 2019-20 and gave details of current activity. 

It was reported that since April 2019 when One Halton funding was identified, the Transition Team had continued to have an impact on the lives of young people.  The intensive and pro-active work of the team, enhanced by the NSW approach, resulted in better outcomes for individuals at the same time as achieving cost savings.  A case study demonstrating this was attached at appendix 1.

Members were pleased to receive the report and on behalf of the Board the Chair passed on their thanks to all staff involved in the pilot.  Members discussed the sustainability of the project bearing in mind the caseloads were set to increase in the future.  The importance of keeping family members and communities together was recognised.

RESOLVED:  That the report be noted.

The Chair, Councillor Joan Lowe, declared a disclosable other interest in the following item as her daughter in law worked for the domiciliary care provider.  She did not take part in the discussion of the item and handed the Chair to the Vice Chair, Councillor Baker, for the duration of the item.

The Board received a report from the Director of Adult Social Services which provided an update on the key issues with respect to quality in local Care Home and Domiciliary Care.

It was reported that in Halton there were 25 registered care homes which provided 760 beds operated by 14 different providers.  The capacity within the care homes ranged from homes with 66 beds to smaller independent homes with 6 beds; four of the homes were now owned by the Local Authority: Madeline McKenna, Millbrow, St Luke’s and St Patrick’s, which equated to 163 beds. 

It was noted that the Care Quality Commission (CQC) was responsible for the registration, inspection and assessment of all registered providers however, the Care Act 2014 placed the duty of securing the quality of care in Halton on the Council itself.

Members were provided with details of the CQC’s assessment process and details of the role of the Quality Assurance Team in the Local Authority.  The report also provided the quarter 2 ratings given by each of them for care homes and domiciliary care services; it was noted that both ratings were almost the same.   With regards to the amber ratings in paragraph 3.13, it was noted that this related to management issues and not the standard of care itself.

RESOLVED:  That the report be noted.

The Board received the Performance Management Reports for quarter 2 of 2019-20.  It was reported however that from page 102 onwards, under Adult Social Care Department – Revenue Budget as at 30 September 2019, this information was incorrect as it related to another department.  Therefore the correct finance information would be sent to the Board following the meeting.

Members were advised that the report introduced, through the submission of a structured thematic performance report, the progress of key performance indicators, milestones and targets relating to Health in quarter 2 of 2019-20.  This included a description of factors which were affecting the services.

The Board was requested to consider the progress and performance information and raise any questions or points for clarification; and highlight any areas of interest or concern for reporting at future meetings of the Board. 

It was highlighted that under emerging issues a review of Intermediate Care Services was currently being undertaken for the reasons outlined in the report.  A report providing further details would be submitted to the Board at a future meeting.

RESOLVED:  That the Performance Management Reports for quarter 2 be received.