Agenda and minutes

Community and Wellbeing Scrutiny Committee
Tuesday 20 September 2016 7.00 pm

Venue: Boardrooms 3/4 - Brent Civic Centre, Engineers Way, Wembley HA9 0FJ. View directions

Contact: Bryony Gibbs, Governance Officer  020 8937 1355 Email: bryony.gibbs@brent.gov.uk

Items
No. Item

1.

Declarations of interests

Members are invited to declare at this stage of the meeting, any relevant disclosable pecuniary, personal or prejudicial interests in the items on this agenda.

Minutes:

Councillor Ketan Sheth declared that he was Lead Governor for the Central and North West London NHS Foundation Trust.

2.

Deputations (if any)

Minutes:

None

3.

Minutes from the previous meeting pdf icon PDF 80 KB

Minutes:

RESOLVED:

 

That the minutes of the previous meeting held on 20 July 2016 be approved as an accurate record of the meeting.

4.

Matters arising (if any)

Minutes:

None.

5.

Healthwatch Brent

A representative from Healthwatch Brent to make a short presentation to the committee and update members about their activity and priorities for 2016/17

Minutes:

An overview of Healthwatch Brent was provided to the committee by representatives Julie Pal and Mike Rich. Members heard that CommUNITY Barnet was the community provider of Healthwatch Brent and delivered work via eleven community partners and Advisory Boards. Healthwatch Brent gave an independent voice to health and social care users and sought to add value to the local health and social care economy. The organisation undertook community engagement, health promotion work and ran small and large grants programmes. A good and improving relationship had been developed with the London North West Healthcare Trust ensuring a receptive response to feedback provided by Healthwatch Brent. One of the organisation’s priorities for the current year was Maternity Care. Meetings were planned with the Senior Midwifery Team and women who had given birth in the last two years and lived in  Brent would be contacted. It was emphasised that Healthwatch Brent aimed to make small, achievable yet significant  improvements to services in Brent.

 

The Chair thanked the representatives of Healthwatch Brent for their presentation. Members sought details of common complaints received, outreach work undertaken with regard to hard to reach communities, the success of feedback mechanisms employed and how the outcome of such work was communicated back to members of the public. Views were also sought regarding the quality of information and advice services available. A further query was raised by Councillor Mitchell Murray (Cabinet Member for Children and Young People) regarding how Healthwatch Brent monitored and processed data.

 

The committee was informed that common concerns included access to GPs, access to NHS dentists and hospital discharge processes. This data was collected via direct approaches by members of the public as well as by outreach and engagement activities. There was a programme of work regarding engaging with community groups, including liaising with the LNW Healthcare Trust  to identify the best way of accessing people using certain services. Regular meetings were also held with the council commissioners and contract officers as well as with the Health and Wellbeing Board to agree work priorities and feedback findings from work undertaken. Healthwatch Brent worked with Healthwatch England to ensure compliance with national standards with regard to the collection and processing of data. It was emphasised that the organisation did not collect large data sets or personal information that could lead to an individual being identified. Rather the research carried out tended to be qualitative in nature. All those who contributed their views and experiences would be notified when the public reports that were subsequently published. 

 

6.

Scoping paper for Signs of Safety scrutiny task group pdf icon PDF 121 KB

Members agreed to establish a task group to evaluate the introduction of Signs of Safety by children’s services. This report sets out the proposed remit, methodology, research methods and objectives of the task group for the committees consideration. .

Minutes:

The report from the Director of Policy, Performance and Partnerships set out the proposed terms of reference for the Signs for Safety task group. Signs of Safety was a practice framework for working with children and families and child protection which was developed in Australia in the 1990s and was currently used by many children’s services departments in local authorities in the United Kingdom, United States, Australia and Canada. Brent Council had adopted this approach in 2014, having been awarded funding from the England Innovations Project. Participation  in the England Innovations Project and introduction of Signs of Safety was a corporate priority for Brent Council. It was identified in the Corporate Plan 2015 as a key priority, and a commitment to the effective implementation of Signs of Safety was signed by the Chief Executive and Council Leader in 2014.

 

Gail Tolley (Strategic Director Children and Young People) emphasised the timeliness of the proposed task group, noting that in 2015 Ofsted inspectors had been impressed with how the council had implemented the approach but considered that there was inconsistency in its application. Ofsted had also recommended that there had been insufficient focus by Scrutiny on Children’s Social Care.  Gail Tolley encouraged the task group to speak with front line practitioners, parents and young people and about their experiences. Responding to a question from the Brent Youth Parliament representative, Gail Tolley confirmed that it would be appropriate to approach the Brent Care in Action group which was comprised of children in care and care leavers to seek their views. With reference to the proposed methodology set out in Appendix A to the report, a member suggested that schools should be included in the list of potential interviewees.

 

RESOLVED:

 

That the Signs of Safety Task group be established as detailed in Appendix A to the report from the Director of Policy, Performance and Partnerships.  

7.

Sustainability and Transformation Plan pdf icon PDF 466 KB

NHS England has published the Five Year Forward View, setting out a vision for the future of the NHS. Planning guidance released in December 2015 set out the requirement for local areas to develop a Sustainability and Transformation Plan (STP) to help local organisations plan how to deliver a better health service and meet this vision. This report sets out the North West London STP priorities, how they align with the Brent STP priorities, the approach to delivering these and the financial implications associated with the proposals.

Minutes:

The committee considered the report from the Chief Executive of Brent Council and Chief Officer of Brent Clinical Commissioning Group on the Sustainability and Transformation Plan (STP). Rob Larkman (Chief Officer, Brent Harrow Hillingdon CCGs) advised that the requirement for the production of the STP was introduced by the NHS England in 2015. The purpose of the STP was to help local organisations plan how to deliver a better health service by addressing three key areas; improving health and wellbeing, improving quality of care and tackling the financial gap. The STP moved away from an organisation by organisation view to establish a broader strategic approach. Brent fell under the STP for North West London. It was acknowledged that work for this was taking place at several levels. At the North West London Level work was underway to draw together the place-based planning taking place in Brent and the seven other North West London Boroughs which were encompassed by the North West London STP. The STP was required to be submitted by the end of October 2016. It was emphasised that the timescales set out for the creation of the STP were extremely challenging. A draft NWL STP had been published and it was now necessary for all the statutory bodies affected by the STP to consider the details in line with their respective governance arrangements.

 

Addressing concerns regarding transparency and accountability, Carolyn Downs (Chief Executive of Brent Council) explained that the challenge of creating high quality plans to the level of detail required within the timescales set out had been extremely challenging. However, the NWL STP was recognised as one of the more detailed plans created and was the only one in the country for which joint governance processes had been supported to ensure political input from all affected local authorities. Reflecting this, five of the eight local authorities had jointly commissioned work to test the assumptions in the plan specifically related to the cost of additional out of hospital care to social care as a result of any proposed changes to acute services. The NWL STP was the only plan in the country to specifically address the social care funding gap. The NWL STP was also one of only two plans to have been published and a series of public engagement events would be held. Councillor Hirani (Cabinet member Community Wellbeing) added that events would be held out in the community in places such as supermarkets, stations and high streets to inform and engage residents.

 

Sarah Mansuralli (Chief Operating Officer, Brent Clinical Commissioning Group) outlined the work taking place at a local level. Members heard that a STP Brent-level working group had been established bringing together statutory partners including the Acute Trust, the Central and North West London Mental Health Trust and Brent Healthwatch, to break down organisational barriers. The working group had sought to identify the initiatives that would have the highest impact in Brent for addressing the three key issues  ...  view the full minutes text for item 7.

8.

Update on New Accommodation for Independent Living (NAIL) project pdf icon PDF 127 KB

The New Accommodation for Independent Living (NAIL) project is the largest and most strategically important efficiency and quality improvement initiative within the Adult Social Care Department. The programme aims to identify, develop and acquire alternative forms of care to residential care for all vulnerable adult client groups in Brent. This report updates members of the committee on the NAIL project. 

Minutes:

A report updating the committee on the New Accommodation for Independent Living (NAIL) project was introduced by Helen Woodland (Operational Director Social Care). The NAIL project was the largest and most strategically important efficiency and quality improvement initiative within the Adult Social Care Department. The programme aimed to identify, develop and acquire alternative forms of care to residential care for all vulnerable adult client groups in Brent. It was explained that outcomes for people going into residential care were not as good as for those who remained in their own communities and the NAIL project sought to address this by supporting people in an independent living setting, allowing them to remain in a home of their own, or in their own communities. It was emphasised that Independent living was not a prescriptive model of service design and could look very different for different people with different levels of care and support needs. The project had been active for two years and the report before the committee outlined areas of learning, detailed mitigating actions taken and progress achieved.

 

In the subsequent discussion members questioned why those with mental health difficulties were not listed in the customer groups set out in Appendix A to the report. Further details were sought regarding the different models of supported living and how they correlated with different levels of need. A member expressed sadness at the difficulties which had prevented several sites from being developed and noting that one unit had been targeted at young people, queried whether consideration had been given to prioritising schemes for young people. The committee queried what work was being done with Brent Housing Partnership (BHP) to provide appropriate sites. 

 

Helen Woodland explained that the Mental Health client group should have been included in the table, noting that at 233 residents it comprised one of the larger groups. Phil Porter (Strategic Director for Community and Wellbeing) advised that a big challenge for this group was that housing need should be seen as pathway and while successes could be achieved in supported living settings, there remained difficulties in securing long term stable tenancies in the community. This had been reflected in the Mental Health Transformation programme which had gone live in January 2016 and sought to encompass the full spectrum of need and identify support pathways. It was considered particularly absurd that someone in a supported living unit would no longer have priority for social housing. A dedicated housing officer was now in place and it was hoped that some of these challenges could be addressed as a result of this closer working relationship. 

 

Helen Woodland outlined models of supported living explaining that these varied from small units providing a high level of support to larger units where a sense of community was an important factor. The former model was considered more appropriate for those with learning disabilities and the latter for older people. The level of need of the mental health client group varied and therefore a mixture of provision was  ...  view the full minutes text for item 8.

9.

Co-opted members on Community and Wellbeing Scrutiny Committee pdf icon PDF 112 KB

This report clarifies the role of co-opted members on the Community and Wellbeing Scrutiny Committee.

Minutes:

Pascoe Sawyers (Head of Policy and Partnerships) advised that the report before the committee sought to clarify the role of its co-opted members and had been prepared following queries raised at the previous meeting. Following a discussion it was agreed that further advice would be sought by officers.

 

RESOLVED:

 

that further clarification be provided regarding the role of co-opted members at the next ordinary meeting of the committee, scheduled for 23 November 2016.  

10.

Update on scrutiny work programme 2016/17 pdf icon PDF 168 KB

This report updates members on the committee’s work programme for 2016/17 and captures scrutiny activity which has taken place outside of its meetings.

Additional documents:

Minutes:

RESOLVED:

 

    (i)        that the report updating the committee on the work programme for 2016/17, including changes to the schedule of items for each meeting and the progress of the tracker of recommendations to Cabinet,  be noted.

 

  (ii)        that the details of members’ visits, requests for information and responses, which had been undertaken and completed outside of the committee’s 2016/17 work programme, be noted.

11.

Any other urgent business

Notice of items to be raised under this heading must be given in writing to the Head of Executive and Member Services or his representative before the meeting in accordance with Standing Order 64.

Minutes:

None.

12.

Date of next meeting

The next scheduled meeting of the Committee is on

Minutes:

The committee noted that the next ordinary meeting was scheduled for 23 November 2016.