Agenda and minutes

Apologies were received as follows:

• Councillor Colwill, substituted by Councillor Kansagra
• Councillor Shahzad
• Councillor Hector
• Councillor Ethapemi
• Mr Alloysius Frederick
• Rev. Helen Askwith

Members are invited to declare at this stage of the meeting, the nature and existence of any relevant disclosable pecuniary or personal interests in the items on this agenda and to specify the item(s) to which they relate.

Personal interests were declared as follows:

• Councillor Sheth – Lead Governor of Central and NWL NHS Foundation Trust
• Councillor Thakkar – employed as a care navigator
• Councillor Sangani – employed by NHS

To hear any deputations received from members of the public in accordance with Standing Order 67.

There were no deputations received.

To approve the minutes of the previous meeting as a correct record.

The minutes of the meeting on 22 February 2022 were approved as an accurate record of the meeting.

There were no matters arising.

To receive a report on care home provision and commissioning in Brent.

Andrew Davies (Head of Commissioning, Contracting and Market Management, Brent Council) introduced the report, which summarised residential and nursing home care in the borough, and provided an overview of the work being done on quality assurance, price setting, and the support the Council had given to the sector over the past 18 months. He advised that, of 57 residential and nursing homes in Brent, 45 were rated ‘good’ and 1 was rated ‘outstanding’ by the Care Quality Commission (CQC). Of the placements Brent made, over 83.5% were in a nursing or residential home rated as good or outstanding, which was slightly better than the London average. Where possible, the Council looked to commission within the borough, but this was not always possible due to pressure from other boroughs for placing residents. As a result, around 50% of placements were made in borough and 50% outside, which was in line with the London average. The number of placements particularly fell during 2020 following deaths due to Covid-19. The NHS took on commissioning of nursing placements for people leaving hospitals, and now the sector was seeing numbers increase to pre-pandemic levels. As a result, it was expected that the Council would spend slightly more than in previous years.

In offering care and support, the Council felt that, wherever possible, it was best to look to support people at home, with residential and nursing home care being the last resort. It was crucial there was a vibrant residential and nursing sector, and the Council spent a lot of time on quality assurance. The Residential and Nursing Team were responsible for quality assuring services, carrying out placement reviews, and taking a lead on safeguarding enquiries in Brent based homes. Each care home had a Placement Relationship Officer managing the close relationship between the Council and the home. They used a quality dashboard and there was good intelligence on the position of all homes in Brent, including those that the Council did not commission services in. The Council also continued to regularly share information with the CQC through quarterly meetings.

In relation to the 9 nursing or residential homes not rated as good or outstanding, an enhanced health and care home improvement programme was running, jointly with the CCG. This focused on medication management, improving links between primary care networks and care homes, and included a peer support programme which ten providers had been through and seen an improvement in their services. Three of the homes that were part of the improvement programme had subsequently been re-inspected by the CQC and had their rating increased.

The current challenge was the impact the vaccination mandate had on staffing levels. Although the mandate was being abolished the day following the meeting, since November 2021 it had been a legal requirement for anyone working in the care home sector to be vaccinated against Covid-19 and staff had left the sector as a result of that. This had not impacted the number of care home beds, and the Council  ...  view the full minutes text for item 6.

To receive a report on the progress of the transformation of community services in Brent.

Steve Vo (Assistant Director Integration and Delivery, NWL CCG – Brent Borough) introduced the report, which focused on waiting times, priorities, the monitoring and measuring of success, and comparatives with other boroughs. The report detailed the Central London Community Healthcare NHS Trust (CLCH) Covid-19 recovery plan in relation to waiting times, with clinical triaging and weekly waiting lists reviewed by clinicians. The report also detailed the transformation programme and key measures of that programme. One of the key projects to help in the transformation work was the change to the EMIS patient record system to align with the system used by GPs, which would alleviate the need to double check data, and increase transparency and fluidity. In relation to Ageing Well, CLCH were working with Central and North West London Foundation Trust (CNWL) to recruit to key posts, although there were recruitment challenges across the sector. The paper also noted the work on patient engagement, which was key for Brent Health Matters (BHM).

The Chair thanked officers for the introduction and invited comments and questions from those present, with the following issues raised:

The Committee were concerned about the number of people on waiting lists, and asked several questions in relation to some specific waiting lists:

• In relation to those waiting for Brent Integrated Diabetes Services, the Committee were advised that this referred to an education programme, meaning that those patients’ care needs were met and no-one was suffering harm, but they were recommended to go through an education programme. The programme had previously been a group learning exercise but it was no longer possible to do that. Some group sessions went ahead virtually but not every patient was able to do that through digital platforms.
• The Pulmonary Respiratory Service waiting list was also backlogged due to patients doing one-to-one rehabilitation where previously this would have been a group class setting. The service supported patients to manage their own condition and had been clinically evidenced to be effective, however there was a very small group of staff running that rehabilitation and this was something that most trusts across the whole of North West London (NWL) had built up a waiting list for. CLCH had looked to buy educational materials for patients to help themselves.
• There were very few waiting for Bladder and Bowel Services but there was a data problem with the waiting lists requiring validation. There was a growing number of patients waiting for reassessment of continence, but there was no risk that their continence pads would cease while they waited for reassessment. Those who may no longer be receiving enough continence pads could contact the service to be prioritised.
• It was confirmed that the NHS still had Covid-19 control guidance issued, which was why many services were not able to deliver group therapies. Despite this, CLCH were still doing one to one service and face to face for the vast majority of services.

In relation to the Brent Health Matters programme, the Committee queried how CLCH would measure  ...  view the full minutes text for item 7.

To receive an update on community engagement for the homeless families service.

Councillor Southwood (Lead Member for Housing and Welfare Reform) introduced the report, which highlighted how the homelessness team wanted to develop services tailored around individuals, using a philosophy that no two homeless families were the same. The focus was on prevention, as it was believed that services that stopped someone becoming homeless in the first place were infinitely more valuable. The report included key statistics for the service and detailed how the service reached out so that people knew what they offered. Councillor Southwood highlighted the importance of gathering data on what people thought about the service and how it could adapt on an ongoing basis to respond to feedback. The Council were eager to be involved in the Customer Service Pilot, which would allow video link up in the Civic Centre.

The Chair thanked Councillor Southwood for her introduction and invited comments and questions from those present, with the following issues raised:

The Committee queried what targeted approaches were in place to tackle different demographic challenges when it came to homelessness, to reassure residents it was not a ‘one size fits all’ approach. Councillor Southwood advised that one of the most important ways the service could outreach was through voluntary and community organisations. She was aware some communities and individuals were hesitant to contact the Council as they believed the Council would not help them in good faith. People were reluctant to speak with the Home Office due to the perceived hostile environment for people with pending immigration status. Going out to the community groups those people were a part of in order to reach out was an important way to raise awareness of services. Laurence Coaker (Head of Housing Need, Brent Council) added that the Council took a proactive approach. There was a team set up to review applications made during Covid-19 lockdowns for the support grants available for people in financial difficulty, and make contact where it was felt those people might be threatened with homelessness, instead of waiting for them to reach a crisis point. Home visits were not currently taking place but this was being looked at for the Council’s housing subsidiary Company, i4B, contacting tenants in arrears at risk of losing their home.

Another way of reaching out was through the homelessness forum which met bi-monthly, where all the voluntary and community groups represented at that forum were informed of the service and upcoming projects. The forum included larger organisation such as Crisis, as well as organisations with specialist skills such as those working with migrants at risk of homelessness or women fleeing domestic abuse. Through those regular meetings the Council ensured organisations were clear exactly what the homelessness service was and what they needed to do to help the people they worked with get services as quickly as possible. The Council also worked with people on an individual basis via email and telephone when they were identified as at risk. For example, those who had made applications for universal credit were offered the  ...  view the full minutes text for item 8.

Notice of items to be raised under this heading must be given in writing to the Head of Executive and Member Services or her representative before the meeting in accordance with Standing Order 60.

The Chair announced that Brian Grady, Operational Director Safeguarding Performance and Strategy, would be leaving the Council and offered thanks to Brian for all his work with the Committee.

The Chair also announced that Jackie Barry-Purssell (Senior Policy and Scrutiny Officer, Brent Council) was leaving the Council, and thanked her for the support she had given since she started in Brent.