Agenda and minutes

The evacuation procedure was noted.

There were no interests declared.

To approve the minutes of the last meeting held on 21 March 2023

Consideration was given to the minutes from the Committee meeting held on 21 March 2023.

AGREED that the minutes of the meeting on 21 March 2023 be approved as a correct record and signed by the Chair.

To consider the Adults, Health and Wellbeing overview report.

As part of the annual opportunity to hold Cabinet Members and services to account, as well as understand the challenges and issues arising at the start of the current year’s work programme, the Committee was presented with the overview report from the Stockton-on-Tees Borough Council (SBC) Adults, Health and Wellbeing directorate.  Introduced by the new SBC Director of Adults, Health and Wellbeing, and supported by the SBC Director of Public Health and SBC Assistant Director – Adult Strategy and Transformation, the report drew attention to the following:

Adult Social Care

Priorities for the year ahead and support for these, including:

• Reviewing the intermediate care offer.

• Focusing on developing further opportunities for supported and residential living within the Borough to enable less out-of-area placements.

• Developing a Workforce Strategy.

• Continuing to work with care providers to develop the care market within the Borough and improve quality of care.

• Developing co-production with people with lived experience.

Challenges and opportunities, including:

• Several key frameworks will be recommissioned in the next 18 months.

• Market Position Statement (MPS) for 2023-2026 completed – will be used to ensure sufficient provision for projected future need.

• Service demand, inflation / financial challenges and recruitment issues continue to impact upon the sector.

• Transformation Programme will continue, with a focus on recruitment and retention, leadership development / networks, activity programmes, and staff skills.  Success of the SBC Well-Led Programme (finalist in MJ Awards 2023) and the Care Home Legends initiative highlighted.

• Recognising the importance of resident wellbeing, a L2 Activity Provision in Care qualification was developed by the Learning and Skills Team – initial intake in June 2023 oversubscribed; second intake in September 2023.

• Responding to medication management issues identified via CQC and PAMMS inspections – commissioned support from NHS Medicines Optimisation Team, created Care Home Quality Group to upskill staff around medication, and created L3 Medication Management qualification (accredited and recognised by the Care Quality Commission (CQC)).

• Nationally recognised local systems in place to enable timely hospital discharge (including use of Rosedale Centre and Rapid Response (care at home) options) – integration key and SBC focused on what more can be done to maintain / enhance this success.

• Created a new Lived Experience Co-ordinator role in November 2022 to transform the Council’s co-production approach.

Officers highlighted the new CQC inspection regime for Adult Social Care within Local Authorities which was introduced from April 2023 – more information on this, and the Council’s preparations for an inspection of its existing offer, would be shared with the Committee in the future.

The SBC Cabinet Member for Adult Social Care spoke of the importance of raising the status of people working within the care sector (which also had the potential to help with ongoing recruitment challenges).  The Council’s Well-Led Programme had supported this drive and had enabled / encouraged managers to more effectively share best practice / ideas / concerns.  The positive quality assurance audit of SBC by the  ...  view the full minutes text for item ASCH/4/23

Consideration was given to the latest quarterly summary regarding Care Quality Commission (CQC) inspections for services operating within the Borough (Appendix 1).  15 inspection reports were published during this period (January to March 2023 (inclusive)), with attention drawn to the following:

Providers rated ‘Good’ overall (7)

• Oxbridge House, Roseville Care Centre and Real Life Options – Darlington Road had all been upgraded from a previous overall rating of ‘Requires Improvement’.

• Royal Mencap Society – 71 Middleton Avenue and Real Life Options – 2 Frederick Street had maintained their grading following a previous overall rating of ‘Good’.

Providers rated ‘Requires Improvement’ overall (7)

• Cherry Tree Care Centre and Chestnut Lodge Nursing Home had breaches in relation to safe care / treatment and good governance which led to the services being downgraded from their previous overall rating of ‘Good’.

• Mandale Care Home had breaches in relation to safeguarding and good governance (as well as a breach of CQC regulations regarding the failure to notify the CQC of important incidents) which led to the service being downgraded from the previous overall rating of ‘Good’.

• Churchview Nursing and Residential Home had breaches in relation to the need for consent and good governance, and Piper Court had breaches in relation to good governance – no change in grading following a previous overall rating of ‘Requires Improvement’.

• North East Ambulance Service NHS Foundation Trust were served with a notice under Section 29A of the Health and Social Care Act 2008 and told to make significant improvements to governance systems, seeking and acting upon staff feedback, incident reporting / investigating / monitoring of actions, and medicines management.  It was noted that the Trust would be responding to the outcomes of this inspection at the next Tees Valley Joint Health Scrutiny Committee meeting on 28 July 2023.

Providers rated ‘Inadequate’ overall (1):

• Ashwood Lodge Care Home had breaches in relation safe care / treatment and good governance which led to the service being downgraded from the previous overall rating of ‘Good’.  The home had since closed, with the last resident being moved out on 12 February 2023.

The Quality Assurance and Compliance (QuAC) Manager presenting the report noted that most CQC inspections now tended to be focused on the ‘Safe’ and ‘Well-Led’ domains, though can be opened up to include the other three previously established domains (‘Effective’, ‘Caring’ and ‘Responsive’) should issues be found during a focused inspection.

Regarding the now closed Ashwood Lodge Care Home, Members praised the QuAC Team for flagging-up issues prior to the CQCs subsequent visit, and were also reassured by the speed of the action taken in relation to residents once concerns had been identified.

With specific reference to Piper Court, the Committee asked for clarification of the CQC timescales around re-inspections should a provider be graded either ‘Requires Improvement’ or ‘Inadequate’.  Officers stated that services were usually re-visited within six months if they were rated below ‘Good’, though the new CQC monitoring framework had made  ...  view the full minutes text for item ASCH/5/23

Consideration was given to the latest Regional Health Scrutiny Update report summarising developments regarding the Tees Valley Joint Health Scrutiny Committee, the Sustainability and Transformation Plan (STP) / Integrated Care System (ICS) Joint Health Scrutiny Committee, and the North East Regional Health Scrutiny Committee.  Attention was drawn to the following:

• Tees Valley Joint Health Scrutiny Committee: The last Committee meeting was held on 17 March 2023 (note: the meeting was not quorate) and included consideration of an NHS England (North East and Yorkshire) update on NHS Dental Services, information from Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) relating to its latest Quality Account, and a presentation from the North East and North Cumbria Integrated Care Board (NENC ICB) updating Members on the Clinical Services Strategy.

Stockton-on-Tees Borough Council would be hosting the Joint Committee during 2023-2024.  The first meeting of the new municipal year was scheduled for 28 July 2023, with agenda items to include a North East Ambulance Service NHS Foundation Trust (NEAS) response to their latest CQC inspections and the independent review of its services, NENC ICB updates regarding Community Diagnostic Centres (deferred from the March 2023 meeting) and Breast Services, and a TEWV report on the role and impact of their Lived Experience Directors.

Discussion ensued around the current state of NHS dentistry, in particular capacity and the costs for dental practices to provide the necessary treatment.  On a more positive note, the SBC Cabinet Member for Adult Social Care highlighted the significant success of the school supervised toothbrushing programme which was helping children to get into good habits regarding oral hygiene.

• Sustainability and Transformation Plan (STP) / Integrated Care System (ICS) Joint Health Scrutiny Committee: No further developments regarding this Joint Committee since the previous update in January 2023.  In related matters, the ICBs new commissioning responsibilities for NHS dentistry were highlighted, as were further developments around efforts to address long-standing health inequalities, and an animation celebrating the one-year anniversary of the NENC ICB.

AGREED that the Regional Health Scrutiny Update report be noted.

Consideration was given to the minutes of the Health and Wellbeing Board from the meetings in February 2023 and March 2023.  Attention was drawn to the following:

• 29 March 2023: With reference to the ‘Post Covid’ item, Members were reminded that the Adult Social Care and Health Select Committee had previously asked for further details from North Tees and Hartlepool NHS Foundation Trust (NTHFT) about its long-COVID service.  Despite being originally requested in March 2022, this had still not been received – the Trust had therefore been contacted again in recent weeks regarding this.

Regarding the ‘Members’ Updates’ item, clarification from the North East and North Cumbria Integrated Care Board (NENC ICB) would be sought in relation to the announcement that a dentistry provider was ceasing services in Stockton.

AGREED that the minutes of the Health and Wellbeing Board from the meetings in February 2023 and March 2023 be noted.

Chair’s Update

The Chair noted a recent informal meeting he had held with senior representatives of North Tees and Hartlepool NHS Foundation Trust (NTHFT).  These six-monthly catch-ups provided additional opportunities to exchange information outside the formal Committee environment, and the notes would be circulated to the Committee (for Members’ information only) once finalised.

Separately, the Committee was informed of the forthcoming Cancer Research UK ‘Race for Life Tees Valley’ which was taking place on 2 September 2023 (12.00pm) at Middlesbrough Sports Village.

Work Programme 2023-2024

Consideration was given to the Committee’s current work programme.  The next meeting was due to take place on 19 September 2023 and was scheduled to consider the Healthwatch Stockton-on-Tees Annual Report for 2022-2023, the next CQC / PAMMS quarterly report (Q1 2023-2024), and a draft scope and plan for the Committee’s first in-depth review of the current municipal year regarding Access to GPs and Primary Care.  An update on the one outstanding element of the Action Plan in relation to the previously completed Care Homes for Older People review would also be presented.

AGREED that the Chair’s Update and Adult Social Care and Health Select Committee Work Programme 2023-2024 be noted.