Agenda and minutes

The evacuation procedure was noted.

There were no interests declared.

To approve the minutes of the last meeting held on 19 March 2024.

Consideration was given to the minutes from the Committee meeting held on 19 March 2024.  Updates were provided on the following items that were on the agenda:

·       North Tees and Hartlepool NHS Foundation Trust (NTHFT) - Quality Account 2023-2024: NTHFT had recently submitted responses to the Committee’s requests for additional information – these would be circulated to Members shortly.  In related matters, the Trust was yet to forward its draft Quality Account document – this would be shared with the Committee once received (and would assist in the collation of the Committee’s third-party statement for inclusion in the Trust’s final published document).

·       Monitoring the Impact of Previously Agreed Recommendations - Care at Home: Further information in relation to Stockton Riverside College Health and Social Care course uptake / capacity was yet to be received – this would be followed up with relevant officers.

AGREED that the minutes of the meeting on 19 March 2024 be approved as a correct record and signed by the Chair.

To consider and agree the draft final report.

Consideration was given to the draft final report for the Committee’s Scrutiny Review of Access to GPs and Primary Medical Care.  Specific attention was drawn to the following:

·       Paragraph 1.7 / 5.3 (page 10 / 45): Expanded to reflect comments made at the informal ‘summary of evidence’ session in April 2024.

·       Recommendations (page 12-13 / 48-49): Streamlined and themed as suggested during the informal ‘summary of evidence’ session in April 2024.

Regarding the proposed recommendations, Members highlighted the following:

·       Recommendation 3 (Councillors be supported in helping with these communication messages as leaders in their communities (as well as their role in raising concerns expressed by the community), and encourage positive feedback as well as concerns (to help share and spread learning and best practice)): It was suggested, and subsequently agreed, to amend the start of this recommendation from ‘Councillors’ to ‘Councillors and local MPs’.

·       Recommendation 10 (Relevant health stakeholders be proactive in encouraging involvement of patients in practice Patient Participation Groups (PPGs), aim to ensure these are representative of a practice’s patient list demographic, and consider fostering links between the Borough’s PPGs to assist in identifying / addressing any access issues): The importance of Stockton-on-Tees Borough Council (SBC) listening to PPG views was also emphasised, something which could be potentially factored into the post-review Action Plan.

·       In addition, whilst the issue did not feature during the Committee’s review, it was suggested that health authorities may wish to consider their links with local Planning Services functions in terms of new housing developments and the potential impact of these in relation to service demand / pressures.

The Committee approved the content of the draft final report (subject to the identified minor addition to recommendation 3) and was informed that the agreed version would be presented to Cabinet in June 2024.  The Chair thanked Members and officers for their contributions throughout the review process.

AGREED that the Scrutiny Review of Access to GPs and Primary Medical Care final report, including the minor addition, be approved for submission to Cabinet.

Consideration was given to the latest quarterly summary regarding Care Quality Commission (CQC) inspections for services operating within the Borough (Appendix 1).  Four inspection reports were published during this period (January to March 2024 (inclusive)), with attention drawn to the following Stockton-on-Tees Borough Council (SBC) contracted providers:

Providers rated ‘Requires Improvement’ overall (1)

·       Willow View Care Home had been upgraded from a previous overall rating of ‘Inadequate’.  Improvements were, however, still required to address breaches in relation to medication management, infection prevention and control, assessing risk, and good governance.

Discussion ensued on the current situation around Willow View Care Home, with Members expressing disappointment that the ‘safe’ domain had remained ‘inadequate’ despite a six-month gap between the previously published CQC report (12 July 2023) and the last inspection (30 January and 8 February 2024), especially given it was a residential dementia service.  The Committee once again noted that this was another case where issues relating to medication had surfaced, and also queried the existing occupancy levels within the setting (an overarching summary of capacity and occupancy was subsequently requested).  Responding to Member comments, the SBC Director of Adults, Health and Wellbeing confirmed that the Council were engaged on a daily basis with Willow View prior to its latest inspection, had met with owners to make clear its expectations of the service, and had spoken with residents and their families.  A further CQC inspection was anticipated around July / August 2024.

The remaining three reports were in relation to non-contracted providers.  Focused inspections of the home care / supported living services, Moon Rise 24hr Recruitment Ltd and Avalon Teesside Services, saw them both maintain their overall ratings of ‘Good’.  Finally, a short notice announced focused inspection of maternity services at The James Cook University Hospital (South Tees Hospitals NHS Foundation Trust) saw the Trust maintain its overall rating of ‘Good’ despite maternity provision being rated ‘Requires Improvement’ due to issues involving staffing levels, environment shortfalls, a lack of action following risk assessments, and inconsistencies around governance arrangements.

Focus turned to the section on Provider Assessment and Market Management Solutions (PAMMS) inspections (Appendix 2), of which there were 15 reports published during this period (January to March 2024 (inclusive)):

·       One service, Longlast, had retained its overall rating of ‘Excellent’.

·       Eight inspections had led to services being given an overall rating of ‘Good’ – Prioritising People’s Lives Ltd maintaining their previous overall rating, with Ingleby Care Home, Victoria House Nursing Home, Highfield (Stockton), Churchview Nursing and Residential Home, Real Life Options – 96 Bishopton Road, Allison House, and Real Life Options – 2 Frederick Street all being upgraded from their previous ‘Requires Improvement’ outcomes.

·       Of the remaining six reports, Five Lamps Home Care (Eldon Street) was downgraded to ‘Requires Improvement’ from a previous overall rating of ‘Good’, and Partners4Care Limited, Mandale Care Home, Woodside Grange Care Home (Older People’s service only), and Cherry Tree Care Centre were still deemed ‘Requires Improvement’ following  ...  view the full minutes text for item ASCH/5/24

Progress report for the previously completed Day Opportunities for Adults review.

Consideration was given to the assessments of progress on the implementation of the recommendations from the Committee’s previously completed review of Day Opportunities for Adults.  This was the third progress update following the Committee’s agreement of the Action Plan in June 2022, with developments in relation to the outstanding agreed actions noted as follows:

·       Recommendation 1 (SBC and its relevant partners continue working with people accessing services and their families / carers to understand demand for both traditional building-based day service provision and community-based activities. This should include:):

e)    Considerations around the potential for assisting with identified transportation needs (e.g. ensuring public / private transport options are accessible and respond to the needs of people who use day opportunities): Examples of Teeswide Dementia Friendly Community Network engagement with local bus companies and the Tees Valley Combined Authority (TVCA) were outlined – this included hybrid (face-to-face and virtual) dementia friend sessions for bus drivers and the SBC Community Transport team, the development of a bespoke online dementia friendly session specifically for bus drivers, and TVCA taking the lead on future delivery of ‘at-stop information’ which included updating the timetable template to ensure users had access to clear and reliable information when travelling by bus, and implementing a consistent posting schedule to ensure they were current.

With reference to the hybrid dementia friend sessions, the Committee asked for details of SBC community bus driver uptake (to be circulated after this meeting).

f)      Changes to the existing budget for SBC in-house and commissioned services: As requested by Members during the previous update in October 2023, a snapshot of the current dashboard involving day opportunities data (Appendix 1) was provided.  Since that last update, SBC had looked at the information on cost / activity and feedback from people accessing support – a re-mapping of the available in-house and commissioned services, the nature of each offer, the level of uptake of offer, and the connection with and use of community assets were being considered.

Members welcomed developments in relation to the dashboard and hoped that any future savings which accrued from using this tool could be evidenced.

·       Recommendation 3 (SBC Adults and Health and Children’s Services directorates reinforce joint-working to identify and support opportunities that are most meaningful to younger people (including a reflection on any updated results from the Disabled Children’s Team online survey), and strengthen the dissemination of information about existing services): As requested by Members during the previous update in October 2023, feedback on the November 2023 event was provided, as well as two subsequent events delivered alongside SBC Children’s Services on 31 January 2024 and 1 February 2024.  A draft Children’s and Adults transitions policy had been produced (engaging the views of young people in the process) – additionally, work with the Stockton Parent Carer Forum had produced a draft ‘information on transitions’ document.  This work would now be subsumed by the SBC Powering Our Future ‘Transitions’ project.

Officers were praised for the progress  ...  view the full minutes text for item ASCH/6/24

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 meeting was held on 15 March 2024, with items including both the Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) and North East Ambulance Service NHS Foundation Trust (NEAS) Quality Accounts, and an update on the recent North East and North Cumbria Integrated Care Board (NENC ICB) restructure.  Regarding the TEWV and NEAS items, third-party statements on behalf of the Committee would be collated and shared for comment / approval once the Trusts circulated their draft Quality Account documents.

Following a Committee request, an informal briefing on TEWVs use of physical intervention / restraint (a source of previous Member concern) was arranged and took place on 4 March 2024.

As part of the established rotational arrangements, support of the Committee had now transferred to Hartlepool Borough Council for 2024-2025.  The first meeting of the new municipal year was still to be confirmed.

Referencing the note regarding the minutes of the December 2023 meeting in relation to the ‘Office for Health Improvement & Disparities – Community Water Fluoridation’ agenda item, Members sought clarification on the deadline for the ongoing North East water fluoridation consultation.  It was thought that the deadline was mid-June 2024, though confirmation would be sought and relayed.

·       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 2024.  In related matters, the NENC ICB guidance on staying well and assisting services during spring, achievements regarding awareness-raising of chronic pain (an issue considered by the SBC Adult Social Care and Health Select Committee in February 2023), and developments around urgent care services across Tees Valley were highlighted.

AGREED that the Regional Health Scrutiny Update report be noted.

Following the Committee’s request in February 2024 that the TEWV Lead Governor should be invited to a future meeting to respond to the latest Care Quality Commission (CQC) findings on the Trust from a Governor perspective, and further to Cabinet changes made at the subsequent Stockton-on-Tees Borough Council (SBC) Annual Meeting, the TEWV Chair (of both the Board of Directors and Council of Governors), as well as the TEWV Managing Director for Durham, Tees Valley and Forensics, were in attendance to provide a response to the latest CQC inspection of the Trust, progress of the Trust’s improvement plan, and the role / accountability of its Governors.

Prior to taking Members through a presentation, the TEWV Chair (in the role for around two years now) reminded the Committee of the Trust’s ‘Big Conversation’, a significant engagement initiative that was undertaken following difficult events at the former West Lane Hospital, Middlesbrough site.  The results of this consultation had defined a five-year strategic plan which TEWV was presently half-way through.  Whilst not yet the finished article, it was stressed that TEWV was not undertaking a process of ticking boxes, but instead sought to fundamentally change the organisation through involvement with patients and their families / carers.

The results of the latest CQC inspection (published in October 2023) were re-iterated, with TEWV recognising and accepting the description of it being a Trust which required improvement (though it was also noted that the Trust was rated ‘good’ in both the ‘effective’ and ‘caring’ domains).  Attention then turned to graphics which compared TEWVs CQC ratings from December 2021 with the current (October 2023) gradings across its 11 service areas.  Whilst progress had been made in general (particularly in improving upon the December 2021 ‘inadequate’ ratings for both wards for people with a learning disability or autism and forensic inpatient or secure wards), TEWV acknowledged that there was too much amber (‘requires improvement’) within the ‘safe’ domain and assurance was given that an Action Plan was in place to address this.

Further detail was provided in relation to the last CQC inspection of TEWV, with ‘positives’ and ‘areas for improvement’ listed.  For the former, recognition of the continued good engagement with stakeholders and partners was highlighted (an important factor given that the mental health agenda did not just sit with the Trust), as was evidence of innovative practice (co-creation initiatives, and embedding of the lived experience voice within governance structures which helped shape the delivery of services).  In terms of the latter, identified workforce issues had since been addressed through strengthened oversight of daily deployment of staff and successful international recruitment for doctors / nurses (TEWV was also now in the top 10 mental health Trusts nationally for employee retention), there was a new strategy in place for physical health monitoring, and the serious incident backlog (acknowledged as unacceptable) had been cleared following the introduction of the Patient Safety Incident Response Framework (PSIRF).  In summary, the CQC had recognised that significant improvements had been made since 2021,  ...  view the full minutes text for item ASCH/8/24

Chair’s Update

The Chair had no further updates.

Work Programme 2024-2025

Consideration was given to the Committee’s current work programme.  The next meeting was due to take place on 18 June 2024 where the SBC Director of Public Health Annual Report 2023-2024 (recently considered by Cabinet) would be presented.  Also scheduled were two briefings, the first on the Borough’s new Care and Health Innovation Zone, and the second on the Council’s preparations for the anticipated forthcoming CQC inspection of its social care services.

AGREED that the Chair’s Update and Adult Social Care and Health Select Committee Work Programme 2024-2025 be noted.