Agenda and minutes

The evacuation procedure was noted.

There were no interests declared.

To approve the minutes of the last meeting held on 21 January 2025.

Consideration was given to the minutes from the Committee meeting held on 21 January 2025.  Attention was drawn to the following:

·         Teeswide Safeguarding Adults Board (TSAB) - Annual Report 2023-2024: Following a query raised by the Committee during the meeting around the stated Section 42 enquiry data, clarification had since been received from TSAB that a formatting issue had distorted the information within the Annual Report (this had since been rectified in the published document).  The TSAB response would be shared with Members after this meeting.

AGREED that the minutes of the meeting on 21 January 2025 be approved as a correct record and signed by the Chair.

To consider information from the following in relation to this scrutiny topic:

·       Voluntary, Community and Social Enterprise (VCSE) Sector (via Catalyst)

·       Service-user / family / carer feedback

·       Other Local Authority approaches / good practice regarding reablement

Councillor Marc Besford wished it to be recorded for transparency purposes only that he was an employee of Catalyst.

The fifth evidence-gathering session for the Committee’s ongoing review of Reablement Service considered a submission from the voluntary, community and social enterprise (VCSE) sector, feedback from those who had used local reablement provision, and examples of reablement activity / thinking from beyond Stockton-on-Tees.

VCSE SECTOR (VIA CATALYST)

Representatives from Catalyst (a strategic infrastructure organisation for Stockton-on-Tees which offered a range of specialist support, strategic operations, and a commitment to push forward the conditions in which its VCSE colleagues operated) were asked to collate views from the sector in response to the Committee’s lines of enquiry.  Catalyst’s Chief Executive, supported by a Project Co-ordinator, gave a presentation which focused on the following:

·         Current VCSE Support: There were no specific reablement services currently being delivered by VCSE organisations, nor was there a large quantity of reablement-related activity happening across the Borough within this sector.  When asked, Catalyst recommended services such as Age UK, Mind, and Heart Support (exercise classes), and also had a good relationship with those leading the North Tees and Hartlepool NHS Foundation Trust (NTHFT) ‘Home But Not Alone’ initiative (a volunteer service offering time-limited support following discharge from hospital).  The former Five Lamps ‘Home from Hospital’ service was another relevant offer in relation to this scrutiny topic, though this ended in March 2024.

·         Barriers: People may be unaware / uncertain about what the term ‘reablement’ was / meant, whilst VCSE organisations considering the provision of / supporting such a service needed to have the required capacity to meet demand and full cost-recovery funding (ensuring a good quality and sustainable offer).  From a sector perspective, perceptions that VCSE involvement was free or cheap should be addressed (i.e. paid staff were required to recruit volunteers, with incentives for the latter also a factor for consideration), and there was a general lack of awareness / information-sharing on the services available (or, indeed, what was no longer on offer).

·         How can we help you help residents?: Addressing barriers would enable the VCSE sector to be well placed to support Stockton-on-Tees Borough Council (SBC) with the delivery of local reablement services.  VCSE organisations were able to bridge gaps in statutory care (working flexibly without being bogged down with bureaucracy), and there was the potential for a Community Navigator role which linked up the broad range of services that existed to make it easier for families to identify possible support (this had already been discussed with SBC and the North East and North Cumbria Integrated Care Board (NENC ICB) – the Wellbeing Hub in Wellington Square, Stockton being a possible base).  The sector also had volunteer networks (supported by a Stockton-on-Tees Volunteers website), and Catalyst worked in partnership with SBC (and with input and support of the VCSE sector) to develop a new Volunteering Strategy for Stockton-on-Tees (this needed renewing in 2026).  Catalyst was trying to secure funding for  ...  view the full minutes text for item ASCH/64/24

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

Providers rated ‘Good’ overall (3)

·         Cherry Tree Care Centre had been upgraded to ‘Good’ overall (rated ‘Good’ across all five domains) from its previous ‘Requires Improvement’ judgement in January 2023, though it was noted that the service continued to receive supportive monitoring from the SBC Quality Assurance and Compliance (QuAC) Team as a result of their most recent PAMMS assessment rating and their ongoing Action Plan.

Similarly, Willow View Care Home had been upgraded to ‘Good’ overall (rated ‘Good’ across all five domains) from its previous ‘Requires Improvement’ judgement in March 2024 (which included ‘Inadequate’ in the ‘Safe’ domain).  This service had been under scrutiny for some time and had received significant support from SBC – much of the improvement could be attributed to stable management.

·         The Old Vicarage was deemed ‘Good’ overall (rated ‘Good’ across all five domains) following the first inspection of this learning disability-focused service.

With reference to the final paragraph within the ‘Supporting Evidence and Supplementary Information’ section, the Committee sought clarity on The Old Vicarage’s use of ‘creative ways of delivering equality of experience, outcome, and quality of life for people’ and encouraged this to be promoted and shared with other providers.  Further information would be shared after this meeting.

Providers rated ‘Requires Improvement’ overall (1)

·         Ingleby Care Home had been downgraded to ‘Requires Improvement’ overall (rated ‘Requires Improvement’ in all domains bar ‘Well-Led’ which was deemed ‘Inadequate’) from its previous ‘Good’ judgement in August 2018 (which included ‘Outstanding’ in the ‘Caring’ domain).  Four breaches had been identified by the CQC involving shortcomings in person-centred care, safe care and treatment, good governance, and duty of candour.  The home had been subject to the Responding to and Addressing Serious Concerns (RASC) protocol since 1 August 2024 (though had recently come out of this in mid-January 2025) and was due a PAMMS inspection in the near future.

The Committee expressed concerns around Ingleby Care Home’s medication practices – a theme which continued to emerge following inspections of the Borough’s providers.  The SBC QuAC Manager acknowledged the repeated medication issues raised by Members, though also emphasised the importance of stable management which was critical to the success of any service.  Noting the ‘Inadequate’ rating in the ‘Well-Led’ domain, the Committee observed that the service was yet to participate in the Council’s Well-Led Programme and asked if this was being pursued – officers would seek further details from the SBC Transformation Team following this meeting.

The remaining three reports were in relation to non-contracted providers.  Homecare agency, AAA Homecare Limited – Teesside received an overall rating of ‘Good’ (with all domains graded ‘Good’) in what was its first rated inspection, whilst another homecare agency, The Robert Atkinson  ...  view the full minutes text for item ASCH/65/24

Mindful of recent developments involving pharmacies (closure of one within Stockton-on-Tees earlier in 2024; the push for the public to go to pharmacies instead of GPs for certain issues / treatments) and the anticipated publication of an updated Pharmaceutical Needs Assessment (PNA) in October 2025, the Committee had requested further details on the existing situation regarding pharmacy provision across the Borough, whether this was deemed sufficient, and what was being identified as part of the consultation phase of the latest PNA review.

Introduced by the SBC Director of Public Health and supported by the SBC Pharmaceutical Adviser, a report (supplemented by some tabled slides reflecting its content) was presented to the Committee which highlighted the following:

·         Summary: The Stockton-on-Tees Health and Wellbeing Board (HWB) published its first PNA on 25 March 2015 (in accordance with the statutory duty to do so), with subsequent updates published in 2018 and 2022.  The next PNA was due to be published by 1 October 2025 (it was noted that the PNA was not a patient- / public-facing document).

·         Detail: Legislation (NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 (as amended)) required the HWB to divide its area up into localities – this was open to local determination, but it was suggested that existing boundaries (e.g. wards) were used when defining these.

Since the last PNA, there had been a boundary review (23 ward boundaries changed and an additional ward created), therefore there was a need to review the Borough’s localities.  The Stockton-on-Tees PNA Review Steering Group (comprising a Public Health Intelligence Specialist, Public Health Pharmaceutical Adviser, SBC Communications / Marketing, SBC Planning Team, and Healthwatch) had considered several options and agreed to use four localities for the PNA 2025 – Stockton-on-Tees North, Stockton-on-Tees South, Billingham, and Thornaby.  Factors influencing this included that two localities used in 2022 may mask variation of pharmaceutical needs in some parts of Stockton-on-Tees (particularly Thornaby and Billingham), three pharmacy closures had occurred since the PNA 2022, the variation in deprivation, local knowledge of the steering group, and to avoid the document being too complex and lengthy.

On 25 May 2023, regulatory changes were made to allow existing 100-hour pharmacies to apply to reduce their hours to a minimum of 72 hours per-week (subject to certain restrictions), though any existing core opening hours (Monday to Saturday between 5.00pm and 9.00pm, Sunday between 11.00m and 4.00pm, and Sunday's total opening hours) must remain.  There were eight 100-hour pharmacies in Stockton-on-Tees, but since the change in regulations, all eight had reduced their hours to between 72-90 hours per-week.  The decrease in hours from the previous 100-hour arrangements equated to the loss of three standard 40-hour pharmacies (something which also impacted upon Urgent Treatment Centres who were reliant on pharmacy access) – this would be relayed to NHS England and the North East and North Cumbria Integrated Care Board (NENC ICB).

Since the PNA 2022, further national advanced services had been added to what pharmacies could offer (pharmacies may choose whether  ...  view the full minutes text for item ASCH/66/24

CHAIR’S UPDATE

The Chair had no further updates.

Members made reference to the recently circulated Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) statement notifying partners that its Chief Executive would be leaving the organisation, as well as those bereaved families from the region who had met with the Health Secretary last week in their push for a public inquiry into the Trust.

WORK PROGRAMME 2024-2025

Consideration was given to the Committee’s current work programme.  The next meeting was due to take place on 18 March 2025, but the well-established annual North Tees and Hartlepool NHS Foundation Trust (NTHFT) Quality Account item was being pushed back to the May 2025 meeting following a request from the Trust.  This meant that the Committee meeting in March 2025 would be used solely as an informal session to consider a summary of evidence in relation to the ongoing Scrutiny Review of Reablement Service and then formulate draft recommendations.

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