Agenda and minutes

The evacuation procedure was noted.

There were no interests declared.

To approve the minutes of the last meeting held on 17 September 2024.

Consideration was given to the minutes from the Committee meeting held on 17 September 2024.

AGREED that the minutes of the meeting on 17 September 2024 be approved as a correct record and signed by the Chair.

To consider information from the Stockton-on-Tees Borough Council (SBC) Adults, Health and Wellbeing directorate in relation to this scrutiny topic.

Following the Committee’s approval of the scope and plan for the Reablement Service review at the last meeting in September 2024, this first evidence-gathering session involved an initial submission from the Stockton-on-Tees Borough Council (SBC) Adults, Health and Wellbeing directorate.

Led by the SBC Integrated Interim Care Team Lead (CQC), and supported by the SBC Strategic Development Manager (Adults & Health) and the SBC Service Manager – Integrated Early Intervention and Prevention, a presentation was given which covered the following:

·       What is reablement?

·       Why (provide the service)?

·       Who can access the service?

·       How we deliver the service?

·       Activity and Performance

·       Feedback about our staff

·       Client feedback

·       Future

·       Powering Our Future

Coming under the wider umbrella of ‘intermediate care’, reablement was one of several short-term support offers involving NHS and social care services.  Providing assistance within a person’s own home, this assessment and support service helped an individual to do tasks (e.g. washing, getting dressed) for themselves rather than relying on others, with support workers working alongside the person while they regained skills and confidence.  The aim was to maximise independence (doing tasks ‘with’ them, not ‘for’ them), and the service could be used to support discharge from hospital, prevent re-admission, or enable an individual to remain living at home.

From a legislative perspective, the Council had a duty to prevent, reduce or delay needs for care and support (Care Act 2014 s2) for all adults (18 years-old or over), including carers.  In practice, this meant early intervention to prevent deterioration and reduce dependency on support from others, and reablement was one of the ways the Council could fulfil this duty.  The Care Act regulations required the Council to provide reablement support free-of-charge for a period of up to six weeks – this was for all adults, irrespective of whether they had eligible needs for ongoing care and support.

The service may be accessible if an individual had a temporary illness / accident, a crisis, a change in their (or their carers’) circumstance, or to avoid unnecessary admission to hospital.  Where a ‘need’ (not a ‘want’) had been identified, individuals would be referred following an assessment via a health or social care professional.  Any subsequent support could be tailored to the individual, and its duration was dependent upon their progress (i.e. this free service could be less than the maximum six-week period).

In terms of service delivery, the SBC Reablement Team consisted of a Manager, a Deputy Manager, four Co-ordinators, an Assistant Co-ordinator, three Senior Support Workers, and 37 Support Workers (courtesy of a recent expansion in October 2024) who were all dedicated and worked alongside individuals to promote independence.  The workforce had a mix of experience, and the service benefitted from good staff retention, with those in post for a number of years able and willing to share their knowledge and expertise with newer recruits.

With a focus on making every contact count, visits to service-users occurred 1-4 times per day, with Senior Support Workers holding regular weekly reviews with individuals  ...  view the full minutes text for item ASCH/36/24

Consideration was given to the latest Regional Health Scrutiny Update report which summarised the work of regional health scrutiny committees and highlighted some recent health-related developments impacting on the Tees Valley and / or wider North East and North Cumbria footprint.  Attention was drawn to the following:

·       Tees Valley Joint Health Scrutiny Committee: As part of the previously agreed rotational arrangements, Hartlepool Borough Council was now hosting the Committee in 2024-2025.  The last meeting (and first of the current municipal year) was held on 19 September 2024 and, following the appointment of a new Chair and Vice-Chair, items included Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) updates on Respite Care / Adult Learning Disability Services and the Community Mental Health Transformation initiative, as well as an update on the Community Diagnostic Centre (CDC) in Stockton.

The next Committee meeting was scheduled for the 7 November 2024 – anticipated items (still to be confirmed) included TEWV presentations on health inequalities and male suicide, as well as a North East and North Cumbria Integrated Care Board (NENC ICB) winter planning update.

Members representing Stockton-on-Tees Borough Council (SBC) on the Tees Valley Joint Health Scrutiny Committee noted the delay between the last meeting in September 2024 and the previous one in March 2024, as well as SBCs involvement and influence on some of the key items on the September 2024 agenda.  In terms of these, encouragement was expressed at both the Respite Care and CDC updates, the latter of which confirmed the anticipated opening of the CDC in Stockton by Christmas 2024.

·       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 May 2024.  In related matters, several regional developments were highlighted, including the ongoing promotion of the NHS ‘Be wise, immunise’ campaign to vaccinate high-risk people against COVID-19 and flu, the ongoing ‘collective action’ by GP services, details of the North East and North Cumbria women’s health programme, a NHS Clinical Conditions Strategic Plan targeting 12 health conditions making the biggest impact on people, and a link to the latest NENC ICB annual report and accounts (1 April 2023 – 31 March 2024).

AGREED that the Regional Health Scrutiny Update report be noted.

Consideration was given to the Health and Wellbeing Board forward plan (as of September 2024) and the minutes of previous meetings which took place in May 2024, June 2024 and July 2024.  Attention was drawn to the following:

·       Forward Plan: The Board’s forward plan had been added to this agenda item to enable the Committee to have sight of forthcoming business that was due to be considered.

·       31 July 2024: Item 6 of these minutes recorded ongoing discussions in relation to the functions of the Board, the format of Board meetings, and the opportunity for Board development.

AGREED that the forward plan and the minutes of Health and Wellbeing Board meetings which took place in May 2024, June 2024 and July 2024 be noted.

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 19 November 2024 where the latest CQC / PAMMS quarterly update would be provided, and the second evidence-gathering session for the ongoing Reablement Service review would be held.  An update on the work of the Making it Real Board was also anticipated.

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

Members were asked to consider a Care and Health Winter Planning Update report which, with the permission of the Chair, had been added to this meeting agenda as an urgent item in order to ensure the Committee had the opportunity to review and comment ahead of the report going to the Stockton-on-Tees Borough Council (SBC) Cabinet on 14 November 2024.

Introduced by the SBC Director of Public Health, it was stated that the report was owned by the Health and Wellbeing Board and covered the Council’s care and health winter planning arrangements (as part of the Board’s system assurance role).  The report would be going to the Health and Wellbeing Board meeting on 30 October 2024 and covered the following elements:

·       Winter planning (including integration workshops and admissions avoidance)

·       Infectious disease surveillance (including COVID, flu and vaccinations)

·       Health protection work with key settings (including local response)

·       Adult social care support (including demand and capacity management)

·       Housing

·       Supporting our communities (including food support and Community Spaces)

·       Consultation and engagement

·       Next steps

The report outlined SBC involvement in the wider winter planning infrastructure and several elements were subsequently highlighted, including the oversight of NHS planning and co-ordination of partners by the Tees Valley Local A&E Delivery Board (LAEDB) to mitigate the impact of winter.  The LAEDB was compiling a comprehensive overview of winter plan arrangements and would share this with the wider system in November 2024.  Attention was also drawn to data on COVID-19 hospitalisations (which continued to have an unpredictable pattern of peaks and troughs), the Council’s Rough Sleeper Team, and the wide range of support being offered to the Borough’s communities.

Praising officers for presenting this report to the Committee prior to it being considered by both the Health and Wellbeing Board and SBC Cabinet, Members proceeded to raise a number of comments and questions.  Commending the Council’s PAMMS inspections of local care providers (robust monitoring arrangements which aided families to make informed choices), the Committee queried whether the stated ‘capacity to undertake up to a further 6 assessment of services which intelligence indicates may be at risk’ (paragraph 36) would include a look into the SBC First Contact service following recent issues highlighted around the Council’s ‘front door’.  Officers confirmed that incident reporting intelligence would help inform where future PAMMS inspections should be undertaken.

Clarity was sought on the ‘ensure home first’ / ‘Discharge 2 Assess (D2A)’ approach (paragraphs 40-42), with officers explaining that this was an initiative to get those who were medically fit to leave hospital out of such settings.  Individuals were discharged to their own home where an assessment would then be undertaken to establish their care and support needs.

Noting the section on ‘monitoring the impact of winter on local people and the social care workforce’, Members asked if the Council’s ‘capacity dashboard’ was available to all professionals so there was transparency around any surplus capacity in local provision.  The Committee heard that the referenced ‘holding list’ (paragraph 43) existed due to  ...  view the full minutes text for item ASCH/40/24