Transcript

If anyone wishes to avoid being filmed, please let the clock know, immediately. I don't see any objections. Thank you. For anyone speaking at the meeting, it's important to speak closely to the microphone, so viewers of the webcast and others in the room can hear you. If you have a mobile phone or other device, please turn it onto silent and move it away from the microphone as it may affect the audio system and distract speakers. Around the room are exit signs, should the fire alarm sound during the meeting, please make your way to the nearest and safest exit. Thank you. We move to item two, apologies and substitutes, Dominic. Thank you, Chair. We have received apologies for Mr. Collar, Mr. Brady and Mr. Game. Any other apologies I should be made aware of? Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Yes, thank you, Chair. Welcome to everyone here today. By way of an update, I'm going to go through to start with a few visits. I have recently made our in-house services run by Adult Social Care. I thought it would be useful to do that, as you might not be aware of all of our many services we provide. So, to kick off, earlier this month, I visited one of our day service centres in Birchington for adults with a learning disability. It was really fantastic to see it. It supports vulnerable adults, mostly with learning disability, but also with sometimes mental health and frailty challenges as well, giving them an opportunity to access activities both at the building itself, but actually very impressed by the huge range of activities they organise in the local community out and about, including actually a huge amount of volunteering, for instance, at Quex Park, local church, but actually giving these vulnerable adults the chance to really get stuck into the community. And I thought it was fantastic to see that. I also visited in May shared live's host Carer's placement. I wasn't that familiar with shared lives, but I'll just say for those who aren't, that it's really like fostering, but fostering a vulnerable adult rather than a child. So, it offers people daytime support, short breaks or long-term placements in family homes with fully trained shared live Carer's. People at the age of 18 and live with a physical or learning disability, mental health problem, autism, dementia or older people can really benefit from the support and companionship from a shared lives Carer who will welcome them into their home for a long or short-term period. This support could be outside of their family home or as an alternative to residential care home type setting to help them get the most out of life. And I have to say, I haven't visited this family and seen them in action. It really is very clear. It's not just about the care, but it's about being part of a family and just giving amazing choices and experiences to the vulnerable adults who were being looked after in this way. So, that was great. I pressed on from there to visit Westbrook House Integrated Care Centre. That is on the edge of Margate. Westbrook is one of our integrated care homes with the unit also provided by Kent Community Health Foundation Trust so that the building, if you like, is a bit of a joint venture. Services at Westbrook provide respite, rehabilitation and intermediate residential nursing care to older people. Generally, I would say older people with some quite serious and complex needs from my visit. Also at Westbrook are the home first team, which we talked about before at this committee. That's a relatively new joint initiative between ourselves and KCHFT showing how we can better get outcomes for Kent residents who need health and social care when we work in a fully integrated way. Under home first, hospital staff work closely with colleagues in the community and in social care to plan for a patient to return home from the first day they arrive. Patients have seen at home within hours and receive an assessment by a home first team made up of community nurses, therapists and social care professionals and actually all the staff working in the home first team, they all have then pathways for their career. Not just further through on social care, that's where they want to go, but also through the NHS. So it's very interesting to see that model and obviously makes for a very good kind of recruitment pitch for staff that they can develop their career, not just in a local authority or NHS, but potentially both. Every patient has a personal care plan and this may include therapy goals, support for carers and any equipment they may need as well as self-help advice, so it's very much a full service provided there by home first. Finally, with Penny and Andrew, visited the Integrated Community Equipment Service last week, their depot in Ellsford, which we jointly commission with KCC, sorry, with the NHS. The service provides community equipment such as specialist chairs, hoists, walkers and hospital beds as well as much more for children, older people and people with disabilities. The kit is key in promoting independence, social inclusion and quality of life and enabling vulnerable adults to live at home for as long as they wish, and it really does help carers and families stay together for longer. The service across Kent is provided by NRS Health Care, and you might remember that last, I would say autumn, we were involved discussing the community equipment service here. NRS sort of recently won that re-tender exercise. They have a team of occupational therapists within the setup there, really making sure that everyone gets the right kit no matter how unique their disability or challenge might be. It operates on an absolutely huge scale, we were very impressed to see they handled over 200,000 items per year. So next, we have the Dementia Friendly Kent Awards coming up, nominations have just opened, so if you know someone making a difference for people living with Dementia and Kent, please recognise their work and give them a chance of winning an award at the forthcoming ceremony. That will be at Valley Park Academy as part of a large-scale Kent Dementia show on Monday, the 21st of October. That will be open to the general public and professionals working in the field. This year we will be celebrating a decade of the Dementia Action Alliance and the 7th Dementia Friendly Kent Awards. The awards are organised by the Kent Dementia Action Alliance and the Association with ourselves and the NHS. However, small or large, every action is helping us build a more Dementia Friendly County. So, please do go on to the website if you have someone you would like to nominate via the online form. The deadline for entries is 30th of June. You'll remember that we had the technology-enabled live service at full council last month, and hopefully if you've got to see some of the new technology and digitally-enabled devices, which we are rolling out to our adults who can benefit from them, we've just gone through 300 people using that new service and who are now empowered to live more independently and safely in their own homes. Designed with people who draw and care and support, social care professionals and a leading care technology provider, the PA consulting led our GENTI partnership. The initiative creates care tech packages tailored to a person's individual needs, and over time it's hoped that similar technology will help thousands of people in Kent to retain their independence. If they have conditions that might otherwise prevent this. So, yes, thank you to the team there for helping so many people take advantage of that enhanced offering already. Finally, the Blackburn Lodge public consultation has closed. That finished on the 7th of May. Plenty of feedback has come forth from that, and that will be presented to the next Cabinet Committee meeting, which I believe is in July. Thank you, Chair. [BLANKAUDIO] [BLANKAUDIO] [BLANKAUDIO] [BLANKAUDIO] It's important, but collection is even more important. So, thank you for that. Now, Richard, I think you want to say something. Thank you, and... [BLANKAUDIO] Thank you. Thank you for mentioning Blackburn Lodge. I've had some lobbying in terms of that, and welcome the opportunity to talk about it in Cabinet Committee when it comes. You can imagine what those kind of representations were. You've probably had plenty yourself. My question is on the visits, which sound very interesting in and of themselves. I just wondered whether you took the opportunity to ask them, ask either those who are using the service or those who are giving the service, what kinds of things those service users who are on higher rates of DLA and PIP, how they used those higher rates in that service, what a difference it made to them, and what would happen if it was taken away by the county. Did you take that opportunity? So, as always, with these trips, actually, who you meet in terms of vulnerable adults is somewhat by chance, who is in that day, and it's not actually always appropriate to go into that conversation. Also, it's a public space. I've never actually with a vulnerable adult on my own, and therefore, just because of sort of confidential aspects of that conversation, I wouldn't hold that. But in regards to that type of feedback, I can certainly assure Mr. Dripfield that I've had lots of feedback from such residents and their carers in recent weeks, so quite aware of the impacts that those changes could make. Actually, Chair, I will just say one point in relation to what you said about NRS, and sorry to hear that the experience was not strong, but on our visit to the depot, they actually do as many collections as they do deliveries, so they do over 100,000 per year on each, and they have a really strong commitment to recycling, and we asked a lot of questions about recycling, because you might remember when the contract was re-precured and it came here to committee, that was a big focus of the questions we had for the officers at that time about improving the recycling offering, and it's very impressive, they have one whole factory warehouse dedicated to bespoke items which have been made for someone with a very specialist need, but they won't assume that they can't be used by other people, and they do store and hold on to them, so they do collect them, store and hold on to them to be recycled at a later date, that's as well as the more general standard offerings which they collect, clean, recondition, and get back out the door to other people who need them extremely quickly. So yeah, a good operation there to see, but like everything in life can always do better and pass the feedback on. Thank you. Thank you. First of all, I'd like to congratulate Sidney Hill, who's behind me at the moment, who has been on the interim director, but this week was confirmed in post as a permanent director for our social care. We also like to thank all the members that were involved in the panel process, I think I really agree it was a rigorous process, and we also had a very high level. When I looked at the names on the stakeholder panel and the partner panel, you've got a couple of chief execs on there from big trusts, so by means it was a rigorous experience, but I just wanted to welcome Sidney. On a note to that, again, I've been involved in the recruitment process a few times in Kent, and we are starting to attract a significant number of applicants. We had 18 applicants for this role. I interviewed five, and I think people agree that three went from the technical into a very, very high caliber. So that gives an indication of the caliber that we have in Sydney here. Also, I'd like to recognize this week is Mental Health Awareness Week midway through. It is a week that we recognize mental health, but it's some of the stats are quite frightening sometimes, aren't they? When you talk about one in four of us will probably experience some mental health episode or support requirement through their life or know somebody who does. Again, take an opportunity just to say hello or check in or have people feel it as well. This is not our own mental illness, it's mental health well-being. So a couple of things, CQC submissions. Obviously, people aware from my last update, we've had our notification. We know we're going to be inspected within the next six months. We're two months into that now, so we are expecting any time now. I'm hoping it's not going to be over summer break or summer period, but again, just we are constantly looking at the preparedness for that. We had done our own self-assessment, that was submitted, identified some areas of strength, but also some areas where we know we need to work harder on. Certainly one area that came to the fore was around understanding how easily ignored and overseeing communities and how we quantify support for those who ignore communities and can. That's not unusual up and down the country, that's an area where I talk to my other past colleagues going through this process, it's an area for the inspection that I think we're all struggling with. So we've got some work to explore there, and also our partnership and our partnership work. But on the whole, I think it was a true reflection of where we are and where we see ourselves. That being triangulated, we had a local association came and did a two-day peer review for us and again identified areas of strength, but also areas where we can do some development and do some work which, healthfully and thankfully, coincided with our own self-assessment as well. So what I'm seeing as an organisation is an organisation that knows itself, knows its strengths, but also knows where it needs to work towards. And just to reassure people that the CQC process is assuring our plans for improvement. So it's really important that we know ourselves. This is quite unusual for all the times I've been in or out of a director. I've always attended our spring seminar, which is the eight-ass spring seminar, and taken colleagues with me. This year we decided not to do that, because of finances and the lens that people look at, they don't look at us through if we don't go in the way to a conference, but also recognising that we've got a huge amount of talent in Kent, and we had our two-day away day rather than going to the conference to look at some of our challenges that we're facing, our finances, our savings programmes, but are dedicated two days away. However, Kent, and I think this is really something Kent to be proud of, were represented at the spring seminar by Peter Zane. Peter Zane is somebody who draws on social care and support. He shares our digital groups. He was a key person in leading the commissioning of our digital offer, and was asked by aid, asked to do a presentation. It was very well supported by Gina Walton as well. So while my leadership team had a couple of days in Sean Park, which was lovely, Peter's sort of the opportunity to go and promote Kent on a national stage, and following that he has been asked to do some more national work as well in that space of co-production. I've had a few visits. Again, I've been to visit the Early Gestures and Planning team. This is a small, but perfectly formed team. Very professional people that work on supporting people to be discharged out of our mental health acute trusts. An area of significant growth and challenge. And I think, you know, a key area where we need to have our partnership and partnership work put together. We've had our Joint Commissioning Management Group. We've now got quite established. I think we've had conversations here about the Integrated Care Strategy, the Integrated Care Board, and how does that operate? How we operationalise in that? Well, our Joint Commissioning Management Group brings together offer senior officers from Kent County Council and the ICB to look at areas where our agendas meet. So we sort of, again, that's been, I guess, had a jittery start, but I can certainly see some green shoots there. I saw the opportunity as well to talk to graduates. I've done that before. I talked to a graduate program. Lots of graduates come in from GET and in GET services, and gave me the opportunity to talk about where the action is at, which is social care, obviously, not in GET. But it was a real good opportunity to speak to some people that are new to the services. And on that, I had an open door, one of my other open door sessions, which is, again, sometimes when you're in this job isn't easy all the time, sometimes when you're in the depths of dealing with things where you've gone wrong, when you get the opportunity to talk to frontline staff, I'm continually impressed and sort of surprised about people's tenacity and commitment. So my open door session is that anybody can come and talk to me for 15 minutes, but end in, they want to, and that translates into some action plan. On a final note, Mr. Richard, I understand this is your last... From an officer's point of view, this is your last committee, isn't it? And I just wanted to say, from an office perspective, is this can be quite a daunting environment for people to walk into, and you do make officers feel very relaxed and very... It's hard to thank you for that, and thank you for the commitment to this. Just one on the self-assessment. Are you able to share that with members ahead of any possible CQC inspection, just so that we have a likely view? It's, yes. The self-assessment's going through, it's gone through its due diligence. It's a live document, so it's a time and place. We develop and move forward, and those areas are weaknesses. We've, ultimately, it's whether we publish or not publish, it's internal or external, I've had that debate. I've had a conversation with my corporate management team, and Amanda Beer, around, Do we put it in the public domain? There is nothing in there that I think is contentious. Or do we do it? How do we do that, in what place? It's ultimately me and my decision is a task, but I don't see there's any reason why we wouldn't circulate it internally at this point. Thank you very much for that update. I just wanted to ask you about the Integrated Care Strategy and the conversation you've been having. In general, are there any barriers that I'm not expecting you to save money, of course? Are there any barriers that you can see, in general, that may hinder that moving forward faster than it could otherwise? Other than money. I mean, that's a really difficult one, isn't it? Because you've got two parts of a system, and we talk about system. We do need to talk about the Kent Pound, rather than the ICB Pound and the Kent Pound, but both Adult Social Care and the Integrated Care Board are under extreme financial pressures. And the challenges in this place, we need to be brave, and we need to be ambitious. But we've also got to be sustainable. So why the Joint Commission and Management Group is so important. It is an environment where we can come together, we can think about things where we've got a shared understanding. So one of those, and I don't think we had that before. The workshop that we had was around getting some working principles about how we're going to work together. Both parts of the organisation are going to fall out. We're not going to get on, ideally, all the time. There'll be areas of tensions. Hospital discharge is one of those areas of tensions. We've got to come together in that space, and that's an area where we're looking for an opportunity, as Mr. Watkins described, as we've got some green shoots around the home first team, joint funded posts, joint training opportunities, single leadership with a single area. So I think that's really positive. I think we need to build on that. But you can't underestimate the challenges of the finances. And I don't think you can take that out. So I think in relationships, I think, are going to be important. I think we need to create environments where we come together to get to know each other. I think there's a difference between the relationship and operational level. I think Sydney and the team could tell me otherwise. But I think at an operational level, they're all really good working relationships. I think it's probably when you get to talk about the money, it becomes difficult. And I think, yes, I absolutely don't dismiss the financial side. But I think it was the cabinet member who once said, sometimes, you know, in business and that, if you have pushed up and had a challenge financially, sometimes it gives you the opportunity to do things better and in different ways. And that's what I've held on to, actually, because it does give us that opportunity, and you've just spoken of that. So it is very positive. And I think we should look at it like that. Thank you. Thank you, Dan. Thank you for your kind words, Richard and both of your reports. We'll move now to item six. This is pages nine to 66 in the company papers. Did you want to open with anything, Dan, or should we go straight to the presenters? Yeah, OK, so presenters Sarah Denson with support from Misha Goldsmith, Michael Thomas Sam and Gina Walton. So over to Sarah. Thank you. Thank you, Chair. Good afternoon, everybody. The self-funded arrangement fee is about the Council's proposed change to its charging policy for adult social care provided in the person's own home or in the community. Specifically, to introduce a new arrangement set up fee for all new self-funders, that is people who have over the capital threshold and who request the Council to negotiate, arrange and manage care and support services with care providers on their behalf. A public consultation on the proposal to introduce an arrangement set up fee for all new self-funders was held from the 6th of February to the 7th of April of this year. A self-under is a person who has over the upper capital threshold as determined by the Department of Health and Social Care and is deemed by the Care Act to be able to pay for their care and support in full. The details of the consultation outcome are attached in the reports that you have. The Care Act places a statutory duty on local authorities to arrange care and support for a person with eligible needs who has more than the upper capital limits if the person requests it, and this duty only extends to non-residential care. These people are not entitled to receive any financial assistance from KCC and pay the full cost of their care and support until their capital falls below the upper capital limits. The Care Act 2014 also sets out the legal framework for charging for care and support under sections 14 and 17. The Act gives local authorities powers to charge a person when arranging non-residential services for self-funders. KCC currently charges self-funders an annual arrangement fee which is paid weekly. The proposal is to increase the annual arrangement fee to cover all costs incurred, including the negotiation, arrangement and management of the care and support. The changes proposed continue to be in line with the Care Act. The Care and Support charge in an assessment of resources regulations of 2014 and the Care and Support statutory guidance. This has also been confirmed by the legal advice which has been sought throughout. If approved, it is proposed that the new arrangement fee would only be charged for new people who are classed as self-funders and would not affect existing self-funders currently supported by the Council. My colleagues and I are happy to respond to any questions or queries of the committee. Thank you. Do we have any questions from? Yes, Jenny Hawkins. Thank you Chairman. So, I've got a few questions. As part of the financial assessment, what does a person's income need to be to be classed as a self-founder? Is KCC expecting there to be an increase in self-funders? How many people does KCC expects will choose not to use the service once the fee is introduced because they see it as prohibitive? And given that the cost of living hasn't reduced, how do we expect people to be able to afford this additional cost? Thank you. Yeah, thank you. Thank you. I was just trying to capture those questions because there was quite a few all at once there. So, for the self-funding arrangement fee, it is people who are deemed to have the upper capital limits. So, they've got over 23,000, 250,000 in capital assets. And the care act has said that those people can fund their own care. So, that's set by central government by the Department of Health and Social Care. I think in terms of self-funders, we have about 100 at the moment, is it Michelle? Oh, is it more than that? Sorry, I'll print Michelle in the spot. Sorry, I'll just come in, yeah. So, we find on average is around 400 new self-funders a year. At the moment, we had about 600 in total, but each year we find there's a 400. But as we have new starters, there's people that will end as well. So, on average is around 400 a year. My other question was about people, you know, they may find this a prohibitive cost initially, so they may choose not to use the service. Is there a way that people can pay this monthly or do they have to pay it all up front? So, as part of the process, we did a quality impact assessment to understand what the impact would be on individuals at the proposal and considering what the mitigations could be. So, within that, we look at the type of support, information advice that's available to people so that we can sign, post and connect people to relevant support. But also, within the quality impact assessment, we identified that if individuals were unable to pay the service, so there's what the proposal is, is that there is an initial one-off fee. It starts the process and then there's that ongoing weekly fee. But if there is an issue around paying that, then options would be considered. Maybe that initial fee being divided over the year if needed to be for that individual. But we have identified mitigations within the equality impact assessment of how individuals could be supported. Thank you, Chair. I'm actually quite shocked that we're bringing this forward when we've only had 43 responses to the consultation. That's not enough. People feeding back in for us to go, We're going to put up the fees. I'm sorry, it's just not enough. It makes absolutely no sense whatsoever to do this. It's actually shocking when you go through part of the equality impact assessment where, let's be honest, as people get older, they get to a point in their life where they are on a fixed income. And it's natural for people to want to save money because they get scared. Therefore, more of them will choose not to come into this scheme. And it states quite categorically that there's going to be a possibility of increased self-neglect. Safeguarding issues, it's quite possible it's going to put even more pressure on carers because as it states quite categorically, carers do not have access to the people they care for accounts. They cannot force them to join. And therefore, there will be quite often more pressure on those unpaid carers, which if anyone saw, and I think it was the network news or whatever, news night, the other night about unpaid carers, they're under so much pressure at the moment that they really are on their last knees. If we put any more pressure overall on that system, it's going to fail. We're going to have people with safeguarding issues. May I suggest we re-look at this? 43 people coming back is just not enough for us to change a whole policy on this. It's just not right. Thank you. Thank you. I think there's going to be some agenda items this afternoon that are going to be quite difficult to discuss, and why not difficult to do us, or need to discuss. But can I just ask the questions on the offices have done the piece of work, the offices have done the consultation, and they're presenting that information to cabinet. So I think some of the questions need are probably not appropriate for offices to comment on. These are not officer decisions. They just want to, you know, probably we're there to advise. Yeah, I will just come in, and I'm sure Gina will come in as well, about how we did try to target specific groups of people. And again, that's written in the consultation outcome report. We noticed that there was a lull in responses that people were clicking into the site to look at the consultation, but then perhaps weren't then completing the questionnaire. So we did some targeted social media, and you can see the spike in the graph for where people then did respond. We particularly targeted specific age ranges, and we also targeted particular postcode areas as we analysed that we were missing, particularly areas across Kent. I don't know, Gina, if you want to add to that at all. Yeah, so at the start of the consultation, we wrote out to all existing cell funders. So that's around 600. But we were also trying to reach out to the wider population, because there'll be people that are potentially cell funds in the future that this proposal could impact. And that was then through various routes that Sarah has just mentioned. And that throughout the consultation, we kept an eye every week on the activity and the data, and making sure that we had conversations. We paid for social media to raise the profile of the consultation, to open it up and raise awareness to the population. But people may have thought at the time it wasn't relevant to them, but we looked at different ways to engage people throughout the consultation, as well as going out to virtually speaking with forums and care providers to encourage people to participate. Yeah, sure. Please, I'm not denigrating any of the good work that you've done, because I'm sure, and in fact, I'm absolutely positive you reached out as much as you can. But for some reason, it just seems that this particular consultation doesn't seem to hit the spot to maybe give us the wider input that maybe we need to actually look at the decision, but thank you anyway. Thank you. I think I'll bring in Dan and then Richard afterwards. Dan? Yes. Thank you, Chair. Yeah, and to Ms. Louise, you know, good point there. Actually, when I became aware of the response rate, I asked the officers the same question. I did seem quite low, but actually having thought about it a little bit more, this is quite a small cohort of people. And actually, if you achieve, say, a 5% response rate in a survey, any of us who've done a lot of surveys, a lot of us who've done a lot of public consultations, both as county counselors or district counselors, will know to get 5% is actually quite reasonable. So, and I was satisfied as hopefully you feel now that the team actually were quite proactive in getting out there to get as many responses as they could. So I think a little bit of this is just, it was a small cohort of people, and that made it challenging to get a large number. Always better to get a big sample size, but on this occasion, I was satisfied that we had done all we could, really. [silence] Yes, I've got one technical question, and I've got a few political ones. The technical one is, am I right in thinking that this is going to raise just 140,000 pounds a year? Yes, that's great. And, assuming the 400 which we've estimated is the number of people coming forward, that could be less, or it could be more obviously. And so, my political question for the cabinet member is, how do you think that the first 140,000 pounds a year that you try and raise comes off this group of people? How is that politically acceptable to be charging people for their care and for an arrangement fee that's going to get you 140,800 in a budget that's 1.6 billion pounds big? It seems that we're risking a huge amount of reputation of political goodwill from our residents, of potential for administrative cost, for the sake of 140,800 pounds. It doesn't make any sense. And all the things that Ms. Mead and I'm talking to were talking about, it could be true. There will be people who see this as kind of going to take their money because we're going to charge more and not going for care. So has anyone done the risk assessment on the basis of what kind of impact this is going to have on the actual care of our residents for the sake of 140,800 pounds? Because it doesn't seem to me that the political sense check has been done on this. In fact, quite the opposite. You've asked officers to come up with any which way, no stone unturned way of saving money, and they have done their duty and come up with this. But it is absolutely a premium case of it being absolutely ridiculous that we're going through this for 140,000 pounds a year. Yeah, I mean, the officers maybe could dial a point about kind of risk assessment on that point. But I mean, I would make a few points here. The survey was interesting. Obviously, the public broadly speaking, half of them support the change, half of them are opposed. In terms of who will be paying this extra amount, you know, it is better off residents to be classed as a self-under. I think it is reasonable on balance that they would pay a few hundred pounds more to be helped to find the appropriate care package for themselves. Because as colleagues have explained, you only get assessed financially as a self-under if you've already got significant financial assets. But yeah, your points are noted. Sure, thank you very much. I think this is just another example of the inability of certain members to accept the financial reality that we are in here. And I've made this point many times. There isn't a magic money tree. This is not a easy decision, I'm sure. But the reality is, if we do not ask those who can afford to pay to cover the costs, then we are putting that burden on people who can't afford to pay. Because that money doesn't come from anywhere else. There is no magic pot of money. And if you're saying to people who've got £24,000 of savings, which I admit is not a huge amount after a lifetime of work, but there are many people with no savings at all, if we say to people who can afford to pay, you don't need to. Then the reality is, others who can't afford to pay will be paying through their cancer tax for those who can, and that's a very simple reality. I think 70% of local authorities in this country, including Labour and Liberal authorities, charge for this service. It's not a brutal decision to be made unilaterally by Kent. And from the figures I've seen, we're probably at the top end of the charging fee. We're certainly not at the top. It's difficult, isn't it? Because the alternative to making these savings is going the way of Birmingham, and Croydon, and Woking, and all those other councils, where we end up with government commissioners coming in and imposing those cuts on all discretionary spending and putting up times to tax by 10 or 14%. I think it's absolutely a moral chairman that a council that does actually try to balance its books gets continually penalised by this government, to be honest, where if you go into Section 114, you're allowed to spend more money and you're giving money. Yeah, that's a reality that we have to face. But I don't see the alternative. The opposition here opposed every single funding cuts since I've been here. Where's the alternative? It's only 100,000 said to Richard Stretfield. It's only 40,000 here. It's only 2 million there. What is the alternative? Thank you. Thank you, Chairman. I just want to come back to the risk issue. To be honest, I think the risk of people not going into self on their own care in residential nursing care for it, because of this minor change in the fee is minimal. If at all people can choose to organise their own care themselves, they don't need to come to local authority. So I just wanted to get my professional opinion is that the risk to this small number of people with over above the capital gains is minimal that the people will choose not to go into residential care because they've got to pay an arrangement fee. Thank you. It only takes one. That one person not taking it up because of the fee could cost us in social services along the line way over 140,000. Really can. You've only got to take a completely different scenario. Some of the SCN transport costs. Just as an example. Two of them could quite easily come to 140. What we're saying is level playing field. We're charging them on a weekly basis for this service anyway. Don't charge them and push some of them away initially. And as for the magic money tree, well, I do believe that after the budget, an extra £50 million, I think it was, was found down the back of the sofa somewhere and was put in reserves. So why don't we use some of that to help some of our most elderly and vulnerable people who've saved all of their lives so they don't have to pay this set up fee because they will be paying on a weekly and monthly basis anyway. That's my response. We're not suggesting there's no charge. There is already a charge for this. This is the increase in the in the charge. And we are talking about something that is going where it's clear that the value of it has been calculated or the cost of it's been that we've calculated, but the value of it has not. Because we've got a situation where we're only going to raise 140,000, but we've put out a county wide consultation that we're putting up charges. Now, in terms of the advertising and the impact that has on that group of residents who, if you've worked all your life and paid all your taxes and you think you should get a, and you've got 25,000 that you're hopefully going to pass on to your, your family. I would have anticipated that the conservative position would be that having worked hard all their life, they should be able to pass that on, not the liberal position. But that's what your matters, the argument you're making, it is the argument you're making. And you're doing it for a, a hapony of the budget. And I think in this instance, we need to step back, have a look at what the impact could be overall, have a look at the amount of money that we're going to be raising and think, hmm, maybe we've got this one wrong. Maybe we can leave the charges as they are, because of the overall impact that would have, and find 140,000 in the very loosest of loose change that this county council has. Thank you for all your comments. Thank you for the assessments. Thank you for the responses. I think Richard made the point that it's actually going to impact on very, very few people. I think that's a good guidance for me. We are asked to make the recommendations of considering endorsing this proposal. I'm guessing that perhaps we're going to need to vote on this. So can I ask, first of all, for those that are in favour, please? Can I ask those that are against? I think that's everyone's voted, so there are no abstentions. So what is the result of the voting? So that's a 6-4 and 4 against. So it is case. I'm going to assume that we want to record it votes. Yeah. Okay, we can do that. Thank you. Yes, thanks, Chair. Not to talk about the topic so much at this stage. I'm sure we'll have a thorough discussion. We're just going to say, obviously, the subject matter is very challenging, changing, charging for disabled people. It's not done lightly. Obviously, background to this is the part of the state of the Council's finances. I just wanted to say, it would be very interesting to see what the recommendations and alternative proposals that people are going to make this afternoon might be. So with that, I should pass on. Thank you, Dan. And we've got the same presentation team, Sarah Denzoon, Michelle Goldsmith, Michael Thomas-Sam and Gina Wolf. So over to Sarah for the lead in. Thank you. So the report on the higher level benefits item details the proposal to change the adult social care charging policy for people who receive care and support in their own home or in the community. Between the 6th of February to the 7th of April, 2024, KCC held a public consultation on proposed changes to the current charging policy for non-residential care and support services that are provided or arranged at home and in the community. The proposal is to stop disregarding the higher or enhanced rates of attendance allowance, personal independent payment or PIP and disability living allowance or DLA when a person's accessible income is calculated. Currently, the charging policy takes into account the lower, middle or standard rates of these benefits. And again, the details of the consultation outcomes are in the attached reports that you have. The Care Act of 2014 details the Council's statutory duty for assessing an individual's care and support needs as well as setting out the legal frameworks for charging for care and support under sections 14 and 17. The Act enables a local authority to charge a person when arranging to meet a person's care and support needs or a care as support needs. For people in receipt of care and support in their own home or in the community, regulation states that the charge must not reduce the person's income below the minimum income guaranteed as specified in part 4 of the care and support charging an assessment of resources, regulations of 2014. The minimum income guarantee is to ensure that people have enough money to meet their daily living costs such as food, rent and utilities. Once all applicable deductions have been made, KCC will use the remainder as income available for charging. The changes proposed continue to be in line with the Care Act, the care and support charging and assessment of resources, regulations of 2014 and the care and support statutory guidance of 2014. And this has also been confirmed by the legal advice which has been sought throughout. If approved, the proposed changes may mean that people pay more towards the cost of their care. Thank you. My colleagues and I are happy to respond to any questions or queries from the committee. I thank the officers for the report that I used to be an officer in the Ministry of Defence and I know when I was writing reports where difficult decisions were going to have to be made. That very often there would be code written into the report that flashed red to anybody who knew the subject and was about to read it. The fact that powers 3.3 and 3.5 are written in bold represent something of that code. I would not going to ask the officers whether that's the case or not, but I know it to be so. This represents considerable risk to the council regardless of where the money comes from. The fact that we're going to the most vulnerable group in our society for 3.5 million pounds speaks volumes about the way this administration wants the council to run. The fact that it is in a powerless financial state doesn't mean all bets are off and the only place we get money from is from the most vulnerable. Even reserves is better than this. Even one off reserves for the year is better than this. It's what kind of a council we want to be, what kind of people we are, the social risk that's not factored into this to the individuals themselves. I asked Mr Watkins earlier, did he ask those individuals on the visits, what that money was actually going to be used for? Because we are taking, after food, rent and utilities, let's think about that, just food, rent and utilities, we're then taking their personal independence payment. The only other income that they get. I feel sorry for the conservative backbenchers because I'm going to put you through it three times. Today, in scrutiny and a motion to full council and you're going to have to vote for it again and again and again because it's not acceptable. There is a legal risk to this that is flagged loud and clear in the officer's report. What's the cost of defending a claim against the council by somebody who's disabled, both in financial terms and in reputational terms for this 3.5 million? Clearly, it is clearly flagged by the officers and it's been accepted by the administration and delivered to this committee in a way that is totally unacceptable. And I know that in a minute, there are going to be members who say there are other councils who charge this amount for those vulnerable people. All I can say to those councils is two wrongs, do not make a right. This is not how we compare ourselves to other councils. We set our own standards about the county we want to be. Throughout the report, there's great big WTF bubbles lining up from those who are administrating. In the best way they can, the council, despite the financial conditions, and we have a responsibility as members to say, no, we do not want to go this way. We want to go a different way, executive, go back, think again, this is the purpose of the cabinet committees, go back, think again, find the money elsewhere because we are not going to take 3.5 million quid off the most vulnerable people in our communities. It is that serious. So, my question, I'll come to it. Thank you Mr. Richard for your patience, is what kind of county do we want to be, Mr. Watkins? Well, we of course want to be a compassionate county that delivers good quality services for all of our residents. But I think it was Harold McMillan who said, as a former Prime Minister, that the only way that you can help the most vulnerable in society is if you have a function economy which makes the books balance in the first instance, we can only pay for all of the good stuff that we do about that. And this is only one aspect of what we do. But you can only pay for that if your books do balance. And so what kind of county do you want to be? I mean, it absolutely is critical. I want to be a county which has a sustainable financial future. That isn't just something that has passed down to me and other members on this committee by our colleagues in finance. That is a truly held belief that we have that we don't want to run out of money at which stage an inspector will make this and many more other cuts. And we'll put up council tax probably by 10 to 20%, which all residents will pay. We'll be in a worse position and we'll be a council with a huge democratic deficit because when the inspector comes in, we lose the power. So that's the kind of county that I want us to be. And it's easy to say, well, we should be different from all the other conservative and Labour and Liberal Democrat councils who've done the same thing. But I do wonder if Mr Shreffel would look leader of a Liberal Democrat council in the face and say quite the same things that he said to me because we're all governed by the same reality. And just as your Liberal Democrat colleagues who run councils made this very difficult decision some years ago, now it happens to be a conservative administration, which is doing it. But ever since the care act was changed 10 years ago, it's been possible for local authorities to make this change to charging policies. And I'm aware because the officers have briefed me that we are doing it later on the most. That's why majority of councils have already done it. So it's an incredibly difficult choice to have to make, but I will have to make in the coming days. But I don't want to be part of a council, which runs out of money and then fails all vulnerable admins completely. We're not running out of money because 3.5 million quit has come from the most disabled. We're running out of money because we have a demographic issue in adult social care that isn't being funded by the central government. And we know that. So we can go into any kind of financial round with our heads held reasonably high, knowing that we don't have to make those decisions, which we know the reason why our council isn't being funded correctly. But in choosing to even start to fill the hole in the dam with the money of the most disabled, we are going beyond the pale. Let's not beat around the bush on that. And I will very happy because I said we're going to come back three times on this, come back next time and find out what other Liberal Democrat councils are doing to make good. Because there are potential things you can do in other directions to give. So, if the most vulnerable are getting other services that enhance their lives, that would might be a balancing commitment. But here, there is no balancing commitment. In fact, everything is going in the wrong direction. So when you visit those people, it is a chance to ask them what they do with that money, what it goes for. And find out the reality of what's behind the numbers of 74% strongly disagreeing that this is a good idea. I'll leave it there. I will come back a little bit on that. Maybe you will give me some at this meeting today. It's your choice if you want to keep calling it in. But at some stage, I would love to hear what they are. That would be useful if we heard some of those points today. But I would also just make one other point. There are aspects of our service which are improving. We have invested in a better technology enabled live service which this cohort people were discussing with this change of charging policy will benefit from that. We've seen it. We know that's a good service and a big step up from what we have before. As I said in my introductory comments, I visited the Community Equipment Service last week and through the re-tendering there, we have enhanced that service. It is better than it used to be. We are giving more to people who are disabled. So I think we can say across the spectrum of services we are delivering, we are always looking to improve and we have delivered some improvements. This is a tough subject and the thing is the savings of almost £4 million per year and they are every year. So you can't balance with one off reserves. I think I should address that point. It would have to be an alternative saving of almost £4 million every year. But I'm really interested to hear what other recommendations are the proposals there are. Thank you. Thank you very much, Chairman. Earlier on in the discussion I heard our officers refer to. I do want to thank our officers for the work they've done on this. They've done their work. They've done a job. I believe they've done it well. So thank you. I don't mind being lectured, Mr Chairman. I don't mind how many times this comes up. But again, alluding to what our cabinet members just said, come on, let's have the solution. This hasn't just popped up today. Let's hear these impassioned outbursts about how awful we are. Let's hear what you're going to do, Mr Strepfield. Let's hear, and why haven't we heard it before? We haven't. I haven't. So, you know, it's already fine to lecture us. But let's have some solutions because they're not forthcoming, are they? This council is unique. What other councils have do is absolutely it will give us insight. But we have a job to do here with this council and our officers have done the job that they've had to do. And I commend them. But let's have some solutions, please, from you, if you can do it better. Thank you. Thank you. I'll just stop by saying there were quite a few budget amendment proposals in the budget that didn't go through. And, you know, so there were other options put forward. I'm just picking up on a point that Mr Strepfield made. 74% of people who responded to the consultation strongly disagreed with the proposals. And I don't believe anybody agreed with them. In the legal section, it says that people's views in this consultation must be taken into consideration. So my question is, will those views be taken into consideration? Yeah, I mean, so thank you for the question. I mean, I would note that the full council discussion on budget, which I was present at, as I recall, all of the proposed changes of any significant values. Not including things like using this venue as a pub and things like that. But of significant scale, they were all balanced by spending more money on reserves. That was it. I could not name one, which wasn't essentially saying we have to borrow more money in this year, and then maybe in the future something happens to balance. So, you know, as we said at the time, that was just a big gamble. On your specific question. So, would you remind me? In the report, in the legal section, it says that people's views in this consultation must be taken into account. Yeah, so although we'll see the officers have worked hard looking at various mitigations, and you've seen there's half a dozen in there. And you've seen that the various administrative and financial challenges with those, they will be considered. There is in there an allowance for, that's been made in the budget for an increased level of disability related expenditure allowance. And what that means in practice is we have budgeted to provide, to give a higher, if you like, disregard to disabled adults who can evidence a higher level of cost. That their individual circumstances dictate such that we shouldn't essentially charge them as much. So, that is an area we've been looking at really, really carefully, and there's worth some further consideration. Thank you, Chair. It would be lovely for this point to be a member of the opposition, really, because it's an easy decision to make, to say, to disagree with this. And, you know, I'm sure we'd all be sitting here thinking, yeah, I'd love to disagree with it and vote against it. But unfortunately, when you're in the administration and you have to make really, really difficult choices, and this is the hardest choice that I've ever had to make. And I've been on this committee since 2009, and I know we have looked at it two or three times in the past because other counts, a number of other councils have already done this. And we have looked at it and disregarded it because it's such a difficult decision. So, it's been put off, often put off, many times, and I think we've come to the point where we all know our finances are in such a difficult situation that we've got to the point where 3.7 million is a considerable amount of money and that if we don't save this, where we would have to find it from somewhere else. And I think, you know, Mr. Strepfield may say, take it from the reserves, and that's one off is all very well, but we have this conversation every year. One, it's not a one off. You know, if we did it one off this year, we'd have to look at it again next year. If Mrs. Binks was sitting here as chair of the audit committee, she regularly tells us that the auditors are not happy with our level of reserves, and we cannot take any more money out of reserves. Otherwise, they will be even less happy with us. So, I just, I hate being sitting here, having to make this decision. It's, it's really awful. But if we don't do it, as Mr. Watkins said, I think we are quite likely to be in a situation where we won't, we won't be, there's no point in us being here because we won't be here to make the decisions. Other people will be making them for us and not be thinking about the residence at all. It will be cross-line here. We'll take that money out there. And we as members who have been voted in by the electorate will have no choice in what we decide to do. So, no, I don't like the decision. But I don't feel we have an alternative unless, as you say, there is a miracle other choice to make because it's not just this decision where we are looking at a range of ways to save a huge amount of money in adult social care over the next year, which is all going to be very difficult. Thank you. First of all, I think we're in great danger of being accused legally of discrimination against disabled people if we vote this through, which actually obviously opens us up to all sorts of legal and financial problems. The very fact that this states that almost everybody who's severely disabled will be negatively affected and we are supposed to be listening to what people say in the consultation, that's a big issue for me. I think it's important that people understand what PIP is actually used for. I know because my husband's on it. Personal independence payment, it's not based on your level of income, it's based on your level of need. And within that PIP care, it pays for things like, Oh, I can't walk very far, so I need to take a cab so I can go and have a coffee with a friend. Something as simple as that, that most of us would take completely for granted. It could be, Oh, I need, I don't know, some sort of nice smelly bath salts because these particular ones, even though they're expensive, actually really help my rheumatoid arthritis. But what we're saying is, No, actually what you've got to do is sit there, we'll come and change you, we'll feed you, but that's it, that's your life because we're going to take every single other penny away from you. That's not life. People deserve an awful lot more than that. We cannot do that to people. And you're talking, Where are the solutions? Well, the solution was actually in our alternative budget, if any of you would have liked to have gone through it, Oh, laugh, go ahead and laugh. But the administration took some of our ideas from last year and brought them into this year, so it can't be that much nonsense. Have a look at that alternative budget. Look at where we're going to make cuts and make alternatives where we could have funded this. But because there are only seven of us, magnificent seven of us, it was always going to get voted down. Yes, I know, I am smiling as well. But it's important, we cannot do this to people. We need to find the money, even if we go and bang on the door at number ten. We cannot do this to our most vulnerable people. It's just inhumane, expecting them to sit there, be fed, and that's your life. Because that's what will happen if this is actually brought in. Sorry, no, absolutely not. Thank you. It's just to answer a few of where my name has been mentioned in the debate. I think I owe that various members a response. Because it wasn't me, Mr. Chair, who said we should use reserves. It was Mr. Gove, who said we should use reserves. Because this year was going to be particularly difficult, and there was a case, and this is it, for use of one-off reserves until the economy turns. Because as Mr. Watkins rightly points out, it's when the economy turns, and you get more taxes in that you can then spend and give more grants. So, by using his own logic, knowing when the economy will turn, and when we might get a bigger grant, this is the moment to decide what kind of county we want to be and use our reserves. So that we don't have to step over the line to tax, let's use the word that should be used for this, to tax our most vulnerable people's income. You wouldn't contemplate putting taxes up against anybody else, would you? Not in their income, penny on income tax. And I know, Ms. Hamilton, I don't wish to let you, I'm imploring you. Please do not vote for this. This isn't a lecture, I'm just pointing out what's on the page, what should be blindingly obvious to everybody, that this is beyond the pale. And on Mrs. Cold's point, as I said in my own remarks, I do feel sorry for the Conservative backbenchers in this Cabinet Committee, because to govern is to choose. And they are being presented with an ignominious choice by Mr. Watkins, and they're being whipped to do so. Because I doubt very much knowing Mr. Kennedy and Ms. Hamilton from three years here, and indeed Mrs. Cole and Mr. Me, that this is being done voluntarily. Can we stop speculation? Well, yeah. Thank you, Mr. Viewer, patience in your understanding. I just would say once again, if we vote for this, we will be having to vote for it again and again and again. Thank you. Thank you. I'm not taking any more questions. This was always going to be a very contentious item. And I think everybody's been fair and honest, and I do thank you for the seriousness of the debate and the questions and the answers from the teams. It's not something that's wanted, it's something that's been proposed by the Conservative Group. And as a committee, we're going to be asked to consider endorse and the recommendations to approve and delegate to the changes to the policy and delegate authority to the corporate director. Clearly, there will be a vote on this, and I assume it will be a recorded vote. I need to go through the process of those, please, that now support this paper. Can you raise your hands? Those that are against this paper. There are no abstentions as everyone voted. Can you now make the declaration, please? Thank you. Six in support and four again, so it will be carried to recommend to the Cabinet Member to say decision. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. So you have enough to that who is in the room who can talk through some measures going forward, and then obviously we'll pass for questions for members. So just in terms of a high level summary of activity over the quarter four period. What we saw throughout this period was increased demand across all key measures, but also I should care. So we experienced more contacts from the public, more requests for care needs assessments, more does applications, increased volumes of safeguarding concerns and more people presented with needs for current support as a result of mental health. What we saw is a positive outcome, though, is despite some of those higher contacts, we were able to see repeated contacts kept to a minimum. So that's where people contact at all social care, have the issue resolved, and then don't need to come back for a three month period because we're able to resolve the issue in a timely manner. We did see an increase in the delivery of care needs assessments in the quarter. It was a 2% increase, but as you'll see from the pack that's available for all of you, this is a measure that remains below target. We saw a decrease in our use of shorts, they're beds, which again is an area of practice that we are focused on. And one of the concerns that we've definitely seen since the build back from the pandemic is an overuse of shorts, they're beds and prolonged periods of time in shorts, they're beds can regrettably lead to individuals becoming permanent. Residents in care homes, whether nursing or residential. And again, as you'll see from the key performance measures in the park. This is an area of performance that remains. It's rated red. It's above where we'd want to be. So technically we're not meeting our target. Whilst we get to see an increase in those applications, our ability to process them in 10. So our overall position of people wetting an assessment of their deprivation of liberty hasn't deteriorated. Regrettably though, and again, this is on assessments and people wetting a review of their current support needs. We are still seeing a high number of people with outstanding queries in those areas. And that also relates to self gathering inquiries. So in terms of the actions that we've taken as a result of this and some of the actions that we're trying to address with an increased focus on improving performance, recognizing that they're not KPIs, the measures about people that are waiting for something. Is that we've done a significant amount of work to enable us to move forward into a forward projection where same how we are going to recover our performance position. So we've worked with our finance colleagues and our performance colleagues to give us a forward look. So that we can start looking into how productive we are and what levels of productivity do we need to return to a more sustainable position of world want to be in performance. And this is kind of Helen can talk through this at the end in terms of where we'd expect to be by April and where we'd expect to be by December 2025. So there are kind of significant plans going forward. I've also our kids some risk from my staffing establishment so that we can bring in some executive coaching capacity. So this is somebody who is already employed in adult social care and going through that individual up and part of the reason why I was doing this is I wanted to make sure that in an area the size of can I could make sure that every manager across can and all of the teams right down to front line delivery have the skills knowledge and applications so that they can do the things that they need to do in order to keep this focus on improving performance and improving outcomes for people. There's also a significant amount of work that we do in around changing the way in which our operational teams are responding to safeguarding so that we don't lose sight on safeguarding outcomes and that that measure doesn't deteriorate as a result of our focus on assessments and reviews to respond to needs. And what you'll see from the pack is an ink, we're not at target for the number of people who are currently residing in the care homes across Canada that are rated good and are outstanding by CQC. So we are at the moment setting out a plan as a director of leadership team that will look at the creation of a care quality and safeguarding function that we will use to take them up proactive and get ahead of the care of a pro or two. Managing the market with an expectation that not only will that improve improve the outcomes and experience of people residing in their homes, it will also significantly contribute to the stability of the market and prevent homes from kind of going into market failure in an unpleasant which definitely does lead to poor outcomes for people and generally increase costs to the council. So if I just can't do over to Helen now we can talk us through some of the changes to the measures for 2425. Lovely, thank you. Each year every director is asked to review the suite of indicators they bring to cabinet committee, which in turn go on to cabinet via the quarterly performance report. We've kept ours at quite a similar level over the last couple of years to ensure we've got consistency when we look at the reporting and have the conversations around them. This year we are going to make some minimal changes keeping the suite as it is currently with a few additions in. The one of the main additions will be a new measure for the outcomes of safeguarding so safeguarding inquiries where a risk is identified what then happened out of that. That is actually a national adult social care outcomes measure and we will be allowed to do benchmarking on an annual basis to see how we compared to other areas of business. It's also part of the integrated care strategy measure as well so we're just making sure we're keeping a thread across all of our reporting mechanisms. We are also going to add in the information from the supporting strengthening independent service which is covering 18 to 25 year olds, which although delivered by the children's young people and education director is actually the responsibility of the corporate director for adult social care. So we're going to bring that information across into the measures where it applies and I've indicated that in table on the table and page 166. I've also going to add in some more information around two of the measures, one that I've listened to our conversations this year in this room and I'm putting in new care as assessments to be undertaken. So we have a little bit more context around the delivery around care as assessments and also the first reviews that we need to do for people reviewing their care and support plan. I am going to change two targets. One is a permanent change which will be for adult social care and health measure one, which we are currently achieving at 5%. So I'm going to reduce it down our target to 5% to see what happens over the next year as we make changes to our work at the people coming in and how we help people around information advice and guidance and providing them with alternative services at the front door. I'm also going to reduce ash two, which is the care needs assessments living within 28 days. We've not achieved this target for some time, 90%. I intend to reduce it just down slightly to 85%. The floor would be 75% with the intention that we produce some healthier conversations with our colleagues and operational teams around delivering that. And we will slowly move that back up. So my intention is that the floor target will move from 75% to 80% before April 2025 and then I will move the target of 85% to 90% by December 2025. So it won't be a permanent decrease in our intentions there. And that's that for the changes. Thank you. Thank you very interesting about moving the targets because obviously we know targets have got to be aspirational, but you don't want targets that are so high that people just give up because they know that they can't get them. So well done on that. There's just two things just to open it up if I may. I'm looking at the excuse me just a second. It's a little bit. So there's two measures that we've got in here are the number of people assessing adult social care and health services who have a mental health need seems to be going up continually. And also the number of safeguarding inquiries is currently at its highest level on the records. I'm just wondering, in order for us to hit targets, we've got to understand why certain things are happening. And I'm just wondering if we do have any insights as to why safeguarding inquiries have gone up and are continually going up and also with the constant and steady stream of increase of people who are accessing the service who need a mental health need. I'm just wondering if we have any insights. Thank you. My cut out of the start of the question. So if I have missed anything in answering, then please do just come back in so that I can cover the entirety of the question. So just in terms of adult safeguarding. One of the, I suppose one of the areas that we would look at is that both ourselves and CQC would want to have proactive open reporting by all of our providers. So it is something that the council CQC and all safeguarding board partners actively promote. So we do have significant drives on ensuring that people are raising concerns and people are appropriately referring into the council. So there is something in that arena around the facts that increased awareness will lead to increased concerns being raised. There is a difference though between the number of concerns that arise and the numbers that then go on to be converted into an inquiry. And that's relatively consistent in terms of conversions within care home settings, but we do need to do more work to understand any inconsistency in practice because there isn't necessarily a target for those conversions into inquiries. And it's a difficult target to set because they determine by individual circumstances. But one of the pieces of work that we're aiming to do around the core quality and the safeguarding function whereby we're looking to get ahead of the curve is the more preventive work that we can do around with giving people's needs outcomes. The more we increase our understanding of the quality of the market and people's lived experience, then we start taking a proactive instead of a reactive approach to adult safeguarding and then what we will see is a reduction in some of those numbers. And as we embed and roll out our quality and safeguarding function, we would expect to see a reduction in the number of safeguarding concerns, not necessarily inquiries that are raised in care homes because issues that should be raised as a quality concern, are currently coming through that mechanism as providers currently don't have a consistent wear of raising those with us. So what as an example, what we will see is see which is our ambulance service will raise a lot of safeguarding concerns with the council. A significant high number of those will not lead to any further activity because they don't meet the safeguarding threshold. So that's the work that the safeguarding and quality team are helping us to understand. But we are looking at building our approach, like I said, around care homes and then taking the learning from that to how do we do more preventive work in the arena of safeguarding around other parts of the markets or home care. And I think we touched on putting quite that self neglect in the last item. Just the other bit as well is that CQC inspect the more inspections of CQC do and there's a link between the CQC inspection and the number of safeguarding concerns that a council will receive. They're either kind of driven by CQC's recommendations or providers themselves raising them because there is more scrutiny and focus on that. So there's probably not one reason why we're seeing an increase in the activity. But we have got plans as I've said to kind of try and address and get ahead of the curve. So I did miss though with the care act, I think it was the assessment question because I broke my microphone disconnected at the start of your conversation apologies. Yes, I hope you get well, Sue Mock, but we're also seeing a very steady increase on the number of people assessing the services who have a mental health need. And it mentions something about autism. Has there been a change? Do we have any reason? But there are a second part of the question because I'm conscious I miss the first part of it. Sorry Mark, I'm talking about the number of people assessing adult social care with a mental health need. It seems to be going up in a very steady upwards slope and I'm just wondering if we've got any insight as to why that's happening. This is early anecdotal without necessarily a deep dive into the situation what we what was predicted on the back of the COVID pandemic was a national increase in the number of individuals that would present with mental health. So there was a recognized impact of measures that were necessary during the pandemic and the impact that they subsequently add on individuals mental health, mental wellbeing. There is definitely more of a presentation of people needing support to discharge hospital settings. And there is a poll on adult social care resources there. The work that we have to do though with our colleagues in KMPT will lead on the transformation of mental health locally is understanding of the work that they are doing and leading on. In terms of a community life response, a community we haven't prevented model around mental health and we are currently working with them around how they can fund social work resources to support the additional capacity and burdens that that's having those social circles those conversations are currently live. I think through your through those additional conversations will be that more in depth analysis of why we're seeing that trend. Is it a trend that's going to continue what does the people like for that trend and how do we get to a more sustainable way of supporting long term mental health needs. Thank you for that in depth explanation. I think it's really useful. May I suggest then that if the number of safeguarding inquiries is really reliant on, you know, if the fire brigade have been into people, if the ambulance people have been into people, it's not really maybe giving us an indication of what we need. Maybe we should swap it for the amount of concerns that were raised that we actually take forward so that we can actually see if there's an increase there as opposed to the amount of inquiries coming in. Sorry, just a thought. Thank you. I can do. We can put that in. I'll discuss that with Mrs Smith and Dan. Yes. No further inquiries or comments. So we asked us to note the report. Is it noted? Thank you. And thank you Helen and Mark as well. So item nine, which is the social care contract pipeline and Richard Ellis is going to introduce this for us. Thank you, Richard. Thank you Chairman. Firstly, apologies, a couple of typos in the report. Miss transcribes some dates from the contract pipeline spreadsheet into the report. The pipeline spreadsheet is accurate, my ability to copy from one screen to another clearly isn't so home care extension and care and it's sort of living contract extensions on to 27 not 2026. However, it's not our intent to use all of those extensions in any case. So let's set out in a report. Our first priority for recommissioning the big contracts is home care reasons that I expect probably obvious perhaps going to. If need be we intend to commence the queue of that in September this year with an award in July 2025 and implementation thereafter. A rapidly followed by older people resident nursing commencing again September, October, 2024, but we'll slightly later in September 2025. That's to manage capacity and not run two things in parallel, but also there'll be a large number of providers to work with on that contract. We have detailed timelines for recommissioning as an 65 and sporty living, but there's a need for discussion and great for colleagues in commercial services and discussions this week around the impact of the procurement at 2023. Our procurements run across the implementation date of 2024 October and there's a decision to made a judgment to be made about how far advanced you are to know which set of rules you're playing to. So we need to take some further consideration of them. But in terms of under 65 residential aim is to award by November, December 26, but certainly no less than March 2076 supported living similar timeline currently indicated, but we follow discussion and management in this morning. Right. So take a little longer. There are real opportunities with our providers in the sector to do something different and move to a very different way of working around trusted relationships. I've met a number of our providers in this field just this week. I think there's a real opportunity and appetite to work differently and do more in advance of going out to tender. So I think that's something that requires further consideration. I'll keep things to note from the report at the time report submitted discussion around the future of the community micro enterprises contract was very live at the point of submission intent was to extend the contract for another year. But just shortly after we submitted decision taking actually not to do so. It's always been a long term intention to bring this service in house. We just bring in that forward and we're in a process of bringing that service in house now and do that no later in September this year. And they will sit alongside our locality commissioners is an opportunity to cite them for them this year earlier than we thought there would be, I think that would be a good fit. Members of course will note in paragraph 4.3 the number of the contracts that expire in 2025. Our subject to review in line with the meeting term financial plan for cut meeting term financial plan savings that are in the budget report in relation to discretionary spend. I'll set the stage is that review is live and we tend to present recommendations to council bookings in July. The options it obviously included repurant extending these contracts account value reducing the value or ending these contracts. I've seen the latitude contract cases that will be subject to consultation and those recommendations naturally will come through this committee. Thank you chairman. Thank you are there any questions or comments Jackie. Thank you chair so I am saying quite a lot today. I just wanted to ask a question on the report under number 5 the financial implications says there are savings that relate to some of these contracts. These are 8 million older people residential and nursing 3.4 home care and 11 million discretionary spend 0.9 million community equipment. So my study is that is money that we were saving on what we expected to spend is that correct. Was that built into the budget? Yes, all those savings are in the budget report that was added earlier this year. And do we think as some of these other ones come through that we'll be finding any other savings that we may not have put into the budget. To first put to Richard's point earlier so that's a policy decision from members we pursue the savings that are set out in the budget report. Thank you. Thank you chair. Yes, the reason we asked this was just to see how the relative value of the ones we were asked to consider in January versus the rest. And it's now clear that the ones we were asked to consider in January versus the rest were they were the lion's share of the overall. And this is in terms of it consideration and comment. I think my comment would be it goes back to that discussion about how would we allow all of those four to come through at the same time. And it now looks like even more of an issue than it did then because we've got. We can now see that see the rest of the rest of the picture so my. My only my only comment is that all of those discussions are now doubly pertinent in terms of how do we get to that to that situation because. The thing I the comment I'd like to have in the minutes is that. I still consider the savings that being generated against those big four with the same contractual measures that they're being extended as making life more difficult for ourselves in relation to actually delivering the savings. Thank you. I just quickly wondered if you'd expand a bit on 4.2, which is the care support offer underway encompassing community navigation and the short break contracts just 4.2 can you elaborate a little bit on that. Thank you. I'm not directly involved in those piece of work, but it's been a there is a review of short breaks and support for care is going on in departments. So naturally, the future of that contracts sits in that review and what we do about that, whether we go out to repeat on the base, we go out to repeat on what that specification looks like will be as a result of that review of and work within the care is most important. Thank you, Richard for answering those questions. And we asked as Mr. Schreff was taken over as chair to consider and comment. Is that agreed? Thank you. Item 10, making difference every day approach self directed support. Mark and Clinton Ferguson will be commenting on this over to Mark to start with. Open. Thank you, Chair. One minute. Just there. Is there any better? It's minimal. Should I jump into Clinton's sort in his technology and hopefully Clinton is going to be able to sort his technology out because it's great. Hello. Is that any better? Yes. Thank you. Sorry about that. I just like to talk about embracing the spoons of self directed support and direct payments as a vehicle. So we make sure people ride and in adult social care, ultimately, the purpose is to support individuals in violence they call home. So roundly for people and things like cherish this mission on the field, the ethos of self directed support and direct payments, which empowers individuals with choice and control. There by getting their lives mean and purpose, it recognizes and embraces the essence is creaturely transforming the culture of care and performance. And the requirements in England represents a significant policy in a nation and designed to operate in the belongs rights of flexibility and independence and control over their parents. The individual sex boy, boy can choose to receive cash payments, instead of convicting or servicing, enabling them to tailor their support system to make personal means closer. It's a problem that only invents this family of self directed support but also elevate support from being a mere service to a vital tool to enrich lives. So, if we reimagine direct payments, the flexibility and control provides the freedom to select services that resonate most with a personal lifestyle and preference and fostering a deep sense of autonomy. And it also gives empowerment or fighting decision making power directly in the hands of the individual and that direct payments reinforce their role as a primary architect of their care and support German and promoting their playing independence. Also, the third element of that would be customization and which is the ability to keep care care and support and services that enhance the relevance and effectiveness of support that ensures that that aligns perfectly with the individual aspirations of those leads, and how they create opportunities to direct payments and enable certain challenges, these can be transformed into opportunity for growth. The first element, some of that might be looking at management responsibility for the responsibility of managing the project might seem daunting, unique opportunity for one skills development to personal growth, really by providing accessible awareness and education and resources that can be missed by the process and turning a challenge into a stand for retirement. So, like in the, the red tape, sometimes referred to as a burden, well, the tasks and the complex, streamlining processes and clear guidance can we use the burden specifically for also this approach not only makes the system more accessible, but also more appealing to protecting people and more on care support. The third element that we would need to think about the risk of mismanagement that is a fear of mismanagement that can be over amplified, the evidence doesn't factor it up. And it's about making sure that there's transparency and the process of people friendly and over-sought mechanisms that can cure a time to fill it in without diminishing the sense of control and only and in doing that, that would help build a supportive community that cultivates a community where individuals can share their experience in a boss is critical there. Such a network not only would boost that confidence, but also provide a full of knowledge, managing a direct payment, less intimidating and more accessible. Ultimately, at that time, I'm not merely a financial tool, but a pivotal in enabling individuals to lead fulfilling lives and deeply connected to what matters most to them. So, by adopting this, it will help focus on hope, a permanent and positive transformation of care support in things, but also direct can be reimagined as an empowering tool that enhances autonomy and promotes a burden for them not. So, the first, to bring a culture of creativity, of course, and a person-centered care, we can ensure that the payments achieve their full potential in enabling individuals to navigate the system comfortably and enjoy the benefits of a lot enriched our meaningful choice with both the point of hand over to you. Thank you, fans. The key slides, if it's all key instead of talking through the entire park, which members have already seen. And I think what I want to contextualize, what I'm going to say by saying that I've been a qualified social worker for 23 years, and I've still felt we've seen anything as potentially transformative and truly exciting as the interventions of direct payments. They really have created an opportunity, I would still argue it's a missed opportunity to really transform the lives of people that kind of draw on current support. So, I think as you'll have seen from our performance information park, we've set a target around the number of people that we want to receive current support through direct payments. And we remember all that target, but we've also kind of wanted to set out within this slide the fabric that needs to be in place in order for these direct payments to work properly. So, first and foremost, direct payments have to be accessible to all individuals, and by accessible to all individuals, it means that we have the processes in place. It means, as Clemson said, they are streamlined, the bureaucracy is set to the right levels. There's implicit trust in the process, because this is people taking choice and control for the wrong care and support, which gives value and purpose to their own lives. This is also about how we monitor, but also the infrastructure that we put in around people so that they can be supported to manage direct payments, where they are either not able to do so or choose to not boost. So that's kind of one of the pillars to take you forward. The next ones around the community resources. I recognize that within this slide, there are some challenging positions of it is a council, but this recognizes how we maximize the use of the campaign. How we ultimately look at potentially transforming the shape of how we spend money to meet, assess needs and outcomes, but for the preventative where and to reduce the consequences of not meeting needs. So this recognizes that that challenge those community resources are very specific to the areas that people live in, not two places in the area of Canada the same. So real challenges in that area. The next ones are around ensuring that we've got kind of like, where people have gotten assessed need we've got confidence that the amount of money that's allocated is proportionate and sufficient to meet those assessed needs. And the people and practitioners have got the understanding of how that should work out. I mean, Clinton's touched on the part of creative support planning, and we're done at parents really have transformed people's lives. This is where people come up with creative solutions that councils wouldn't come up with within their own commissioned responses. And again, this is about seeing different ways of me to needs and outcomes, and ultimately driving through all this, it changes the relationship between the state, which in this case is also account on the individuals, because the choice and control and the decision making of what a good life looks like is the individuals and now I was so really just wanted to set out what does it mean to have a gloriously ordinary life. And what do we need to have in terms of down at payment. So if we could go to slide seven, please. So, based on all of the work that we've done, I just wanted to highlight some key. We'll talk to a lot of them, but just some key bangers that we've got. We've already touched on the overly bureaucratic processes that are currently in place. So part of the work that we'll be asking our audit team to do is to help look at how do we get that balance right between assurance groups and it and flexibility about people need the needs and outcomes. There's also that recognition that people got choice and control in this area not only in terms of holding up this needs and for current support map, but whether or not they want to receive direct payment. And I think in the bottom left on corner public expectations and perceptions of real significant kind of area because creative solutions could present challenges, could present question marks about how councils use is public money. And I think that we can get, especially within the company within the climate that we're in. But what we recognize is that money follows good conversations and good outcomes. And there is currently an over-reliance in Ken on traditional services, which are expensive. And what we're trying to do is to make sure that we have the right balance between those traditional services and those creative solutions that help people choose the life that they want to lead, which is different for every single resident of Ken. So if we can just go through to slide eight, please, which is the audit. So I've worked with our colleagues in internal audit. What I'm asking them to do when we can bring that will be bringing this back a little later then when the kind of requested is we want to make sure that our current practices policy and approach to direct payment is consistent with the spirit and expectations of the care wrapped. It's led by people, outcomes, not service requirements, and really just transform the way in which support is delivered for people of Kent. And people of Kent will need to know that we're with them, we're supporting them because being supportive will be a key and airborne to helping more people access a direct payment. And I think just picking up on a comment before the reason why I highlighted the wording in black italic text is because this does require a fundamental reset in all of our collective thinking about what is an appropriate response to assess needs and outcomes. And it does require brave decisions about every officer and every manager to create that culture change that really is required by direct payments. So just in terms of the last slide before we pause for any questions, which is slide 10. I just wanted to use this slide of an illustration of some of the key building blocks that we're working on that we believe will enable us to really start getting some traction in the area of direct payments and increase people's confidence in the tech or retention of the direct care and so that they don't feel like the left alone and that there still is that relationship between the council and themselves. So, the puck down now if that's okay and happy to take any questions. Thanks Mark and thanks Clinton as well. Are there any questions Richard. Thank you Mark Clinton that was a very comprehensive set of presentation. My question is on the barrier to entry to direct payment and how transformational an increase of from where we currently are at about 27% direct payment to say 37% direct payment. What that would do because the only reason I asked this because I was in a thing the other day where that's the kind of level that at least one other similarly sized council has managed to achieve. And if and they did it allegedly very simply by reducing the barrier to entry and I wondered how much a kind of percentage difference of that magnitude in relation to direct payments would save. Given where the other pressures that we've already discussed this afternoon are. Thank you. Within our original sustainability plans there was a proposed methodology around cost avoidance and long term savings for social care in terms of new starts with home care and direct payments. Some of that methodology has been challenged in terms of the the actuals in terms of the people who did start with the direct payment. How did the cost look. I think the challenge that we've had though is when we've looked into how people are using direct payments people using them on various traditional solutions. So if you're going to use direct payment to purchase something that the council could purchase through commissioned resources. The potential opportunity to reduce spend is going to be negligible because there isn't going to be a serving in that area. And the reason why I'm asking our audit to look at the culture and practice and those mechanisms about how we could reimagine meeting needs and outcomes is that will lead us to a more confident and more sustainable way of saying that's what we expect to deliver through that. It's really hard to say what it would mean for every individual who has every individual's assessment and with you on circumstances for big tech what that means for them. But in every area that I have worked where you get the culture around direct payments where you limit the rules on what people can utilize their direct payments for where you have flexibility in people's ability to chop and change how their current support needs are met because that's how life works from one week to the next one month to the next. Spend is generally less in those areas because you're maximizing a wider pool of resources whether in the voluntary sector, whether through equipment, whether through technology. There are other things that you can purchase through your direct payment that are not traditional social care services. I think an unintended and not so much an unintended consequence but an indirect consequence is the more people that draw on direct payments and have the needs met through creative solutions. The less dependent there is an existing traditional services. And again it seems as a key lever in order to how do we get control of an inflated cost of traditional models of current support. Where our current model does if I wanted to create some challenges around our ability to influence some of those cost setting kind of challenges that we face. Thanks, Chair. Thanks, Clinton and Mark for your presentation there. It is a very interesting area and area I believe we can make a lot of progress on both the better outcomes and as Mark said more latterly to help support the care market more generally and realize some efficiencies in that way. Clinton, I think when we've talked about this previously for the benefit of the committee here, I think when I ask you what the one thing you'd like to see the Council and therefore the members kind of grant you as it were in our attempts to improve what we offer in this area. I think you asked that we be a bit braver in designing the rules and giving people a bit more freedom which of course from a publicity point of view if we put it like that does maybe sometimes require us to be a bit braver if something makes into public domain which might seem a little controversial but ultimately for every one of those there could be hundreds or thousands of good outcomes for people who would spend the money to make their lives that much better. What do you say? Is that a fair kind of summary of directionally how you'd like us to try and move in the months ahead? Thank you. Thank you very much again very comprehensive presentation and there's a lot of information there. Can I just ask in terms of the material here? Will it be put over to encourage new social workers coming forward and part of the training programs because as you say it's a different way of thinking and different way of moving forward making people more independent perhaps. Do you see a link with the training so that you're not having to retrain qualified social workers that are coming on board at the beginning of their career of course? It was a bit difficult coming through the mic so I think the way in which I would see as being able to address this through social care, social work education is our first opportunities around the, if you think of our own workforce and the opportunities that we've got in Kent to grow our own through the apprenticeship level and there is an opportunity around how do we use that to create a bit of a critical mass and a changing thinking in our social workers in Kent predominantly because that's what I'm concerned about social work in Kent is the best social work it can be and is embedded through these values that really do sit well with social work training. The next bit ultimately then is how does our social care academy in Kent work with the local HEIs to influence. This is a very similar model to what I experience when I was on the teaching publish you can create a Manchester where employers influence the education agenda of social workers. So when we talk about social workers being fit for practice and being ready for statute reduces it's not just about your legal literacy it's about your ability to interpret the changing expectations and culture of the care act choice and control. And what does it really mean to get choice control to individuals and to support them and to be with them. And then again it's thinking through those opportunities through any developments that we make around our practice framework our operational model. Our engagement with the public so around co-producing the way forward so it's not just about what's doing this it's about was co-producing this with residents across Kent who need confidence in the process. So I think there are a number of ways in which we can address future and kind of existing social workers to drive this way of thinking and this way of working and it's really all of those levers. Okay thank you very much I'm just noting from your background pictures that they're exactly the site. Does it mean that one of you is living in a parallel world anyway you don't need to answer that thank you for your time. We've been asked to consider and comment on that is that agreed. Thank you. Now we've got approaching the end everybody item 11 this is going to be covered by Dominic but before I hand over to him. I hear that he's leaving us on Friday to go to the planet where he lives and will now work so thank you very much for your attention to detail and advice that you've given me and others I'm sure. And may you have a very successful onward transition from here to so if you'd like to take item 11 please. Thank you very much for the kind words share. The work program is as says out in your reports we've got a couple of items on Blackburn Lord's due to come to the next meeting and we can discuss further such additions to the agenda at the agenda setting meeting which due to be held after the meeting. Thank you. Right thanks very much so I'm going to call an end to the meeting now whatever it is. 10 plus four 16 10. I'm sorry I didn't call a break earlier for. Thank you. Thank you very much. Thank you. [BLANKAUDIO]