Children, Adults, Health and Wellbeing Policy Development and Scrutiny Panel - Monday, 10th June, 2024 9.30 am
June 10, 2024 View on council website Watch video of meetingTranscript
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Okay. Well, good morning everybody and welcome to today's panel meeting of children, adults, and health and wellbeing policy development and scrutiny. I'd like to welcome everybody to the chamber. I will ask everyone to introduce themselves in a moment, but I just need to read out the following statement. As we are now in the pre-election period, it is important to note that the panel will be observing the requirements so as not to make statements and/or enter into debates of a political and/or sensitive nature. So, does everybody understand that statement? Okay, good. Right. Now, without further delay, I will introduce myself. My name is Councillor Dina Romero and I chair this committee. My name is Councillor Liz Hardiman and I'm the vice chair of this committee. David. David Harding, Councillor of Chew Valley Ward. Chris. Christopher Batten, Education Union representative, non-voting. Joanna. Hello, I'm Councillor Joanna Wright, Landbridge Ward. Thank you. Ruth. Hello, good morning. I'm Ruth Malloy, Councillor for Weston Ward. Kevin. This is usually a good test for the technology. Is that-- come on. Yeah, sorry. Good morning, Kevin Burnett, Professional Association representative, the NEHT, non-voting member. Paul. Suzanne. And I don't think your microphone is working. Alison, try your microphone. I think officers and Councillors now, it's all been sorted so you can all log in and I'll know who you all are. Okay, it's working now. Yes, I'm Alison Bourne, Councillor for Whitcomb and Lincoln and the cabinet lead for adult social care and public health. Suzanne. Suzanne Westhead, I'm the director of adult social care for Bath and North East Somerset Council. Jill. Somebody sort Jill out. Lesley. Good morning, my name is Lesley Mansell, I'm the Councillor for Radstock. Mark. Good morning, everyone. My name is Mark Dernford, I'm the democratic services officer for the panel. But by no means least, Kerry. Morning, I'm Kerry Williams and I provide the scrutiny officer support to the panel. And can I just remind everybody that the way that our camera and microphone system works, that if you leave your microphone on, the camera will remain on you even if somebody else is speaking. So can I urge everybody to turn their microphone off when they're not speaking? Thank you. Jill, are you ready to announce who you are? Yes, I'm Jill Kirk and I am the labour group assistant. Welcome, everybody. I now turn to Mark to tell us what to do in the event of an emergency. Thank you, Chair, yes. If the continuous alarm does sound, you must evacuate the building and proceed to the assembly point. From this room, you follow the green running person signs to the exit, using over the marble staircase or the main staircase. Please do not use the lifts. The assembly point for this building is the Orange Grove grassed area just outside the Browns restaurant. There is an evacuation chair for use by the disabled people who wish in the corridor outside the County Chamber of Public Gallery. Alternatively, the area at the top of the marble staircase has been designated a safe refuge where persons needing assistance should assemble. Thank you, Chair. Thank you, Mark. Are there any apologies for absence and substitutions? No, none that I'm aware of, Chair, no. Thank you very much. Are there any declarations of interest? I've not been notified of any. Are you-- has any others been notified to you? Okay. Okay. I've just been advised that I should advise the panel that I am standing in the general election as a candidate. Okay. So the next item is urgent business. I have none that's been asked of me and therefore I don't believe there is any for me to announce. I've not been notified of any public or council statements or questions. And then we move on to the minutes of the last meeting which has a focus, as you know, on children's services. But we will-- I'll just ask for any comments. First of all, does anybody have any reason to believe there's not an accurate record, Kevin? Yeah. Thank you, Chair. Page 9 of the minutes, it mentions that Councillor Maye informed the panel. St. John's attended a recent meeting of the Health and Wellbeing Board, said the minutes of that meeting should be circulated to the panel. I understood that after bits of discussion through the meeting, we had agreed that Paul would bring key points from the health and well-being panel in his report to the meeting that we could then highlight and pick out. So, if that's what the panel thinks, could we just change that, please? Of course, I think that was my understanding too. So, Mark, will you make a note of that? Okay. Thank you. And obviously, ensure that the cabinet member does make those points in his report in due course. So, we have had a discussion about how we can better align the minutes to the theme of our meeting as I'm sure everyone knows that we have alternate children and adult focus. And so, we will try and find a way of bringing key points from the appropriate meeting to the next appropriate meeting as well, just so all is aware that we've covered that point. Any other errors or concerns? Kevin? Sorry, Jane. Not necessarily errors or accuracy. This is on matters arising. Do you want to do that, or? Okay. Well, let's focus on the any other errors. So, is everybody content to agree that they are an accurate reflection of the meeting, bar the point that Kevin raised? Okay. Then I think we can take that as agreed. Kevin, so matters arising. Yeah. Thank you, Chair. Page six, and again, I always have to preface this by saying that technology allowing, because sometimes my computer doesn't accept the things that should be accepted. I haven't received, put it that way, whether the panel has, any summary, community summit summary from the education team that Chris Wolford was going to circulate. That was on page six. Also, it was mentioned on page eight about how many pupils will be taking part in the Language for Life project, which I don't think I've had anything, and also about the progress of pupils, their ability to receive speech and language and further support downstream. And finally, on page 15, the HRSS changes. Chris was going to review and respond. And again, I haven't seen anything come back on that. Mark, I know you're making a note of that. Will you be able to chase up responses? Thank you. Okay. And I think if any of the points that are raised by you, if they are responded directly to you, it would be helpful if you then send that to Mark so the rest of the panel can see any responses that you've received too. Right. So are we happy to move on from the minutes? Okay, good. Right, I turn now to the cabinet member update. And I invite Councillor Bourne to address the panel. Obviously, we will have all seen her report that will have been circulated, I think, on Thursday or Friday last week. Hi. Has everyone's had a chance to look at it? I won't go into it in huge detail. But I'm obviously happy to take questions. I mean, the main elements, the main things that have been happening recently are the transfer, which obviously we're talking about as a separate item. And we have started our review of community support services. And that's a long-term piece of work that's been carried on across the year. And also, at the moment, the main area of focus is preparation for the CQC inspection, which we will be having in the next few months. So we don't yet know exactly when. And lastly, I'll just mention in relation to the transfer, Suzanne and I have been visiting services to see how they've settled in and how they're finding it now working back in the council. And generally, the feedback we've had is very positive. So those are the sort of the highlights. But as I said, I'm happy to take any questions. Thank you. Thank you. Any questions? So Kevin first. Yeah, thank you, Chair. Morning. Thank you for the report. Just on the community support services, am I right in assuming that during the time when we were saying about services had to be cut and saved? These are the ones you're talking about now. You mentioned in the last paragraph, just before the CQC inspection heading, that there's been a meeting to look at the process and the timescales of the review. Would we be able to understand what those timescales are and the process that's going to be undertaken, if that's already been agreed or has that not been agreed yet? We're not quite there yet, Kevin. We've been working on a timetable. We expect to be able to have a specification ready to go out in around September, October. The aim would be that we would award the contract by the 31st of March, 2025. However, there's quite a lot of work to do with community partners, and we really want to engage with them. And we're not going to be pushed into a timetable and not be able to work with them. So that's why it's fluid at the moment, and that's a really important point to make. And we made that very strongly when we met with all the community partners as well, because they want to be very engaged in the process and the principle of what the new specification looks like. So I'm giving you that's the timeframe we should be at. It might slip, and if it slips, then we need to think about what we will do. So, sorry, can I just -- so is that, in essence, that by September, you will have done the discussions to understand what services you want with those partners, so that they're helping you build the contract specs. Thank you. Thank you, Kevin. Do I have any other questions? Joanna. Hi, thank you. Thank you for your report. Item number three, sexual and reproductive health. You've got £54,000 to be spread over Wiltshire, Swindon, and Bains. Can you tell us a bit more about this two-year sexual reproductive health action plan, and what the outcomes aim to actually be? Unfortunately, I don't have the detail on that, and there is nobody from public health here today. And I had hoped that Laura Ambler might be able to answer the question on that, but there's nobody from the NHS either. So, I will have to take that back as a question to public health for further information, and they'll respond to you. I have one more question. On number five, leisure services and physical activity. It says GLL's better brand has been endorsed by which, which is fantastic, but I am aware that cycle infrastructure at the leisure centre has been asked for repeatedly, and it's been very hard to get a proper piece of work there. So, although it's great that we have leisure services, getting people to the leisure services is problematic. So, could we have a bit more information about that, please? Okay. Yes, I'm very happy to take that out. There is some cycle parking infrastructure, but you're wanting more. Is that what you're saying? It's insufficient. There is insufficient, and there isn't very much for cargo bikes, and it's very problematic to access and get to, and the location is very challenging. Okay. I'm happy to take that out. I'm not sure whether that will be a GLL issue or a council issue, but I'll take it at both routes and find out. Lesley and then Kevin. Yes, thank you for the report, Alison. I want to ask a series of questions, supporting what's just been raised on sexual health, bearing in mind the increase in STIs, which are probably at the highest they have been for a long time. Clearly, this funding is very welcome, but certainly like to see a further report on this and actions that we're, we're taking in the future if you can't elucidate today. On four, on drugs and alcohol. So again, it's good that work is going on with the police, but what other work is going on around drugs and alcohol and promotion, health and safety promotion around these? And the leisure services, I actually use the GAL service in Bath, and I'm not sure when that questionnaire was sent out, survey was sent out, but it would be good to have a bit more detail on that because there are a number of issues with the center. I won't go into any more than that, but ask if you've got anything more on that. And finally, on item six, tackling inequalities. Again, it talks about a number of projects across Baines, but can we have some more detail on what these projects are and what the outcomes are? Thank you. Okay, yeah, it's really unfortunate that we don't have anyone from public health here today because we're getting more questions on public health than we normally do. I'm happy to take those forwards, and the inequalities work. I think they have been doing a major piece of work on that, and there will be further detail coming forward on that soon. The other thing that I can respond to is I spoke to the Director of Public Health about the drugs and alcohol and the concerns about there being a higher incidence of people overdosing because of the strength of synthetic opioids that are available currently. And she said there is a lot of partnership work going on with that currently, so it's not just the police, it's all the agencies involved. But I think it's being done across the Avon and Somerset police area, and they won't be reporting on it until the work has been done across the whole of the police area, but there will be further information forthcoming on that. And it's certainly work that they're, you know, something they're working on very actively because of the concerns. Okay, I think what we might do is invite specifically the Director of Public Health to attend our next meeting, I think probably the September meeting, if that would be appreciated by all. Yes? Okay. We'll do that. Right. Kevin and then Ruth. Yes, apologies, Chair, because I think these are also around public health as well, sadly. The two questions I was going to raise, which haven't been mentioned yet, are one around does the public health nursing include school nurses, and the impact of what that means for schools. And secondly, will the services be the same, they're under sort of specification, will there be the same specifications as before the new contracts, or is anything being changed on the new contracts? Well, I think it's very unlikely that after seven years there won't be any changes to the contracts, because obviously the world has moved on in that time. But the new contracts will include public health nursing, school nursing. But again, I think it's probably best if somebody from public health answers that in detail, because I've got some knowledge of it, but I don't have the really detailed knowledge, so we can add that to the list for an update next time. Yeah, I mean, that's, excuse me, a fair point that I'm sure something's going to change. I suppose we would like to check that it's not going to be in any way negative change, but it's going to be a positive one. Thank you, okay, Ruth, and then Liz. I have another question about public health, right. It was good to see about the school's health and wellbeing survey that 62% of primary schools have signed up to take part. But I was wondering how, what can we do to encourage the remainder, because, you know, it's something you would hope they'd all be wanting to do. And then about the secondary schools, you've written that their results will be available in June, Tom, but do you have any information about the percentage there of the, have they all responded? Do you know the secondary schools or? That would be interesting to know if you can find out for next time. Thank you. Yeah, again, I will find out more for next time. Thank you. Perhaps what we could also do is make sure that we've got all these questions for public health put in such a way that our director of public health can sort of answer those and that will give a good focus for when she presents in September. Thank you. Liz. Three questions, and it's really teasing out a little bit more about what has been said. And firstly about the community support services. This new strategic board has been set up, but I note that none of the three SG organizations are involved with this board. But obviously, just what Kevin has found out is that there are discussions, ongoing discussions with these organizations. So that is good to know, although they're not part of the board, which we would think probably would be a good idea. What I would like to ask is that, Alison, at our last meeting on April the 15th, you said extra funding has been found to support the savings and the financial pressure is less than anticipated, which cuts the 802,000 balance cut. Now, obviously, you can't elaborate now, but again, this is a question perhaps at one of our next meetings, you would like to be able to elaborate and reassure us on those points. Moving on to the CQC inspection, and we're one of the first to be inspected. Have you any idea how this short list of first local authorities to be inspected was drawn up? And could you let us know how prepared are we for this inspection? Thank you for the questions. The first one around 3SG, they actually scoped out the work that we're doing at the moment, so we're working really closely with them. And for the meeting that we had last month with all its community partners, it was 3SG that led on that and to make sure that we've had that engagement, in particular for the smaller providers. Because not all providers are represented by 3SG, so that's why we couldn't just work directly with 3SG. So I hope that answers your question. Around the 802K of community services savings, that still sits on my budget. And some of the work that we've been doing around the bigger social care budget is supporting the 802 right now. And I've had to report the chief exec what I'm doing to -- so we realize that saving. So it's not on the community partners, but it is on the adult social care budget. So just to be clear about that. CQC and the reason why we are the first of 15 being inspected, I have no idea. And they haven't made it clear to anybody what the criteria is. There's been three councils now that have published their inspection results. Hertfordshire, Harrow, and West Berkshire. They've all got good. Hertfordshire has had one outstanding in its community involvement. And the other two have had a couple of requires improvements, but overall good. There's about another four we're waiting to hear from. But I have no idea what the criteria is. And they haven't shared that with us when we've asked. You've asked, are we ready for inspection? We've done the self-assessment. We've shared that with CQC. We needed to give all our data, and they were very interested in waiting times, equalities, co-production, and personalization. We submitted 187 pieces of evidence, as well as the self-assessment and all of the data that they requested. As of today, the LGA is in with the frontline staff, talking to the frontline staff, and preparing for inspection, sharing the self-assessment with them, and also asking them, you know, what's good about what you do, what are some of the challenges, and just really to build that confidence in when CQC come in. I have no idea when they come, but they will have to be here by the end of October because all of the data was submitted in May. So I expect in the next four months we will have to have -- I know you'll have to visit. For that report, and we wish you all the best. It's never an easy time having an inspection, so we look forward to hearing a report back on that. My last question, unfortunately, once again is due to -- it's a question about public health and an update, and it's really good to see that there's going to be a women's health hub, which is going to be set up. But obviously it can't be answered now, but it will be really interesting to know, will people be targeted for this particular hub? And there's going to be a two-year plan, and could that come to panel just to let us know what is involved? So thank you. Alison? Yeah, that needs to go with all the other questions. I'd be grateful, Mark, if you were able to collate them all, yeah, from the recording, and then we can make sure that they're all -- we've got all the answers that you need next time. Thank you. Kevin? Yeah, thank you. Alison, I may have got this wrong, but in my notes, I seem to have written down that somewhere in the February meeting you mentioned there was an additional $500 million for social care funding, and I just wondered, has it come through, and has this made any difference to Baines? There was a fairly late announcement of additional funding for social care, and Baines did get an allocation of that. But it was -- I think ours was $1.5 million. That was the amount that we got, but it was one-off short-term funding. So it's brought us a little bit more time to do the review, and it helps us in the short term, but in terms of the longer term, it doesn't make any difference to our funding position. It just gives us the time to do the strategic work that we plan to do. Sorry, Chair. So has this funding come in sense? Have you sort of allocated it to anything, the $1.5 million, and how is that -- because obviously it was a bonus, but I don't recollect to see where it may have gone. Where I'm using it at the moment is for the provider services, and what we can do is uplift the provider services because it's not recurrent. But where they've asked for extra support, one-off, we're utilizing it in that way, and we're working with many of the providers right now who are struggling financially due to the financial crisis of last year. So that's where it's allocated. It also is allocated just to support the underlying deficit that runs in adult social care. You'll have seen that last year in '23/'24 that we were overspent. That's because the activity has increased in adult social care since COVID. So that's where it's allocated. It's up against what I call my purchasing budget just to make sure that we get to a close, a breakeven position for the end of the year. And it will be spent, but the problem is it's not recurrent. And I really struggle with that because you can't then give it out to the market and say, you can have this every year. You can only give it out for this period of time, which is very frustrating. I was just checking if there's anything else to be said. Okay. If that is, everybody has had their say on this item, I think we will duly note your report, Alison, and move on to the next item, which is the adult social care transfer. Alison, would you like to introduce this? It's a report on the evaluation of the transfer of adult social care services from HCRG back into the council. And the services transferred at the start of April this year. So what this report does is looks at the process and looks at the outcomes and evaluates whether there were any things we could have done better, any things that went wrong, any things that went particularly well. Generally, I think the feeling is that the transfer went very well. These services have been transferred across a number of providers in recent years, so they've been transferred on numerous occasions, and the staff who I've met with have often commented on the fact that this transfer has gone so much better than any of the previous ones. So I think we did really try very hard to learn from the experience of previous transfers. We were very keen to try to ensure that the people who received the services didn't notice any difference. So from the end of March, the beginning of April, there was no disruption to service. Things carried on. Our IT worked from day one. The corporate services were fantastic in the support they gave. We had IT experts available on site, so if people had any questions, they were answered really quickly. HR did a fantastic job. Payroll ensured that all the staff were paid on time and paid the appropriate amount. So it's been a major logistical piece of work. We had over 200, well, nearly 250 staff transferring, and, you know, it has gone well, and staff seemed to be happy to be back with the council, so we're very pleased about that. Thank you, Alison. Any questions or areas of consideration that you'd like to highlight? Kevin. Thank you, Chair. Yes, thank you again, and it also is what seemed to shine through was the good liaison on cooperation with HCRG, which is always a bonus, but it doesn't always happen that way. Can I -- and the other bonus point seemed to be, which is sort of a question, was about the -- seemed to be the projected cost of the whole project seemed to be less than you were anticipating. And I'd like to know a little bit more about how that was achieved, because that sounds fantastic. Well done. And the other bit was really, overall, I was maybe, hopefully, looking for, and it's probably too early to know at this point, but if it is, which I appreciate it very well, is probably too early, when it might happen, is the key benefits of this transfer. Obviously, the outcomes for that were set out as to why we want this particular transfer to happen. So it would be lovely to see whether those wonderful desired outcomes have been achieved, and hopefully, more than achieved, because, you know, these things do come with a bonus sometimes. And there was just a couple of other specific little things. One was on 5.2.3 around staff training. You -- I just -- you've got some numbers there, but it didn't really sort of mean a lot in terms of if you had five people, and was that five out of 5,000, or five out of 10, or -- and also, was that -- is the training -- do you think it's compulsory? And if it was, or is, when might that training be completed? And I'll come back to some of this later, if that's okay, Dina. Okay. Alison. I'll start, maybe. Okay. So the first question was around the underspent of the costly allocation that we put there. It was very hard, when we started, to know what the overall cost was, and that's why the council allocated the money that would be spent, and it came, actually, from the Adult Social Care Reserve, which I'm responsible for. I think -- I know the reason for that. We used a lot of our own staff. We didn't bring in as many consultants as we expected to do. We were expected to do -- the biggest cost, really, was IT. That was the biggest cost, and we did need extra support for IT. When you think about e-mails, and you think about computers, and having everything ready, that cost. But, again, a lot of it was born internally. The other area that was expensive, as well, was the program management, and making sure that we had enough. But, again, we used our own resources, and we did -- we bought in very little extra support. Payroll was probably the biggest piece of work we had to do to make sure that those 237 staff came across in a way, and would be paid on the 24th of April, which they were. But that was a lot of work around that. But we used -- where possible, we diverted our staff across the council to support this, because it was felt at the time that this was one of the biggest jobs we would be doing within the council. So we wanted to use our own skilled staff as much as possible, and not use consultancy. So that helped, but we thought, initially, we'd need more consultancy than we did. So I'm pleased we were able to do that. The benefits of the transfer. I think that's something we are working through. One of the biggest benefits we've seen so far has been around what I talked about earlier, a purchasing budget. So we have in place what's called a forum, where, so far, we've had 400 cases presented. There's three meetings a week where they're presented to the senior manager, and they're advised on, you know, the appropriateness of the placement, making sure it's a strength-based approach. And that means making sure we use all of the community of resources, not just the social care resources. And we're tracking those savings, and we've seen benefits to that. So that's one thing. The other area that I've seen, and I think we'll need to get a baseline on it, is that staff satisfaction's been really good. As I've gone around, and I spend two days a week in services, you can see the satisfaction rates are really good. But we need to do some more work on that. And there's other things we need to do. But I think, at some stage, and I wouldn't say straightaway, but maybe within the year, bringing back the benefits. What we said we would do, and the benefit of that would probably make sense. The issue around the number of training, I take your point. I think we do need to do that as a percentage. We're pushing to training, which is mandatory training. And for those mandatory training, we need to be at 100% for all of our staff. So the next hour, we'll come back. And again, it won't be before Christmas. We should come back in our update around a training package and where we are with our staff, percentage-wise, because that would make much more sense. Sorry, Suzanne, could you just clarify? Did you say it won't be, or it would be around Christmas? After Christmas. It won't be before Christmas, I'd say. It will not be before Christmas. We bring that back after Christmas, yeah. But reasonably close to that side of the year. Okay. I mean, it looks like the transfer has gone very well indeed. But you're very honest about areas of improvement. And there are quite a number there. And it looks like things fell apart in the last month almost, maybe as the pressure gathered as the transfer was about to take place. So what would you do differently next time around? I mean, what lessons have you learned? I won't put cost into it because I'm not sure how that is, if that's a factual question or not. But perhaps that might be a factor. However, what would you do differently next time around? I think what I would do differently is that we didn't have all of the staff, the list of the staff that came across until, I think it was the first week of March. And we were due to, on the 31st of transfers. And you can imagine through payroll, and they're on, they're on four or five different terms, conditions around pensions. And some of them are on agenda for change, which is the NHS, some of them are on Sirona, and some of them were on the old Baines contracts. That really put us back. And I think I would put a clause in a contract in future when that happens, that if you are two-ping back, that make sure you've got at least two months of that information. That was so tight. That's the biggest lesson I think I've learned. And the other thing is to involve the more middle management. We worked very much with the senior management. And I think, you know, the team managers and the service managers, we would have done much better to work closer with them. At the time, because their jobs were so big in HCRG, it was felt that they needed protecting. But I've learned a lesson there, and I think you really need to understand the detail before it comes across. So there are two things I would do differently. But the two-ping information, the legal requirement is the 28 days, and it came back as was legally required. So there's no criticism of HCRG. It's just the legal requirement is not really sufficient. And I agree that it would be helpful if we could put in a clause that made that more generous, should that be an issue in the future. All right, Liz, did you have any further questions? Or is that-- Leslie. Yes, thank you. And I think we ought to really offer you congratulations because this has been a massive undertaking. I'm really welcome to see that it's come back in-house. And I can understand your frustration with all the different contracts you've had to deal with. Picking up on the training on page 26, it says infection control 18 completed. Now, I'm not sure whether all those 250 staff needed to take that infection control training if they're not frontline providers. But will there be a priority given to that? Because I know in our hospital where I work, it absolutely is a priority. On page 27, it mentions the risk assessments. It doesn't say how many. So how many of those are there? Is there an action plan with those risk assessments? And can we see those at some future date? Thank you. Priority for infection, yes, that needs to hit 100%. But you're right, it's not all staff. So for instance, administration staff, they wouldn't need to do that. So what would probably be helpful for the panel is to understand people who have to do it, are they at 100%? That's what you want assurance of. So we need to do some more work on that. Around the risk assessment, adult social care has a risk profile and a risk matrix and a risk assessment. And the priorities of that go up into the council risk assessment as well and report it directly to cabinet on the key risks. But I'm quite happy at any time to share the adult social care risk register and where we are with each of those areas. It would make perfect sense. Maybe that will give you a level of assurance as well. Thank you. Are there any other questions? Jo and then Kevin. Thank you. And yes, congratulations. Well done on bringing this in-house. It's a massive achievement. I'm just thinking about HCRG. Is there anything that you've learned about how they worked that could be improved? It's a sort of tautology question, really, because I know we've now left them, but there are issues with other companies like that that we are working with, that we need to have in place to work better with, so that should we want to bring other things in-house, that we already are making those steps, if that makes sense. Have we learned anything about that? Very good question. And as I went around, I saw one of the things, they had a very flat structure, so their decision-making was much easier for the middle managers and senior managers. And what they have said, coming back, they found we have lots of layers and systems and bureaucracy, they call it, that are in place around the council, because we're bigger and we need to have level of assurance so they would have a credit card, for instance, as a manager, and they'd be able to spend that on anything, and that worked very well, and there was records kept, and it was audited. But definitely, they were much more flexible. And that's one of the things the chief exec recently said, we need to learn from HCRG on how flexible they were in decision-making. Our decision-making is harder. So that's one thing that we're going to be trying to put that in place, because staff found it very hard to understand our layers of approval, for instance. And then also, in terms of working with the union on bringing those contracts over, how did that work, and was that effective? And could there, again, be more lessons learned from that? Because HCRG didn't recognise unions, they had what was called champions, staff champions, they sat in the union groups that we had. So we had monthly meetings with the unions from our side, from the council side, updating them on the 237 staff coming in, and we then had champions, which was able to feed back to the staff. Whereas the opportunity, of course, when staff came across the councils, they could join the unions, because we recognised the unions. So yeah, I had found that really helpful, because the unions took the approach, it was all about the staff, about their well-being in the transfer, and what best we should put in place. And they were critical at times, in areas that we hadn't done as well as we could have, around communication as we were going through, and they supported us with that as well. So I thought it was a really good experience with the unions, they held us to account, and we had to feed back, and we were expected to demonstrate each time where we were, each month. So it was effective. Forward with the union, how do you expect that piece of work to be taken forward with your new set up? So we continue to meet with the unions once a month, updating feedback on some of the issues. One of the issues the unions would say is that they would like to see all the staff on Baines' terms and conditions. That's not possible because of 2P and the way the 2P works, and because not everybody wants to be on the Baines' contracts. So we're doing some work with the staff at the moment about, you know, next steps around terms and conditions. But that's hard, because some people want to and some people don't, but 2P is there to support their terms and conditions as they came up through the council. One final question, and it's going completely from my head. It might come back. Pensions, that's what it is. So we are with Avon Pension Fund at the council. How has that worked with the piece of work of bringing people over, and are there any problems there? There was no problems with those people who were already on the Avon Pension Fund. That was quite easy, but not all staff were, and that's really the issue. Some staff would like to be on the Avon pension scheme, but the terms and conditions are the terms and conditions. So right as we do our -- being our best, we're working through that. That's the -- being our best, as we call it, Bob in the council, is the big restructure that's going through the council at the moment. And that may pick up some of those issues. But 2P applies, and we've got to be so careful that we don't enforce, well, the council's terms and conditions when people haven't chose to take them. So it's not a clear answer, because it's a complex issue, because of all four or five different terms and conditions, different pension schemes. Because I sit on the Avon Pension Fund Committee, I'm just wondering, you know, one of the things that we need to do is have better -- less siloed environments. Is there anything that you should be bringing to that committee on this issue? Not at the moment, but I think that in time we will be, when we've got to a position where, as we go through, we've been our best, and we've worked through all the different layers, and some staff may want to move across, and it'll then probably come through Avon Pensions when that's happening. Okay, Kevin. Thank you, Chair. Yeah, just two quick questions, please. Section 5.5, you mentioned about there are still issues around some individuals' pay in terms of conditions. Is that a large percentage of people, or is that just a very minor glitch at the moment? That's very small numbers, and we pick that up as we go through, and that was part of our learning, yeah. Fine. And the last question was around the key risks that you've identified going forward. What would you say are the key risks currently at the moment going forward? I think our biggest risk is retention of staff. We, HCRG brought, you know, tooth bead staff across to us. We don't have an agency staff, and that's really unheard of in adult social care, so we don't hold agency. I think we've got two agency in OT, and that's it. That is really fantastic, so we've got to make sure that those staff and their well-being and they're happy in the job and they stay with us. For me, that's the biggest risk of transferring across. The other area I would say is around the workforce generally around apprenticeships, making sure we keep with the number of apprenticeships that HCRG had developed. They put 18 social workers over three years through apprenticeships. You know, it's great. It's fantastic, so they're the two key risks I would think that we need to keep at, because retention and recruitment are hard in adult social care. Can I forget, because also, obviously, were there any benefits that staff felt anyway coming back to the council that may help with that? And also, given the current situation with everybody promising to increase care workers' pay, and I doubt if it will be funded, is there any contingency for that at the moment? You know, there's the reserve that I just talked to you about earlier on, but that's not recurrent. Once you spend it, it's gone, and that's an issue. There is a new adult social care workforce strategy. The Skills for Care is working with, and I've been involved nationally with that, and we've been looking at the pay of care staff, social workers, and OTs. And we've been lobbying hard through ADAS to be able to make sure that we increase the funding into the sector. I can't say any more than that, because of the position we're in. So I'll only talk about ADAS, which ADAS is the Associate Directors of Social Services. But the strategy will actually come out. It's expected out on the 16th of July as the first adult social care workforce strategy we've ever had. So I'm really pleased that we've done that. Next year, we'll work with the NHS workforce strategy as well, so it'll be a three-year phased approach. So it won't just be about BANES. It'll be about the National Adult Social Care Strategy, and it's out there, and there's lots of tweets going on about it at the moment. Quite excited about it. It also means that the provider side and those care staff, making sure that they have the right salary for the jobs that they do and the right training. And I won't say any more than that, because it could become political otherwise. Thank you very much, Suzanne, for your care and your answer. Okay, I'm not seeing any more hands going up. Nope, I've had that confirmed. And so I'm now going to take us to the work plan, and one of the things I'm taking from adult -- so Yasha was just speaking on, is the need for us to bring this back to this panel. So she said after Christmas. I know that the next adult focus meeting immediately after Christmas is in January, so if we put that on our work plan for them, that will make sure that there remains a keen focus on that. We have, as you see, other items on our work plan. We've already added to it from items from today, such as the public health update. And there was something else, I think. What else was added to that from this meeting? Okay, so that was everything. Okay, so is there anything else anybody sees that -- or feels that ought to be added on to that work plan? So I'll take Kevin, and then Ruth. Yeah, thank you, David. Just on the current headings that are there, on the 3SG update, it might be too early, I expect, but obviously there is still the update on all voluntary services, and will that be part of that discussion, or is that too early in September for that one? I think we could come back with a timetable, and sort of an update, because we'll be working through. We won't be able to say, oh, this is a specification, but we can have a tighter timetable, so you can see where we're going, and what the next steps are, and what the principles -- if we're as far as the principles of specification. So that would make sense for September. It might be small, but at least it would keep it on the agenda, and from the community partners' point of view, that's really important. I think that would be helpful. There was also the care homes and COVID reports. There were learning points coming out of it around infection control, and pandemic planning, and when that might be a suitable update. So just being whispered to there, we can add that to the public health part of that meeting, September meeting. Okay. Anything else, Kevin? Yeah, I've also got for public health, they were talking about their whole system of health improvement framework, which they thought would be ready for September. Obviously, the schools' health and wellbeing surveys might be January, unless they wanted to give us an interim one around the secondaries. There is also several points for the ICB, the Children's Health Services and Young People's Program. There was the birth trauma may fit in with the Women's Health Hubs as well. Then the SendRep, the partnerships for inclusion of neurodiversity in schools. The update around pharmacy, pharmacy strategy, their capacities, and the big primary care access plan that they were talking about. They also mentioned, but it might be a couple of these items are small reports, but the police and mental health support, dental vans. I think that's about it. Well, I think we'll pick this up as we have our agenda-setting meeting and we'll work out how to best place all those various items because I think some of them fall under sort of overarching headings and report authors, so, okay. Thank you very much, Kevin. Ruth, and then Joe, was your hand up as well? Okay, Ruth. Thank you, I was just going to say, I think we also discussed having an update about the suicide prevention strategy, so at some point. Okay, I think that's cancelled in for November, but we'll confirm that, okay. Liz. I think cabinet member for children and young people and Paul promised an update on the safety valve because we had to resubmit our submission, our bid, so it would be good to get an update on that. Thanks, absolutely. Thank you, Liz. Okay, any, Kevin? No, I missed the Paul May bit. He was going to update around school streets, the AP provision, suspension and exclusion, and the savings on early health progress and Charlton House residential. I'm sure those are all duly noted, thank you. Okay, any other subjects people want to include? Otherwise, we will settle on what we have. Okay, so this may well be one of our shortest meetings. I would like to thank you all for your attendance, and I will now close the meeting. Thank you, everybody. [ Silence ] [ Silence ] [ Silence ] [ Silence ] [ Silence ] [ Silence ] [ Silence ] [BLANK_AUDIO]
Summary
The Children, Adults, Health and Wellbeing Policy Development and Scrutiny Panel of Bath and North East Somerset Council met on Monday, 10 June 2024. The meeting focused on updates from the cabinet member, the evaluation of the adult social care transfer, and the panel's work plan.
Cabinet Member Update
Councillor Alison Bourne, the cabinet lead for adult social care and public health, provided an update on several key areas:
Community Support Services
Councillor Bourne discussed the ongoing review of community support services, highlighting the importance of engaging with community partners. She noted that the review process and timescales are still being finalised, with a specification expected by September or October 2024.
Sexual and Reproductive Health
Councillor Joanna Wright raised questions about the two-year sexual and reproductive health action plan, which has £54,000 allocated across Wiltshire, Swindon, and Bath and North East Somerset. Councillor Bourne acknowledged the need for further details and promised to provide more information at a later date.
Leisure Services and Physical Activity
Councillor Wright also inquired about the cycle infrastructure at the leisure centre, noting that it has been insufficient. Councillor Bourne agreed to investigate this issue further.
Drugs and Alcohol
Councillor Lesley Mansell asked about the work being done around drugs and alcohol, particularly in collaboration with the police. Councillor Bourne mentioned ongoing partnership work across the Avon and Somerset police area, with further information to be provided once the work is completed.
Tackling Inequalities
Councillor Mansell requested more details on the projects aimed at tackling inequalities across Bath and North East Somerset. Councillor Bourne indicated that further information would be forthcoming.
Public Health Nursing and School Health
Councillor Kevin Burnett asked about the inclusion of school nurses in public health nursing and the specifications of new contracts. Councillor Bourne confirmed that school nursing is included and that changes to contracts are likely after seven years.
CQC Inspection Preparation
Councillor Bourne mentioned the preparation for the upcoming Care Quality Commission (CQC) inspection, including a self-assessment and submission of 187 pieces of evidence. The inspection is expected to occur by the end of October 2024.
Adult Social Care Transfer Evaluation
The panel reviewed the Adult Social Care Transfer Evaluation Report, which assessed the transfer of adult social care services from HCRG back to the council. Key points included:
- The transfer, involving nearly 250 staff, was generally successful, with positive feedback from staff and minimal disruption to services.
- The use of internal staff and minimal reliance on consultants helped keep costs lower than anticipated.
- Lessons learned included the need for earlier access to staff lists and greater involvement of middle management in the transfer process.
- The importance of staff retention and maintaining apprenticeship programs was highlighted as a key risk going forward.
Work Plan
The panel discussed their work plan and agreed to include updates on the adult social care transfer after Christmas, with a focus on training completion and benefits realization. Other topics to be added include:
- Public health updates, including the suicide prevention strategy and the women's health hub.
- Updates on the safety valve submission for children and young people's services.
- Various health and wellbeing initiatives, including school health surveys and primary care access plans.
The meeting concluded with a commitment to continue monitoring these key areas and ensuring effective oversight of the council's health and wellbeing policies.
Documents
- Agenda frontsheet 10th-Jun-2024 09.30 Children Adults Health and Wellbeing Policy Development an agenda
- Mins 20240513
- ASC Transfer Evaluation Report Scrutiny Panel 10th June 2024
- Appdx1 ASC Transfer Evaluation
- Panel Workplan
- Public minutes 10th-Jun-2024 09.30 Children Adults Health and Wellbeing Policy Development and S
- Lead Member Update Report June 2024
- Public reports pack 10th-Jun-2024 09.30 Children Adults Health and Wellbeing Policy Development reports pack