This meeting was to note reports on the Care Quality Commission (CQC) assessment of Adult Social Care in Westminster, the annual report of the Safeguarding Adults Executive Board and the progress of the Changing Futures programme. The Committee was also scheduled to consider the work programme for the rest of the 2024/25 municipal year.

Changing Futures

The Committee was to be asked to scrutinise the progress of the Changing Futures programme, a four year, externally funded programme designed to improve the lives of people in Westminster experiencing multiple disadvantages. The Committee was scheduled to receive a report that argued:

Changing Futures supports cross-council budget pressures by providing support to some of the boroughs most vulnerable residents, reducing escalation of issues upstream for individuals and the need for costly crisis responses. It is morally right to provide services for the most vulnerable and it supports people that, without it, generate some of the highest costs to the Council and public sector, as well as reducing involvement in anti-social behaviour and crime.

The report explained that as part of the programme, the council had commissioned research that showed that an estimated 38,600 adults (20% of the adult population) in Westminster are experiencing at least one of the disadvantages covered by the programme (homelessness, substance misuse, contact with the criminal justice system, experience of domestic abuse, or mental ill health). The report noted that Mental ill health and substance misuse being the two highest disadvantages recorded, reporting 23,346 and 14,551 affected individuals, respectively.

The report explained that the programme has three strands:

1. The Changing Futures Specialist Team: This team provides intensive support to young people (18-25) in Westminster who are experiencing multiple disadvantages. The report states the team is currently supporting 66 beneficiaries, and has supported 170 since the programme began in 2021. According to the report, analysis of the cohort found that 97% of those supported were referred with mental health issues, nearly two thirds had experience with homelessness, and over a quarter had been in contact with the criminal justice system. 41% of referrals to the specialist team come from children's services, and 40% from mental health services, demonstrating a gap in support for young people as they leave the care of children's services. 90% of beneficiaries had experienced four or more Adverse Childhood Experiences (ACEs), and 32% had approached the council as homeless. 65% of those who engaged with the service saw improvements in their anxiety and depression, and 80% had an improved quality of life. The report identified this team as a vital source of support, as there is very little support available for young people experiencing multiple disadvantages who do not meet the thresholds for adult social care.
2. Assertive Outreach: Single Homeless Project are commissioned to provide assertive outreach to two groups of people in Westminster: People who are considered 'change resistant drinkers' and residents of Churchill Gardens experiencing multiple disadvantages. This team, according to the report, is currently supporting 23 people. As a result of the support, people have experienced, amongst other things: Reduced contact with emergency services and anti-social behaviour teams; increased planned contact with support services; reduced isolation; stabilised living situations; and increased engagement in education, training and employment. The report noted that all beneficiaries of assertive outreach had a disability or long term health condition, meaning they were likely to already be in contact with multiple professionals. This 'Team Around Me' approach was identified as a key learning point of the programme.
3. Barka UK: Barka UK were commissioned to run a three month pilot project providing peer outreach to eastern European rough sleepers. The pilot successfully helped seven people to achieve outcomes like reconnection with family, repatriation to their home country, and access to rehabilitation. The pilot has been extended by a year.

The report was to ask the committee to make recommendations on how the learning from the programme could be embedded into the council's work after the external funding is scheduled to end in June 2025. In particular, the committee were to be asked to consider whether it wanted to recommend that the council continues to fund the Changing Futures Specialist Team.

Safeguarding Adults Executive Board Annual Report 2023/24

The committee was scheduled to receive the annual report of the Safeguarding Adults Executive Board (SAEB), a multi-agency partnership which provides leadership on adult safeguarding in Westminster. The report uses case studies and personal stories from service users to highlight the SAEB's work during the year. It was to ask the committee to note the report and endorse the SAEB's strategy and priorities.

The report, which is for residents as well as professionals, describes the purpose of the SAEB as to:

ensure that member agencies work together, and independently, to secure the safety of residents who are at most at risk of harm from others, or through self-neglect

The report is structured into four sections:

1. Communities Keeping Themselves Safe: This section focuses on the work the SAEB has done to promote safeguarding in the community. This included the launch of a network for Black, Asian and Minority Ethnic residents to discuss safeguarding within a cultural context, articles on carers' rights and the mental health of young people, and details of awareness-raising events delivered by the board's Safeguarding Ambassadors.
2. Making Safeguarding Personal: This section of the report explains how the SAEB has promoted awareness of different forms of abuse and the importance of understanding a person's individual circumstances.
3. Listening Leading and Learning: This section describes the partnership's training programme, its response to pressure ulcers¹, and a 'Mental Health Learning Programme' in support of a local suicide prevention campaign. It also contains an overview of a review into fatal fires in the borough.
4. Quality Assurance and Performance: This section of the report is about how the board uses data to guide its priorities. The report notes that in 2023-24, the profile of people who were referred to the SAEB closely matched the profile of people receiving ongoing care and support, indicating that the partnership was effective at reaching people from different backgrounds.

The report also sets out the SAEB's strategic priorities for the coming years, which include placing adults at risk at the heart of safeguarding, creating a diverse safeguarding culture, promoting continuous learning across the partnership and ensuring the effectiveness of safeguarding arrangements for adults at risk.

Care Quality Commission Local Authority Assessment

The Committee was scheduled to receive a report summarising the recent assessment of adult social care in Westminster by the Care Quality Commission (CQC).

The CQC’s new assessment framework focuses on four key themes:

1. Working with people: This includes making sure that people are involved in decisions about their care and support, and that services are tailored to meet their individual needs.
2. Providing Support: This means making sure that people have access to a range of services that can meet their needs, and that these services are well-coordinated.
3. Ensuring safety: This includes making sure that people are safe from harm and abuse, and that their rights are protected.
4. Leadership: This means making sure that there is strong leadership in place to drive improvement and ensure that services are of a high quality.

The report explains that following the assessment in June 2024, Westminster's Adult Social Care and Health (ASCH) directorate was rated as 'good', with an overall score of 75%. At the time of writing, this was the highest score in London and second highest nationally.

The report details the feedback received from the CQC. The CQC had received largely positive feedback from service users about their experiences of services. People told the CQC that they felt listened to and that they had control over their daily lives. However, some people also said that they had found the process of accessing services confusing. Unpaid carers said that they felt supported by the council, but some felt that there was a lack of specialist respite care available.

The report also highlights some areas for development. The CQC found that there were gaps in contingency planning for unpaid carers, and that some carers felt that there was no plan in place if they were unable to fulfil their caring role at short notice. The CQC also found that the uptake of direct payments in Westminster was low, and that some people felt that they did not have enough choice and control over how their direct payments were used.

Overall, the CQC found that Westminster City Council was providing good quality adult social care services. The council was praised for its person-centred approach, its responsiveness to people’s needs, and its strong leadership. However, the CQC also identified some areas where the council could improve, such as contingency planning for unpaid carers and the uptake of direct payments.

Work Programme

The Committee was to be asked to discuss and agree its work programme for the remainder of the 2024/25 municipal year. It was scheduled to discuss its current work programme, which included future meetings on: Substance Misuse Services; the Reablement Programme and Aids and Adaptations. It was to consider whether to add to the work programme for 2024/25, or start to consider the work programme for the following municipal year (2025/26), which currently included items on: The Community Equalities Strategy; the Community Hubs Programme; the Hot Meals Delivery Pilot; NWL ICB Primary Care Governance; Community Grants; Healthy Weight and Preventative Services; Prevention of Violence Against Woman and Girls; LGBTQI+ Services in the Community; ICB New models of Care; Community Health and Wellbeing Workers; Provisions for Learning Disabled Residents; Autism Strategy Delivery Strategy; The Future of Place Based Partnerships. The Committee was also to consider whether it wanted to set up any 'Task Groups' or 'Single Member Studies' to consider topics in greater detail.

Finally, the committee was scheduled to review the progress of actions and recommendations made at previous meetings.