Transcript

I am chairing tonight's meeting. Please note that we are not expecting a fire alarm test this evening, so if the alarm is sounded, please follow my instructions and evacuate the building. This meeting is being forecast to allow those who cannot attend in person to follow the proceedings. Please, could I ask you to turn on your microphone when invited to speak, and to remember to turn off your microphone when you have finished speaking. Please, could committee members and officers introduce themselves, starting on my right? Councillor Mcgilgun, Solomon Ward. Councillor Janet Burgess, Junction Ward. I think officers introduce themselves when they will present their items. Yes, thank you. I received apology from Councillor Gilligan, Councillor Clark, Councillor Croft. Councillor Nargundo is sending apology because he has to attend another meeting, Council meeting. I don't know, this is an apology or attending other meeting, how it's going to treat it. Yeah. Thank you. There is no substitute member for this meeting. Are there any declaration of interest? Thank you. Chair report. As you are aware that we had our scrutiny visit to Malmage Extra Care Scheme on 7th January, 2025. Thank you to those who attended. Babaya has drafted some notes and this has been circulated to the members who attended. Please, can you review and get back to her if you have any comments or would like to add? The final version will be submitted to the committee for noting at the next meeting. We have arranged an additional meeting to receive evidence from Islington and Swordwish Housing Association. This is a virtual meeting scheduled for 27th of February, 6pm. Babaya has also sent and teams invite for this meeting. We also have a focus group meeting coming up, which has been incorporated in the Let's Talk PR event on 20th of February, 2025. The event will be taking place 222 upper streets from 10.45 to 1.30pm and our slot for questions will be 11.50 to 12.15. Unfortunately, I have sent my apology due to personal reason and Councillor Kopp has agreed to lead on my behalf. There is a capacity for two members to attend, so I am hoping that one other member is available to attend alongside Councillor Kopp. And I would like to say thank you to officers that arranged the visit to Malme. Also, I would like to thank you on behalf of this committee to the Malme staff. They did a really fantastic job. They are hospitality and everything. On my community, I would like to say thank you to them. They are here. And also Neki and other team, they did a fantastic job to arrange this meeting. And everyone happy to visit. Thank you for that. Please, can you keep your presentation to a minimum presenting key points? One way. Moving on to the question item. I have agreed to vary the order of business this evening. We will take item B2, Adult Social Care Budget Report as the first item. Because I thought it's better members can understand our budget. And it will lead the question to the witness evidence, which will help us to identify the question and answer everything. That's why I decided this one. And also, we will consider any questions from the public after each agenda items. May I ask B2, Adult Social Care Budget Report, John Everson, and Shaquille Yassim to present. Please, go ahead. Thank you, Chair. I'm John Everson. I'm the Corporate Director for Health and Social Care. And as you indicated, today we're going to give you an overview of the Adult Social Care Budget Report. Just before I hand over to Shaquille, who is the Assistant Director who supports Adult Social Care from the Finance Team for Adult Social Care. Just to say, this is the Quarter 2 Report. So, taking us up to September 24. We are moving into Quarter 3 at the moment. And that reported position will come out shortly, but isn't yet available for discussion today. Shaquille will give a really sort of clear overview of the Budget and how that's made up. The forecast position is at Quarter 2 and a reflection of the work and the challenges within the Adult Social Care Budget that the Service has been working hard to address, whether that's through our approach to promoting independence, so to ensure that people are able to stay healthier and more independent for longer, whether that's through our commissioning activities and our approach to ensuring that we get value for money, for the care and support that we purchase, whether that's through making sure that we've got strong operational approaches in place that enable our frontline staff to support residents at the right time, in the right place, in the right location. So, without further ado, I'll hand over to Shaquille. Good evening. My name is Shaquille Yazan. I'm the Assistant Director of Finance, as John introduced me earlier. And the presentation is broken down into three parts. One is the Budget Overview, and it just shows how the Adult Social Care Budget is put together and what goes into it. The second part is the actual Budget Monitoring itself and the risks it raises. And the last step is just background slides, so that's the information, so I won't go through them unless there's specific questions, but I'll go through the first two, which are the finance parts. Okay. First part is the Budget Overview. So, the Out of Social Care Budget for 24-25. We have a gross budget of £163 million, and that is the amount of money Out of Social Care has to spend on various services such as home care, residential care and staffing. We then have an income budget, and this is the amount of money we expect to receive from various income streams such as client contributions, money from the NHS, and money from other activities such as recharging other services. That is £106 million. And that leaves a net budget of £57 million. And that net budget is funded from the Revenue Support Grant, which the Government gives us, and the Council's Tax we raise. Now, the next slide breaks down the income in a bit more detail. So, the first bit is we get £54 million of central government grants. These are separate from the Revenue Support Grant. These are specific grants to support adult social care. These are such as the Social Care Grant itself, and the Improved Better Care Fund. So, and this year we also got the Market Sustainability and Improvement Funding from central government, specifically Ring Fence for Adult Social Care. The second large bit of income we get, sorry, the first bit was £54 million. The second bit is Client Contributions. This is assessed charges for residential and home care services, and we get £13 million of that income per annum, and it increases each year as the number of clients increase. We also get an income from the Housing Revenue Account, and that is mainly for services we provide, which also have the function of supporting people in their tenancies. is to pick rules around HRA income, and we ensure we meet those needs. And we get a profit of £2.4 million from that. The other large bit of income we do get is from the NHS. We get £29 million from the NHS to support social care, which also has health benefits. And that's made up from several areas, the biggest bit being the Better Care Fund. And so a large amount of money is transferred all from the NHS to local authorities as part of that. We also have a number of pool budgets. A pooled budget is essentially where health and social care put money together in one part to actually meet the needs of residents, and it's dictated by NHS section 75, hence it's called a section 75 agreement. It's a legal agreement with the NHS, and they transfer the money. So we're quite advancing that in terms of integration with health. It's been a long-standing process in Islington, you know, before other people have done that. So it's actually quite a thing to be proud of, our integration with health. We also have the final bit, the final big bit, is our Revenue Support Granted Council Tax. That's £57 million. So that's how the income is made up in adult social care. It is quite a lot of income streams that come in, and that does make us quite vulnerable in terms of if those income streams do reduce, it does cause ongoing pressure in terms of what we can spend. The next element is actually what we have to spend. So all that income supports what we can spend the money on. And as you can see from the pie chart, 73% is actually spent on placement. And these are varying activities such as providing home care services for people, providing day care services, residential care units, nursing care units, supportive accommodation, extra care, anything that helps meet the client's needs, whether they are discharged from hospital or come from the community, and if they meet Care Act eligibility. And we also have an element of housing-related support, and that is where people don't quite meet the Care Act eligibility, they're just below that threshold, so we do fund that activity as well to the tune of £5.5 million. So on top of what we call placements, we have housing-related support activity. So as you can see, a lot of our money is tied up into placements, as in frontline provision of care for vulnerable residents in Newlington. In terms of staffing, in terms of social staffing, we spend 9.5%, which is £15 million. So that is a breakdown in terms of a big area in terms of our social care spend. Okay, I'll move on from there. The next element is a breakdown of the placement expenditure by type and care group. I think one of the misnomas in terms of social care is that we provide care for older people only. Actually, we provide a lot of care for people who are 18 to 64, few with profound learning disabilities, physical disabilities, and mental health needs. Overall, we look like we are spending about £50 million on that area of spend. That's nearly 50% of our spend is on younger adults, and that's primarily in the learning disability care service. We spend a large amount on residential care, providing people care in residential care homes. But we also spend a lot of money on home care, ensuring people stay at home, get the right level of care to meet their needs. And the push is to have people receive more care at home because it actually increases independence and has a better chance of enabling them to get better. We have split accommodation, which is in between having a home care setting and a residential care setting. It's an accommodation where you get care coming in and out. And then we have nursing care, which is a step up from residential care and is where people actually need a nursing care intervention. And then we've got personal budgets, which are direct payments that services need, clients will get, and they're around their own care. And those are big areas of spend in terms of placement budget. And again, like I said, £120 million is spent on placements for meeting people's needs. Okay, so that was how our budget is constructed. Now the next bit is what our forecast is and what our pressures are and what our risks are. And as John mentioned earlier, this is a quarter two forecast and we are working on quarter three and that will be with you, I would say shortly, but I think in a few months in terms of when you reach the executive. We at quarter two are showing a £739,000 overspend. And that is due to the historic unavailability of the KU type beds. They are now available, they were available in 20, back end of 23, 24. And we are now filling them. The reason for the pressure is that we can't fill a care home all at once. It has to be done in a phased way to ensure that the service users who are in the home and the people who are coming in there get the right level of care and also the staff there can actually build an opportunity provider with care. So we've modelled how long it will take to fill the home over the years. The full year effect of that pressure was £2.4 million. Initially at quarter two based on the occupancy, it was £1.65 million. We've actually come down to £739,000. And that is sort of the work, hard work, commissioners, operational teams and other parts of the council have done working together to actually get people into those homes. That pressure will not be there next financial year because the home will be, I think it's sort of at 96% occupancy currently. It's fantastic. And so therefore it will be business as usual and that will not be a pressure going into the next financial year. We have, as all council say, we have risks for this year but we have potential risks for the next financial year. And on the next slide they are actually detailed. One is additional demand due to one, NHS discharge pressure. People being discharged from hospital and a push for that. That will create a pressure in our social care. Pressure from the community in terms of people needing further care to support them from the community and also to prevent hospital admissions that are thought to us. And as people get older they get frailer as well. But there are plans and mitigations to actually minimise that impact. And the Integrated Quality Assurance meeting they have every week that actually looks at making sure the right care is put in, the service users needs are met and a strengths-based approach is used in terms of assessing service users. And also challenging each other in terms of making sure all the provision within Islington, voluntary sector and paid care is used. The other one is increased acuity of need of existing service users exceeding our budget. What that essentially means is the people we have currently in care increasing their needs as they get older. And as they get older their care needs increase so therefore we see an increase in cost. And we are seeing that both with older people, we are also seeing that with people who have learned profoundly on disabilities. As they get older sometimes their carers can no longer look after them. So therefore we have to intervene then so that will be an increase in cost for that existing service user. But also as they reach old age they will start presenting with those needs which are covenant with older age. So again that will cause an increase in cost as well. So we are seeing that and we keep an eye on that to make sure that we are monitoring that, measuring that and put that into a demographic forecast in terms of going forward. NHS funding changes. The NHS like the local authority are facing spending as I call it squeeze. So therefore some of that they would look to us in terms of how much they are providing to us. And there are risks around that. But we have a very good working relationship with the NHS currently. And we have worked through that in a partnership sort of way to make sure that this doesn't actually impact frontline adult social care. Children's transition to adult social care is another pressure. And this is we are seeing more children coming through with profound learning disabilities and physical disabilities into adulthood. Which is a good thing they are surviving into adulthood that is a positive. But that is causing a pressure in terms of the level of care needed is quite profound. So we are working with children's services through the progression to adulthood team to make sure we identify these people as early as we can. And actually start not having a cliff edge when they reach 18 but having a phase sort of progression into adulthood and minding that cost. Delaying opening and social care accommodation. Again, and that is partly down to COVID, the back end of COVID. We have seen that a lot of projects have been delayed and getting the supply chains, the issues of supply chains and getting work. But actually a lot of these things are now coming across the line. We are getting a lot of care of these projects across the line as you've good news. And the final way facing savings slippage. That every year we monitor our savings and make sure that we are maintaining the level of savings we need to make. But also identifying substitutions if we don't meet the current savings we have. This year we have been quite successful in terms of our savings. But there are challenging savings this year and going forward to next year. The next bit is about savings and manual actions. And this slide just gives you the last five years of savings our social care have made. And what they've got fastening for next year. But this doesn't take account of the savings that are going through council currently. So for 24-25 we've got savings of £6.65 million to deliver. And the good news is, if you have a slide in colour you'll see that that is a green column. Meaning we are on target to achieve your savings. Which is good news. They have been very challenging. And again I think it's testimony to John and his team, I think commissioner and operational team in delivering that savings is very challenging and they have delivered it. But again we can't take our foot off the gas because these savings will continue into next financial year. That is all the aspects in terms of the finance bits. The other slides are background slides and in terms of what adult social care do and the pressure. And I wouldn't intend to go through them now unless you want me to go through them? Okay. This is fine. We can ask the member if they want, they can ask the question. They already had that. Thank you. Thank you. If you have any questions? Can I ask the committee? Great. Thank you. And thank you for the work and the presentation was really clear and really helpful. I'm very conscious that it's taken a lot of work to make sure that there is a balanced budget. And you know, there are massive congratulations to the office. I'm very conscious that it's taken a lot of work to make sure that there is a balanced budget. And you know, there are massive congratulations to the officers to make that happen. But I'm very conscious for the difficult decisions that are required to make that happen. And I'm very conscious of all the difficult decisions that are required to make that happen. And one of the things that's on my mind is the level of unmet need that is caused by these reduced budgets. And I'm wondering how do we tell the story of what unmet need there is out there in the borough to help move decision makers that we do need more funding for adult social care? If I pick that up, I think there's a real, that's a really interesting question. So for one, so there's a balance here, I think. So one of the things that we're able to do in Islington and as all local authorities do, of course, is to really clearly look at sort of pattern of support that's provided. And benchmark ourselves against other sort of local authority areas. So we know that in Islington, when we look at that, that we have historically been able to provide a high level of support to our residents. And in some ways, I think, and one of the reflections has been particularly in line with our statutory duties to reduce delay and prevent the need for care and support. That actually what we need to do is to work with our partners at an earlier stage, with our NHS partners, for example, to stop that deterioration and that escalation of need on one hand, which in effect then helps to reduce costs. Similarly, making sure that we're getting best value for money for the care that we purchase. So making sure that we broker things effectively. And the other point, and probably linked to some of the conversations you've been having about our accommodation strategy, is making sure that we've got the right care and support in the right place at the right time. So residential and nursing care shouldn't be the first point of course, should it? It's about what can we do to support people to remain more independent in their homes for longer, and then what's the step-up options if those needs are required. So there's a bit, I suppose, for us where I feel assured from the statutory perspective that what we're doing is promoting people's independence, is making sure that we step in at the right point in time to enable people to live those healthier, more independent, fulfilling lives. And therefore, we've seen over time those sort of costs legitimately coming out of the system. And we're much more effective, I would say, now at making sure that we're getting the best value for money, that we're getting people into the right care and support at the right time. But if you look over time, and we look forward, we know that the age of austerity has been with us for a long time. It's created a real pressure in the system. We've got our provider markets are really at risk, I think, if we're not able to support them over the medium term. We also know that we're going to see an ageing population who, if we're not able to step in at that point and reduce the sort of complexity of need, that the current forecast in terms of the money that we get in will be outstripped by the need coming through. So I think for a sustainable adult social care, we need surety, really, in terms of what the funding will look like over time linked to the complexity of need that we can see coming. But that's one thing we, with our finance colleagues and our performance colleagues, should be really clear about what we're expecting to see in terms of complexity of need and demand over time. Thank you. I understand the answer and I think, you know, there's lots of admirable work there and understand why the answer is the way it is. I'm also very conscious that if I'm a treasury person and I've heard that answer, I'm hearing efficiency savings, it all sounds good, it's a problem for tomorrow. And, you know, the end result is we've got an adult social care review that's taking two years instead of meeting the urgent need. So I'm really conscious that I think we need to be telling this story of unmet need much more clearly and much more loudly or else decided decision makers aren't going to take the action that we want to see. Just one example, because I know that was a very political answer and not a question or comment. When it comes to learning disabilities and the support that we're providing to adults with learning disabilities, where is the threshold right now? Has the threshold moved to where we used to provide support? Is it just people with severe learning disabilities getting adult social care? Are we still supporting people with moderate need? Which I'd be very pleased to hear. Yes, we don't change the eligibility criteria in that sense, absolutely. You know, it's all based on individual assessed need, which our operational colleagues are very adept at. So we will step in. It's our duty to step in to make sure that people are supported effectively over time. And the point, I think, back to the, you know, what the risk is for the system, I think it's a valid point and obviously a political point that's important to challenge. Thank you. Thank you. Just before I go to the, Janet, how much is it up to, what is it called, quarter two, how much is overspend up to now? Quarter two, we reported a £739,000 overspend. And we are, the, all indications are that will come down for quarter three. And we are hoping that we can balance the budget at the end of the year. Pardon? No, no, £739,000. Janet. Thank you, Chair, and thanks, Shakir, for the report. Really, really interesting figures. And you also reminded us that half our budget goes on people of working age, and particularly people with learning disabilities. So I just want to pay tribute to Jean Wilson, who died recently, who was an advocate for people with learning disabilities, profound of multiple difficulties. And at one time, she was the national face of it actually. And she did such a lot in the country, not just in Islington, because she gave me a very hard time always pushing for more. But nationally, I think she changed people's, the way people look at it. Those of you who knew her will know what I'm talking about. So I just want to pay tribute to her at this meeting. And Councillor Williamson, can we do that at full council? Could you, could you take that? Yeah, we can do it. I think she did tribute at the last full council, but we can, I think, do some applications. She was a wonderful woman, really, really amazing. Thank you. Just briefly about the day centres. The day centre has been impacting austerity. I know a day centre manager that I know in another area of country, Norfolk, they've had their grant cut. I just wonder how does it affect us here in Islington and our neighbouring boroughs maybe? Well, I can pick up from the service perspective of the industry. I suppose in terms of Islington, in fact, we had a naming launch today for Evergreen Day Centre, which is, we brought together, Olsen and New Park. And so our commitment to providing day care and day centres is definitely an asset for us. And we're able to support people with some of, you know, some of the more complex needs within our day service settings. So really exciting. You're right, lots of councils have not been as fortunate as that. And having come from Norfolk previously, I'm aware of their strategy. So having a building base from which we can think about how people access the wider community is an incredibly important part of our portfolio of support for people. Thank you. I have some questions. First one is supported accommodation. Yeah. Is it for the learning, disability, memory and mental health? Because we used to have a shelter accommodation, it's called supported. It's normal. We don't provide any more shelter accommodation. Do you? We provide support accommodation in terms of, I think shelter accommodation is slightly different in terms of what it provides. I think support accommodation is primarily to support people's care needs as well. And shelter accommodation is more in terms of housing, in terms of ensuring people from homelessness and temporary accommodation. So I think there's a difference in terms of our social care would provide support and accommodation to meet a client's needs. And it's where the client's needs are, they can't stay in their own home, but they're actually not at that point with any residential care. And this actually helps them promote independence. So it's a slight sort of a difference with that core service. And also, yes, you said this year, 6.1 million savings, you are thinking, yes. Is this saving going to be affecting any of our online services? Anything affecting any of our online services? From a finance perspective, I think what these services have done is they made sure the savings dovetail with actually the vision of our social care in terms of making sure their strength-based approach, making sure the right care needs are provided, and ensuring that the service user's needs are met. So from that perspective, from a finance perspective, we're not seeing actually a cutting in services in that respect. It's actually making sure the service is the right service for the resident. And sometimes it is better to have a lower level of service because actually it promotes independence. And we've had a take-home and settle service which has been very successful in terms of making sure that people who only need a short-term intervention are then made sure they get that intervention and they're actually independent and they don't need any further care. And that's delivered a lot of savings. And we've also had the re-advent service step up as well, which has made sure, again, to make sure that people have the ability to sort of be more independent, therefore need less home care. So all of that's contributed to it. We've also been quite successful in terms of, we've worked with other boroughs in terms of getting a continuing health care, and that is health funding for packages which were previously funded by social care. And that's actually yielded a lot of savings. And the person gets the same care, but actually it's better for them because they don't have to pay client contributions because it's provided by health and health are actually supporting them with their needs. So John can maybe answer a bit more on the need side, but I think from a financial perspective, none of the savings are there that are saying cutting needs and impacting residents in that way. Yeah, thanks Gil, you carried most of that. And sort of back to my earlier point, there are a number of ways that we're able to sort of manage cost. One is obviously about preventing, reducing, delaying the need for care and being able to step in the short-term interventions to get people back up on their feet, which is absolutely the things that take home and settle. Reablement, we're able to do the use of assistive technology, for example, as well. And I suppose the only thing that I would also pull out a little bit is the really great work that our sort of contracts and brokerage teams do to make sure that we're paying absolutely the right amount of money for the care that we're purchasing. So, you know, having those really important negotiations with the care market to make sure that we're paying a fair price for care, that obviously meets all the requirements around London living wage and those sorts of things. But I think it's a combination of our ability to get good value for money, to be able to prevent, reduce and delay the need for care and support, and making sure that we can bring in where appropriate NHS and other funding streams to support people's care needs over time. Two more questions and finish. So, you know, the assistive equipment and tax, this is, I understood that we had a contact with a company and we give a new contact, yeah? And can you make sure that because when I was a member of this committee and Janet was executed, I did raise so many time that OT equipment was delivered and some resident died, no one collected that one and we are paying, paying. And that time. And even now, the company, whoever the providing a service, are you sure that they're going to collect the equipment, which is very expensive, especially hoist and everything, we can reuse and save money? No, thank you. Absolutely. And the performance of that contract is something we've been monitoring extremely carefully, and since it's mobilisation, I'm really pleased to report and we can provide, you know, obviously more details as and when required. But, you know, we are seeing that performance improving over time and particularly in terms of, you know, as one of the benefits of this contract was the fact that it would be collecting equipment in a timely manner. But, you know, we will be working with our partners as part of the London consortium to make sure that we keep a very close eye on that. And our commissioning and contracts colleagues are very much doing that in partnership, as I said, with other London councils who are part of this consortium with the incumbent provider. Last question to you again. I believe you agree with me, the face-to-face assessment every year, sometimes save money, sometimes also give good outcome to our residents. Are you going to be, give us an assurance that, because of the pandemic, our social worker, they do, they did all lots of assessment through phone call and everything. Yeah, you're going to give us an assurance that you're going to do start assessment, early assessment, face-to-face. So there's a combination, obviously a combination of those things. In terms of the assessments, we will always do those, you know, do those in person. There's an opportunity for us to stay in contact with people once they've got care and support. So, and we will review their care and support needs. So, keeping those things in place is always going to be important as we go forward. And I'm pleased to say, you'll see in some of the performance report that Victoria's going to talk to you later, they're really seeing that sort of progress of getting those, that reviews activity up and performance coming through. So, yes, absolutely. John, I would be grateful if you can make sure that our residents get face-to-face assessment. And I would be grateful if you can do this now. Thank you. Thank you, John and Sakel. Thank you for your hard work to getting down our budget. Thank you for that. Good evening, everybody. I'm Sakelba Gerda. I'm Head of Planning Policy and Biability Service and Planning. And I'm Karen Sullivan. I'm Director of Planning and Development. Good evening. Right. So, I'll quickly go through my presentation. I understand you've already had a chance to look at it. In terms of context, I'll say a little bit about the local plan. So, we're looking at how Planning Policy and Section 6 can help with achieving the objectives of other social care and health both with the providing accommodation for people with the care and support needs. But the starting point for everything in planning is the local plan. Basically, we have child policies and requirements and all of these things. And if you don't have them, then you can't seek things. So, it has to be in the local plan in order for us to have the basis to negotiate with developers and secure various things. Also, in terms of planning obligations, there are criteria set in law as to what we can ask for. So, it needs to be related to development in terms of scale. It needs to be reasonable, fairly unreasonably related in scale and kind to development. So, the reason I'm highlighting this is we can't just ask for anything and just come up with things. There are restraints within the law as well as within planning policy. But we do achieve a lot and we continue to. I'm going to outline quickly our affordable housing policy, which is the Council's key priority. And this has a direct relevance to how we secure accommodation for elderly people and people with other vulnerable groups, other adults. So, the strategic policy is 50% of all additional housing should be affordable. And then within that, on sites that provide 10 homes or more, we seek, if they're private sites, 45% without public subsidy, plus 5% to try and get to that 50%. From private sites and then from public land sites, we seek 50% affordable housing without public subsidy and then a little bit of an addition through getting grant from the mayor and from other, if there are other sources of funding. And in terms of the 10-year split, we seek 70% social rented housing and 30% intermediate. So, that's from bricks and mortar sites which deliver on-site affordable housing. And for smaller units, for smaller schemes, sites under 10 units, we seek affordable housing contributions. We are one of the very few local authorities in the country that secure money from these small schemes. Normally, the previous government was against these, but we continue to secure them and we've actually secured a lot of money over 30 million which then go to our housing colleagues to build social housing. So, in terms of the policies for what we refer to as specialist accommodation, they're grouped in two policies. So, there are policies around meeting the needs of all the people and then separately a policy around meeting the needs of other vulnerable adults, whether they're people with physical disabilities, sensory disabilities, learning disabilities, mental health issues and other groups. So, it's kind of in two parts. But the main emphasis really is on elderly people, on all the needs, meeting the needs of all the people. We are highlighting, stressing that the primary route to do that is through delivery of a conventional residential accommodation, which is designed to be adaptable and to serve, to meet changing needs all the time so people can stay in their homes for as long as possible. And we see that as the best, kind of most sustainable form of accommodating all the needs, including needs from elderly people. There are some needs around affordable accommodation in extra care units. But ultimately, the thing to emphasize is, and we've left this in policy quite clear, that we will secure this accommodation if there is need demonstrated through evidence that other social care colleagues will have. So, it's always based on need and those needs will be changing over time. This plan looks at the next 15 years. And then specialists, all the people with residential accommodation, such as care homes, et cetera, might be suitable if there is, again, need of unmet local, if there is evidence of unmet local need. And again, it's down to evidence from colleagues in adult social care. There is also this benchmark that comes from the London plan of delivering 60 homes per year that are homes suitable for elderly people. And that's basically, it's an aspiration set in the London plan. The Mayor of London has looked at the evidence all the time in terms of growing needs for accommodation for older people. And then they've basically allocated a figure for each local authority. It's an aspiration. It's to have this as part of various other things that we're trying to secure. So, 60 homes per year then translates into 900 over a period of 15 years, which is what our plan looks at. And then there are various, very detailed range of design and locational criteria that need to be met. And I'll return a little bit on that. And then in terms of planning for supported housing for other vulnerable adults. Similarly, it's again based on need, identified local need. And the accommodation needs to be designed in a way that's suitable for those for whom it's intended. And again, there's lots of detailed criteria about how those are to be designed and managed. And also, we are looking at why the environment, not just specific design of that particular building, but also the location, access to public transport, shop services, and various other things that enable people to stay living as independently as possible. This diagram, which you've seen, just shows the range, the spectrum. And we use it in planning and colleagues in adult social care use it. On the one hand, it's people living independently in their own homes. So, general needs, homes meet those needs. And then homes that are adapted to enable people to stay in their homes. And then gradually, more and more care, I suppose, being delivered into people's homes. And then all the way to the other end of the spectrum where you have residential care and nursing care. But ultimately, our focus is on trying to provide conventional housing that can meet people's needs over their lifetime, effectively. So, I think this is quite helpful, this diagram. Just in terms of other criteria and other policies, we've set very high standards in terms of designing quality homes, generally. In terms of space standards, in terms of circulation, how buildings are designed, how the wider public realm works, the pavements and streets, and all of these things, generally for everybody. And then, of course, that's directly relevant to delivering homes for older people, as well as other vulnerable adults. So, we set, for instance, I've just put a couple of points on here. There's loads of criteria, you know, pages and pages of different standards and dimensions of how things need to be built and designed. For instance, we are requiring that 90% of all the homes being built should be built to be accessible and adaptable standards. And then, 10% to be wheelchair housing units. So, effectively, all of the housing should be good quality, high quality, to enable people to stay in their homes. And then, 10% wheelchair housing. There are all the specifications around distances from parking spaces, drop-off points into the main entrance of the building or the actual home itself. There are criteria around communal space, circulation, access control, all of that. And, you know, step-free, lift access. So, all of those things are in there. I won't bore you with them all, because there's too many of them. And, ultimately, all of our planning policies look at environment as a whole and the kind of inclusive design principles. So, it's not just about the building, but the wider environment. Whether it's transport, whether it's public around the streets, pavements, all of that stuff. So, it's all in there. And, it's quite... Each time we have a new local plan, we kind of move things forward a little bit. I think Littleton was the first local authority to introduce the requirements in planning for 10% wheelchair housing. Then, that was taken up by the mayor. So, we always try and push things as far as we can. And, then, in terms of examples of what we've secured in recent years. On the hallway prison site, which is currently under construction, as you know, just under 1,000 homes in total. We've secured 60 social rent extra care units in consultation with colleagues in other social care, as well as communal space and space for staff. The nomination rights for these homes go to the council, 100%. And, then, Section 06 agreements specify, you know, what fixtures and fittings need to be put into those homes. So, this is an example of us working together from the outset to secure what has been identified as needed. And, then, on 250 City Road, again, another big scheme. We've secured 10 one-bed units for people with moderate learning disabilities and in need of care. And, then, also, a couple of studios for on-site carers. So, those are just two examples of one for adults with different needs and then also elderly people. And, this is just a visual of, or some visuals of Holloway prison site. It's one of our, well, it's one of the biggest sites in London currently and certainly the biggest in Islington for many years. Which provides an opportunity to secure the homes that I've talked about. But, also, it's not just about homes. It's, you know, new open spaces being created in the middle of a completely new neighbourhood. Which, and all of that is being looked at from inclusive design perspective as well as these specific needs that we've talked about briefly. And, then, on the planning process, how to feed into the planning negotiations and Section 6 process. The policy talks about need and local need and need to demonstrate that. So, we, as a council, need to have, you know, colleagues in other services, clear idea of the need and what is the list of priorities. So, we can then, planning, officers can then have that as part of their negotiations with the applicants. We need detailed specifications of what accommodation is being sought. Some flexibility around, you know, on some sites, perhaps more limited provision could be made. But, we need to, we need to be mindful of that. And, we need to have, it's a joint up, a council position that means around sharing nominations. Because, the, the other social care nominations come from all of that affordable housing. It's within that, it's not a separate extra thing. We do have an officer working group which meets regularly and we can highlight potential opportunities early on in the process. So, this is, I think this is my last slide. The key thing to, to consider is that any support accommodation which is sought by other social care comes out of the overall affordable housing pot. Which is why I've started with setting out what the affordable housing policy, 50%, etc. And then, colleagues in, in different services need to agree around nominations. The affordable housing is managed by RP unless it's ours. And then, again, we always have to, this is something I said at the beginning, we also have, we always have to be mindful of those tests for seeking sectional six obligations. It needs to be of the scale that's appropriate for the scale of development. It needs to be fairly and proportionally related to the development itself. We can't just ask for anything. It has to be what meets those tests. Design specifications, we'll always have that from the outset to negotiate on. Some of those design specifications might be more costly and may, but then, conventional housing might have some implications on financial viability of the scheme. So, we need to be mindful of that. And one final point is that we generally have relatively limited opportunities because we have very few sites in the borough left for housing development. And this is partly because, well, largely because we've been delivering a huge amount of housing for over 20 years, and now there are fewer and fewer sites. And some of them are, you know, smaller and more complex, and they might not provide an opportunity. So, the shortage of land is an issue. But within those sites that are coming forward, some of the larger sites might have an opportunity to provide some accommodation, which will then go towards meeting those needs of colleagues in adult social care. I'll stop here. Thank you. Thank you. Thank you. Just like I want to ask my colleague to ask, because you can understand our budget. You can see that most money is going to the gap position and everything. And that's why, and it will be helpful for your view, your comment, how, as it, especially the planning committee, how help, you can help us to make a recommendation, to make more care homes, more services, and where the barrier is. Yeah. And this kind of, because we are policy makers, if we can make a policy to break the barrier. Like if I give an example, like 10 units, more than 10 units should be 50%. This kind of policy now help us to get more social housing. Now we're going to do something about older people's accommodation. And I'll actually turn on my colleagues. Okay. Great. Thank you. Thanks for the really comprehensive report and really detailed. I really appreciated it. And so we recently went to visit the Malmaze service on Newington Green, and they're currently going through a process of trying to provide more flats in their block. And one of the things that they raised with us is that they actually found the process really complicated. They felt that they've been providing information and having to go back and provide more. And I'm conscious that they're a really interesting service, that they're primarily focused on care. They are not maybe housing developer, right? They've not got all the same expertise. I'm wondering how do we make... Is there anything... Actually, sorry. Is there anything you think we can do to make the process easier for services like this, so that they can do things like adding an extra four or five flats onto their block? I'll make a spot on Karen. You might want to chip it. I mean, we do... We are mindful of small organisations not having as much professional support or funding to hire consultants. So we... Normally there is a pre-application process where they have to pay for pre-application process, but we have in the past provided free advice and tried to call the people's hand as much as possible. And that certainly could be an option with this organisation. We do try, because obviously these are trying to be joined up and deliver as much as possible of stuff that needs, you know, the needs of most vulnerable people. I think Councillor Hammond asked it. Can you allow us to take that, what we can do to work with the organisation to unblock them? But apologies, that one simply isn't on my radar, so... I think it could be potentially a really nice case study. And, you know, whether or not there's something about a special process for services like this, because as we heard from the report, right, it's really challenging to provide this kind of accommodation. So if there's an opportunity to easily allow existing services to expand slightly, it seems like a really good opportunity. Are they at a very early stage? They haven't applied yet. They're just thinking at this stage. I think they have submitted something, and they've been asking what... OK. Actually, I think one officer behind me might be able to help with the detail. OK. We'll take that now. Thank you. We'll take that now. Thank you. Hello, I'm Nikki Ralph, Assistant Director for Age Well Commissioning in Adult Social Care. Yes, they have made a planning application for the additional 11 units at the Mal May scheme. So, yeah, that process is underway, and it'll be fantastic if it can be looked into to support. So, one thing that I'm really passionate and interested about is the expanding movement for intergenerational living. So, inspired by Netherlands, where older people are living with younger people, and there's a growing movement in the UK as well of where childcare services are co-located with adult social care homes. So, you know, you've got people over 70 and 80 replying childcare services. What I'm interested to know is, do you think there's any barriers in our local plan to providing that kind of care? Or even, indeed, is there anything that we could do with our local plan to encourage or incentivise that kind of interesting models of living that, you know, increasingly the amounts of research are showing are great ways for dealing with tackling loneliness and providing new kinds of accommodation? Can I just quickly come in on this one, but I'll let Sakiba consider the issues of barriers in the local plan. But, and again, I'm probably going to rely slightly on my colleagues in adult social care. But I think initially, when we entered into negotiations with Peabody on the Holloway prison site, where we have actually secured 60 homes for social rent, but with extra care provision, I think initially, when we started the negotiation, we were looking at securing those as housing for older people. But actually, in the course of conversations with colleagues in adult social care, they said that in terms of who would be eligible for that housing, they actually wanted to move beyond, you know, simply just making that housing available to older people, and actually to make it available to a broader range of people who need extra care. And I believe it was based on a model in Camden. In terms of the model that you propose, I can't, and I'm looking at Sakiba here, but I can't see anything that would be in the local plan that would immediately disqualify that form of housing. Effectively, we will negotiate the bricks and mortar and then work with our colleagues to actually determine who the end occupants of those buildings would be. But, Jodie, I don't know if you want to say anything more about Holloway and the kind of model that you're pursuing at Holloway, which is not identical to the model that Councillor Hamdash is describing, but it's moving towards that model. Indeed. Jodie being director of strategic commissioning, and I'll let Nicky, who's doing most of the legwork on this, talk to it. But yes, we are very keen to think about intergenerational housing in a whole range of ways, and the Holloway site has lent itself to the model of just working age to older adults to live there. Do you want to? Yeah, there are examples from elsewhere, including Camden, where what you want to create if you think about a conventional block of flats, people live side by side of all ages with a whole range of backgrounds, needs, strengths, interests, and actually by creating extra care schemes that are intergenerational, you're creating a less institutionalised environment that enables people with different strengths to be able to contribute to that community in different ways. So we are exploring, expanding it, and we've discussed with older people, and particularly residents at the current Mildmay scheme, about what that would feel like, and that was really well received, and that actually they feel like they would really benefit, or older adults would benefit being in that type of environment. So we are exploring intergenerational. I'll just add, from the local plan perspective, absolutely there's no barrier in the local plan. I think what, all of our policies, including the policies around dwelling size mix, how many, you know, one bedroom flats, two bedroom family accommodation, all of that, there are layers of policy that try and enable intergenerational living. Effectively, it's kind of good planning, but also how the spaces are designed, inclusive design is embedded in everything, how communities or different groups interact in the public open space. So all of that is in there. I think one of our biggest challenges, and that's, there's no escaping it, is lack of land, lack of land to, you know, build more, and then when you have slightly bigger sites, then you have more opportunity to be creative and have all of those aspects addressed. Whereas some of our sites are incredibly small, very tight, and then that's where it becomes difficult. But certainly, having, you know, mixed and balanced communities, the overall intergenerational, as well as everything else that's being looked at, it's all in there. It's the, our challenge is the land, really, and that will continue to be the issue. But certainly on all of the sites, we have, you know, there's all sorts of specialists that work on every single site to negotiate the best possible outcome. Thank you. Thank you. Councillor Gleby. Yeah, I'm interested in, I mean, I think that's quite useful, actually, that chart there. People that want to still be independent, our residents want to be independent, but need their housing adapted. And I just wonder how, in terms of, like, a timescale of people that probably need assistance in a walk-in shower, for example, what sort of timescale would, having one of those fitted, if one of our residents wants to keep their independence. I mean, that's got a picture for those that want to know that. A mobility stair uplift. And I don't know, I just imagine they're quite expensive. But I just wonder, realistic terms, our residents, when they become poorly, they still want to, their independence and yet to have their homes refitted to suit their needs. That's slightly outside of our room, but I think what, if it's a social housing, social rented unit, then assessments are made, then funding can be provided. I'm not sure about the terms, because how quickly that can be done. Obviously, people in private homes do it themselves and funding themselves. But one of the things that we've done, which has a bearing on that, we require wheelchair housing for 10% of the development. But sometimes if there is quite a few new developments with a lot of wheelchair housing that might not be needed in that, but there might be, the needs might already be met, then sometimes we secure money, contributions for accessible housing, which can then be spent elsewhere to create an accessible home from another home. So we have tried to be creative with securing money to then try and help through planning to help colleagues in housing to make somebody's home adapted to their needs. But I'm not sure in terms of the time, so how long this takes, we can talk to colleagues in housing. I think that's broadly speaking, the housing management issue that wouldn't be impacted by planning. But one thing that we do in planning through legal agreements with developers is, where we secure wheelchair accessible housing, we have an obligation on the developer to fit our individual person, because they are not a uniform group of people. And generally that obligation hits each time a new tenant moves into that cone, because one person may require a certain set of adaptations, the next tenant may require a completely different set of adaptations. So we control that through planning where we can. But I think the question that you're asking is more broad housing management questions. I don't know if you're having anyone from housing in particular evidence. Possibly a question for Matt Weston on housing. Yeah. Thank you. Janet. Thank you, Chair. Thanks. Great presentation. Really interesting. And I'm really pleased that you are building new houses to be accessible and adaptable, because Victorian houses, I'm sure, were built with the maximum number of stairs possible. And also the housing that was built in the 70s or the council housing. Again, there is not one flat, even surface to get in and out. I have a constituent problem, a piece of case work, which like so much of our case work throws up a wider issue. And that is this constituent has a mobility scooter, an electric mobility scooter, but she can't charge it up because of the fire regulations that housing is rushing around trying to find somewhere suitable without any success. And this seems to me to be a real barrier. And I wonder if it's something that you could bear in mind when you are, you know, planning for future development. We have, sorry, we have built it in into the new requirements that wheelchair festival housing should have adequate storage for various things, various equipment. It's mobility scooters, it's hoists, it's all sorts of other stuff that's needed. The issue is the existing stock. So in terms of the newbies, certainly, it's all in there. In the list of things that I haven't put on the presentation, it's all in there. It's just that the existing stock, which is the majority and will be, is the real challenge in terms of how you adjust that. And then building regulations, of course, there's been a number of fires with scooters, other scooters, not mobility scooters, which is where the concerns come from. So I'm not quite sure how we can address that with the existing stock. Thank you. Thank you. Thank you. Just one question. You know, there is a, you said 900 dueling. That means, is a big development where is 900 dueling that you can ask for the shelter accommodation or care room? Is it a threshold is 900? It's basically an aspiration to try and deliver around 60 homes a year that can be suitable for elderly people. It's not a target. It's a kind of aspiration. It's a benchmark. And then you work that out over a 15 year period that would come to 900. So the mayor of London has set that up for each borough. It's basically to, the idea is to try and build up a stock of housing in London all the time that's suitable for elderly people. And their definition of elderly is 55 plus, I think, 55 years plus. So it's basically there to be part of us thinking about all the, all the other needs. So it's not one big development. It's a little bit, you know, and it could be anybody building it. It's not just council or housing association. It's private element as well. Just like here. Because as you said, Ellington is a small borough. We haven't got enough space. Can we, as a, we can recommend that we can shorter the, what is called, the threshold. Instead of 900, can we put 500 or 300, some kind of thing, which can help us to get more older people home like that. Can we do it? We, the only thing we have that we have an obligation to try and meet is the overall housing targets. And the overall housing target is 775 per year, of all homes, of any kind. So that's the target that's really, you know, strictly monitored and it's a really big deal. Has been for many years and there's even greater emphasis on meeting housing targets now with the new government. The elderly, housing suitable for elderly people is kind of part of that, I suppose. It's part of the mix, but really the main target is the target of everything together, which is 775. And we are, because we have built so much housing over so much time, over such a long period of time and are suffering from acute shortage of land suitable for development. Our target is relatively, our main target is relatively small as compared to other local authorities. It's effectively gone down. The London plan is being reviewed now. All of these figures are being looked at again. So that the mayor has started the new process for the new London plan. We are involved in developing various pieces of evidence, including looking at housing, land available for housing. So this is a very thorough piece of work happening and that will then inform the new housing targets for each London borough, including us. So that's all being looked at at the moment and that will take two or three years for that to be adopted. The London plan, and then the London plan targets become directly our targets. Thank you. Another question is, I have to declare myself because I work for Clarion Housing. My question is coming from this side. That's why I have to declare myself that I work for Clarion Housing Association. Question is, Islington has a purpose-built, some accommodation, used to be called shelter accommodation. I can give you some name, which used to be shelter accommodation, then we would draw the funding, support funding. But this, because we need a, because we haven't got enough space, but we have a building, which is owned by now a thousand association. But this building is, as you said, need to accommodate by the older people, because I can give you the coverage. There's one, there's some, about 16, so far I know, easily we can, used to be shelter accommodation, some where I work used to be extra care. How we, as a council or social service can, or your plan individual can work with the, our stakeholder, like any housing position, to get this building back to our older people. Do you have any policy or you can, what we can do that can perfect? So it's currently sheltered housing? It used to be sheltered accommodation, and all the building is, park was built for the older people. Then I can give you the card booths, the one, there is some other, four or five, easily people can make a sheltered accommodation. It used to be sheltered accommodation, but because of funding. We certainly want to have discussions, pre-application discussions with them to try and assist provision of, you know, accommodation. For example, some building was built for, I can give you the kitchen, everything was for older people, yeah? Now this is locked, because it is not for sheltered accommodation anymore, but this is a park was built building. When it was granted the application, it was for older people. And we gave the permission to build this one, and we are not using this one. And I think, like you know, as planning and adult social care should look, this is still there. How we can use this resource from that to use. This is my first question. And another question, like you know, me, I came from, this is more than 50% people living in England, BME, especially Muslim. What is your plan for culturally appropriate shelter, or care home, yeah? Which is, I visited in Tauranga, they have already done two, one is the Sunali garden, yeah? What is your plan, like this kind of thing, to build in England? I think the, as I was saying very early on, the policies talk about need. So if there is need for a particular type of accommodation, that would go via adult social care, to demonstrate that need, and then a facility can be designed. So we will then negotiate it, and if it's for a particular group of occupiers, then all of their needs will be looked at, and then you design it around them. But it needs to be, need needs to be demonstrated, and then you go through the process. Anyone have any more questions? Thank you. Many thanks, it's really good. Many thanks for coming here, for giving, and really helpful for us too. And if we may need any clarity, if you're anything, I will ask to send a message. Thank you. Thank you very much. B3 quarter, two persons report, Victoria, next time to present. Please come, Victoria. Just Victoria, focus what, where is the, we can meet the target, yeah? And people already read the report. Fantastic. Thank you, Chair. So the committee are asked to note performance against targets in quarter two. So we're looking back at quarter two, 24, 25, for measures relating to health and independence. Just a note on the report summary. Performance targets are set based on benchmarking and trend data. Targets are reviewed and updated each year. The next set of targets will be reviewed in April, 2025. The percentage of people with an outcome of no support needed after a period of reablement. So of residents who received reablement in quarter two, 77% were reabled and did not require long-term support from adult social care. So the target of 78% is the latest London average performance figure from December 2024, the ASCOF outcomes. New admissions to nursing or residential care homes. There have been slightly more admissions compared to quarter two last year. So there were 74 new admissions last year. However, performance has still met the target of having no more than 100 admissions in quarter two. Islington has a lower rate of new admissions to care homes per 100,000 of the population compared to London and England. Percentage of adult social care service users receiving long-term support have received at least one review. As of quarter two, 36% of the service users who have been receiving services since the beginning of the year have received a support plan review. Quarter two performance has reached an all-time high driven by increased activity and enhanced data capture. End of year projections estimate performance will exceed the 52% target. Percentage of service users receiving services in the community through direct payments. In quarter two, 30% of Islington service users receiving services in the community were supported via a direct payment. Performance for this indicator has improved compared to last quarter, which was 29%, and is within 5% of the new target ambition of 31%. Benchmarking from latest published statistics in the ASCOF framework shows Islington is performing better than London and England. Making safeguarding personal, which is an individualised approach to safeguarding that focuses particularly on what the resident would like the outcome of safeguarding to be. In quarter two, 96% of service users reported that their desired outcomes were fully or partially achieved. This has exceeded the target of 95% and end of year performance last year of 95%. And finally, the proportion of section 42 safeguarding inquiries where a risk was identified and the reported outcome was that this risk was reduced or removed. In quarter two, 94% of service users had reported the outcome of risk removed or reduced. Quarter performance was within 5% of target at 96% and better than end of year performance last year, which was 92%. Are there any questions? Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you very much. Thank you. Thank you. Thank you, Victoria, thank you, thank you, thank you, thank you. Now, I think it's before Executive Member Health and Social Community Report, Councillor Wilson to present this. Sorry, I've already got a problem, I'm just there. So, thanks very much for having me at scrutiny this evening. I'm just going to, I'm going to assume that you've all read the report that I've put in the pages, but I just quickly want to briefly pull out a couple of highlights from the last 12 months and then I want to just focus a little bit of my time on the priorities that are on the final page and just give a bit more colour and flavour and a bit more flavour to them. So, I'm going to start by looking back on the last 12 months and just pick up on some of the positives that have happened. I think for me, one of the big positives is, as we've sort of alluded to, is it does look like we're going to have a balanced budget by the end of this year. When I meet other lead members from other councils, which I do quite regularly, and talk to them, honestly within one minute the first thing is, how's your budget and your overspend looking like this year? Like the sheepish thing, and then we're going to ask like millions and millions of overspends. And they cannot believe that we are coming in on budget and that we've managed to have a process that means we're not expecting to have significant overspend and we're not a significant impact in the rest of the council budget because of it. So, I think this is a huge testament to the team's hard work, but also actually to the council for actually allowing for demographic growth within our budget and actually to discreetly members keeping basically an eye on our performance as well. It's a huge positive. Moving on to some of the ways of working, that I think I've seen real positives in the last year. One of the things I've been really impressed with since taking this role since the summer is actually the co-production in the way of working. I think particularly the carers' strategy, I think it's a really good example of that, where residents are really put at the heart of developing those strategies and are listened to and are listened to and it is a strategy with them written, you know, with them really involved and actively taking part in it. Another positive I want to draw your attention to, again, a good example of our partnership working with our health partners or VCS, we've got a few different partners that we work a lot with, is the integrated front door which was started only in autumn, so it's still super early days and that's bringing our NHS colleagues together with our council colleagues to physically sit in a room together and be a single point of access for adult social care, community health and for hospital discharge. As I said, it's still early days and I'm monitoring it but anecdotally the feedback we're getting from residents, staff in the service and health staff, so GPs that sort of thing is really, really positive around a really sort of integrated way of working. I'm not saying it's perfect, because obviously with anything like this it's always going to be dealing with problems, but I think it really shows quite a sort of dynamic possible way that we can work with the wider health system. Now looking at some of the challenges that we face, we've actually already spoke about it a bit earlier tonight, I think one of the biggest challenges that we face is stability in the care, well both the care market and actually to a wide expense, the workforce, the vacancies within the workforce, so the wider workforce and not so much in the council in the same way. This is not a unique problem to Islington, this is a national, it's a national problem. Ultimately in my opinion there's probably only really more of a national solution. There are some things that the team have done to mitigate concerns with the instability of the workforce, so one of them was the home care framework, there's quite a bit of information in the pack, which sort of supports involve more local suppliers to provide home care. things like accommodation strategy help us to have a bit of a plan of what we may need from suppliers as well in the future, and also having a commission team who are working really well for suppliers and benchmark them against costs, against what's going on across London to try and support it. But it's challenging, and I do have quite a lot of conversations about our suppliers and what's happening and the challenges that that is causing. So looking forward, so I'm going to quickly jump to the final slide in the pack. I've given you basically, I wanted to put a couple of priorities, this is not an exhaustive list by any stretch of my information, but something to currently hold me to account and come back to in a year's time. So what my priorities will be looking at over the next 12 months. So CTC inspection, we had them on site just two weeks ago, and so we're going to have that report coming, and looking at what findings that that report comes with, and taking some actions on it. As I believe you should know, at the start of this year, the adult social care team, the public health team were brought together under one director with John Edgerton, as the corporate director for adult social care and public health together. I think this is going to be a really, really positive step with us working with our partners and within a health system. I think it gives us one cohesive single voice in talking to particularly our NHS partners, and I think it will help us work in that system and shape us. So I think it's real positive, but with anything, when you're working in a slightly different way, again, there's sort of early days and bringing it together so you can, we can maximise the benefits of it. Jumping ahead, in my priorities there's two things from that around basically having a new government who are taking a slightly different approach to the, slightly different, quite different, approach to the previous government, where I think there are opportunities, and I think we might be well-placed to take on board some of those opportunities. So the first is around the move to a much more community-based approach and a much more neighbourhood sort of model towards delivering health care. There's already work happening within the Islington Borough Partnership. It is being driven more on the health element, about how you can have more of that community-based health care and neighbourhood-based health care. But I also take a kind of bigger picture look, and we already have a really good localities model that's working in Islington. We already have, even like home care contracts, working in those localities. So the council as a whole has already got something that hopefully we can tap into a bit more around delivering, or working with our NHS colleagues around delivering health care where people actually are. The other big thing coming down the line for us is obviously the adult social care and care review. I'm taking it as a real positive. While it is two years, there are earlier interventions around that short and medium term of what needs to happen. But I think the reality of our adult social care is it's very complex around what, like how should it be funded? What should it be? What care? And it's really, it is really politically I think challenging for a national government to make the decision. The fact is taking a cross-party approach I think is really positive to actually learn from previous governments who've tried to make changes and have failed. For me, one of the main changes that really has happened and is actually something that the council's whole is really pushing for is around the fair funding formula. That kind of, in my head, that sort of takes two approaches. One of them is the council's budget of being like, is it fundamentally fair, this is, I'm throwing out a rhetorical, not rhetorical question, just a challenging question. Is it fundamentally fair that every year we increase the adult social care budget because of demographic growth, because our population is getting older, their needs are more complex, their demands on adult social care are getting more complex, which also means that we're probably having to make savings from other council budgets, which might actually, if you took a really long-term approach, support wider population to be resilient, healthier, fulfilling, if you took a really, really, really big picture approach. And I ultimately think there needs to be really fair central government funding for that. I also think there's an element with a fair funding formula around, again, throwing out a question, we're like, is it, like, how much is a fair amount for somebody to be paying, particularly personal care, when, say, they've got a physical disability and they just need some support? How much is there because somebody's got dementia and they're living with it for a very long time and they just need that extra support? And they are challenging questions and they're going to have a challenging answer. And the fact, I think there is a review happening that I think is taking a step back and looking at it as positive. And I think in Islington we can be part of that conversation as well. Moving on to jumping a bit to a different bit of my portfolio area. I think over the next 12 months there's some more work we can do around food poverty in Islington. We already have an Islington food strategy, which, again, is a really good example of partnership work done by the council. We've got an Islington food partnership, which is chaired and led by Mallard Gardens, but it involves basically all the community groups and food co-ops and food banks that work in this space, as well as the council. But it's definitely not happening. It's much wider in the community. But the council is starting to look at over the next 12 months its poverty strategy. And we start to have some roundtables around what does food poverty mean and what can the council be doing and what can we do in this space. And what's really clear is the reason we don't have like food deserts. The reason why people can't get good healthy food in Islington isn't because they can't physically get to it. I think I struggle to think of anywhere in the borough which would be more than 10 minutes walk from a shop or a supermarket selling good decent fresh fruit and veg. What we believe is that people just cannot afford to buy that fresh fruit and veg for whatever reason. And so actually really tapping in a food element to our poverty strategy, I think the council could take a bit more of a lead and complement the food strategy by having an element that's looking at tackling poverty and supporting people's access to good quality food through their sort of more poverty lens and understanding that it's money not access. That's the particular issue. And finally, we've got another opportunity, I think, for Islington coming up with national legislation, which is the new legislation on tobacco and veg and hopefully creating a smoke-free generation. Smoking rates in Islington have tumbled quite significantly over the last many, many years. And we believe that's one of the contributing factors, as you may have seen in the pack, that life expectancy has actually, and healthy life expectancy as well, has actually improved quite dramatically over the last 10 years. Our smoking rates are now down to 10% of the population, which I think is the first time it's ever been that low. I think it's just such an opportunity to have a completely smoke-free generation and really supporting people from a very early age to start living that really healthy lifestyle and healthy life that can help them have a long, healthy and hopefully very fulfilling life in Islington. I'll hand over now to any questions. Thank you. Thank you for that. It's really an infographic question and everything. And just the first question is, like Nanda, you are really honest in everything regarding the funding here. And we do believe that because of the conservative, sorry, Labour came to the power with big whole of the project and everything, it's very difficult for Labour government to do anything. But other sites like Nanda, as your executive councillor, you should and with us to negotiate with our Secretary of State of the Year. They need to understand that our older people, we are really suffering. They're not getting what they're supposed to get the service. They're not getting. I know John and others, they are doing a very hard job to keep service running. But because of the funding cut and everything, somewhere something is going down. And I hope you can arrange the meeting with Secretary of State. I'm happy to go along with you and still face-to-face that this needs to be done something about that. And this is, for me, it's not now, it's a long time for me. They're going to do the carrot, they're going to do something. They haven't done anything. I'm not going to blame Labour Party because they just came in the power with the whole year. But need to do quick for our older people. This is my first year. Yeah. But my colleague... Okay. Councillor McLaren. Thanks for the report, Flora. Yeah, just sort of, I mean, there was a couple of things raised at the meeting, we mentioned about austerity. And I think if anything that showed up in equality is the fact that we've got food banks in the last 15 years. There's also, if you look back in the COVID during the lockdown, it was great. There's some real good volunteering work, people helping each other who were isolated through the lockdown period. I think food insecurity, I call it food inequality, really. I think it's good that this item, item 6 on your report has come up because I think it's something that, you know, in Islington we've been a pioneering council on school meals for primary school children. So I think, not really a question, but I think we could take this forward. This is the first time I've come to a meeting where we've discussed food and I think diet is an important part. But I think as well, we should challenge some of the, well, you know, sadly our school children, queuing up outside food chains, you know, the 57 varieties of different food chains that you get. And I think that's, you know, really it's not a healthy way to go forward. So all these things I think we can bring up in policy, definitely, I think. Thank you. Thank you. It's not a lot of question either, really. Just comment on the various aspects. Well, social care should be free at the point of view, shouldn't it? The same as health. So, you know, good luck in achieving that. Food inequality. But we also have some of the cheapest fresh food in Islington, don't we? And occasionally I go to Chapel Market and I think, this is amazing. You know, if only my arms were stronger, I could carry loads home. So it is a question, isn't it, of distribution. And then on the smoking aspect, only 10% is real achievement, isn't it? I have, again, referring to my casework, I have people who live in flats and the smoke goes up or down, depending on where you live. It's a real problem. It's a real public health issue. And you can't stop people smoking inside their own homes. So actually, I, in a way, I think that it's more important to stop people smoking in their own homes if they live in flats than it is in pub gardens. But, yeah. Anyway, thanks. Go ahead. Go ahead. Go ahead. Go ahead. Go ahead. Thank you. Do you have a few questions? So, on the CQC, I know we've had conversations about it's been quite a drawn out process. I think it's the first time that we've been inspected of the council. Will there be an opportunity to feed back to the CQC and whether or not we'll be able to nurse them towards maybe some more of the efficacy that Austed have demonstrated? I mean, we do get basically a right to reply on the report, but I think that's probably the moment I would give feedback on it. I know, I mean, I possibly will look to John for this one, but I know there are some more sector-wide, I think, conversations and I know I've spoken to some other lead members who have had concerns about their experiences. I don't know if John wants to have anything to ask. No, absolutely. Well, one, I think the CQC colleagues who came in were really eager to have feedback. So, I think that's really important. They reflected on some of their own learning as an organisation. So, we did take the opportunity to keep detailed notes of areas where we felt we might want to feed back and we will do that at the most appropriate moment. Some of that we did at the time where there was some inconsistency or some misinterpretation, but I think even they recognised that this is an evolving, developing picture and would want to have any feedback that would support them going forward. One thing I would add, so we're quite, we're one of the later councils in London, so there were some pilot councils. And I think it would be fair to say, and Dr. John could say, it's what I've heard from colleagues and other councils who went early, like their concerns, I think, seem far more extreme, I think. And so, I think some of those early achieving issues we may have benefited a little bit from. Do you think that's a fair assessment? Yeah. I think it's still absolutely evolving. Yeah. That has evolved. Great. And another one for me. So, a quick question about one of the slides and a statistic on it. So, we've got slide 13, which is ask off areas of success. And we've got the figure for overall satisfaction of carers. And just questioning that figure, is that net satisfaction? Or is that the percentage of people who are expressing satisfaction with their carers? Yes. I don't know if anyone's trying to find out, but actually John may be able to, how, I think that's data collection. I think I'll have to press share to you. Oh, sorry. Oh. No, I would have to get back to you to confirm that. I'm afraid, yeah. I think what we're going to do, just a written answer will be given to you because for the answer. Is it okay? Can you give the written answer to? Yeah, we can do written answer. I think one thing to say that ask off is like a standard, I guess, benchmarking of data across different, different councils. So when we're comparing us against someone else, it is comparing apples and apples, if that makes sense. I'll just give maybe a comment in advance. If that is that 46% are expressing satisfaction with their carers and 54% aren't, I'm a bit concerned to see it portrayed as success. I get that like we're doing better than other councils, but I think it goes back to my other point about unmet need. I will agree a bit that we're normalising what is basically a problem of national government not providing us enough funding and then having to do the best with what we can. I mean, I would, I would agree with that completely. And I mean, I think against the benchmark, it is a real positive. So against what, what others are doing, which I think is often a fair way of doing it. But, I mean, it does worry me that if you flip on, certainly like against London, like London as a whole, there are carers out there who are struggling. I mean, this is, I think, why this adult social care review is needed. So particularly carers, like in, I don't think this should be a particularly audacious thing, but caring for your loved one should be an active choice. And the only real way it can be an active choice is if you feel like you've got choice and that you can get the respite when you need respite. It doesn't have to take over your entire life. We know that carers themselves are far more likely to get into ill health and more likely to be getting into financial difficulties because it is really impactful on their lives. And actually, if somebody is taking that love and care for their loved one, like there really should be more support there and wraparound. Some of that would be money. Not all of it necessarily is. Some of it may be around looking around employment laws and giving people the support they need so that they can work and taking care of things and getting more flexibility in the same way that we have some more family-friendly policies and that sort of thing. But I think it's taking a, it's a nutty, difficult question that's I think been avoided too long. Which is why I am, I am really welcome to the Adult Social Care Review because while two years is a long time and I am impatient and I want things now, I appreciate that actually trying to resolve this and get something that works and will stick. Unlike every, in fact every colour of government over the last like decades and decades have not been able to move this forward. And what's the point, like let's try something different that's got a bit more of a cross-party, broader approach. One final one for me, nothing I promise. Because I do want to come in on the Adult Social Care Review. I've reminded myself that the actual target date is 2028, so three years. And the sector really responded in despair for that length of time. Should I take it by your comments that we're not going to be joining the chorus for a speedier review? Because I do understand the desire to get it right, but the experts in the know are saying this timetable is just not right. Look, it's long, but it's got earlier recommendations before that. It's not like absolutely deftly silenced for three years. I think we've got to, I would rather we take time to get something that works and then fundamentally start. I think that, and it's also not like there's not activity that's already happened. So for me, one of the biggest problems in the care sector as a whole is around things like the workforce. The fact we've already got an employment bill that's going through that has things like a click-to-pay agreement for carers is really important. Because I've seen some wild statistics around carers that if you've been in a caring job for five years, on average your hourly rate is only increased by something like, I can't remember the exact number, but it's something like 10p. I was like, we do not recognise the work of carers, and we have a shortage of carers. Like these two things are not rocket science, and that is taking a first immediate step and trying to address it. So I don't, I think it's, there's a big wide review, but there are some shorter term things that are happening. And quite frankly, you can't, you're not going to be able to do any review of adult social care without making it a great place to work in, first of all. And I think that's a really first step. And the fact we had that within, what, three months of the Labour government, I don't think that's a, I don't think that's a small task. I think we share a diagnosis of lots of it, but I think it's the journey of how we get there. And I do express some concern about the emphasis on a cross-party consensus. The last 20 years have shown that political incentives don't reward that kind of collaborative behaviour. And to be frank, right, we're resisting a Tory party that's going off the deep end. I worry that we're going to spend three years' time, and you're not going to get that buy-in from that Conservative party, and you will spend a longer time trying to get it. So, I join that sector's concern about the process, the timeline, and the end result. Thank you for, I just, like, I would also echo with Janet, like, on the, I strongly believe, and other people, social care service should be free of charge, but, and if you think, like, you know, we are in the first world, yeah, our older people, they spent their whole life to build this country, and now they are suffering. They are not getting adequate support. It's not acceptable. And the charging people, like, you know, the, every, when I was to work in the Camden voluntary sector, we are told new system is parcel centre care provision. That means people who have a 23,000 less than 2,000 should not pay anything. But actually it's not. People, money for the care, they're paying. If they're getting, what's called, attendance allowance, something, this kind of thing, should not be paying, should be free of charge. Because they already paid their tax whole working life. And they should, this is like point of view. Another question is, we did recommend our scrutiny review in-house domicile care. Will you be working on it to look again to get domicile care in-house? I mean, obviously the council's policy of in-house, first of all. I have had conversations with John around, when contracts are coming up, around giving the space and time to actually have a serious look at in-house being always an option, which is already part of the council's policy. But I'm not going to commit to anything straight off the bat. But it's very much preference. Thank you. Thank you for this fantastic report. It's the six month, you and your team doing fantastic to reducing budget and everything. I know this is very, very difficult for a social care position. But one thing I would like to urge you is to give our older people adequate, at least adequate response. One day, especially I raise the, any inquiry to the online inquiry should get the reply. Anything like the safeguarding or anything should get a reply. And any inquiry from the older people, our staff should be patient because they are really frustrated sometimes. And give the good response to them. This is my ask to you. I know they are doing a very fantastic job. But as a colleague, as a comrade, this is my, yeah. Thank you. Many thanks for coming. Thank you. Thank you. And thank you. I think we have a B5 work program. Do community members have any comments on that? No. Thank you. The next meeting is 20th of March. And there being no further business. I declare this meeting closed. And the minutes before the, the minutes of the last meeting will be producing the next meeting. And we'll go through everything together. Thank you. Thank you. This is time. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you.