Transcript

We are ready to start, everyone. Welcome to the Adult Social Care and Public Health Committee. This meeting will be webcast and a record retained on the council website for up to two years. By participating in this meeting, you are consenting for your name, the content of what you say and your image to be broadcast and stored to the council website. If any member or member of the public addressing the committee has concerns with this, please contact committee services officer immediately. For those at home viewing the webcast, I'd like to inform you if you look above the video you'll see a resources tab, select this and the link to the agenda will appear in the right hand side. This will allow you to open the agenda, impedia, form and follow the discussion and debase. Second item is apologies for absence and we have council at a moment on when, we'll be substituted by councilor Ewan Tomini, so welcome to committee and councilor Colin bald, we will be substituted by councilor Gary Vannett, welcome, that next we have member declarations of interest, so I'm just going to ask any members whether they've got any discloseable pecuniary interest or any other interest in connection with any items on the agenda. I have to be clear an interest as a member of my family is a social worker. That's noted, thank you, anyone else, okay, no we'll move on then. To the minutes which is pages 128 and I'm recommending that we approve the accuracy of the minutes of the meeting held on the 28th of January 2024. Do I have agreement by a cent, thank you, Tony did you want to say anything? One of my, just to make a brief comment, Chair, on the item, end of life care best practice, I volunteer for the council network's palliative care committee, enhanced supportive care of formerly court and there's a lot of education sessions take place on that which I attend as a lay member and I thought it might be a good idea to try and link up the two with what happens in the community and other hospitals and that would be like, I was pleasantly surprised among shock really at the amount of training and cross-versalisation that is between the different agencies involved in palliative and end of life care, so I just thought I'd make that statement. Thank you. So it's not necessarily any kind of correction but it's nice to have a little bit of positive words from Councillor MURPHY, okay we're going to move on to public questions, statements and petitions when we've got the following public question from Ian Sadon on behalf of Will Eunison, thank you. Thanks Chair. I'm Ian Sadon, I'm an organisation for Eunison and Will and another social care. There is an agreement dacing from April 2023 that frontline domiciliary workers in adult social care, working for care providers under the Will community care market were paid an enhanced rate of £12 per hour, Eunison are aware of one provider who received funding for the £12 per hour rate from April 2023, it was only began paying eligible staff from August 2023. The union asked for clarification about the funding on a number of occasions and eventually through a formal channel received confirmation from Whittle Council Care Commissioning that the provider in question had received the funds from April but that they were only paying it to their staff from August 2023. This was queried again by Eunison as it appeared from the response that the care provider had received money but not fully passed it on. No explanation has been given to us over what had been done with the funds. On various occasions we were told that the issue has been discussed with the care provider but that no answer could be given to our question as it was commercially sensitive. To remind a committee, it states in the Will Council markets and sustainability plan that in March 2023 the Council agreed to use the fair cost of care and market sustainability fund to raise pay to £12 an hour to both maintain and grow the markets and those payments reduced to begin in April 2023. We would like an investigation into why the provider in question has not passed on the money which was specifically for the one purpose of enhancing pay and the answer communicates it to Will Eunison as soon as possible. This is public money for a provider for a particular purpose and it's also in the public interest to find out what's happened to those funds that haven't been paid out and if the company still has it then it belongs in our members' pockets. My question is Eunison would advise that the care provider have been funded to pay qualifying staff for April. These payments only began in August so what happened to the money that wasn't paid out. Thank you. OK, well thanks for that. Given the fact that this is ongoing and certainly a matter of confidentiality and we're discussing any details here tonight, I'd just like to thank you for your question and obviously reaffirm the committee support for the real living wage and I'll ensure that a full written response is sent in due course around the investigation side of it. Thank you. The following statement has been received by Sean Kirby on behalf of Acorn House. I believe Mr Kirby is here but he doesn't wish to speak so I can have it read out by Vicki. Thanks. Thank you, Chair. Mr Kirby's statement is, I would like to raise some serious concerns about the fee setting process and the resulting draft proposals which have been put forward for approval next Tuesday evening. I have read the report in the agenda for that meeting and there are some inaccuracies I think you should consider carefully. The process is unfair and not transparent. Getting the correct information to consider has been difficult and at times unavailable. The draft fee rates have been set mechanistically and if there is going to be a consultation process in the future, it should have an inclusive organic approach which is well integrated with open comprehensive, accurate, up to date information network. The Councillor is supposed to be working in partnership with providers to care for the vulnerable and sick on the whirl. I'm afraid it is far from that. The current draft proposals make no allowance for any increase for general training, recruitment, handyman, gardener, other non-staff costs, medical supplies, domestic and cleaning supplies, trade and clinical waste, professional service costs, admin costs and managers salary. The whole true cost of care with modelling should be the only figures we should be considering and then we can openly discuss affordability. Other neighbouring local authorities are proposing increases on average between 5% and 9% above whirls draft proposals. Whirls proposed fee rates are too low and if approved a setting providers up to fail. We can't pass on our cost increases to our customers. The Councillor responsible for paying providers a fair price having followed due process and given due regard to the actual cost. I hope you will be able to seriously consider the above points and access additional funding to approve realistic minimum fee rates to provide good quality care. Okay, thanks for reading that out. I'm not certain that's noted. Thank you. So we're going to move on to section A of the agenda and the first item is item number 6, national substance misuse grant funding update. Sophie Bird is going to present the report with Gary Rickwood, Dave Brad and Dave Bradburn as well as supporting. Sophie, do you want to start explaining this example? Yeah, of course, sorry. There is a confidential appendix and this item can be discussed in public if members agree not to refer to the exempt appendix. However, if members feel they need to refer to the confidential appendix during the deliberation of the item, we will need to move to exclude the press and public now. So are there any members here that feel that they do need to refer to the confidential appendix as part of the discussion we're about to have? No, okay. Thank you. We'll continue. Would you all hand-toler in their sign? No. Okay, we'll continue then. So Sophie, who's like to start? Great. Thanks very much. So we're all have been receiving a grant from national government each year since 2021-22 to supplement our substance misuse treatment and recovery in whirl. This used to be called ADA and is now called SSMTR, which stands for supplementary substance misuse treatment and recovery. Whirl's grant funding for this year has been confirmed as little under £4.4 million with an additional £11,364 for inpatient detoxification. This committee report seeks acceptance from the committee of this grant funding as well as setting out our nationally recognised successes to date and a provisional delivery plan for 2024-25, which is in the exempt appendix. We expect this delivery plan to be approved by O-HID shortly. Parts of our progress to date, just to summarise, includes the publication of the Whirl Drug Strategy and the successful establishment of the Whirl Combating Drugs Partnership, who approved the provisional delivery plan ahead of our submission to O-HID. The Combating Drugs Partnership is a group of partners, both within and outside of the council, who meet regularly to review progress and provide governance of the SSMTR program. Our delivery plan, which we've already discussed, although it's so we don't anticipate any issues with our submission, builds on the previous three years' developments, extending existing programs and projects, and adding further ones for the year ahead. And just to say that some of the additional programs include addressing near-fatal overdoses, supporting vulnerable groups, expanding specialist roles and children-young people provision, enhancing residential rehabilitation capacity, supporting recovery, and enhancing lived experience initiatives. And the last thing to say really is just to emphasise that our actions are very much about investing in system-wide action rather than just the treatment service itself. And we've got really encouraging evidence so far that key indicators are improving locally since we've been spending this money. So that's, thank you all being members. I just want to thank you for that. I know that when the council first sort of became responsible for OVC and delivering this service back when I first became the council, it was kind of a little bit, there was a little bit of disquiet and it wasn't quite a seamless transition from whence it came. And I think that, you know, from the great work that we do, you know, we do with our strategy around drug misuse and also drugs and alcohol misuse, you know, we're an exemplary and we're a beacon to all the councils across the country and the time and resources that we invest in those services. So that's just a thank you from me and I did see Tony, your hand went up and signed the job. Just a brief comment of M.H. about the paragraph 4.4. I was quite taken by the sentence about public health saying that it's estimated that four pounds of social return for every pound invested in drug treatment and increases over the years, 21 pounds or over 10 years and it does show the value of investment. And I think some of that, what I might call probably indirect social benefit is on the impact that a drug taken on 40 can have on communities across the borough. Thank you. Okay, Chair, thank you very much. Just a question, I don't expect an answer, but I was contacted by a constituent who is connected with the alcohol free bar in book and head and there's been perhaps a delay in the funding allocation. I wonder if you could have a look at that for me and see if there is a delay or if there is a reason for the delay, let me know the reason and just be in touch. That will be grateful. Thank you very much. Bill? I'm not going to go into the detail of the exempt appendix, but merely say that the range of work and the number of organisations is impressive and what I'm interested in making it to be early for us to say or approached to a year ahead to see how the funding is going to go in future years because it requires a recruitment, retention of staff with specialist skills, probably with skills that very few people have that need bringing in and supporting and continuing this work. So I think we always need to keep a weather eye on what happens when the grants get reduced if they do. Hopefully not. Okay. Anyone else? Just from my group and I'm sure of me others, this was really well received. This update and I think it's widespread recognition that we're doing brilliant work on we're all. And also I suppose historically culturally on we're all. We've got sort of still a large cohort of people that are involved in, you know, that have been involved in drugs for decades and that will possibly enter pension age and go beyond with that. I know of people that work in the sort of care homes. That's in where methadone is administered because that's how far back the drug habit stretch though. It's something that's not gone away in a doubt ever will. So thank you. Thank you for all the work that you're doing. So okay. If nobody else wishes to speak I'm going to move on to the recommendations which is that the Adult Social Care Public Health Committee is recommended to one accept the schedule 2024-25 SS MTR grant of $4,376, 408 pounds from OHID and degree the provisional delivery plan outlined for this funding. That's an appendix one. Accept and approve the provisional utilisation of the 2024-25 inpatient detoxification grants of $111,364. Three note the progress made today in delivering the SS MTR and inpatient detoxification grant funding programs. Four note the successful establishment of the World Combating Drugs Partnership and the publication of the World Drug Strategy and five authorise the Director of Law and Governance to finalise the legal documentation arising from the acceptance of the grant funding referred to in recommendations one and two. I'm going to move that to have a seconder. Seconded. Can we read by a cent everyone? Thank you. Right then. So we're moving on to adjourned item seven which is session and slide learning, disability and autism housing strategy and Jane, you're going to present the report. Thank you. Thank you Chair. This report outlines the new strategy of a work program that has been working across Cheshire and Merseyside with the independent and full full in lives group. The strategy has been jointly produced with the Housing, Learning and Improvement Network to establish a framework for commissioners to meet future housing to model and meet future housing demand. It also supports the assessment of local housing need and helps us with our planning for these people for the future. It is a key decision and it does affect all wards. The strategy is also provided in an easy read version that has been shared and engaged with people locally for the development of that. We're asking for approval of the strategy and the report and also asking that the report be shared at a future date with the economy regeneration and housing committee for information. This is a coordinated regional policy and with a view that it signals to both the housing and the provider market about what our future demand will be. We are planning to meet the need for housing for local people with both learning disability and autism and the spectrum of housing that it covers includes general needs housing, supported housing, people living in very specialist care homes, people who maybe impatience who may require housing when they're discharged from hospital and also young people preparing for adulthood as well as people currently living with elderly carers who may require their own accommodation in the future. The view is that the spectrum of accommodation that we've modeled that we will require and that the strategy supports will mean that people will have assured tenances or may even be able to purchase their own properties in the future. The strategies aimed in particular at housing organisations, care and support providers and community organisations who have a key interest in working with people with learning disability and autism. It also refers to a gap analysis that we did working across Cheshire and Merseyside with Campbell-Tacall that models future demand of up to 259 units across the five to ten year period and the strategy will be in place 2023 to 2027 to support that forward work programme. Thanks, Jane. Does anyone have Tony? Thank you, man. All right, thank you very much, Jane. Your reference to transition and also from the people living with older parents and things of that nature taking back about 35 years to when I was working with homeless people in Chester, I was actually a chair of housing at the same at the time and had a meeting with Scope in precise that situation where the children were 8, 40, 45 or something, they were becoming sort of 70-year-olds thinking, Oh, my God, what's going to happen to my child when I can't cope anymore?" And so the thing is what I learned at the time is that it doesn't happen overnight, if you like, and I'm sure you've got that in hand coming to terms of almost the negotiations over possibly if not months, years as well to make that transition to independence. And they worry about safety, finances, abuse, all sorts of things come into mind. And so I'm glad that that's on board in what you've just said. Kieran? Hi, I've well taken it to economic, the generation in housing. I'd like to suggest you also take it to the children, young people of education, to pursue as well. Thank you, yes, that's something we've found consider. Sign? Jane, thank you for the report. With joint strategies, of course, you tend to get a bigger bang for your book, but you run the risk of not getting your fair share. Are we happy and confident we are going to get our fair share? Yeah, the strategy sets out a framework really for commissioners, so that isn't necessarily something to draw down from, but it sets out how we would approach developing our housing offal locally on the whirl. So in terms of the strategy, it's more about an approach really than a drawdown of actual resources. But in order to carry out these activities, there'll have to be some funding somewhere that comes from somewhere to do things. Will there be a joint pot, or will it be just the whirl? We'll be using whirl resources for whirl people, but where we might need very specialist services across the region, we might develop those locally with other local authority areas. Brilliant. I'll take the point, I think that one of the reasons that we develop this strategy across Cheshire and Merseyside, of course, is because that's where the NHS footprint is now. At the Integrated Care Partnership, which is the Cheshire and Merseyside place that elected members make a link between the health and wellbeing strategies and the delivery that health does across Cheshire and Merseyside. There were a couple of questions asked around, are we working together to plan to meet the needs of people with complex needs together? And are we bringing resources together to meet those needs? And the answer to both questions was no, not at this point in time. So this is really a catalyst to enable some of that to happen, where it seems clear that it's appropriate for local authorities to work to develop general needs housing and to develop some of the supported housing types of options. But when we get to people with very complex needs, with very specific services, then it makes sense to look across a much bigger footprint so that we can work with the NHS to plan to meet those. So that's really the intention. But at this point in time, there are no resources, as Jane said, allocated to it. Okay, anyone? Phil? I mean, the report does mention seeking funding through NHS, England, and homes England is appropriate. So it'd be helpful to know what approaches are made to homes England. In the report, it mentions the possibilities of surplus NHS land, but I don't personally know of any of that. But there may be some sites. So if we can be kept informed about what reaction we get from the Massey side structure, the Cheshire side structure, and NHS and NHS homes England as the work continues. Okay, so that's noted. Good to see the planning committees involved as well, I think, here. We've been asking for their involvement, something we've for a while. Okay, so if nobody else wishes to speak, I'm going to move to the recommendations, and they are. But one, we approve the Cheshire and Massey side learning, disability, and autism housing strategy, as set out in Appendix 2 to this report, and degree for the report to be considered for information at the economy, regeneration and housing, committee, and we're also going to add as suggested children as well. So I'm going to move that to have a seconder. Yeah. Happy to agree by a cent. Thank you, everyone. Thank you. All right, then we're on to agenda item 8, which is outcome of annual rate and fees engagement, pages 91 to 98 in your part. Jane, this is you again, thanks. Thank you. This report describes the outcome of the annual rates and fees engagement exercise that the Council undertakes with its community care market for rates and fees to be paid to care providers for financial year 2024, 2025. And it covers rates and fees for residential and nursing care, supported living, extra care, care and support at home, which is generally known as domiciliary care, direct payments, shared lives, and specialist residential placements. I recommend the officer, we're asking officers, they're asking for approval for the rates, I set out in sections 4.2, 4.3, and 4.4 of the report to take effect from the 1st of April 2024. And that is for services that are commissioned jointly between the Council and NHS Cheshire and Mergeside Integrated Care Board for Whirl and in respect to the areas that we've described. We have undertaken a comprehensive exercise and we have allocated to meet the funds and the new demands for increases in both the national minimum wage and the real living wage a total of 10.4 million pounds for our next financial year. We have had an emphasis on meeting local need and we've listened to what providers have said about the continued challenges of recruitment into this sector and also taken into account our local preference for meeting payments for frontline staff, including the implementation of the real living wage. Proposals are made in the context of continuing financial pressure for the Council and the funds made available to the Council through the Market Sustainability Improvement Fund have been at 7.8 million pounds and so the Council has committed to meet the requirements for both the national minimum wage and the real living wage 10.4 million pounds to meet those demands. We are proposing specialist fees increases of 4.6 percent and also the same 4.6 percent for out-of-butter providers who provide specialist services. We did for last year's rates and fees provide substantial increases in many sectors up to 18 or 19 percent in particular for residential and nursing and allocated all of the funds that were made available to the Council last year which were at at 14.1 million last year. For 2024-25 we have prioritised wages for frontline staff with the funds that have been made available to the Council and for any future planning we have taken into account what providers have told us for other areas that we would consider should any further funding become available. Thanks Jane and good to hear. Does anyone wish to speak to this? Mary, your hand was up there. Thank you, Chair. Thank you for that, Jane. You said a lot about paying the real living wage which we are all obviously totally committed to but I noticed in the statement that was read out earlier there was a list of other priorities which providers were concerned about. The first of which was general training and I'm not quite sure what they consider to be general training because NHS has mandatory training and I'm not quite sure about in terms of residential care. However, I'm looking more to more specialist training and in particular obviously dementia training. My question would be regarding is there supernumeric staff in care homes to allow that training to take place? Is there a way that we can actually enable that training to take place? Now, I met with the director of the House of Memories last week. She was on a visit to St. Oswald's Court and I went for Julee because Julee was away. They provide training to care homes for their staff and to immersive memory training for the people who live there as well. It's a fabulous service. It's absolutely free of charge. We are determined to become a dementia friendly borough and in my experience as a dementia leader in my time in the NHS I've gone around hospitals and the training is quite good but I have been totally shocked by the lack of training in dementia and the lack of knowledge among staff in those homes and I think if we've got the chance to deliver some training to staff for free we should take up on it. Many providers do take up that offer of free training in particular for the House of Memories work and I think they also do visit services in Liverpool where those are also provided. Where providers are providing care for people with dementia and they're registered under Care Quality Commission for that, that is a requirement that they will deliver dementia training in support of staff there. Our model for the rates and fees does include an amount for training and numbers of days of training, a lot of which is mandatory based on their care quality inspection regulation as well. Just one thing I can remember back in the day we wanted dementia training to become mandatory. It wasn't at the time I was working in it. Is it now mandatory training? Can we mandate it? For dementia providers yes we can include that in their specification and actually for care quality commission if people are if providers are delivering dementia services they are required to show to the regulatory body that their staff is suitably trained to deliver that service that they are regulated for. Do Tony think your hand was up? Was it an anchorion and then Simon? No it's not okay right. I'm going to go with care in the next and then fill in the Simon. Are there people in the receipt of direct payments for the support rather than commission services? Are those people paid a sufficient amount to pay the PA's the real living wage? For direct payments recipients we have included the real living wage rate for for direct payments employers to pay their front line staff so we are anticipating that they were paid staff at £12 and I would like we have provided for in other sectors. It's on page 94 of the reports. Okay that's that's that sounded like a yes thank you. Okay so I think what we've been driving for for the last three or four years now is some stability in the double salute care sector and it would appear that because we've gone for the higher wages the real living wage that there is perhaps less turnover and it's now seen as a career that people want to enter and stay in. I was looking at a recent CQC report I'm not going to say where it was about but clearly one of the things that the homes have is a turnover of managers and within the homes each time I see CQC reports there are issues about medicines management about keeping accurate records but one of the reports I looked at recently was particularly about the turnover of staff and how people receiving dormitory salute care are really grateful or pleased that there are regular staff. They get concerned when the changes of staff who don't know them that message came across particularly in that report so having consistency and training and the ability to retain staff we went through appeared when people would often say well I can go down to a certain supermarket and get more for an hourly rate for just being on a tell which was distressing really when we want to have a service whoever provides it that people receive, enjoy, can feed information back on, seek improvements in as a core of staff who are dedicated to those services. Yeah thank you. Thank you for the report. 10.4 million pounds additional money is that based on the percentages so that is that based on the 85, 99 and 96 percent continuing at that level of paying the living wage as opposed to the minimum wage because if that is the case if those roughly 20 percent suddenly decide to pay the national living wage that could be an extra two million pounds that we're looking to find is it or not and we've got the maths rule. Thanks. They are currently for providers who are already paying that. Our budget makes provision for 100 percent. Sorry Jack can I just come up with one thing. Clearly this will live and die on whether we continue to maintain good capacity or not or we managed to put people out of business so the proof of the podium will be needing won't it. Thank you. Okay thanks everyone. Thank you. Thank you. Thank you for the report. You mentioned so in the reasons recommendations it talks about balancing maximization of value for money and cost of care. It also mentions consideration of local factors. I think you mentioned staff retention was one of the specific local factors. Are there any other that kind of particularly came out? There are some factors to consider for domiciliary care in particular where the borough is not as largely populated so we do have some challenges in more I'm going to say rural areas and you know I'm from North Yorkshire so rural and rural aren't quite the same things when you say that but where we where our areas where they're not necessarily as highly populated so we we do take that into consideration in terms of mileage and people getting to you know some parts of the boroughs in many parts of the borough we do have staff that cycle and come walk for domiciliary care visits because their clients are people that receive services will be very close together but for other parts of the borough they are much more dispersed. Thank you and can I just also ask the the maximization value for money etc. Does that include a formal inclusion of the the staff retention issue? Is that just something looked on the side or is that included in the calculations in terms of value for money? Thank you. Yeah so our biggest challenge it has been domiciliary care and sufficiency in domiciliary care so we have incentivized that sector with an enhanced rate actually above the real living wage for last financial year and so for next financial year and given we are aiming to keep and maintain as many people in their own homes as we can we're introducing a three-tier rate so a minimum wage a real living wage rate and an enhanced rate for domiciliary care next year. On a green grey a minute at this point. So I think just just ready to be clear what what what we've done here is use the resources at been made available to us nationally and locally through our budget setting process of course the the budget is fixed now this is this is our budget so we're giving as much as we possibly can to the care sector and I think officers in in social care and this committee have a great deal of empathy towards the care sector and that's reflected in in each year we've given as much as we possibly can I do understand I fully understand that the costs and the pressures in the sector are becoming very difficult and we had a statement earlier on and I think that does reflect the reality of the situation however as a council we do have to set a balance budget and we have to make the resources available as best we can and I think our commitment is to continue to work with the sector very closely to aim to get the best that we can for them in terms of annual settlements but you know finances are very tight and any action money that comes into social care is one of the part of the council so we do have to work that balance that's the reality. Thanks Graham. If the one else is indicated I'm going to move on to the recommendation which is which is about the adult social care and public health committee it's recommended to approve the rates as set out in sections 4.2 4.3 and 4.4 of this report to apply with effect from the 1st of April 2024 to services commissioned by the council and jointly commissioned services between the council and donate just Cheshire and Merseyside. Merseys integrated Kerboard in relation to residential and nursing care supported living extracur care and support at home direct payment and shared lives do I have a seconder? Thank you. Can we agree by a sense? Thanks everyone. You know to section B now which is budget summary and performance management and the first gender item is also number nine which is all age disability strategy and G you're going to present this report. Thanks. And Donna as well. Okay good evening everyone. The purpose of this report is to present the draft all age disability strategy 24 to 29 for approval as detailed in Appendix A. Appendix 1 sorry with the easy read version in Appendix 5 of the air pack. This strategy was part of a work program as an outcome from the all age disability review that was approved back in June of last year by this committee. Report is a key decision and it affects all wards. This report is also being presented tomorrow evening at the Children's Family and Education Committee to note as well. The key points that I'd like to highlight from the report are particularly the co-production journey has been comprehensive. This has involved working together at all stages of that co-production journey from thinking about the underpinning values of the strategy to what matters most to people with disabilities and to looking at good practice across all the parts of the country. This is illustrated in Appendix 2 the co-production journey of your pack and Appendix 3 the best practice research that's also in your pack. The strategy has also achieved co-produced status under both the send the special education needs and disabilities charter and the adults co-production charter which you'll hear Jane present later today at this evening. The process of the co-production of this strategy as involves listening and recognizing that language and inclusive approaches are important. The term used throughout this strategy is people with disabilities and it was stressed by the people who lived experience to keep the writing easy to understand and the hope that we've done that this evening. The strategies for anyone any age who has more than one or more disability and enable their parents and carers to support that network. The strategy itself has a clear purpose vision mission and core values which is defined in points 3.8 to 3.11 of this report and it's also underpinned by four focused outcomes that people will live experience and their families told us that that was important to them. These were improving health and well-being, living in rich lives, having an independent lives and gaining employment and economic well-being. Under these four outcomes they are interlinked and we recognize that it's hard for people to achieve their goals in one area if all others are not in place. It's also important to recognize that it's a multi-partnership approach to enable those outcomes to be successful and appendix 4 visualise is the overlap between several strategies and plans both within the council and its partners across the system. Under each of those four outcomes within the strategy, the section covers what the people with disabilities told us they need, what else we know about that particular outcome, local statistics, research and insights and what we need to focus on. The next stages of this strategy will to co-produce a measurable implementation plan that will be monitored by the all age disability partnership board and will make the necessary annual impact reports of this committee and the place-based partnership board. So in summary chair, why this strategy is important? With 71,000 people live in Whirlpool are disabled under the Equality Act

1. This means that 22.2% of people in Whirl live with some form of disability or impairment that limits them on a day-to-day activity. This is compared to 19.4% of people in the northwest and 17.3% across England. So we carefully need to think about the services that we offer to ensure that we make the best use of those resources so people are supported and able to live the life to the fullest and active lives. So it's really a great pleasure that I ask this committee to approve the co-produce strategy that's in your pack and receive an annual progress report and impact to this committee in 12 months time. So thank you for listening and I do hope that you like the strategy. Thank you. We do. Thank you too and we did. So thank you for all the hard work that went into that and it's great visually to read as well. So Julie, your hand shot up first. Thank you very much, Jean. It was a really good read and what I was delighted about was the importance placed on co-production and the whole theme through many of the reports this evening have been about place and involving the experts, those who were living with the disability. So that was really pleasing. I just want to ask about employment and I know you've mentioned that and about supporting people into employment. I'm not talking about where people trip up and do free volunteering. I want to know what support has been put in place, not just for those who are seeking work but the employers who might need to understand more so that they're gainfully employed. It's sustainable that they're not let go quickly then and they move on to somebody else. Thanks, Jean. Thank you. Yeah, absolutely. What's running parallel to this strategy is a supported employment strategy for people with disabilities which will come to a future committee in July of this year. But there is lots of things that's in place at the moment. So we've got job coaches, we've got organisations that are offering opportunities for employment for people with disabilities. The main emphasis that we need to focus on is that supported pathways into employment. It's not just about getting the employment, it's about sustaining the employment opportunities and helping companies have that support there. So the strategy will look at all of that when I present it in July. Just quickly to come back, thanks for that. I mean, I was thinking in the olden days when we used to have disability advisory officers and I don't know if we still have those but I was working in a large company at the time and we had lots of people working on assembly lines and we had two people that were completely deaf when they turned up for interview. So they were helped through the interview process and with one young girl, she was, I can remember that she was always late and rather than just put her through the normal disciplinary process, we inquired more about why she was late and it was simple as getting her an alarm clock that vibrated under her pillow and flashed. So, you know, it's important I think to make sure that there's money there for equipment and it will just be simple stuff most of the time. So but thanks very much, good report. I've just said to Graham, I can't use that excuse them. Kieran? Page 101.3.6 in papers, autism is not a disability, really. In your opinion, does autism not have a significant long-term effect on personal disabilities coming out of normal, dated activities? Yeah, sure. So when we were doing our research, Kieran, we were looking at autism and there are different schools, of course, in terms of autism or whether autism is considered to be a disability or not. Some schools have thought, say, that autism doesn't impact and some people would argue that vice-versa said that actually autism is aligned with a disability as well. So we made reference to that in the report and that's what that's referring to. Okay, thank you. I get the fact that it says later on in the easy-vids version, the more nuanced line that you've taken. But in the main report itself, it is quite explicit autism is not a disability. What would be more vacuous is a lot of people with autism don't accept a label disability. Yep, no, I can take that feedback back, great, then what can Kieran and we can have a look at that? I kind of get what Kieran's saying there, but actually I took from that that statement was in the report, that's kind of a statement, not necessarily what you think, it's about what kind of people you've got autism, challenge that perception that is a disability. So, okay. Yeah, totally. And then Mary. Thank you very much, Jean, for the report. Two or three things that like to sort of draw together. There's a reference to brain injury in the report and I remember when I was the pound manager at Walton and Uruguay, it's a refer people to the local headway branches, including a rural headway who were actually a valuable resource for people in the community. From the voluntary sector. And also, I referred earlier to the needs of older parents with children who were approaching maybe some level of need for independence. You actually got your parent care and survey in here as well. So, I'm kind of joining those two things up together. But you didn't really say that you're not going to, if this isn't health orientated, I might accept that. But there are things which where health needs are quite important to be aware of. I mean, mentioned brain injury. And when I worked at Walton's Centre, I met probably hundreds of young people who were transitioned, who had transitioned from older hater Walton euro who had a shunter fitted. I think I issued over 300 shunter layer cards in that over the seven years. And the point about having a shunter fitted is that they can function very well for 30 years, or it can malfunction after six months. And so, I just want to flag up as a kind of, it's still going to run in parallel with the health issues, as well as social issues, financial issues, and ability to be independent. In terms of this all age disability strategy, in terms of its outcomes, improving health and wellbeing is fundamental. And that's what, all the way through the co-production journey was loud and clear from the people that were speaking to us. The strategy in itself can't be delivered on its own. It has to work with all the strategies like the health and wellbeing strategy and with all the colleagues. And a multi-agency approach is definitely needed in terms of the implementation of this. For me, the outcomes itself need to happen, interlinked, and that will enable a person with disabilities to live their best life, whatever that looks like to them, and to enable them to be as independent as they possibly can for as long as they can, and whatever that looks like. So, it isn't in isolation. We're trying to give that over to thank you for that. Mary. Thank you, Chair. Just looking at the the section on enabling people to get into work, and I can remember back in my manufacturing industry days when we used to employ stuff from Renploy, and that organisation ceased to exist. So, I'm wondering, is it something along those lines? Or how does it compare with the two-tech system, which in my opinion is more of a tick box exercise, which basically says, if you have a disability or a long-term condition, you are guaranteed an interview tick, but we're not giving you the job. So, is this something that goes far further than that, and really does help people into meaningful employment? Yeah, absolutely. It's far from a tick at box exercise. The strategy that sits behind the supported employment looks at the pathways to enabling into employment, supported employment, and that's sustained employment for all opportunities for people with disabilities. So, it's more than a tick box, definitely. And does that include long-term conditions as well as disabilities? Because not all long-term conditions are disabilities. No, it's enough. But they're very often seen as such by employers. Yeah. This strategy is around all age disability, and it has got to focus on those people with a disability. We do appreciate that there's obviously health benefits and mental health benefits as well, but it's very much focused on people with disabilities. They're the pathways that we want to put in place, particularly for supported employment, because we do know if we start earlier in, like, preparing for adulthood from children into adulthood, and we offer those supported employment opportunities, we know that we can increase and improve outcomes for those individuals, but we will avoid those unnecessary costs later on in life. Phil. Looking at what is page 120 or small print 13, and this is about living independent lives, as a sentence in there, we know that living independently only works if homes are accessible, and you have to write adaptations and support. A bit ago we did talk about how things work with what was housing and getting adaptations completed, and we talked about how in performance indicators are having adaptations. So you probably remember that we issued a contract to an organization that has a contract already, Medequip, who I have to get on with all those easy things, handles and rails and all those side of things, but I'm wondering if we might have a way of monitoring just how many adaptations of more extensive nature are carried out. I know we had some of the money that came to us from the government some months ago, which topped up the budget or added to it, and so I don't think we perhaps got a picture of just what's going on to sort out properties and make, whether it's walking showers or more detailed work, than the simple jobs and how we progress with those. You've got to be engraving on that one? Yeah, so whilst that reports haven't come to this specific committee, Disabled Facilities Grant, we do receive as officers a regular report from the team that's responsible for those in the go to a place called the Joint Health and Care Commission Executive Group, but if this committee wanted to look in more detail at Disabled Facilities Grant adaptations, both low level and high level adaptations, then it's a perfectly suitable scrutiny item for this committee to look at in more detail. Alongside and have a growing list. I think we need to be a little bit more focused, well, although yeah, can you make a note of that? Okay, so no one else has indicated they want to speak. Thank you so much for that. As you can tell, it was very well received and supportive voices all around the table here. So I'm going to move that. We approve, where am I? Sorry, that we approve the COVID up to draft all age disability strategy 2024 to 29 as noted in Appendix 1 and receive annual progress and impact reports of the implementation of the strategy. Do I have a seconder? Thank you. We're really happy to agree via centre, everyone. Thank you. Okay, so we are now on to... Ten. Sorry, they've got relatively similar titles. I just read out the wrong recommendation. So we're on gender item ten, which is all age disability review implementation. Gene likes yourself again. Yep, that's me again. Okay, they are similar titles, but very different and but related. So the purpose of this report is to present the progress to dates of the implementation programme following the all age disability review that was approved by this committee last June, 2023. The implementation programme as detailed in Appendix 1 covers high level thematic areas and if you recall back in June, those areas were starting earlier at age 14, better joined up planning and collaboration, enabled to prepare for adulthood, improved housing options and choice, better training, volunteering, employment options and choice, and improved accessibility and relevant information for people, parents and carers. The work programme also looks at the workstream lead, the Pacific project itself, key actions, timelines and progress statements for members to look at. Each workstream within this work programme are interlinked and part of a continual improvement journey that will enable that improved outcomes for people with disabilities that are underpinned by the council's co-production charter, where appropriate. This report is not a key decision, but it does affect all worlds. The key points I want to highlight from this report is that each of the work streams within the implementation programme has made significant progress and it's been a busy six months with the support of Donna and her team and some of the work streams have been completed all are certainly on target for completion. The summary of the work programme itself is detailed in points 3.5 to 3.13 of the report and is supported by appropriate appendices, but I'd like to highlight the following. The co-production of the strategy which you've just heard about has already been presented in a separate committee report that has been completed and thank you for approving that. The second point is the co-production of the Parent for Adultered Transitions Protocol. A framework has been produced and is being considered against the set of principles. This is detailed in Appendix 3 and the framing of this protocol is based on some desktop research across best practice across the country which is also detailed in Appendix 4. This work is scheduled to be completed by early March but unfortunately wasn't available for time of writing of this report. The next point I want to highlight is capturing Thomas' experience a storyboard which is in Appendix 5. This is a real-time storyboard of Thomas and the benefits of personalisation and systematic transition from one service to another by Thomas and his family. This has been completed. These are Thomas' words and this is Thomas' family's words as well and I appreciate that not everybody's circumstances is the same. However Thomas' story and his top tips highlighting early planning of care and support around individuals can lead to greater outcomes which we all agree with. The next point I'd like to highlight from the report is the progress against the Education Health and Care Plan. There was a desktop research completed. This was a snapshot of 25 plans across an age profile of 14 to 18 year olds. This has been completed and is detailed in Appendix 2. The purpose of the snapshot was to establish a baseline of current practice and to identify tangible opportunities for age-appropriate improvement in preparing for adulthood. This also includes an analysis of cost of care, support packages for improved outcomes and to forecast potential opportunities for cost avoidance. The snapshot itself in the report covers any evidence of input from adult social care, plans for training, volunteer and employment and plans for housing options for 18 year olds plus. It's worth just a point to note that this was a desktop research and can only review the information that's in the plans at the time of the review. Just wanted to add a little bit of a disclaimer because that's okay. I just want to highlight one of the elements of the report itself. Of the analysis it was projected that with good preparing for adulthood planning we could support 15 of the 25 individuals into employment. So a little bit about the earlier point of are we really serious about supporting people into employment? The answer is yes. And 17 of those into housing options to live more independently. This will enable us to put better plan and to have those better pathways in place to support people with disabilities. In terms of the report it was comprehensive and there is its own set of recommendations that we will take forward in the preparing for adulthood collaboration with all stakeholders. The next point I want to highlight is the contribution to the development of the Cheshire and Merseyside learning disabilities and autism strategy, housing strategy. Again Jane's kind of presented that work this evening and that is aligned with the all age disability strategy that alignment there. The other progress point I want to flag is about the co-production of the supported employment and volunteering training. The strategy is on target for completion and is tabled at this committee for July 2024. It will detail the supply and demand the opportunities and the implementation of how we can support more people with disabilities into employment but keeping them there as well with that support. Sorry this is a long one apologise. The next update is really around also we're looking at a supply analysis and management report. This will look at the current service model for young people transferring and transitioning from children into adulthood and that will allow us to look at and make recommendations of changing the way that we work and improving that strengths based approach to enable those children young people to prepare into adulthood and flourish. Nearly there guys. The co-production of the pathways as I've mentioned before from the Education Care and Health plans that will be in the summer of 2024 and then last but not least is the age appropriateness information advice and guidance for the children young people, their parents, carers and professionals enable them to have the right tools in place to enable those children young people to prepare into adulthood. So it's a great pleasure chair to again to ask this committee to note the significant progress of the implementation program following that review last year, last June and all the supporting documentation and just to note that again this report will be also presented at children's families and education committee tomorrow evening and thank you for listening and happy to take any questions. Thanks Jean and we'll say that we all love Tom to story by the way really do and another lovely report and you know it's another the reports that have come before tonight make me like really proud to share this committee and you know what role they're in, what you, you know, your colleagues and Graham's team and Dave's team are doing it's just a fantastic committee so thank you again from us all. Anyone got any comments they'd like to make on this? I think we'll just Tony. I'd just like to hear having quoted several experiences I've had in my work in the past um there was um I worked at Manweb and in the old days used to be a certain if so many people employed there was it 3% had to be registered disabled or something along those lines and at the annual meeting in the in Chester there was I used to ask every year what about our percentage of religious disabled people and it was always below the statutory target and then I was challenged then to do something about it of course I was doing it as a trade unionist anyway so I went to several organizations and one of which was FAB physically handing up naval bodied and they had a young man there who um who had a severe cerebral palsy um and um and it's got a long story short and didn't get him has some experience and then actually a full-time job at Manweb and his ability was to work his computer with his left foot and it was absolutely fabulous to see how he worked in the finance department at headquarters in Chester for Manweb and the thing I remember most about it on the day that I was retiring sorry leaving I should say Manweb I went along and asked him to come along to my celebration I said which in the east wing on the second floor this afternoon and before I could bat an eyelid he typed on to what time and so just to kind of encourage us again it's not Thomas's story and that you've got there but it's an example which sort of certainly remains sort of important to me as an individual but also a learning point as well okay huge thank you from everyone thanks very much I'm just going to read out the recommendation which is that we approve the sorry I did go to the wrong one then I knew we'd do it at some point tonight that we recommend the recommendations that we know the significant progress today's of the implementation program following the all-aged disability review as in appendix one I'm more than happy to move that to have a seconder yeah can we agree by a sense thank you thank you very much now back to Jane for the co-production strategy thanks Jane thank you more on corporate co-production which is good and so this report provides an update on the research development and the co-production of a co-production strategy for use within adult social care and health services and with wider stakeholders the requirement for the strategy has been highlighted as part of our care quality inspection preparation for adults care and health and does represent best practice when working with people who use services either as individuals or stakeholder groups we're looking this evening for approval for the co-production strategy and also the co-production charter which have been co-produced with local stakeholders, carers, people who use services and we would look to implement this within adult care and health there is of course no single formula that we can apply when we're co-producing services with people and we would look at each co-production piece with a fresh set of eyes and work with a joint approach with people and communities or stakeholders that are involved the key part of course is that we're involved in experts by experience when we are co-producing services that we are aiming to deliver our commission. We will look to put in place a monitoring approach for highlighting which pieces of work we will co-produce and how effective they have been and the report also outlines something which to co-production language describes as reciprocity which means giving something back to people for their input in terms of co-producing with us which could either be in terms of a financial response vouchers or in some cases a thank you if that's what people ask for which we would always do anyway. It builds on our strategy builds on our strengths based approach and it will also mean that we'll have an area of development within all of our staff teams in working with and using this co-production approach. We haven't yet produced anything in accessible formats which we agreed with the stakeholder group which once we've got the strategy approved if committed as approved that tonight we will then work with the stakeholder group to develop something in a range of accessible formats. Thank you I was just saying I'll do like a charter I was just saying I'll great the charter was and are we going to like officially launch it and you know other councils like doing the same thing or you know would they be following our leads so we are going to launch it officially so that's grace it looks brilliant again thank you for all your hardware chain and not just this report for one other one should be sent to tonight and does anyone have any comments or questions Kevin Julie? In terms of how things are going to be coped produced and who makes the decision as to what will be coped produced I think it's a little thin on the ground I think in fact I move that we don't accept this this tonight I move this we send it back and the chain does a bit more work on the on how how it's going to be implemented Okay well I think that's just a do you have a seconder for that? Are you going to second that? Okay are we going to discuss that anyone? Do you specifically going to discuss that? Yeah just the only word in the document which I would disagree with Kevin with all due respect but as when it talks about coproductions and working in networks and across silos and they probably would have deleted the word silo because it implies that if they exist then we have to work with them as opposed to they should become a department but other than that I sort of I would oppose the amendments and I think it's an excellent document that you produced. James Gonna say something. Thank you Chair so I think what elected members have been asked to do tonight is to sign off the strategy and what that does is it commit us to co-produce so that's the decision that you're making tonight you're not making the decision of all of the detail of how we will co-produce because I think that depends on the individual circumstances the groups that we work with I know for example when we're working with gene service we have a very different approach to involving people that want to make a difference in day services compared to say we would be working with the other people's parliament you know very very different approaches it would be very difficult to put all of the different approaches into one document and I think that's probably an ask too far of a strategy and however what members have been asked to sign off is the commitment to co-produce and that we will make it happen and we will find ways to make it happen thank you Chair. So I'm a bit confused then obviously because it's one expected are you basically saying that you're going to vote against that commitment to co-produce? No. So you're not going there's no amendment then. Okay so you want to withdraw it. Okay the main body of the discussion please. Julie I don't need to speak no I'm pretty much backing up what I just said thank you. Okay no complaints with the strategy just one thing that can I ask is that an old foggy here can we have the font in black rather than gray because I can't see it and I had the same problem on the previous items where you had five colors and the fonts were all in the same color as well and I can't read them. Phil? I think what we're getting into now is the result of the Care Act 2014 and I remember a slogan from the Health Service which was something like no decision about me without making it and that says I think where we are and what we want to do. I think it's personally think it's a great ambition I think but the strategy the strategic approach that we've taken across the board with this committee is going in a really positive direction I'm really pleased to see it. Okay well we clarified that so thanks Kim for clarifying that and withdrawing it. Can we move? I'm happy now to move the recommendation as it stands which is that committee is recommended to approve the co-production strategy and co-production charter which have been co-produced with local stakeholders, carers and people who use services for implementation with an adult care and health. Happy to move that to have a seconder by everyone it seems. Can we agree by a sense? Thank you. Thanks very much both. So we're next going to move to our public health grant and that's David you're going to present this on its pages 267-274. Thank you Chair. Apologies I am struggling with a bit of a cough so I'll do my best. I don't think I'm infectious because I've been ill for a couple of weeks now so hopefully I'm not infectious. It's just a remnants. Anyway this paper is a fairly short paper to build on the discussions that we had at the members workshop at the end of January which outlines the proposals to spend the public health grant reserves or at least bring them down to an acceptable level over the period of three years so we don't just chuck the money at it and have some short term. Within that and those discussions that we had we really emphasised the need to make sure that those investments were made upfront that where we would be able to monitor the impact of that but be clear that we needed to build sustainability into them or there was a clear exit strategy at the end of those three years for the areas that were proposing to invest in. The areas the thematic areas that we discussed at the workshop are outlined in section 3.8 and this is the amount you know nominally allocated over a three-year period so there was going to be further investment in the community voluntary and paid sector. There was the discussion that we had around housing and health clearly we've listened to that and we're going to make sure that we take on board committee's recommendations in that area particularly if you recall that was about how we had oversight of some of the work that might take place in another committee's area as well so we needed to make sure that the public health grant aspects of it was clearly still reported back into this committee as we go forward. It's always coming I think that I think the concern was that this committee would be paying for staff and then it's the additionality that we will define to make sure that it's not funding the core staff from from those services it is the additionality in line with the public health grant that we'll really emphasize in that. There was a work around the falls prevention and also working much more upstream than falls prevention so bringing it into a stronger for longer type approach as well. There was a bit there which we didn't discuss at the workshop and it came as a bit of surprise when the public health grant was announced to us that we would actually take on board an additional responsibility that was going to fall on the council which we haven't previously funded which was the NHS uplift for our NHS Commission services so we have been given a small uplift in the grant to cover for that but at the moment we're still working it through to see what the implications of that are the early signs for that is that it won't be sufficient so we're building some in for that purpose there and then there's another number of other areas there that are outlined around fuel poverty, environmental climate emergency, the positive inclusion program, tobacco control and the speech and language enhance parents support so that's the the broad outline there that we we will adjust that slightly as we go forward but that's the initial proposals. I hope that's okay with everyone. That's kind of just bringing formally to the committee what we discussed at that workshop Simon. Sorry, just to could you refresh my memory on the environmental services climate emergency? 200,000 pounds, what that was for please? Yes, Simon. The proposals for a number of these are not fully worked up yet and the team are working them up with other offices as well to define what would be the best approach to supplement what we're already doing in line with. The initial proposal was to look at a post that would be based in the neighborhoods team to supplement the work that they were doing but again that will depend on whether they can define the additionality and what is going to happen on top of what we've got available there. Because I think what we were all clear on really was that we, you know, public health grant funding is not there to kind of bung into other directors, you know, just to fill a gap it has to have that public health outcome and public health element branded one. Very quick. The tobacco control, does that include the babes? Yes, so there's some work there around, particularly around trading standards and some of the the fact that we don't have capacity at the moment to do test purchasing and restricting sales and the like, so that is part of that programme. It definitely needs to do that. Okay, don't see anyone else that's indicated. I'm just going to read through the recommendation and that is that we authorised Director of Public Health to make effective use of the public health grant reserves to tackle the identified emerging pressures in line with spending proposals over a three-year period from April 2024 to March 27 up to a maximum value of four and a half million pounds. I'm going to move that to have a seconder. Seconded. We're happy to agree by a cent. Okay, we're moving back at your voice back before you present the health and all reports. We're on to section C, which is over with you in scrutiny, agenda item 13, adult social care and public health 2023, 24 revenue and capital budget monitoring for quarter three. Thank you, Chair. This is the quarter three report follows, obviously, behind the previous reports that we've had through the year. At this point in time, there's a forecast of 435,000 pound adverse variants or overspend against the net revenue budget of 131.25 or 7 million. The outcome figure assumes full delivery of the savings that we've set out for the year and it has used already adult social care in market reserves of half a million pounds. We have also deployed winter pressures money that was set out to enable us to work with the NHS, particularly focused on hospital flow and discharges and that's contributed to the current situation where we have very low delays from the hospital half from the last year. So that progress is good. However, there is that 435k adverse position. We're all happy. We're okay with that. All right, thanks. I'm going to move the recommendations. It's that the committee is requested to note the adverse position presented at quarter three, note the delivery of the 2020-2324 savings program at quarter three, note the reserves allocated to the committee's future one-off commitments, and note the level of reserves at quarter three. I'm going to move that. We'll have a seconder. Thank you. Can we read by a sense? Thank you. So next we're on to a January 14, pages 283-324, adult social care and public health performance report, and I'll be eagle-eyed, might have spotted the sign as little bibbles. Jane, she's our thanks. Thank you. The report performance report again, a course of performance report, and the one that we bring to committee is in the APAC and we're asking members to note the content of the report. In terms of highlighting some areas in the report, we, I'm asking you to pay attention to the increased numbers of people that are being supported in the quarter three report, over 9,000 people now supported by adult social care department, and also the increase in the number of people who are being supported by technology enabled care, over 5,000 people now who are supported by that within the, within the borough. Also to note the continued increase in domiciliary care provision, beyond pre-pandemic figures now we've returned to that, and we are also aligning that with new home first services that have been developed within the NHS to help and support people to remain at home. The 8.5% factor within the community care market care home sector does reflect that we do have sufficient to say within our local market, and that 8.5% is actually for admittable vacancies, the true vacancy factor is in excess of 10%, but the 8.5% is those that are admittable at that point in time. Just to note that the CQC care quality inspector will be changing the way phased in, how they undertake their inspections from November last year onwards, where they'll be working as part of a self-assessment process and working with providers in terms of reporting on those. We do have improved performance where our services have wrapped around and helped to support hospital discharges, we've got good reduction in the number of people who do not meet the criteria to reside in the hospital, in particular over the last three quarters, and you'll note also from the report a good reduction in the length of people have stayed in hospital which means our focus on increasing domiciliary care has helped to support people out of hospital quicker. Just to note in terms of extra care, the report notifies 388 people and pleased to report that we've recently opened a new extra care scheme within the last two weeks, the schema sigma house in list guard has opened, which will greatly improve our figures for the next quarter. Yeah, it's great to see that open in my ward as well. Okay, everyone, have any Julie? Thanks, Jane. I'm really concerned looking at tables 2.6 on page 295 electronically, CQC, care home ratings, and I know you said that things are going to change in how they're reported, but there are 35 that require improvement. Now, I know we've got three inadequate, and I know we've discussed this in past committees, what happens with those, but I'm really concerned about those 35, and if you look at the table underneath where it breaks it down, in particular, when you look at dementia residential and dementia nursing and mental health residential, I think it's really poor. That backs up something that Mary said before when we were talking about or you mentioned about care homes and that CQC, for those who are having dementia nursing or dementia care, it's mandatory that staff do some training. That doesn't tell me that that's what's happening when I look at that. And I wonder whether perhaps we pick this up in the next municipal year, I've asked this before, that we keep it on the agenda, and maybe that there's a subgroup setup, where to have a look at it, to do a bit more of a deep dive into that, because I think that's really worrying. And I'm happy to take part in that working group or whatever it could be called, but yeah, that's my only comment. Thanks. Thank you. Members may recall, we have previously presented and had agreed at committee a new policy that relates to commissioning contracts, and quality, and we've introduced a new quality management system and a new quality management tool that is helping us to support. What we can't do is get CQC to come back out and inspect services at the pace that we would like them to come out, but for those services that are requires improvement, we have had a very focused piece of work undertaken with our quality improvement practitioners to improve the quality of those services. And you will recall that in April, we'll be at a member's workshop representing that quality work that we've been undertaking and showcasing that at a member's workshop in April. Okay, yeah, that's good. I'll reserve judgment then until after that. Thank you. Okay, no one else indicating. Okay, thank you. I will move to the recommendation. That is that this committee is recommended to note the content of the report and highlight any areas requiring further clarification or actions where I'm happy to move. Do I have a seconder? Yeah, can we agree by a sense? Okay, thanks, Jane. I think you can take a breath, can you now, Jane? Jane, you'll step it off again next month. So it's the annual complaints report on that to pages 325 to 344. Okay, thank you. This will be the last one from me as well, Jess. Okay, the council has a statutory requirement to produce an annual complaint report for the Adult Social Care Committee, and that was included in your PAC. This is a non-key decision, and we're asking for committee to consider and note the content of the report which is tabled in Appendix 1 of this PAC. The report will also be made available to the public via the council's website as well. Today, the report focuses on the complaint received between April 2022 and March 2023, and there's some key points I want to note from the report. From the report, there has been an increase in complaints in this reporting year of 13%. This has risen from 142 to 161 complaints. The emerging themes from this reporting were similar to previous years, in particular about the standard of care and support, social work concerns, financial and charging issues. 87% of the complaints were resolved at a local resolution stage and didn't progress to the local government's social care on MUDSPRSOM. This was a similar position from previous years. We've seen an improvement in the average response time and a decrease from a response time from 62 days to 52 days, a working days, whilst every effort can be made to respond to complainants in a timely manner. The complaints coming through are often complex and require further in-depth review of case files and discussions. So often, those types of complaints will exceed the timescale of 25 working days. 61% of the complaints were fully or partially upheld. Historically, this has been around 50%. This reporting year also shows a similar number of complaints that has been escalated to the Ombudsman service of 19 contracts received over a year and 11 complaints were upheld. The council are 100% compliant with all the recommendations noted in the reports, so no public reports were issued against the council in this reporting year. The report itself also looks at the learning from complaints, and I've added compliments in there as well, Chair, which I'll share on her compliments as well. These are valuable to the service and often an opportunity to gain feedback on the quality of the service that are offered from a customer perspective, so we really do welcome complaints and compliments, and we do see it as learning and theories of improvements. This reporting year, we recorded 80 learning points, which is an increase from the previous year of 41 learning points recorded. The report itself gives insight into those learning of those complaints across three key areas, as I've mentioned earlier in the report, and the actions that have been taken for that area of improvements. Finally, I'd like to report on that we've received 16 compliments in this report in that reporting year from the people that use the service or their representatives. In 2023, we've also introduced a new appreciation scheme whereby staff members receive a handwritten appreciation card from the Director of Adult Social Care when that compliment has been received. Since April to date, we've had 33 compliments lips issued. We're committed to celebrating Adult Social Care's success, and I'd like members to take this opportunity to share a bit of feedback from one of the compliments if you can just bear with me. A family member felt hopeless prior to the social workers' involvement. The social worker helped the family's support mum safety and wellbeing, which was life-changing for them and their mum. The social worker showed nothing but compassion and care, resulting in their mum being in the best condition she'd been in a long time. The family have managed to get a bit of their life back, and also their mum back, the social worker was an asset. And then one from the family member from the Dom Silerie Care Agency, the care provided by the staff was superb. Sadly, the person we support passed away, and the care worker was present and spent time consoling and supporting the family. The family said that they would never forget this assistance at such a sad and difficult time. The care worker attended the funeral, which meant a lot to the family, and was really appreciative. So thank you for listening, and happy to take any questions, Chair. Thanks, and thanks, Randy. On that note, really, I think some time to people, we all forget how crucial it is to be kind, and say thank you, and that was a good job. Thank you. It's easier to criticise and complain. That doesn't mean to say that the complaints obviously quite a high percentage were upheld, so they were perfectly valid and upheld. So things have gone wrong and rightly upheld. But by the same token, and we know this as elected members, people are very quick to fire off an email. I'm never getting my first thank you, and I had to reread the email. Hang on a minute, because I just think people, it validates what you do, and it keeps you going some times, and times are really tough, doesn't it? So that's a nice note to end on. Thank you. Anyone? Tony? Thank you for the report, and as the Chair acknowledges, you know, some complaints have been upheld, and may it were a first serious nature. I don't know if it's a contradiction, say that they're broadly the same themes, but there's 80 learning points. I wasn't quite sure how you would sort of come around that. But in health services, some of them call never events. I'm sure you're aware of that. And the first theme of our standard services, in the case of hydration needs of residents, and so on, to go to hospital. But you talked about the degree of unit to talk to infections in a previous committee meeting, and I just wondered if somehow we could have a kind of a never event in terms of hydration, you know, for residents in care in particular. Yeah, we can we can look at that and consider that. Yeah, thank you. Okay, you're it. Yeah, I welcome this the reports. Yeah, well done. But you've highlighted in what you said this, there has been an increase in complaints. Why do you think that same might be? What we have been doing is raising the pro raising the profile that making complaints is a good thing and compliments. So we've been we've increased the profile. I believe that the reason for the increase is that we've increased the profile and increased the profile of the team and our partners encouraging people to get feedback from customers, whether that's in a complaint or a compliment to enable us to improve further in that learning. Thank you for that. So in other words, more people know that they can make complaints which is why there's there's been an increase. Yeah, more people know how to make a complaint. They know it's okay to make sorry a complaint, but it's also good to make a compliment as well and we're making it more accessible to people and raising the profile of how it's how to comply. I think as well, I think over the years, because people can come via email, whereas if someone had to write a letter and go and host it, you know, I don't know whether or not people would be less inclined to go through that. Obviously it depends on the you know the complaint and the seriousness of it and I'm sure a post that I said wouldn't deter some people if it was a really serious thing, but some of them are minor and I think it's okay to say I mean that there are quite a number of complaints about charging and finances and I think we have seen an increase there. We know we've got more to do with the personal finance unit that provide financial support to our residents. It isn't part of the direct, it's separate and sometimes that separateness does create issues because I know that certainly in my complaints that's going to know in a lot of elected members, post banks, a lot of the issues is to do with charging and you know whether the calculations have been correct or timely and all of those sorts of things. So we are actively working with the personal finance unit in terms of their performance and seeing how we can improve that in terms of the notes that go out, the timeliness of charging and all of those sorts of things which I think has been quite a long-term area that needs to improve. Thank you. Thanks for the report. apologies. I totally appreciate what you were saying about you know there's lots of different types of complaints in here and obviously the kind of the more serious out of safeguarding there's not so many of them and the majority or the biggest category looks like standard of care service and I appreciate as well that it's now easier to complain for some people than you actually invite these because it helps improve service. I suppose that can I ask is the increase compared to last year of both complaints and the number that are upheld is that are you concerned by that at all? Thanks. Not concerned greatly from the previous year however still concerned around the areas of improvement needs to improve. In terms of the learning points, the 80 learning points that have come from this year I think it's because also we're looking deeper into the complaints and the learning from it and encouraging teams that we don't work directly with to have those improvements in place as well. So not overly but I still think there's room for improvement. Yes. Always. Be interested to see how we fair as well compared to all the local councils in terms of percentage of complaints upheld as compared to the previous years and also what does that represent? Is it a trend in specific complaints being upheld? Okay. Thanks everyone. Are we happy to move to the recommendation? Yes. Okay. The recommendation is that the committee considers and notes the contents of the annual complaints report upon Dixbong, relating to statutory adult social curse service delivery. I'm happy to move to have a seconder. Seconder, thank you. Happy to agree by a sense. Okay. Okay, David, you're big moments and you're not well. It's typical, isn't it? But we've got Becky on standby, just in case. Great, moving away. I'm all right as long as I don't talk, so that's going to go well. Okay. Anyway, so I'll give this a go. As you say, Becky, I'm so finking contributing as well. So this is my first public health annual report. Directors of public health have to put a statutory requirement to produce an annual report every year. You can choose whatever the focus is. It's up to the director of an independent report and what I would like to emphasize is it's been a really collaborative effort in pulling it together. There's no way I could have written that report just by myself. I'm not an expert on employment. So I've drawn up a lot of our expertise in whirl. So really, really grateful to them. So it's been co-produced. There's loads of links to other discussions that we've had already this evening and a number of other reports as well. And it's quite aptly titled Work in Progress because it very much is a work in progress. And obviously, there's a little bit of play and work there. So the focus of that report is around the importance of good work and the impact on health and well-being for individuals, families, communities, and then the health of our economy as well. So that's kind of two-way into play. The evidence is really strong about that social determinants and the impact on people's health and well-being. And that connection between those two is really important. So I'm really, really pleased to focus and draw attention to that as an important area that we can build upon. Because we've got a lot of really good work already in place and I think it celebrates a lot of that work. But it also highlights a lot of the barriers and some of the challenges that you see. And a lot of those are multiple barriers by a wide range of people that you might not normally think of as having barriers that exclude them from employment. So I'm really, really glad that we were able to include so many of our resident stories within the report. I think it really brings it to life and shows some of those difficulties that they're having, but also where we've been able to intervene and give them some support. And some of them are fairly, you know, sometimes you might think these are fairly easy things to intervene with, but to do those little practical things and show that flexibility sometimes from employers that are required. Just those little things that can help people to sustain employment and get the benefits from a good employment are really crucial here. And there are a lot of those case studies shown that through. I think I'm not going to talk for ages on this at all. But there was a couple of things that, a couple of the figures when I was looking at researching some of this that came out. The figures were saying there's 21.2% who were economically inactive of our work and age population. And of those, nearly 36% of them was due to a long-term condition of being long-term sick. So that's clearly an area that we need to have a lot more focus on. But also the one that's already been mentioned tonight as well, which is about the 3% of the population with special educational needs, disability, who are in paid employment. That is a very, very low figure that we need. And we've already started work on it, but that's something that hopefully in a year or two time we will be able to tell the story of how we've moved that significantly away from the 3%. Some of the things there around the job density and whirl around the fact that there's only six jobs for every 10 working age residents as opposed to nine in other areas. So again, that links into it. So what can we do? And the evidence is really strong on the fact that that's based on the local regeneration that we're right on the precipice of doing that, making sure that's very people-focused and people can benefit from that economic regeneration that we're going to see within within, nearly there. Those fair and inclusive employment practices really benefit from those anchor institutions as well, that we've clearly the council is one of those and the leadership that we can show as a council, but also working with other anchor institutions. If we've already started under the health and wellbeing strategy, we've had a number of workshops, we've had a number of discussions, leadership discussions within the council already on the back of some of this and the work that we've been doing under health and wellbeing strategy. So it is the work in progress. There's a number of recommendations there that can just help move that on to the next level, I think, and just give it a bit of a nudge in the right direction, and hopefully that collective approach to this will really help that lift up to where we need it to be and improve the health and wellbeing of our residents. So anyway, that's enough from me. Well done, getting through that. Thanks, Dave. Again, this was, as I'm sure, in other groups, really well received. My just made a few quick notes for a group of colleagues about, and pleased to mention about anchoring institutions, because that's part of our community wealth building strategy that I kind of launched about five years ago. But I put the phrase down, it's not just work, there was it, it's type of job, the security of a job, because work gives people financial benefits, but also physical and mental wellbeing, and that doesn't, that mental wellbeing can't come with a really insecure, poorly paid job where zero hours where you can't budget and stuff like that. So that kind of automatically negates that positive aspect of work. So it's about finding meaningful, secure, and well paid work, isn't it really, I think, not just, you know, I see people, you've got three, four jobs, and then it's going from one to the other, to the other, to the other. They're all zero hours, can't budget, can't get a mortgage, in a way. So, well, I'm really pleased that you highlighted that, it's absolutely crucial to our residents wellbeing. So, Tony, your hand went up first. I'm going to look at you, Sophie, in case you can answer, sorry, I think first of all, the thing is an excellent report about the barriers to employment, and so on, and sustainable employment, and so on, and it's really well presented. I think there's a rich variety of case studies which you quote, and so on. I'd like to, but I'd also got some niche issues as well, and I'd like to quote the three of them. One was an ex-military personnel, I think, you know, taking a step back and looking into the issues with people who've come back who may not be able to set them back down in Sivy Street, sort of thing. And migrants, refugees, and asylum seekers have actually cut and pasted that paragraph already to a new charity set up here, and we'll call restart, because one of the issues that they've been trying to do is to help asylum seekers as they're a newly sort of approved home office organisation into employment. And then the last one is also is homeless people. I think, again, just to come from my previous experience, when I used to work at Just Later the Homeless many years ago, we hadn't dwelled in our night shelter, who literally was it, we tried to sustain in work while we were trying to sort out this housing accommodation and so on. And so thinking, you know, those sort of what niche issues, if you like, was the big picture that you quote, and I think it's really important to show the value of the work and the presentation that you've done. Anyone else like to? I suppose the other point where I had a financial appeal, I believe it or not. And previously to that, I've been collecting, selling waste paper, doing all sorts of things. We took the ages to find employment after that, because people thought this man has been sick, and what uses he. So there's something I had lucky to get a job and an opportunity, which kept me going for another seven years or so. So after that, you get this dignity and you get the satisfaction of contributing to society and doing things. I'm often haunted by a picture of a worker in the northeast leaving against a war with a cloth cap that pops up in many histories. And you think of the dignity that the people who went on the Jarrow March wanted and how they were helped on the way by the various communities they went through. I was just pondering me the other day about the relationship that we're all wallace-y and with South Wales. In that period, in the 1930s, Wallace-y sent aid to families in South Wales. There was something really cooperative about that dignity and having work and given the purpose of life. Some people sort of summarize it, we live to work or we work to live. Somehow steer a course through that because we're really trying to provide for our families and bring them up and do what we can. But the issues you raise about having to go from one job to another to trying to make ends meet. It must be really wearing for people trying to do that. You meet them in the street and you see the strain in their faces. And I think that's what we're seeing as people wander around the supermarkets looking for the yellow and no priced items in order to see what they can manage to afford that week. So I'm looking to see and I'm going to watch the budget tomorrow, see what the government does about the homes and family scheme that we put, I think, six million or so in over the last year in rural to help organisations and help groups and help people for this difficult time. Yeah, I think, I mean, it will seem but it's so blind in the offices that work. Meaningful work pays well. It is a little inchpin for anyone's mental and physical well-being and from that, most everything else follows. And actually, there's no dignity and poverty. You know, people say, oh, you know, it might be poor but the salt of the earth and that, there's no dignity and poverty and there shouldn't be such discrepancies in wealth in this country and everyone should have that entitlement to a decent, well-paid job. And that's the aspiration we should have as a society. And it's great that we've got, that's Bora. So thank you for that. I just, yeah, really well, we see you, thanks very much for that focus on, that focus on a hugely important issue for us as a committee and our residents. And so without further ado, I can move to the recommendation. Okay. So I'm happy to move that we review and endorse the public health annual report. And that we support the ongoing work to drive forward action on ensuring inclusive employment opportunities and addressing health-related worklessness in rural. Happy smooth. I have a seconder. Seconder. It's real happy to be by a cent. Thank you. Okay. We're coming to our work programme update, Vicki. Thank you, Chair. Yes, members. This is the report which comes to each meeting of the committee to enable you to comment on and contribute to the committee's annual work programme. This is, of course, the last meeting of this municipal year. But you will see from the papers that in the appendix, there is a number of items that are listed which are scheduled for the committee in June and some further items that are scheduled for committees after that, all those are awaiting to be scheduled. I understand that officers have proposed some changes for you to consider. One is that the CWP contract review be moved from June to July. There's a report on learning disability and autism respite service commission be brought by Jane as a key decision in July of 2024 and that the health protection strategy update be moved from April to June with at least an annual update instead of a six monthly update and that the conf grant item be removed from the work programme. So those are some recommendations from officers, but if there's anything that members would like to comment on or anything further you'd like to add for the committee next year, this is the opportunity for you to do so. Are you all happy with that, Phil? I was struggling to remember what I mentioned in the briefing the other day and it came to me in the end that if it's possible for officers who are imposed in the future to come to committee during the year to tell us more about how the three conversations is working with staff talking to clients and how it's feeding through reducing the changes or the careful choice of packages and administration packages to so we can see how it's impacting. Is that in? Well, I have actually been notified of one AOB because Graham, oh, okay, just going to leave the exemption, so you, no, no, you've got to stay. So I am sorry, I'm just moving that we keep the exempt item example and basically, yeah, you're happy to be brief at that. Seconded. Let's get on to the fourth bit, Graham, it's your last committee meeting with us. Sad to see you go, you've been here for 12 years, you came on the same time as I did. You've continued to go upwards. It's been an absolute pleasure working with you and I have to say that throughout my time here, there's been one committee I confidently knew that safest of safe hands were on it and that was you with this and adult social care is just so that one of the most important things that we deliver as a council and we couldn't have had a better person at the helm. To Steve was through really choppy waters, you know, through Covid, through cuts, your austerity and you've still managed to deliver up to our residents the best care possible and not just our residents but our workers as well. And I feel I'm immensely grateful and I will miss you there as chair. The only other disappointing fact I've got is I've only realised you're a little fan of the speech, so if I don't know, it was a no. But sincerely having amazing retirement and thank you for everything that you've done for Rural Council, for all our residents and for all our from the workforce as well. So yeah, I think it's my go now. Fully endorse all the comments, thank you very much. I would say that a number of staff have commented to me. These are only points for noting by the way, the recommendations. A number of staff have noticed and commented and I'm not quite sure what it means that they've commented. But the first thing that came to mind was you parading through the office in your lycra, having gone off your bicycle. So you've made an impact and I don't know what that says, Graham, but you've made an impact. And Nicky reminds me to please don't forget to take your spare pair of shoes from under your desk when you go, which apparently you've always kept, which is of interest. I would say and probably importantly, congratulations on your longevity here, because I think it's brought some stability to the department, which is important and as you been alluded to you, you steered us through some interesting and difficult times. So thank you for that. I think it's important to say that I've found you open and available. You have the ability to say yes and no, and it goes home. So thank you for that as well. But importantly, I think it's important for a bot, you're not here to be liked, you're here to do a job. But I think no one dislikes you, which is nice. And you leave the department in a better place than when you arrive, which is always the sign of someone who's done a great job. So thank you very much. Phil? Oh, here we go. Phil? Yeah, pondering on this. I spent some time the other day trying to work out how many directors have worked through, or how many directors have gone, come and gone by the time I've been on the council. I got as far as six, but no, no. So it certainly does, you do get the record for longevity. I particularly remember the times when the leaders at the period were receiving weekly reports about how the hospital and other services and how care homes were coping with the impact of COVID. I remember very difficult meetings where it was being predicted that we would have to hire a terminal building, sheds at Liverpool Airport, to receive and look after the number of people who passed away. It was an awful time to live through, but you went through it gracefully and kept leaders informed, built a good partnership with our health providers, and also at the time when homes were having to be closed because of the outbreak, we kept it cool when we could fume bitterly about the way people had to leave the hospital budget homes without what was called adequate checks, but when we got through that period with your guidance, I was, you'll forgive me, that Thomas's story in here, I think, refers to how much Thomas likes Doctor Who and Star Trek, so I may just give a quote. I was watching Star Trek Voyager the other night, and as you do, and one particular episode of the huge row between two of the lieutenants about what was happening to a particular problem on board the ship, and in the end, one of the lieutenants said to the other, and I wrote it down when I watched it, I assure you, you'll never get less than my best, and I think that's what we all think of when we remember what you've done for us over the years. Did you want to come in? Yes, please, yes. First of all, thank you all for your really very very calm comments, and it does mean a lot to me. I first worked for Will 40 years ago, and of course, that 40 years has stacked up really nicely into my pension, which is the reason for leaving is that basically it's a good time to go and enjoy my pension at the age of 60. It absolutely isn't because I don't love working for Will, because I absolutely do love working for Will, and I've been honoured, absolutely honoured to serve this committee. I think it's been a great committee to work for, and I think that our committee system is something to be proud of. It's brought greater transparency, and I think what I see in this committee is engagement and everybody working together to improve the outcomes for our residents. There's never politics in this room, and I know I'm realistic, you know, you are all politicians, but you don't use politics in this room. What you do is you provide challenge, but you also provide support and reference so that we can do as officers the very best job that we can, and I really value your input. I think that's been absolutely superb, and I've felt very supported in this context, in this committee, so I just want to thank you all for your input and the work that you do. I was so proud a few months ago when Mary and Julie did the workshop around dementia, because that felt like a new level as well, you know, that as elected members, you're so engaged that you are taking things forward yourselves, and it doesn't feel, it feels like we've shifted from being officer-led, if you like, in many ways to much more remember that place, and I think that's really good. So I just want to thank you all for your comments and just to say, you know, I've looked working here, and I'm really looking for two times. Yeah, I'll talk about spare pair issues, they're very big ones to fill out me, and I do remember those times during COVID, and they were, you just can't overstate the horrific nature of those meetings, it just seemed never-ending, and just never-improving as well, it was awful, and so all-destroying, wasn't it, and distressing, so you were there, and that was, so thank you, have a great retirement, and can we see that we forever, for evering your debt, for all the professionalism and the expertise that you've shown since you've been here, and it is the last committee, so I just want to say thank you to everyone that's attended throughout the year and participated, to officers, to, you know, you've done, and you are, you have, and you are doing an amazing job, and you can tell by the reports that you've presented, they've got real heart and soul in them, and that, and I know there's a lot to get through, and sometimes, you know, it's a big asset to come here and sit before everyone, and what they really are appreciated, so thank you so much for everything that you do for our residents, and thanks to all members really, you know, there's a lot of new people here, it's a lot to pick up and run with, and so, you know, I'm new myself as well, and I have to say, I really, really enjoy this committee, and maybe it's, I've come home, back home to public health, so you know this, yeah. Just to add, I'm substituting in for Amanda on women tonight, but she asked me specifically to say to you all the best in the future, and thanks for everything. And for the next, I don't know when the next meeting is scheduled, but hopefully it's rather simply the same membership, because it's been a great committee, yeah, thank you. [BLANK_AUDIO]