The meeting will include discussion about Westminster City Council's plans for the 2024/2025 municipal year; a report on the requirements of the Care Act 2014; the outcomes of the recent Care Quality Commission inspection of the council; and progress on the externally funded Changing Futures programme.

Work Programme 2024/25

The report pack includes a proposed Work Programme for the committee during the 2024/2025 municipal year. The document lists several topics of interest, to be considered at future meetings, including:

• Substance Misuse Services.
• The Reablement Programme and Aids and Adaptations.
• The Community Equalities Strategy.
• The Community Hubs Programme.
• The Hot Meals Delivery Pilot Update.
• The NWL ICB Primary Care Governance.
• Community Grants.
• Healthy Weight and Preventative Services.
• Prevention of Violence Against Woman and Girls.
• LGBTQI+ Services in the Community.
• ICB New models of Care.
• Community Health and Wellbeing Workers.
• Provisions for Learning Disabled Residents, including respite care.
• The Autism Strategy Delivery Strategy.
• The Future of Place Based Partnerships.

The document also lists a number of briefings and site visits the committee has received or undertaken since its last meeting on 17 October, including:

• Sexual Violence and Women's Safety Briefing.
• Aids and Adaptations Briefing.
• Annual Director of Public Health Report 2024.
• October 2024 update from the Care Quality Commission.
• Information about the NHS North West London (NHS NWL) and the Integrated Care Board (ICB).
• October 2024 Partner Update from Imperial College Healthcare.
• A tasting session to sample the various meal options for the Winter Hot Meals Programme with the provider, Care Premier.
• A visit to Victoria Library to speak with officers and external partners about the Changing Futures programme.

Safeguarding Adults Executive Board Annual Report 2023/24

The committee has been provided with the Safeguarding Adults Executive Board (SAEB) Annual Report 2023/24. The report outlines the work done by the SAEB and its partners to safeguard adults at risk in the Bi-Borough. It describes the purpose and achievements of the board including its commitment to community engagement, working with safeguarding ambassadors, and the importance of using safeguarding data.

The report also describes work done by the SAEB and its partners to:

• Launch the BME Network in May 2024 to promote safeguarding within a cultural context, including a discussion of Carers Rights and how they relate to The Care Act 2014.¹
• Work with Healthwatch on a survey of the impact of the pandemic on young adults' mental health and promote the role of the Central and North West London NHS Foundation Trust (CNWL) in providing services to this group.
• Host a webinar during National Safeguarding Adults Week 2023 on the topic of Hoarding and Self-neglect.
• Establish a SAR Champions Network in February 2023, focussing on disseminating learning from local Safeguarding Adults Reviews.
• Create a new multi-agency approach to the treatment of pressure ulcers.
• Launch a Mental Health Learning Programme, including the ‘Stay with us’ Suicide Prevention campaign, led by Public Health.
• Monitor homecare providers, care homes and supported accommodation services across the bi-borough.
• Raise awareness of modern slavery in the care sector.
• Launch the Transitional Safeguarding Steering Group to improve the process by which young people transition from Children's services to adult social care.
• Develop bi-borough strategies to tackle serious youth violence and exploitation.

The final section of the document describes the SAEB's four strategic priorities and actions.

Care Quality Commission Local Authority Assessment

The Committee will review a report (Westminster City Council: local authority assessment) on the recent Care Quality Commission (CQC) assessment of Westminster City Council. The CQC assessment took place over several months, including a site visit to Westminster City Hall in June. The assessment was conducted against four themes with sub-categories, namely:

• Working with People.
• Providing Support.
• Ensuring Safety.
• Leadership

The document states that Westminster City Council’s Adult Social Care and Health (ASCH) directorate achieved an overall rating of 'Good'. This includes receiving 'Good' ratings for each of the four themes and their subcategories. The report pack includes a copy of the full assessment document, published by the CQC.

The feedback received from the CQC about the assessment was largely positive. Some of the key findings noted in the report included:

• A commitment from the local authority to involve people and unpaid carers in designing, developing and reviewing services.
• Positive feedback from people and unpaid carers about their experiences of assessments, care planning and reviews.
• Easy access for people to information and advice about the Care Act.
• A responsive and timely approach from ASCH to carrying out assessments and reviews.
• Highly effective reablement services that enabled people to live independently after being discharged from hospital.
• Well-supported staff, skilled in safeguarding adults at risk.
• Good mental health provisions.
• Positive feedback from The Local Account Group, who felt listened to and valued by the council.
• Clear governance arrangements and strong multi-agency working.
• A commitment to tackling health inequalities.

The report pack also highlights some areas for further development. They include:

• A lack of appropriate mental health support for those with on-going needs who do not meet the threshold for crisis services.
• Some inconsistency in people's experiences of using direct payments.
• Difficulty recruiting staff and a shortage of places for people requiring specialist dementia care.
• Low uptake of direct payments among some teams.
• A lack of clarity among some local authority leaders about how equalities data is used to inform strategy and the council's plans to address inequalities.
• A need to strengthen relationships between adult social care and Black and ethnic minority communities.
• Issues relating to the availability of advocacy services.
• Challenges relating to gaining landlord permission for home adaptations.
• Difficulties contacting the safeguarding team for advice and guidance.
• A lack of plans to support unpaid carers in the event of an emergency.
• Some services that made people feel unsafe.
• A need to improve awareness of adult services among those working in children's services.
• Gaps in knowledge and training around the Mental Capacity Act (MCA) 2005.
• Challenges faced by the ICB due to its large size and recent leadership changes.
• A need to improve information sharing between housing and adult social care.
• A lack of consultation with some partners.

Changing Futures – Overview of the Programme Learning

The committee will discuss a report about the progress and outcomes of the Changing Futures programme.

The report pack states that Changing Futures is a four-year programme, funded by the Ministry of Housing, Communities and Local Government (MHCLG) and The National Lottery Community Fund (TNLCF). It was designed to improve the way local authorities work to support people experiencing three or more of five disadvantages:

• Homelessness.
• Substance misuse.
• Contact with the criminal justice system.
• Experiencing or perpetrating domestic abuse.
• Mental health issues.

The document says that, in Westminster, Changing Futures has introduced:

• A Specialist Team to provide support for young people aged 18-25 experiencing multiple disadvantages.
• An assertive outreach service delivered by the Single Homeless Project for change resistant drinkers and residents of Churchill Gardens who experience multiple disadvantages.
• A peer, own language outreach pilot scheme, delivered by the Barka UK charity, for Eastern European rough sleepers.

According to the report pack, funding for Changing Futures is due to end on 30 June 2025, but there is a possibility it will be extended for a further year. The committee will be asked to review the learning generated by the programme, to ensure it is embedded into council activities.

The report pack states that the Changing Futures Specialist Team has:

• Supported 170 individuals since the programme began, with an average of seven Adverse Childhood Experiences (ACEs) recorded for the beneficiaries.
• Improved anxiety and depression in 65% of the young people supported.
• Reduced re-offending rates in those referred by the Youth Offending Team.
• Provided training and support for staff and young people in homeless hostels.
• Delivered a Psychologically Informed Environment (PIE) in Hostels pilot, including a grant scheme for providers.

The document states that the assertive outreach pilot has:

• Supported 23 people to achieve positive outcomes, including reduced alcohol use, reduced contact with emergency services and anti-social behaviour teams; increased planned contact with support services; reduced isolation; stabilised living situations; and increased engagement in education, training and employment (ETE) activity.
• Used a Team Around Me approach to coordinate support from multiple professionals/ services.

The document states that the Barka UK peer outreach pilot scheme:

• Made 225 contacts with 42 people in its first two months, resulting in positive outcomes for seven individuals.

The report pack also notes that the Council will be submitting a proposal for investment in a continuation of some aspects of the programme as part of the Medium Term Financial Planning (MTFP) process. The proposal requests £0.92m to cover the cost of the Specialist Team and associated workstreams.

The document states that if future funding is not secured the Changing Futures Specialist Team and Systems Change project team could be subject to redundancies.