Transcript

Live, so we're now live. Good evening everybody and welcome to evening's adult social care and health services scrutiny subcommittee meeting. I am Councillor Annie Gallop, Chair of the subcommittee. This meeting is being recorded and is being broadcast live. The recording of tonight's meeting may also be used for quality and training purposes. While we hope everything runs smoothly, please be patient if we hit some challenges in this hybrid meeting environment. In the event that technical issues require the meeting to be adjourned and it cannot be restarted within a few minutes, further updates will be posted on the Council of Democracy's twitter account which is at lbldemocracy. Please note that the Council has a duty to protect sensitive personal data through which to ensure that such information is not inadvertently disclosed. Please avoid using full names or any other details that may reveal the identity of others. If you would wish to discuss individual cases there are other more appropriate avenues for this. A bit of housekeeping, so fire exits exit the room from either door then go up the stairs to street level toilets. There's an accessible toilet just outside the room. Is it on the left or the right? This accessible toilet. Thank you. I have received this evening received apologies from Councillor Harris. So we now go on to the declarations of pecuniary interest. Thank you. Do any adults and health and social scrutiny subcommittee members wish to declare a pecuniary interest in any item on tonight's agenda? No amendments have been received by Democratic Services. Are the minutes agreed? We will now move on to the first substantive agenda item, adult social care for LGBTQ plus in Lambeth. Report item three on the published agenda pack, pages 9 to 28. We will first hear from the cabinet members for healthier communities and the members of the Council of Democracy. Thank you very much for your attention. We will first hear from the cabinet members for healthier communities to introduce the item, but firstly I think Madeline McGovern. Yes, just on the first item I just wanted to declare to Estyn I am the policy for older people. So I've been tangentially part of some of the conversations about this programme, but not in a way that would be expected in this. Thank you. So who's, are you presenting Tim? Yes, yeah. Spot the cabinet member, I think it might be. Yeah, so briefly, so I think that some of the work that we outline here really aligns with the golden thread of our plan around justice. In this area we are, I do think it's part of everybody to say we're leading in the country, but I think given the size of our LGBTQ plus population, I think that's only right. And I think we're always looking to improve further, so really welcome. Scrutiny of some of the initiatives that are outlined in this paper. Thank you. Are we having officers speaking? Thank you chair, yes. Jane Bowie. I'll start. My name is Jane Bowie. I'm director of integrated conditioning for adults, which is a joint post between London Council and that is London ICB. I don't know whether it's possible to get the slides up, but there were some slides in the pack which summarise some key elements of the report. Thank you. It's just about two or three slides. It's just, yes, two substantive slides next to it. I want to find the button that says I can play it. Thank you for your help. OK. Like just if if committee members have the papers in front of them, I'll just start talking to the second slide, which sets out the framework for adult social care commissioning services in Lambeth. And what we're looking to embed is alignment of three levels of current ones through the national regulatory Air Quality Commission, which registers our clear home and home care providers. The second one is our Lambeth's policy and commissioning practices, which include focus specifically on LGBTQ plus issues. And then the third one is individual care providers own specific policies and practices. And what we're looking at is not just partnership working between those three agencies, but crucially also other core partners and stakeholders within the Lambeth borough that represents and support the LGBTQ plus community within the borough. What we're looking to do is to build resilient delivery for services for our diverse community, which we want to support. I'd like to pass on to then my colleague. Please. I'm Andrew Billington, I'm the associate director for commissioning for integrated health care. So I was going to pick up on the action plan that we're proposing to produce sort of this details about the actual planner in the report, so I won't repeat anything in the report, but just to draw out some of the key key points around that to add a bit of an update, actually. So the work that I was talking about was often being called and paid in the actual good practice, etc. But it was also very much, it is an action plan, so it will be action focused. And those actions are very much around sustainability and improvements. It would be an action plan that the council plus partners will sign up to. The action plan is co-produced, so it reflects obviously reflects the needs of the local community service users, residents and their priorities. To this end, the action plan will be overseen, the production of it and the implementation of it will be overseen by a partnership group. And I'm really pleased to have that key local stakeholders and really will be part of that partnership. LGBT Foundation, also Blackthrive said they'll join the partnership group with LGBT Hero. There will be a few others as well, so we'll be working with them, but we'll also be working obviously with local groups, with local service users groups, community groups. I'm just very aware of the kind of intersectionality issues that there are here, so people may identify as being the ones that are the ones that are the ones that are the ones that are the ones that are the ones that are the ones that are the ones that are the ones that are. But not solely or primarily. So I think, you know, that having that kind of partnership, that approach will very much generate a way of reflecting that diversity of voice. The intention is to have that actually plan in place by the summer, but we're not waiting for the summer to go on with the actions because there are some actions that we absolutely need to have done. Well, we're doing those actions now. we know they need to happen. So for instance, delivery of the pride in care award, that's happening at present, and there are providers that are already doing work, should in the action plan they're getting on with it. So Excel Care for instance, but there are others doing it. But that plan will be in place plan as I say by the summer. Thank you. We have some people wishing to speak here with us. Firstly, Tina Wothern, Wothern, Wothern, sorry, hello. Yeah, nobody can say it right, don't worry, not a problem at all. Wothern. Wothern, yes, don't worry. So my name is Tina, I'm the head of education for the LGBT Foundation. And thank you really very much for inviting me. And I'm here to support the things that Andrew has been talking about. I'm really excited to be working with Lambeth on this project, which sees Lambeth not only as the first local authority to adopt the care award, but actually leading the way. There is, it's one at Lambeth is one of the first organisations to adopt it. The care, the pride in care work is modelled on a project we already run called Pride in Practice, which is 10 years old and trains health professionals. So GPs, ophthalmology, diabetic eye screening, and others. And we've trained something like 20,000 people in over 1000 health settings in the last year. We know for older people navigating care can be complex, and it comes with added stresses. If you identify as LGBTQ, how do I fit in? What happens if I tell you? Will my care change? Will people treat me differently? And we know in terms of LGBTQ awareness in the care sector, there's a really wide range of knowledge from organisations that don't know anything and haven't even considered thinking about LGBTQ populations to others that have amazing insight into their resident populations and what the care award seeks to do is to standardise those approaches. So working with those that are already doing great bits of work, and also working with those who who really haven't even considered it. And it consists of self assessment and a training package, an action plan. So organisations can can work towards best practice. And it takes place over a six month period. And really, it's about enabling and empower, empowering care settings, how to it's about teaching people how to create safe, inclusive spaces, where older LGBTQ people don't have any fear about being their authentic selves. Often we hear that narrative in in a project we do called pride in ageing around how people go into care settings and then don't feel able to be their authentic selves don't feel able to talk about their histories and to to engage in in care settings in a way that that means they can be authentic. So that's what the care award what pricing care does is it sets out a programme where we support organisations to to create those safe spaces. And that's all for me. That kind of helps and I'm happy to I don't know if you take questions, but I'm happy to take questions as well. Thank you. Thank you very much. We don't usually take questions. Okay. Okay, so I'm not sure who's in the room and who's on the screen just yet. So next we have Claire. Should I come forward? Yes, come on. Thank you. Yeah, I'm here representing Lambeth Link. Lambeth Link is the local LGBTQ forum. We work closely with our older people in our community. Thanks for inviting me. I'm pleased to see the the action plan and the report, and especially that it calls for continuous progression and sustainability. By now, you should all be aware of the case of Ted Brown and his late partner and the awful homophobic abuse and prejudice they faced. We thank the council for the positive way that they've addressed... Sorry, we can't really give out people's names and be that specific. He's aware that I'm speaking about him? It's not part of our... Are we there? Sorry. Okay. Well, anyway, we thank the council for the positive way they've addressed this since Lambeth Link has been involved. Statistics from compassion and care show that theirs was not an isolated incident. The founder, Eileen Chubb said, alarmingly 90% of their calls involve care providers rated as excellent or good by the Care Quality Commission. There are issues with care in general, we know. But we have an added dollop of homophobia or transphobia on top of that. There are no specialised care homes to provide for our cultural need as yet. Okay, some of us are used to shouting up for gay rights, but not everybody can be that brave. Lambeth Link, we're very worried about the ordinary vulnerable people who spent a lifetime being discreet. So we started something called the Not Going in the Care Closet campaign, because we shouldn't be asked to go in the Care Closet just because we're old. We do three aims. One, raise awareness of the issue. Two, influence those in authority to improve. And three, educate our own community about how to navigate the system. To that end, we organise lots of workshops and in those workshops, we learned lots of things. We learned care language and jargon is widely misunderstood. No one knew what safeguarding meant. There's a racial and intersectional aspect to it. Couples who were one partner was black and the other was white reported they were aggressively questioned. You have 30 seconds or I should have mentioned at the start, three minutes. Yes, okay. The systems are so labyrinthine that not even professionals understand them beyond their speciality. The lack of simple printer device came up repeatedly. You can find online is useless to people who are too ill, disabled or have never used a computer. People did not know about the helpful resources that exist in the borough, like Lambeth Carers Hub. There is a demand for more workshops and more education. Lambeth Links are part of the consortium, Brown Table, working with organisations across London, and lots of work and studies are on this nationally. The committee may be interested in the precarious large report that came out this week. I am developing a UK website for our campaign and we hope to be able to point to the good work that Lambeth is doing as an example of good practice. Thank you. Thank you very much. Kelsey Joyce. Hello. Okay, if I sit down. Of course. Yeah, perfect. I just wanted to say thank you so much for having me here today. And at XL Care, we are committed to fostering a positive and inclusive work environment and a living environment for people in their environments. This year, we're focusing on gathering and using our diversity, equality and inclusion data. So we're tracking participation in fight events and other LGBTQ plus events as well. Is it possible just to raise your voice? Sorry. Yeah. So this year, we're focusing on gathering and using our quality diversity inclusion data. We're tracking participation in pride and other events across our regions. And we're identifying the areas with the highest LGBT people in graphics. The region with lower participation, we're providing additional support to highlight the importance of representation and inclusion. We're also developing specialised trainings for our team, which includes terminology and real scenarios. This will help the team to understand the importance of leading with empathy and being respectful as well. And in just in terms of allowing us to kind of show the results of that on someone's wellbeing and sense of belonging. Additionally, we're refining our interview process to incorporate inclusive questions, ensuring we attract candidates who value what we value as an organisation, and who are committed to providing inclusive person centred care. Whilst we have made some progress, we're completely looking for new ways to prove ourselves and the way we do things. I believe that in this space, that's always important. It's not as much as a ticking box, but it's constantly looking at what is next and what can we do more. Along with Pride Network is our team network that we set up. And we regularly meet to develop strategies and talk about what best practice looks like for us. And again, just what ways that we can do things better and looking at the gaps within our organisation. Ultimately, we want everyone to feel accepted and be able to live authentically, work authentically in our care homes as well, regardless of people's gender or sexuality or whether they fall under the umbrella of being elderly. Thank you. Thank you. I didn't quite, could you just give me a little bit more information about Excel Care? Yeah, so we are a care home provider within the UK. So we're in London, and we are in Milton Keynes, Cambridge and Essex as well. So that's why we were invited here today to share that more about our information of the progress we've made, but also to kind of show what we hope to be and what we hope to do as well. When you said share, I'm hoping you'll share some of that data with us as well when you get it. Yeah, of course. I'm happy to. Thank you. So now we have Senia Hurdill, also from Excel Care. Okay. Are you expecting Senia? I was, yes, but she might have had an issue with logging on. In terms of the hybrid setting, it can be difficult sometimes to say the same thing. I double checked on Senia today, this afternoon. Okay, well, shall we move on to members questions? And if she pops up, we'll... It's not even inverted in there, let me... Okay, well, shall we move on to members questions? So anyone got any questions arising from the information that we have been given or other information? The question, shall I introduce myself? I think your name, but thank you. It's really commendable, all the work that has been done and that's been the first one. This is incredibly considerable. You've got also the largest elderly community in the city, just to see it from like a diversity perspective, it just, I mean, the action plan is yet to start, but all the training that has been devised so far, the care homes and practices, how much training has been provided on the intersectionality, especially like what the effects of like, for example, the quality on, for example, black LGBTQ, most of our community could assess the action plan will focus on the intersectionality, with a focus on the name, because it will recognise that communities may have a different experience off because there's a lot of racism that exists. I think that's what you were saying, wasn't it to me? The mainstream LGBT community, so like how much of that is part of that training, the care providers that we have done, but we come to the action plan. Does anyone want to come back on that? I think it's a bit difficult to hear at this end. I think the question is, is how much of the training actually covers intersectionality? I think we have the experiences of the ethnic minority, like in London, like it's just extra disadvantage experience with them, more isolation, more issues with mental health, health over the existing health inequalities, even within the mainstream LGBT community, there's a disadvantage of how that is known. I mean, I can talk about the training that we deliver. So particular training particularly talks a lot about intersectionality and how different sections of our community experience health inequalities in very different ways. And it's an integral part of what we do is thinking about how how LGBTQ people experience prejudice in lots of very different ways. In that in that kind of way of intersectionality, if that makes any sense, I'm not sure I'm making sense. But yeah, it's definitely something that's integral to our training. And we look at when we're doing things like we use a lot of case studies, and so he's a lot of very varied case studies that cover that intersectionality. So yeah, in terms of the training, the actual training, we cover that a lot. Follow up? No, it's just that the finest is my concern is like even having start now. Hacks and you know, other individuals in care homes, that might not be enough to make from community that didn't already feel safe, even within the wider of that community, if you say in those ones, so just what extra safeguards or assurances is provided and given to staff members. So as long as that's part of the training, then yeah. It is, and Andrew might want to build a little bit, but it is in a variety of case studies, but. Yes, I was also going to say that's actually completely I hope within the action plan that will be the focus of the action plan as well, partly in order to bring different communities together to create the action plan. That's the receipt that's specifically what that needs to address actually. So I'm part of the parts of the private care training is we're tailoring the private care training to the settings well, so there will be different voices going into that. So it's not if you like the private care training won't be standard set of it won't be standard to every single situation. Every single sign. That's a space and yeah, it's just a follow up. Actually, it's based on a question that counselor Adam asked a separate meeting about the coarseness of the courses of the grain of the identity options so. Like the the range of identities represented are not particularly fine grained, so it's like things like black or mixed or so they're quite like they're quite. Horse brains, so I think the response to that question was that we're dealing with the. The categories that we take from external organizations. That was my that's my memory of the response, so I just wonder if. Relating to the intersectionality issue, there's anything that we can do on our end to make that grain slightly finer, whether that would be a benefit, and if there's any way of us obviously working within the confines of the external pressures, but there's any way of making the grain finer for our own work. I mean, thank you for that. I mean, what? What is one of the things that we will be able to look at and able to review and perhaps even after the first year of operation and so that focus would be helpful for the communities who are coming through. So it may well be that again through the points that have already been raised, there's a particular stream or a particular capture that's going to be useful for our land with communities and that might not stay static. It might change, so I think that may well be one of the things that we could review or pick up after the first year of operation of this. Because what you want any data collection to be able to do. Is to be functional in terms of helping that continuous improvement cycle. Yeah. Richard, just to add to that, we've been trying in social care also subdividing those categories. We have to gather some data, because there's national concerns related to this. If we skew that. And so what we've allowed this is such a grace, putting in subcategories based on language and including all countries in the options that people have and other like their subsurface subscribe themselves. So hopefully over time that gives a bit richness and information. Thank you. I think that's a really good point. I think that that's a really good point. Thank you. On the action plan, is there, I appreciate that it's still in motion, but is there anything in yet on how that would be monitored and will there be a role? You've talked about the groups that be involved in putting together the action plan. Is the plan to also have those groups involved in longer term monitoring as well? So we have some sort of community feedback in how things are going. I mean, absolutely, as Andrew said, you know, we think partners would add real value in terms of the co production of the action plan and then implementation. I've already had volunteers about helping to champion that work, but again, to have that strategic multi agency overview in terms of how that's rolling out, we think their role is as important as implementation as well as producing the plan in the first round. Andrew's got plans for looking at, as he said, individuals, members coming together to form that strategy group to do those two elements. The only thing to follow up on. Okay. Uhm? I think it's to be a matter of, excuse the pun, pride that we are sort of leading and leading on this, so well done. Makes me proud. I don't know whether we're ready to move on to recommendations from the committee. Just given that we're talking about sort of going first on this and we do have significant part of the population and other parts of the country and even the city is wondering like what is there anything that we are doing or could be doing to capture learning in this process that might be useful as well to other areas and that's come after us? And maybe that could form a recommendation as well. I think that would be helpful. We do and have kept the scan of other areas just to see both. Also other local authority areas like Brighton as well as tapping into some of the practice that they're doing because we very much believe there's a benefit in looking at how you can do that. We've had useful input from stakeholders, but also research and papers that have been done by Age UK and by other agencies as well. So we've benefited from that and we'd be keen to contribute to that sort of range of experiences as well. Should also add some of our partners, not just Lambeth based, so there's already a kind of Lambeth footprint to this. We can grow over time. They're mentioning a bit of a campaign to deliver this nationally as well, so I think yeah. We hope to point to all the good practice that's going on around the country so you can all learn from each other and I'm hoping the country can learn from what's happening here. Thank you. Does anyone else want to say anything? Well, recommendations, I mean, I suppose it's a continuation thing. I was suggesting that, you know, we continue to make intersectionality and safeguarding a priority. And I think it was interesting what you said about welcome packs. Yes, the welcome pack, the visuals. So, training as well. Training and welcome packs. I'll just ask a question, with the welcome packs, would they be for service users or for staff? I mean, just, you know, you said the environments would be welcoming, like explicitly welcoming off the community, but wouldn't that just make it a bit more explicitly about the intersectionality as well that it represents and that training is reflective of that. And I think the other is capturing the learning. I think that's really something around, I just, I know it's already happened, but just recommending that we consider ways that we can document the learning and be part of the learning is this area where it grows across the country and the city. Anyone else got any recommendations they want to put forward? Yeah. Yeah, absolutely. OK, well, thank you very much. And let's move on. Yes, great. Thank you. Then we now come on to the annual safeguarding report. Item four on the published agenda pack, pages 29 to 64. We will first hear from the cabinet members to Healthier Communities to introduce the item. Richard Oucham. Sorry, Tim. It's a lot for the day, maybe. First name. I guess I'll just say that I think while I think Manberth Hills, the secretary, hosts the safeguarding board, I think its success very much belongs to Manberth Council and all of its partners that are formed by our fantastic independent chair, Annie Singh. So with that, I think I've been really blown away by the involvement in safeguarding board by, I think, sort of getting the right people in the room and the generosity that they bring, the deep dives into specific topic areas and obviously share challenges, best practice and education training materials. I know this has grown over a number of years, but I think again, I think this should be a source of pride for Manberth. It does function so well. I think it's really an exemplar of a one Manberth plan. So I hope the committee agrees that that comes across. Thank you. I've nothing to add to that. Maybe I'll just. OK, great. My new thing is here to speak. She did a bit of an update on the actual report. Yes, brilliant. Thank you. Yeah, I mean, I don't want to take up the committee's time if you feel you're familiar with the report, but I can do a couple of things. One is just kind of overview building on Tim's introduction and then a bit of specifics in the report. But I'm conscious, you know, Richard's in the room. So you've got the experts in the room. You've got the staff. You've got the staff. Richard's in the room. So you've got the experts in the room as you as you see. And I guess just building on Tim's reflections. I'm blown away. I'm absolutely blown away by the by the generosity of partners across Manberth who give up time, but also real passion to make things different for people, especially our most vulnerable. So across the obviously the council who who are exemplar hosts. We have really ambitious partners for change who are chairing our subcommittees, who are driving really gritty, tough conversations about practice change across all of our partnership domains. And you don't see that everywhere. And I think, again, just building on what what Tim outlined, there's something about our starting place. So our starting place is one of significant relations maturity. So as the independent chair, I work across a number of different geographies and, you know, familiar with very, very different local authorities and systems. And actually, it is something to be proud of, that the relationships across Manberth, especially when things are so strained. So some of our partners, as well as the local authority, are experiencing real budget challenges at the moment. And sometimes that can that can come out in difficulties around investment or how you deploy your staff. But also it's about how you spend your time. So sometimes when people get strained, financial environments, they don't turn up to meetings, especially partnership meetings. We haven't seen any of that in Manberth. Our subcommittees are really strongly chaired. Our board has amazing representation. And when people turn up to the board, they bring their whole selves. So we've had a couple of really emotionally taxing sessions where we've gone into some case studies that have given us a lot of learning across the different members of our partnership. And we've not shied away from that. We've really leant into it. Our development day that took place this time last year, again, everybody was super present. And we talked about things that we probably not talked about in as much detail before, such as homelessness. And, you know, really pleasing to have just picked up after the last item. But that EDI lens, especially around the LGBTQ Plus community, something that we absolutely embraced in that development day and spent a lot of time understanding, learning and then tilting our efforts across the annual cycle of the board to getting better at. So you'll see hopefully in the annual report. And if you look at previous annual reports, we are seriously getting better and better. There's a fair bit of data in our report that shows us some really exciting things, such as conversion rates getting better, more favourably comparable. That just demonstrates some of the practical things that Lambeth Council have led, such as thinking differently about front door, thinking differently about learning, thinking differently about training and support in creative ways is making a massive difference. So I can talk a little bit more detail about the actual report, but I'll pause there and see if I want to talk more strategically or get into some of that detail. Happy to do either. Thank you. Well, can I ask the committee, would they have a bit, would they want to hear a bit more detail? I think we're OK for now. OK, thank you. OK, so we now move on to members questions. Just one of the things that struck me in the report is the, and thank you, thank you for that, it's the high levels of sort of inappropriate referrals that are coming through and the report sort of talks about actions to try and kind of address inappropriate referrals. I guess I'm wondering like how do we manage that driving down inappropriate referrals without, as a consequence of that, then suppressing what might be serious concerns? Yeah, because it's not suggested to have over-reporting then under-reporting, but the level at which, you know, I think it's 69% didn't warrant any further action. So yeah, how do we get the balance right, I guess is the question. Did you want me to come back on that or Richard? So I think we've worked hard in Lambeth around promoting what adult safeguarding is with partners. I think one of the things we did do through the board was actually bring partners together and do an audit of cases that so we all looked at them and said, well, why was this safeguarding? Why wasn't this safeguarding? I think some of the learning when we looked at those cases was actually often people are referring to using a safeguarding pathway when actually they just want to give us information. They might want to tell us about something that's happened, or they might want to be actually making a referral for general assessments for adult social care. So some of that is about better understanding of the pathways, how to access the local property. And some of it I think is people sometimes have just had to manage their concerns that aren't actually safeguarding risks. And that's a lot of what the partnership board is very good at doing is trying to be clear on what is safeguarding, what isn't safeguarding, what are maybe professional risks that we all have to carry and hold in our work, but wouldn't actually constitute the local authority or the thresholds for a formal inquiry. And I think that's an ongoing discussion, ongoing dialogue, but I think we can see that the conversion rates are improving and I think that the referral level is slightly low. I think that's a positive thing as well because what we want is more targeted work. Just a just an insurance to the community. In marks 24 there is an audit of 80 plus case examples where the decision had been not to take forward to a safeguarding and that was so the auditors found that that was a correct way of dealing with those referrals. And it was they were then flown through to different pathways, often it's assessment, are that safeguarding means safeguarding to express their concern for something's urgent. Using it as a gateway kind of thing. It's understandable that a lay person thinks that they're concerned about something, therefore that must be a safeguarding. Actually safeguarding is defined in law. It's quite strict criteria. What we've got to keep trying to do, which we're showing we're having some success is improve access to those pathways. Make that as clear as possible to people about how to access the right support at the right time. That's what we're doing. I think we're showing some success. I'd like it to be 40% at some point. I'll make a note of that. I'm just adding to what Richard was saying. I think some of the issues that we've had are the mechanisms that people have to report through to us. So that systems may automatically show that this is a safeguarding referral and actually isn't a safeguarding referral, but that's how our systems are set up. Some of the other issues that potentially we find are people's understanding of what is a concern. I think if you want people's legislation, it's very clear about reporting concerns and you should be concerned about something. Sometimes you have to backtrack on that. For example, we might have a referral for someone going into hospital with pressure sores and that's raised as a safeguarding concern. Actually, when you look at it, there were a whole range of mechanisms that were in place. The tissue viability nurse was involved. There was a plan to manage that. It may be the person's prognosis that means they're more susceptible, but it's raised as a concern, but actually there isn't a concern because everything's in place. So there's a lot of work that comes through from those sorts of groups where there is no action for us. Would social prescribers have a stronger role? Would that be not really relevant? It potentially could, but sometimes it's the interface between primary care and secondary care. Obviously, hospitals are really busy. Acute trust is very, very busy and they might not necessarily have the time to go back and backtrack to see what was happening. Thank you very much. I have a question that I don't know if I missed it. It's kind of methodological, I suppose. At one point, it says on page 42, it says that self-neglect has seen a steady increase, which can be attributed to increased awareness and identification. I just wonder how we know that that's what's behind the increase. I want to add to that. I was going to add to what Verity did say about the reporting. If there's that number of referrals coming that are not accurately safeguarding, safeguarding is meant to be everybody's responsibility, then as the speaker earlier was saying, then it becomes only the specialists who know what safeguarding is and how to report. There's so many people who wouldn't be able to report. A few days ago, I was trying to report something and they said, no, this is not safeguarding. And then I was trying to scroll. It's not that one. It's not that one. And trying to find, but it is a concern and then not knowing where to go. If it's just email this one, if it's not, then call 999. And my worry is that organisations give better training and it's just that as the speaker was saying, who knows what safeguarding is and how, what the mechanisms are and what happens once you have preferred as well. And especially with, I guess, marginalised community, there's a lot of resistance in safeguarding. And that did come from when they said call 999. I said, I don't think I want to because my experience of previously reporting a safeguarding is the ambulance turned up with the police and it's like, is that going to happen as well? And because people know that as well and the people learn less and how could you make safeguarding, reporting a safeguarding accessible so anybody knows where it is. Because there's definitely a concern. It might not warrant this level, but there's some... Yes, I do think we need to do a recommendation on that. And what happens as well once you've supported it because I said just a minute, it said to call the ambulance, I said the police is going to turn up and then that triggers people a lot. Just from the members of community, a reluctance to report it, just what can we do to increase reporting obviously because we don't want people to reach crisis points then because it's supported earlier and the intervention is better. Some communities need more reassurance. So then reporting is easier, it's safe as well. Are you answering this point or trying to go to the self-leglect? So I was going to go to the self-leglect. So the person who decides that is the assessing manager when it arrives is to try and categorise it and the categories are going to be set in. So that's how we know when we're auditing what the managers have been doing our collective view is that they're getting more accurate in that call. Try and flow self-neglect, often people don't want to engage through a referral for an assessment in the first instance. On the second question I can move on if that's answered. No, I mean I don't want to raise too much of a kind of a rock concern but it's just more like how, if it's getting into too much of the nitty-gritty of the methodology then tell me, but I'm just not entirely sure how you would decide this. So if you see an increase in anything it's difficult in general to tell if it's an increase because we have higher detection rate or whether there's a general trend that we're witnessing. So if for example there was a growing trend of self-neglect for some other reason then I wonder if there's some way from our limited perspective of discerning whether that's the detection issue or an objective. I think there is but you're, so in summary I'm happy to take this offline and have a discussion around it. If you look at the reports that we've done year in year out, see those long achieving trends that's where you get that view around with something going up and then you dig into the data and you have a closer look around what's going on and you have to have an in-depth knowledge of how the system works within the social care teams, the social workers and the managers and the audit processes work out is it your internal processes and reporting that's getting better or is there an actual trend and I think we're pretty good at it. Thank you. Are we up to date then? I do think that we should include in the recommendation about more reassurance. Sorry yes. It's all on Councillor Adam's queries I guess. So I think some of what we were talking about earlier around what the board has been doing around understanding thresholds is a slightly different conversation to the general public. So I think general public we would always encourage if you've got a concern referring to adult social care so that at least we know we can then help in that decision making, that sign the rules team, that advice so even if it's not safeguarding we can understand the situation and work with people. I think the work with partners and professionals is slightly different because we're working with professional organisations who are obviously getting training around safeguarding and it's making sure their training is aligning with systems within Lambeth and their understanding of those thresholds. We absolutely I think we take a point around actually we want things to be accessible if we were to be able to adapt to adult social care where they've got concerns or queries and we can then help signpost and make sure that work sits in the right process. Thank you but how do you see it going forward with professionals? So how do you see those pathways are going to be more accurately signed? So I think through some of the things said in the report and that is ongoing through the board so the partnership working to actually do case audits together and the learning from that and the sharing and understanding of actually what some of the themes and trends are so that sets some of the priorities for the board for the next year and I think some of the narrative around self neglect has been that's been a big priority over the last couple of years as safeguarding board looking at practice and how we do that is possible. So that's some of the sort of things where we then say see an increase in referrals that one of the hypotheses there is actually we've been having that as a priority so actually awareness and promotion of that referrals coming in that's a good thing that's related to conversations we've been having. I write the same things now the difference with how we should be working with the public our expectations our bar should be much much lower that's not there if you look at our website it says ring this number you can fill out a form if you want to put any in it somewhere but with actually all of these mobilisations and statutory problems you do expect them to understand their roles and the law to train their staff how to use that problem but if you agree it'd be good to work up an action but it has to be around the actual legislation and of course yeah I'm slightly confused between the public and the professional are you saying that the public you recognise the need to clearer pathways to the public? GP colleague is making referrals to social care we would expect them to fill out the online referral form to answer the appropriate question to give enough evidence just as if we were referring to them we would do the same and that they should do their safeguarding training and understand what's the appropriate referral and by and large they do but it's too big a queue of hospitals 20,000 staff each so we keep that training ongoing to make sure those referrals are coming through the right way from large groups of staff Two maybe I'll just ask them together just at the same time one is on financial abuse which is increased in the cost of living crisis and says that this will be a sort of particular focus in the coming year I'd be interested to know what that might look like in terms of trying to mitigate that and then the second question was just on the age breakdown whether that matches so that's what we would expect in terms of the age breakdown of the caseload or whether there are any age groups which are showing us over or under we know that through the day it's not in the report 100% certain about the day the age range I think generally when we were looking at the report we felt that most of the demographics were broadly representative of the people that are accessing support with adult social care I don't think there was anything that was really being flagged up as an outlier generally what we've been trying to do with most of these reports whether it's safeguarding complaints is understanding what the impact in particular groups are and if there are outliers then we would tend to do a bit of a deep dive on that see if we could understand why but certainly there is an increase around financial abuse and I think we are seeing a range of age groups that are subjected to that either because of their own hardship or they are victims of financial abuse and I guess the other bits we have to be substantive around financial abuse what we have done when we've looked at the inquiries where actually we've established actually some abuse has taken place in a bit of a deep dive we had 62 where the outcome of financial abuse or neglect over the last year 44 of those were linked to someone that was known to that person so a family member or partner someone that they are already had a relationship with in some respects and there is also some cross category weren't there sometimes that is also linked to a domestic abuse and sometimes it is also linked to psychological abuse but I think some of the themes for us around that is that often these are complex relationships that are taking place as opposed to people who have been financially abused by strangers or sort of scam type things and it is an area I guess that we continue to work with it is a tricky area for practitioners because they are often working with a lot of dynamics in terms of those relationships just to give a little more context I guess to that insight we get from someone and just adding to that I think often within those sort of situations you are looking at risk minimisation with people because particularly with the complex family dynamics the person who is on the receiving end of abuse doesn't necessarily want action taken so we are trying to often change mindsets when people think about actually how can we keep you safe but even if we can't completely interject I would like to add on that we use that information to help the board design more training and practice weeks that we organise how are you going to focus those so through that process people see things that are rising forward if practitioners are struggling with how you deal with that you arrange training and you can have those discussions through actually using the data in a positive way or indeed there may be legal mechanisms that will be introduced in particular where there are formal arrangements that can be one of the most challenging areas where someone has court protection deputy ship, power of attorney and then misusing that and often most of the cases where there is quite significant financial abuse Anyone else? Just making safeguarding personal it's a success measure of making safeguarding the extent to which the person's desired outcomes are met How does somebody who has been someone reporting them as having safeguarding it's just whether about the capacity or the language that's used just to have an example of what that looks like when somebody has been made and that safeguarding that sport is made personally Someone who is so vulnerable how do they express what their needs are if they even know what they need That's a good question It's one that we've done quite a lot of work with our frontline staff to understand to try and simplify that because I think when we talk about an outcome or making something worse when we take it down to the very base level it's asking someone what they like to change or what they want out of this safeguarding process and the outcome can be very simple in some respects very simple things but what we're trying to do is to understand from that person's perspective what is the thing that's important to them in this process So it might be I'd like a bit more control I'd like this person to stop doing this thing to me and that's what we mean so we try and capture it in the voice of the individual rather than us optimizing or putting our sort of professional view over that I think, sorry, they always know that's what I mean Sometimes not but I think that's the skill of the people our workers when they're working and I think it's a challenge because prior to the Care Act Safeguarding was done to people I think you are being abused I'm going to make a decision about what's going to happen to you Care Act has completely changed that so it's about what this person wants to do Richard might be being financially abused by his son and when we're working with Richard, Richard says well I know what's going on, I can manage this actually I don't want anything to happen that's what Richard wishes to happen, we have to respect that because if he has capacity to make that decision, we are not in a position as council representatives to do anything other than uphold his wishes, if he didn't have capacity then we would probably be looking at capacity assessment to actually think about what is in his best interest Because in the case of neglect and the other types of abuses like I think or how do you say what you want I think we need to think about it as a mechanism for social workers to think differently from the starting point of talking to the person I'm very proud of the fact that we are one of the few authorities that counts, do we offer that to somebody do we start our conversation around making that safe calling person Now they may not know the language they may not be able to express it in a way that fits with the legislation but they will tell you something, you'll be surprised how starting in that way there's something coming back to you about what they want it may not be realistic in terms of have the power to deliver but they will definitely tell you something There's some case examples that are cited here Because it's good to centre the person with the use of care to centre the person instead of being dug That also has the potential to alienate or to exclude the people who actually know So is the input sought from family members As long as that person agrees that the consult will do that or they may want to do that discussion with someone present within Africa, that's perfectly fine Perhaps I'll send you an example of trying to do this They clearly need help but then the person close to them or cares about them knows what would be best for them That's the rub of the legislation because if the person has capacity to make a decision even if a family member says I think this is best, it's still the person's decision providing they have capacity We also have to play within those two bits of legislation and make sure we're applying them effectively because we can't impose something on someone if they have capacity and they don't want to That's something I was dealing with over Christmas It's really frustrating for family members but ultimately if the capacity is there they have to make that decision It's really hard Does anyone else want to say anything? I'll say this again in this report David Jennings ran a really fantastic training session for councillors at the end of last year where he had some case studies and a quiz that's not too flippant but you get into these discussions I think it was quite an engaging conversation quite a lot of surprise about what would or wouldn't be safeguarding I think we as councillors and I imagine most staff have to do mandatory safeguarding training I don't know if colleagues remember it but I think it's an online video with Lambeth pin pasted over another logo I know you might be keen to do something around training or recommendation there I think the approach to the public and professionals that are taking is right but you might want to reflect on training for new members after 2026 or whether we try and do repeat safeguarding training I don't know how many of those are in a weird place between the public and professionals and also going outdoors It's essential to find people that require safeguarding and I know several councillors aren't always sure what to do in that situation I'm not saying this training will make them safeguarding experts but pressures on it will give people that confidence So that's specific to councillors in their role? The committee has four expertise but also I think it makes some change I'll bring some examples and just ask the professionals where does it fall and what about you? So if that was a recommendation you're also suggesting that it's a bit more modernised and not cut and paste is that what you're saying? I think it was 26 The recommendation from the committee and not so sure date but I know date is very busy so it was a really interesting session That's absolutely fine because legislation changes, practice changes so it's useful to have professionals and I think what that training really showed is that there's a tension for a lot of us between someone being vulnerable and actually someone and we have to work differently those people and try different efforts to keep them as safe as possible I might want to do the next one themes on capacity and safety So included I mean we had very good attendance at this one and I think on a yearly basis we might struggle to guarantee that but I think maybe there's conversations there with WIPs We're ready to do it probably after the year and if you'd like it Right, so what you're saying Richard is including the capacity I think don't specify that if that's OK chair but there's a range of options within that umbrella we could have the debate around the theme read with myself as the chair I had a recent plan with the children so it'll get we've found a little step or in various cases so we're able to get more how to deal with things like that Right, OK Thanks to Tim I have now one recommendation I didn't have any before I don't know whether anyone else So that is specific training for the role of councillors in safeguarding possibly including some different categories i.e. capacity Very much So is that OK with everyone? Thank you Right, so we're finally ready on to the work programme We've got the annual performance Where's that gone? I've spawned two pages apologies You've got me excited Where's it gone? There you go Yes, right So we now have the performance report and annual complaints and compliments report That's the final report of the evening the performance and annual complaints report item 5 on the published agenda pack pages 65 to 132 We will first hear from the cabinet member for healthier communities to introduce the item Just a review of the annual report I think there's a wealth of information here which shows the breadth of fantastic work that adult social care does continuous improvement that we're pursuing and I think likewise very interesting information on the plates I guess I'll just flag a couple of questions so the government's recommendations respond within 60 working days to complaints but we have a slightly more ambitious target that we also measure against which is 30 days and it's mentioned here but it's not fully reflected in the data but at the end of last year we also introduced an appeals process which sits just before complaints so I think that's probably something to explore a little bit more in next year's report that should reduce the number of complaints that we receive as issues are resolved The usual to hear about an appeal before a complaint's raised You can raise a complaint and then appeal for complaints Yes Interesting Tell you where it comes from Yes please So we've actually in the Care Act there's a quite reference to councils having an appeals process Most councils interpret that issue we'll have to make that part of the complaints process because they thought why would you have two and the various LGO rulings have kind of hinted you should be having an appeals process first so it's not explicit Think of a few other processes and areas where that would be useful Helping when someone is apparently having a decision around their care Sometimes you can just resolve that You don't have to get into the full letter exchange I think that's really good So I think the appeals process is very specific between certain bits of practice and certain decisions So I've had an assessment and the care plan is put in place and I'm not happy with the care plan I would make an appeal first for a certain period of time it really focuses on that piece of work Anything outside of that would probably fall into a complaints process So we're hoping that by having an appeals process we can turn some of those decisions around much more quickly, much more effectively and hopefully avoid complaints Would that appeals process have some sort of like indicators or some kind of to Yeah, so we we have a work step on mosaics We can track all of those, we can track the outcome of them, what the appeal was about what the decision was about in the same way that would be complaints and the outcome of that also then potentially helps us to think about are we making the right decisions, are we applying eligibility in the right way, are we engaging with people in the right way before we actually finish a piece of work And then they have the option to decide whether they wish to take that further I think this is where I turn to you Richard I tried to turn to you earlier Well My apologies first that the report is so long as Tim has to show the breadth of information I tried to include recommendations from the last time in terms of detail of some of the activity reports in tracks and also explain why we were called for certain things Mostly they are related to violence, family health and social care too but in terms of recognizing covers the period that we don't get the information in the entirety until the second week in December each year So you're always lagging behind and our performance is still improving so if you were asking what's our current one of these indicators would be better that they are interested Hopefully it's interesting and showing you and giving you an idea about what to ask I'm not going to take any questions on any event I'm certainly proud that our compliments are going up slowly, one day they will overtake our compliments so it's a fair outcome I mean Absolutely Hey, we've questions Thank you So There's no timeframe that we're binding ourselves with the responses So the idea is that 60 days is like the outside limit that we're happy with but we aim for 30 But I guess if it looks like we're going over 60 by 33% I think the report says So in some of those the issue is complexity I guess I just wonder on the basis of the directions I've had with residents who submit complaints When we're going over time because of things like complexity are we updating are we updating complainants in a way that's likely to kind of satisfy them temporarily just so they're aware that some kind of timeframe is being kept to So we weren't and there was an LGO complaint that basically said if you're not going to meet your timeframe you need to make sure that you've gone back to the complaint and have let them know what the reason is and that was on a particular case that had got some lag on it and it was very complex As a result of that we've updated our policies and procedures around complaints in the work step for the complaints based on the risk ranking so the risk ranking we have about the seriousness of the complaint that sets an automatic timeframe and the instructions that have gone back to staff is once that timeframe is set your complaint manager needs to diagonise that so you know where you're meeting that deadline we also commit one to that and we've rolled out some training with staff around the complaints that actually if that is going to shift you need to make sure that you've recorded that you've been in touch with the complainant and you've set any timeframe so we can start monitoring that more closely I guess, can I ask you related? So I guess just relatedly if the outer limit that we're happy with is 60 days we kind of aim for 30 but then it looks like we don't majoritatively hit the 30 day target, is that setting up I don't know, it feels like are we setting ourselves up for for what it is It's there, it's there Are we setting ourselves up to create further complaints? Do we get kind of meta-complaints? I think because we publish what generally we add to our behaviours often in those cases that are slipping past 30 days is because we measure from when we receive the complaints and when we completely close the complaint down, we've upheld so that then pulls back to our post-data so the complaints that are over back times are generally still actively working and often what we're doing is we're trying to completely resolve the situation and try to take it longer so that skews the figures if we if we close the complaint at the points we've made contact and we've agreed with the person what we're going to do at some point we might get much quicker we then can't she wasn't satisfied I think the general issue is so interesting I think the general ethos is around our communication skills so it's not a very end, it's an ongoing dialogue and that's what we're working on continuing our managers who are leading on complaints speak to the person and understand so yes there's a general move to improve some of our timescales and this year where we are missing 30 days each of the people that are reasonable will understand if we explain why we can't do that before waiting for information from other sources anything that we can get out of is a particularly part of that investigation but I think in the previous practices David says it's been a bit more we've got it and then there's a bit of a black hole at times for some people to actually get the outcome which obviously isn't great I'm not sure what's happening a related one on that on complaints is notwithstanding what we've said about 60 days and 30 being quite a high standard to hold ourselves to from what I understood from the report the response rate within 30 days has gone down from around 38% I think to 37% we know that it's that complexity so why aren't we able to go I think well if you look at the ones that take the longest that's what we're seeing in terms of taking the long time we're trying to align that response across the government to reference it just takes some time overlay complaints subsequent complaints when you work on a complaint adding something on to that and then sometimes that happens two or three times you get to the point where you think I can't ever finish that trying to work with our staff about treating each as a separate incident rather than being a complaint that takes a long time I'm just going to add relatively speaking complaints into adult social care are relatively low by comparison to other areas that I have over here so the percentage is I think you need to have some caution as to how you interpret this particular when we start to split them down into stages because they are not this is not high volume activity they're important and they're really important by standing our business not wanting to improve and I think we demonstrate that there's a lot of thought and learning that comes out of individual complaints but I think relatively speaking the volumes are not very high at the rate that would be certified so we can make that point Also thinking from a professional contact the workforce pressures might also be holding us if we're having an aged population perhaps more demand that the services that we were still working for a smaller workforce would that affect how quickly we can respond to complaints as well which is not exactly in our hands I guess we would all like more resources we have to work with what we want and we have to make our best processes work in the best way for our populations so if I see anything that's not quite as good as we'd like it we then work on how do we improve so there's elements here we're working on now but no doubt next year some of this will improve and then the other things that's just the flow of the work I was going to ask something about the benchmarking with other local authorities because I can understand what you're saying about there's a difference because when certain data is released and also Enfield has very low but because of other complications anyway to cut a long story short working forward is there any chance that we could align more with other local authorities so the data is likely to be more is that really I'm not sure on the complaints part that's going to be quite tricky so we don't get this really so we have to go through those authorities websites where they are supposed to publish these these are the these are the ones we could find OK I can't get into the detail of the Enfield figures other than it seems to be lower than three other authorities by a significant amount no colleagues who work there I would go and ask them why that is I would say that it's because some of the complaints they are reporting especially in Spanish I say the corporate in the numbers that's exactly it when we found that information it was clear that Enfield had said that they moved their financial complaints to corporate complaints but technically a financial complaint about adult social care is covered by the regulations some authorities also capture their social care complaints through corporate complaints but the regulations are different so it's really difficult then to look at our corporate complaint reports and unpick which of the actual social care elements of it but these authorities are reporting it in this way so it seems to for us to do some benchmarking another peculiarity is when you look at stages of complaints we have a two stage complaint process the authorities have stage one and appeal, stage two and appeal so when we were trying to think about actually how some of these things are measured it's really tricky just because some people have like really extended processes yeah you can see that yeah I mean I don't want to push it too much it sounds like it's quite you know but I don't know whether there's any capacity to find you know just to see if they're not necessarily local neighbours but are more aligned to publish their figures the way that we do but it could be quite arduous for a small amount of data so has anyone else got anything? I just wanted to go back to our complaints on the actual the ASC performance report and the internal KPIs and if I can not quite pick there's a mix I guess but one of the indicators and I say there's not totally fully understanding it but it looks quite far off the target which is the median of people assessed within six weeks from contact to completion of assessment looks like it's running at about half of what the target is and going down so just wondering what information about what that is sorry yeah 74 the test results should be pointing upwards sorry sorry I guess in terms of it's slightly worse than it was the year before it's still well within target okay so less is yeah so it's okay right so 19 is really good because it should be within 42 days actually I think the year before we were something like 17 days so it's a green arrow down sorry if that's a bit misleading that's okay we've highlighted a good thing good okay thanks anyone else wants to add anything I do have another question of course so one of the pages sorry I don't have a page number talks about the threshold for a provider concern so some of the complaints persistently about a particular provider and then there's a threshold that gets reached and then there's an investigation about the threshold for a provider concern so some of the complaints are persistently about a particular provider and then there's a threshold that gets reached and then there's an investigation into that provider you guys need a page number I can find it there thank you page 23 well I guess maybe I can ask my question the question is just what is the threshold at which we start thinking that provider is a persistent problem and what does the investigation into such a provider look like so there isn't just one threshold there'll be a couple of occasions that can trigger further intervention from the council one is if we're completing our routine contract monitoring and we find a consistent number of complaints into a particular issue or if we might have a complaint raised with us by either a family member or service user or it might be the regulator the Care Quality Commission and it's of a nature and degree that we feel that we should be involved in the investigation of that complaint don't leave it to the provider or if there is an issue that comes up as a significant theme that's coming through over a long period as well so it's not just one there's a number of reasons that might trigger us to be involved and actively look at a complaint. What we'll do is we'll do it openly with the provider so we'll go and we'll share and discuss with them what the issues are, what the concerns are. It might involve, after we shared that, that we might want to do an unannounced visit or go and check about well but again we'll let them know and tell them what our plan in terms of how we follow it up and then depending on what the particular issue is we will both look at having an improvement plan to address a particular issue which we will then oversee whether that's by a specific process or whether that's through usual contract monitoring until the issues have been identified as addressed. The report does say if there's issues of particular concerns that might fall across the threshold of safeguarding as well and we will be referring to having them logged in Sorry I couldn't hear that last bit. There might be some areas that are of a particular concern that they hit the safeguarding threshold so we would be referring them on to colleagues and they would be investigating under that framework. Thank you. The question was specifically around the threshold so it's the same going process for the complaints but fine. I don't know whether anyone else has anything. I was going to ask Jane how do we have as a local authority with care providers we don't have the ability to go with special measures or anything. I mean our powers sit with the contracts that we have with them so the contracts might be that we have a contract with an actual overarching provision or it might be with an individual placement so if we feel that at an end point that there's been a breach of contract with concern about that contract then what we can do is make remedial measures. What we would be doing, we heard earlier on about making safeguarding personal and having a starting point about looking about what's in the best interest and what's the preferences and wishes of a service user involving consideration from family and friends as well. We would be looking at what measures or interventions would best meet what their interests and preferences would be so often it is about what it is that improvements can be made or adjustments can be made to their existing package or support. It can be that we look at changing placements or changing providers. If we are particularly concerned about a provider or a particular provision we can look at contract suspension routes and formally serve notice that we're looking at suspending and the other placements going in with that provision. I don't know whether I actually realise that there is still, if you make a placement into a private or whatever it's called, that you still have that ongoing responsibility for that individual which is quite reassuring. We do, we absolutely do. Obviously it's a shared relationship with the provider who's got responsibilities to deliver but we've actually, yes, because we commission a contract for that service we have responsibilities for the appropriateness and safety and quality of that placement provision as well. Again, I think I'm a bit bereft of recommendations. I don't know whether... I might just ask, we're just looking at the ethnicity data on complaints and it's just quite hard to read, sorry, pages 96 in the PDF or 92 in the top. It's just quite hard to tell actually what it's telling us because a third of the complaints, it's not known or stated what the ethnicity is so it's kind of looking like there's lower levels of complaint among certain ethnic groups but actually it's quite hard to read. I guess it's voluntary if people state their ethnicity, right, so there's nothing we can do about that. It's just quite frustrating to not actually be able to tell whether there is anything in that in the data or not, whether there's any under or over representation within certain groups. If that's an observation. I mean one of the things that we are keen to do is look and see if we can make individuals comfortable about sharing their personal data and that is part of the process. If you're looking at the table that we've got on care providers, often they don't get that information when we refer somebody to a placement or for support so it's difficult then, particularly if people have got particular disabilities to identify to do that but what we're trying to look at is improving the system response to data collection so it's not just at that final point but it's about how we can encourage people to feel comfortable through their different contacts and periods of care if we capture that data. If we look at that page sorry to keep adding things I noticed as well when we were looking at that that on age there's a sort of over representation of complaints among 18 to 64 but then the complaints kind of tail off to be under represented in older age groups. I guess my question is do we know what that tells us? Is it that there's more cause for complaints in younger age groups or my assumption I'll just name my assumption is that it's what I'm about to say which is that older people are less likely to complain. Do we know where that is? I guess that's a fair conclusion to draw from. I'm sort of saying that from the perspective of this kind of attitude of a lot of older people that they have a deference to as an authority I don't think we've got any way of actually knowing the answer to that apart from recognising that's an issue. Trying to make it as transparent and easy to do as we can. As Ruth said it is low numbers so it skews it a bit as well. The thing I would add as well is if you look at the adult population in the 18 to 64 year old age group those individuals often have a very long relationship with us over very many years over which time they'll have reassessments they'll have changes in their care needs so they'll have multiple touch points whereas older adults tend to by virtue of age be with us for a shorter period of time. The younger population might have more family members involved in the whole. Although I suspect even in older age groups many communities are generated by family and carers rather than necessarily the older people themselves but that would vary too. I mean I guess a really good way of doing it is by caring you or something like that but it's probably a very complex way to characterize it. We do have an annual overview of provided concerns and feedback that we have just to look and see if we can get any trends that come out and just to spot whether there are requirements that we should be focusing in on. I think similar as we raised on the LGBTQ plus work what we really want to do is make comfortable environments so that people feel that they can make complaints because apart from Richard's point obviously what we do want to do is have more compliments collected than complaints. We also really want everybody to feel comfortable about giving that feedback which can be as a complaint and seeing that as a learning opportunity. Okay, thank you. Thanks. It's possible to have like a theme of complaints by ethnicity and we've got numbers of feelings about intensity breakdown and the Black or Black British to be of a representative value. Do we have like what are the themes of that? What's that, sorry? What are the themes of that group of complaints? The nature of the complaint. Yes. Yes, we do. Yeah. So. I'm just going back to Richard's point, the more you kind of break it down that way, the more volatile the data becomes because, well, there could be one complaint or one theme about ethnicity in one year and then not for the next two years so it becomes an infinite shift or something like 100% shift between years. I think it's valuable to look at but it can be difficult to draw people from conclusions. So we've got two different sets of data here. So we have the complaints that are made directly to social care and the complaints that are made to the providers. So how we capture our complaints on those, we could break that down but that would probably get quite granular. I'm not sure how challenging that would be to get that granular level from the providers. But we can cover the data however you want to really from our reports but that might be difficult because the complaints directly into other social care are very low and I think also probably the complaints to providers retrospect or realistically are quite low when we consider the number of hours they are providing. So once you start breaking that up it gets quite interesting information and challenging information. But actually the level of complaints that are made to the providers far outweigh the number that are coming through to us and they are dealt with directly by the providers. So I'm not sure how much we can do to help the providers but I'm not sure how much we can do to help the providers dealt with directly by the providers but that's offset against the hundreds and thousands of hours that are being provided. Thank you. I still am fairly bereft of an idea of any recommendation. I don't know whether we're asking to look at it now or whether it's a recommendation. I do recommend that. I did write that down. We want to correlate the nature of the complaints with the ethnic identity of the person people are complaining. To the extent that it's possible. Explore. We may go over past nine o'clock. So I don't know if we can all say yay or nay. Are you okay that we may go over by nine o'clock? So that's the correlation of the nature of complaint with ethnicity. ethnicity later gathering. So it's deeper more if it's possible to correlate the nature of complaints with the ethnicity of the complainer to see if there are any trends or themes. The next report will be like in a year. A recommendation that next year we have enough time I guess. The next annual report and the outcome of that I'll word it. This is part of the conclusion already. It's even our understanding of the different groups. Experience of different groups. I had suggested to Richard that we might want to think about redesigning things so actually we can break each of the categories down into the different demographics if that's useful. If you see it we can see whether there's anything that, you know, if it's useful or if it's, you know, just review it. That recommendation with the outcome of that data collection to be included in the annual report for 2025-26 complaints annual complaints Thank you. I'm going to jump about a bit now because I actually omitted to bring the questions that were submitted by Councillor Donna Harris to the committee in her absence today. So we have a number of questions. Two, so there's I don't know whether everyone else has had a copy so I'll read them out. Thank you. So we have a question that we will provide two questions that we will provide written answers to because they contain sensitive information about names of people and places. So I will start with the question what details are included in the contracts with care homes and can we see an example or a model contract? I can certainly give examples of contractual mechanisms that we have to look at supporting Do you want to send that round to the committee? I can send around samples of elements that we have and contracts to do that Thank you Thank you Jane and the next one is how many care homes and or care providers do not meet the accreditation standard for pride in care and how many have serious shortcomings? Is there any mechanism to relocate LGBT plus residents in those cases? So we haven't today had any care homes that have failed the accreditation and haven't had any that have demonstrated serious shortcomings that we discussed earlier of actions that we could take including we could have mechanisms to relocate individuals if there are issues in their placement but primarily what we would be looking for is the views of the individual service user they carers, family members and look and see what would be in their best interests and quite often that might not be relocation, it might be about making revisions or adjustments in placement but we wouldn't make an expectation And lastly, what is the Lambeth Council doing to develop social housing care care homes for older LGBT plus residents? So and there is a because I did have a copy of the questions there's a second question after that about outline of our strategy We publish our market position statement which is the strategy of what services we identify in the borough, what it is that we want to do to develop those and our plans for doing that that is online we refresh that annually and perhaps I could send a link to the committee members so that you can see that within that what we do look at doing is making sure, as we've said, the provision is accessible for people with different diverse needs and if there's the opportunities like there are with a provider like BankHouse for particular provision we welcome supporting the development of that but what we really want to have is provision that could be accessible whatever some of these in particular preference and needs are so we're not having a special focus of developing homes for LGBT what we want is all provision to make people from that community feel comfortable and accessible with an aim to more direct provision going forwards or just that what we want, well we're very open to individual opportunities being specific if there's a demand and there's the opportunity to do it what we do is have a primary provision to do to make sure that all of our provision is accessible and comfortable for different groups you will see the details of that in our market position statement I will send it through thank you just to be clear that's commissioned provision, not provided by the council, commissioned thank you I think that's hopefully concluded that yes we are on to the work program we've got the work program which is the ongoing plan for what we're going to be discussing, I mean this is the last meeting of this and I think we've got quite a lot of stuff the time around after the committee changed maybe it's better if we wait till whoever is on the list exactly there will be a specific work program session at the end of the beginning of May for the next meeting, we're aiming for probably end of June time in July before recess so unless anyone's got a burning issue we're going to leave it at that and feedback and see what the next committee I'd like to close the meeting so thank you everyone, good night