The Vulnerable Adults, Health and Communities Policy and Scrutiny Committee will be asking questions about a range of services that are provided to vulnerable adults by Westminster Council, including the ways the council supports people to continue to live in their homes, and the ways that the council supports people with drug and alcohol dependency. The committee has previously asked for, and will receive, an update on how the finances of the Community Hubs programme are being managed.

Substance Misuse Services

The committee will be provided with a report that describes the substance misuse services that Westminster Council commissions, with a particular focus on their role in reducing drug related crime. The report explains that:

Substance use (both drug and alcohol) is a significant public health concern, affecting individuals, families, and communities in complex and far-reaching ways. It is a particular concern in Westminster City Council (WCC), due to the borough’s central London location, thriving night-time economy and large transient and rough sleeper population.

The council currently spends around £5m per year on substance misuse services, with most of that money coming from the annual Public Health Grant. The committee are scheduled to discuss the 2023 Annual Director of Public Health Report on Substance Misuse at the meeting. The report describes two main providers of substance misuse support to Westminster residents:

• Turning Point - Turning Point is a national charity that provides support and services to people with substance misuse issues.
• Change Grow Live - Change Grow Live is another large national charity that supports people with substance misuse issues.

The report highlights the complex needs of people who are sleeping rough and misusing substances, and describes some of the specialist services that Westminster commissions to support them, including the Doctor Hickey Surgery. The report also explains that:

The evolving landscape of substance misuse presents new challenges for the local treatment system, including changing drug trends, drug-related violence, and increased complexity of need due to trauma, mental health, and poly-drug use.

It goes on to describe the risks associated with Nitazenes, a particularly potent form of synthetic opioid. The report highlights the council's collaboration with the Changing Futures programme, and explains the council's intention to continue to part fund the Blue Light Project beyond March 2025.

Supporting residents through reablement services and aids and adaptations

The committee will receive a report on the ways that the council supports people to continue to live in their homes after a change in circumstances has made it more difficult. The report explains that:

The Reablement Team supports residents aged 18 years or older who might have experienced an injury or illness, or those who find it more difficult to complete tasks they could previously complete independently but need support to regain their abilities or learn new ways of completing tasks. This includes people leaving primary care.

The report clarifies that the service is free, and that:

Reablement is offered for up to six weeks with no charge.

The report describes the ways that the council collaborates with Central and North West London NHS Foundation Trust to deliver the service. It highlights the effectiveness of the service, explaining that it has:

improved outcomes for residents, reduced pressure on bed capacity in the acute hospital sector and offered value for money.

It goes on to explain the situations in which people may be eligible for financial support to adapt their homes after a care assessment:

If residents require longer-term care following reablement interventions, they are assessed under the Care Act. This includes a financial assessment to determine their eligibility for long-term care costs being met by the local authority in part or in full.

The report also describes the ways that the council collaborates with Effectable to provide adaptations to homes in Westminster.

Work Programme for 2025/26

This will be the final meeting for the 2024/25 municipal year, and the committee will be asked to consider its priorities for the 2025/26 municipal year. In doing so it will consider the five points contained within its vision statement:

Scrutiny is a vital function to promote transparency and accountability. On behalf of Westminster’s communities and stakeholders, local non-Executive Councillors will endeavour to ensure services in the City not only meet people’s needs but enhance lived experiences by: 1. Championing the best possible outcomes for communities and stakeholders. 2. Holding the Council, its partner organisations and external bodies to account for decisions taken and the impacts on our communities. 3. Examining Council priorities, actively engaging in policy development and offering constructive challenge prior to decisions being taken. 4. Working strategically across the city to focus our efforts on policy and service areas where scrutiny can make the biggest impact. 5. Demonstrating integrity and commitment by adhering to the Nolan Principles of Public Life.

The committee will be asked to consider its Terms of Reference when deciding its priorities for the next year, and to pay particular attention to whether any areas of the council's work require more detailed investigation by a Task Group or Single Member Study.

In making its decision the committee will be provided with a report on its activities during the 2024/25 municipal year, including an update on all of the outstanding recommendations and actions that have been carried forward from previous meetings, which are recorded in the Recommendation and Action Tracker. One of the actions that will be reviewed at the meeting relates to the Community Hubs programme, where the council committed to keeping the committee updated about:

the financial investments made in each community for the hub programme against need as an ongoing process and to avoid any duplication of services for residents.

The committee will also review an action relating to the way the Community Hubs programme is being managed. The council previously committed to:

be[ing] rigorous in monitoring, auditing, and the accountability of the financial expenditure for the development and expansion of the Community Hubs programme.