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Vulnerable Adults, Health and Communities Policy and Scrutiny Committee - Wednesday 2nd July, 2025 6.30 pm
July 2, 2025 View on council website Watch video of meetingSummary
The Vulnerable Adults, Health and Communities Policy and Scrutiny Committee are scheduled to meet to discuss their work programme for the coming year, contract management and quality assurance in older people's care homes, and access to local dentistry services and oral health promotion. The aim of the meeting is to allow the committee to review existing policies, propose new areas for scrutiny, and ensure that the needs of vulnerable adults are being met. The meeting will be held at Westminster City Hall.
Access to Local Dentistry Services and Oral Health Promotion
The committee is scheduled to discuss current and future plans for access to local dentistry services and oral health promotion in Westminster. A report accompanying the NHS England report on Oral Healthcare and Access to Dental Services in Westminster City Council summarises prevention and early intervention measures to address poor oral health in children and adults.
The report notes that tooth decay among five-year-old children in Westminster is 32%, higher than the England average of 23% but lower than the London average of 27%. The top three evidence-based interventions for reducing tooth decay are:
- Reducing dietary sugars
- Brushing teeth twice a day with fluoride toothpaste
- Regular visits to the dentist (from the age of 6 months)
The report also highlights that Public Health has a statutory responsibility to assess oral health needs, develop strategies, and commission or provide oral health improvement programmes, ensuring these are inclusive and address the needs of diverse groups, including those with special educational needs and disabilities (SEND), looked after children, and homeless individuals.
The report outlines a range of existing services and initiatives, including:
- Healthy Start Vouchers: Promoting the use of vouchers to purchase healthy foods like milk, fruit, and vegetables.
- Breastfeeding Support: Developing an Integrated Breastfeeding Plan to strengthen support through various services.
- Health Visiting Service: Providing oral health promotion training for staff to offer advice to families.
- Healthy Early Years and Healthy Schools Programme: Supporting settings to improve their provision around oral health.
- Keep Smiling Programme: A supervised toothbrushing and fluoride varnishing programme in targeted schools.
- Change4Life: Embedding oral health messages in weight management services for children and families.
- Community Outreach: Providing oral health promotion at community events and supporting vulnerable groups through various settings like Family Hubs and Children Centres.
- Community Dental Service (CDS): Providing NHS dental care for rough sleepers and supporting hostels with resources and training.
- Care Homes Pilot: Training and supporting care home staff to implement oral health care plans.
- Oral Health in Early Year Settings Pilot: Upskilling early year setting staff to deliver supervised toothbrushing to children daily.
The report also notes challenges in accessing NHS dentistry, including difficulties in registering with NHS dentists, negative experiences post-Covid, and the rising cost of dental services. Healthwatch Westminster1 has published a report in 2025 highlighting that struggling to afford dental treatment was the most significant healthcare barrier reported by residents.
NHS North West London (NW London) invested £98.5m in 315 NHS dental practices across NW London in 2023 and has developed a plan to improve access and availability of dentistry and address inequalities for children and young people.
Older People's Care Homes in Westminster: Contract Management and Quality Assurance
The committee is scheduled to review and note the role the council plays in monitoring and improving contract management and quality assurance in older people's care homes. The report states that Westminster City Council's management of care home services forms a critical part of its commitment to delivering high-quality, person-centred care, as outlined in the Fairer Westminster strategy.
The report highlights the following key points:
- Shift Towards Community-Based Support: A reduction in permanent admissions to residential care, with a focus on supporting older people to remain in their own homes through reablement services and extra care housing models, such as the Carlton Dene extra care scheme.
- Investment in Modern Care Facilities: Commitment to ensuring facilities are of the highest standard, such as the Beachcroft House care home.
- Out-of-Borough Placements: A relatively high proportion of older people placed in care homes outside the borough due to limited local capacity and specialist care availability, with a robust monitoring and oversight framework in place.
- Contract Management Approach: Commissioning care home placements through a combination of block contracts, spot purchasing, and framework agreements, managed by a dedicated Commissioning and Contracts Team.
- Quality Assurance and Provider Engagement: Integrated Quality Assurance Framework that brings together contract monitoring, safeguarding, resident feedback, and regulatory intelligence.
- Safeguarding and Risk Management: Clear safeguarding pathways and escalation protocols, with regular training for staff and accessible information for residents and families.
- Cost and Sustainability: Ensuring the financial sustainability of older people's care home provision through the Fair Cost of Care exercise and engagement with providers to review fee levels.
- Provider Engagement and Market Shaping: Maintaining regular engagement with care home providers through forums, one-to-one relationship management, and responsive support.
- Veteran-Friendly Care Homes Initiative: Encouraging local care homes to sign up to the Veteran Friendly Framework for Care Homes.
The report identifies challenges such as workforce pressures, rising complexity of needs, financial sustainability, out-of-borough placements, and limited local capacity. Opportunities include the expansion of extra care housing, digital innovation, and integrated care partnerships.
Work Programme 2025/2026
The committee is scheduled to discuss and shape its work programme for the municipal year 2025-2026. The report asks the committee to discuss topics for its work programme, considering the work of the committee since its last meeting on 4 March 2025, and the vision and purpose of scrutiny at Westminster.
Formal meeting dates for the 2025/2026 municipal year are:
- 9 September 2025
- 9 December 2025
- 10 February 2026
The committee is asked to consider whether they would like to establish Task Groups or commission Single Member Studies to examine key issues in more detail.
The proposed work programme includes items such as:
- Residential Care: Considering the council's role in monitoring residential care providers.
- Access to Local Dentistry and Oral Health Promotion (NHS): Considering the current landscape and future plans for dentistry service access.
- Octopus Project/ INTs (Integrated Neighbourhood Teams) Development (NHS): Reviewing the new model the ICB is implementing.
- Community Priorities Programme and Grants: Considering how the council allocates grants.
- Community Hubs Programme: Carrying out further scrutiny on the council's proposed Community Hubs Programme.
- Carlton Dene Preparedness: Reviewing and considering the procurement strategy for the extra care services at Carlton Dene.
- Annual Safeguarding Report: Reviewing the annual report and making recommendations for future planning.
- Mental Health Reconfiguration Implementation (NHS): Considering how these plans are being implemented.
- Provisions for Learning Disabled Residents, including Respite Care: Reviewing and considering the Learning Disability plans 2023-26.
- Homecare Mobilisation: Scrutinising the place-based homecare model and transformation programme for homecare commissioned services.
- Annual Director of Public Health Report: Considering this annual report with a focus on children's school health.
The report also includes a Recommendation and Action Tracker from previous meetings, inviting members to review the work undertaken in response to those recommendations and actions.
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