Agenda and minutes

To receive any apologies for absence.

An apology was received from Cllr Bill Pipe who would join the meeting later.

The Chairman welcomed Cllr Robin Legg to his first meeting.

To receive any declarations of interest.

No declarations of disclosable pecuniary interests were made at the meeting.

To confirm the minutes of the meeting held on 17 September 2020.

The minutes of the meeting held on 17 September 2020 were confirmed.  The Chairman would sign then at the earliest opportunity.

To receive questions or statements on the business of the committee

from town and parish councils and members of the public.

Please note that public speaking has been suspended during the

Covid-19 crisis. Each question or statement is limited to no more than

450 words and must be electronically submitted to

helen.whitby@dorsetcouncil.gov.uk by the deadline set out below.

The question or statement will be read out by an officer of the Council

and a response will be given by the Chairman. All questions/statements and the responses will be published in full within the minutes of the meeting.

The deadline for submission of the full text of a question or statement is 8.30am on Wednesday, 28 October 2020.

Details of he Council's procedure rules can be found at: Public Participation at Dorset Council meetings.

The Chairman explained that a number of questions had been received from members of the public, Swanage Town Council and Dorset Council Councillors.  The questions were read out and responses provided.  The full questions and responses are included at the end of these minutes.

To consider responding to the Trust's Quality Account.

The Committee considered the Quality Account (QA) from Dorset Healthcare University NHS Foundation Trust 2019-20. 

QAs were produced annually and Councillors had the opportunity to comment on the QA prior to its publication on 15 December 2020. The Chairman had asked Councillors to submit questions for a response at the meeting.  Two questions had been received and these related to the duty of candour and members were shown updated information about pressure ulcers in relation to the second.  Links to benchmarking websites would be provided for members outside of the meeting.

One member described his good experience of end of life facilities at Yeatman Hospital and the award that the Hospital had received for them.  He asked whether there were enough end of life facilities as there was likely to be a growing need for them and also asked about the number of Matrons available across hospitals.  In response it was explained that discussions with the Dorset Clinical Commissioning Group were continuing with regard to services to be provided by community hospitals and that the reference to the Matrons (East) and (West) referred to Mental Health Services which were structured differently to physical health services.   Community Hospitals were more complex, had more departments and therefore more Matrons.

With regard to the Trust's aim to reduce suicides by 10%, another member asked how this would be achieved, what current figures were and whether there were any plans to introduce mental health drop-in centres in Weymouth or the west of the County.  In response it was explained that there was a retreat in Dorchester and people could also access the on-line Steps to Wellbeing service.  With regard to suicide figures, these were not available but would be shared after the meeting.

The Chairman informed members that it was possible that they would receive more QAs and suggested that a working group be established by the Committee to respond to these and then report back.  This approach was agreed and Cllrs Rod Adkins, Nick Ireland, Jon Orrell, Bill Pipe and Gill Taylor volunteered to sit on this.

The Chairman would forward any QAs submitted to all members prior to the working group meeting so that they could comment if they wished.

Decisions

1.   That Dorset Healthcare University NHS Foundation Trusts Quality Account for 2019-20 be noted.

2.   That a working group comprising Cllrs Rod Adkins, Nick Ireland, Jon Orrell, Bill Pipe and Gill Taylor be established to respond to any future Quality Accounts and report back to the Committee.

To consider a report by the Programme Director Urgent & Emergency Care, Dorset Clinical Commissioning Group.

The Committee considered a report by the Programme Director Urgent and Emergency Care, Dorset Clinical Commissioning Group which set out performance information regarding length of hospital stays during the first wave of Covid-19 and the new Home First Programme.

Members noted that performance information for delayed discharges of care had not been collected during the first wave of Covid-19 and that information regarding length of stays had been captured instead.  In June/July 2020 there had been a review across health and social care and a move was made to a Homes First model.  Its purpose was to enable people to achieve independent living within their community, to speed up discharges from hospital and to prevent unnecessary hospital admissions.  A further set of guidance was issued for implementation of a hospital discharge service beginning from 1 September 2020 and this was model was complemented the home first programme.

A multi-agency approach was now taken so that people were assessed by health and social care teams at home for the ongoing support they needed.  There were now five cluster teams for Bournemouth and Christchurch, Poole, East Dorset and Purbeck, North and Mid-Dorset and West Dorset and Weymouth.   They comprised acute hospital staff and community social care staff working together to undertake assessments in people's homes in order to support their needs and prevent unnecessary hospital admissions.

One member welcomed the new programme but asked whether the same number of people were being discharged from hospital or more and referred to the previous frustration of trying to arrange care packages and asked whether patients were being discharged without care packages in place.  It was explained that the single point of access meant that the patient returned home safely with the support they needed.  There were then ongoing social care reviews within the community to ensure that the right support was provided as their needs changed.  Over time the new programme would provide a more consistent, less fragmented approach, would provide a better experience for residents and enable the community and voluntary sector to support the programme.

With reference to Tables 1 and 2 on page 13 of the report, a member asked whether this was a snapshot on a particular day or whether figures were for the whole month, and whether some patients might be double counted if they had been in hospital for a long time.  As the report author had not been able to join the meeting, a broad overview was given.  Members asked that this information be circulated following the meeting so that they could better understand the information presented.

Members welcomed the new Programme but highlighted the need for funding and staffing if the system was to work well.  Officers explained that they could only work with the resources available.  It was hoped that by being more efficient, reducing duplication and working together resources could be maximised.  If any gaps were identified, commissioners would be approached to address these.  The aim was for residents to gain greater independence and  ...  view the full minutes text for item 19.

To consider a report by the Executive Director of People - Children.

The Committee considered a report by the Executive Director of People - Children which provided an update on actions following the Local Government Social Care Ombudsman(LGSCO) investigation into the Special Educational Needs and Disability (SEND) provision provided by Dorset County Council for one young person.  

The Executive Director of People - Children introduced the report.  This was a significant area of work for the Directorate and she reported receipt of a letter from the Care Quality Commission the previous Friday on their recent visit.

The Committee noted that the underlying issues had related to special case delays in providing education and the writing of Education Health and Care Plans (EHCP).    Currently in excess of 80% of EHCPs were completed on time and by working closely with schools this had been maintained throughout the pandemic. There was a focus on improved outcomes for children and a better experience for families and schools working with the Council.  The pandemic meant that progress was slower but attendance in schools remained high.

There was some discussion about the benefits of children being in school and, with the forthcoming lockdown and increased cases of Covi-19, that parents might be worried about children remaining at school.  In view of progress made, it was suggested that this be publicised.

The Chairman referred to the fact that the report would be considered by the Health and Wellbeing Board the following week and asked where this item should be scrutinised in future.  The Executive Director of People - Children suggested the Health and Wellbeing Board retain oversight of progress.

Decisions

1.   That the progress made be noted,

2.   That the Committee is content for the continuing monitoring of this item to be carried out by the Health and Wellbeing Board,

3.   That the progress made be publicised.

To consider a report by the Independent Chairman of the Dorset Safeguarding Adults Board.

The Committee considered the Adult Safeguarding Board's Annual Report for 2019-20 and its Joint Business Plan for 2020 onwards.

Annual Report for 2019-20

The Independent Chairman presented the Annual Report highlighting points of particular interest; the independent report into how well the Dorset and Bournemouth and Poole Boards were working together; the need for adult social care staff to know safeguarding adult procedures; shared objectives with other partnerships particularly around domestic abuse and the need for a more integrated approach; the need for more integrated work between adult safeguarding and domestic abuse structures; better integration so that people did not fall between the gaps; the successful event for providers; the need to make sure that any lessons learned from reviews were implemented in practice; and work with service users on domestic abuse to make them aware of self-protection;

An explanation of a Section 42 inquiry was given. The Annual Report would be sent to members by email following the meeting as some text was missing from the agenda papers.

One member highlighted the fact that domestic abuse affected everyone and she praised the Board for its work in trying to reduce the number of people who did not understand domestic abuse.  The Portfolio Holder for Adult Social Care and Health added her thanks for the report and the important work the Board undertook.

In response to why there had been an increase in referrals in the over 75s, it was explained that a high proportion related to women who lived longer than men.  This was being kept under review.

Joint Business Plan for 2020 onwards

Attention was drawn to the four main priorities within the business plan: safeguarding in the care sector; domestic abuse; neglect and self-neglect; and Safeguarding Adults Board Governance Review.  A two-year rolling plan had been adopted because it was not known how far current resources would stretch and some flexibility in targets set may be needed.  Assurance was sought from partners and the work they were undertaking to mitigate risks in adult safeguarding.

Members asked questions about abuse of parents by children, whether records of safeguarding issues were kept which would show those who needed help and those who were unable to access this, and whether there was support available to intervene to help those with no family support and who might suffer neglect as a consequence.

It was explained that abuse of parents was primarily an issue for the community safety partnership to address; that Covid-19  related data was kept, that there had been no significant increase for Quarter 1 and the current increase was being tracked; and multi-agency risk meetings were held to look at self-neglect cases in order to provide support and retain their dignity.

The Chairman welcomed the report and thanked officers for attending the meeting.

Decisions

1.   That the Dorset Safeguarding Adults Board Annual report be noted.

2.   That the Board be thanked for the work it has done.

3.   That the Business Plan for 2020 onwards be noted and the  ...  view the full minutes text for item 21.

To consider a report by the Corporate Director, Legal and Democratic.

The Committee considered a report by the Corporate Director - Legal and Democratic, which provided an update on the numbers, types and outcomes of complaints made against services at Dorset Council and appendices which met statutory reporting requirements for Children’s Services.

The key message from the report was that the Council was dealing with, listening to, acting upon and learning from complaints.  The report covered the pre-Covid period.  Of the 722 complaints received across Directorates only 4 had been upheld by the Local Government Ombudsman and only one of these had a financial penalty for the Council, which was an improvement on the previous year.

It was noted that complaints were increasing in number but so too were compliments.  The recent restructuring of the Complains Team had provided an opportunity to change the way complaints were dealt with.  Officers met with complainants, took a positive approach and tried to learn from them.

Members received clarification of the different stages in the complaints process.

In response to why 90% of complaints in Quarter 3 were justified, it was explained that the number of cases were low and so the percentage figure seemed high but in fact the performance was an improvement.

Decisions

1.  That the complaints performance for the financial year 2019/20 be noted;

2.  That the focus on working with services to ensure greater organisational learning form complaints be supported.

3.  That the savings associated with informal resolution, mediation and relationship building be recognised.

Following discussion at a recent informal meeting, the following Liaison Member appointments are to be confirmed:-

Dorset Clinical Commissioning Group - Cllr Gill Taylor

Dorset County Hospital NHS Foundation Trust - Cllr Molly Rennie

Dorset Healthcare University NHS Foundation Trust - Cllr Nick Ireland,

South Western Ambulance Services NHS Foundation Trust - Cllr Rod Atkins

The new Poole and Bournemouth Hospitals NHS Foundation Trust  - Cllr Rod Atkins

Decision

That the following Liaison Members be appointed:-

Dorset Clinical Commissioning Group - Cllr Gill Taylor

Dorset County Hospital NHS Foundation Trust - Cllr Molly Rennie

Dorset Healthcare University NHS Foundation Trust - Cllr Nick Ireland,

South Western Ambulance Services NHS Foundation Trust - Cllr Rod Adkins

The new Poole and Bournemouth Hospitals NHS Foundation Trust  - Cllr Rod Adkins

To consider the Committee's Forward Plan and the Cabinet's Forward Plan.

The Committee considered its Forward Plan and that of the Cabinet.

The Chairman stated that as the Committee was new the Forward Plan needed more work and that it was important for the Committee to concentrate on the Covid-19 pandemic and finance.

One member referred to the previous Health Scrutiny Committee and items it had identified for scrutiny and that the new Committee should honour any commitments given.

The Chairman had contacted the Dorset Clinical Commissioning Group and asked that the Committee be involved in any planning regarding the Swanage Ambulance Car so that this could be added to the Forward Plan.

In the meantime, the Chairman suggested that she and the Vice-chairman review the current Forward Plan and then email the outcome to members for comment.

With reference to the item on the Housing Associations Liaison Day to be held in Summer 2021, the Chairman asked for volunteers to scope out the inquiry day.  Cllrs Molly Rennie, Jean Dunseith and Jane Somper volunteered to be on the working group.  Anyone else wishing to help should contact the Chairman.

Decisions

1.   That the Chairman and Vice-Chairman review the current Forward Plan and the outcome be emailed to members for comment.

2.   That a working group comprising the Chairman, Vice-chairman and Cllrs Jean Dunseith and Jane Somper be established to scope out the Housing Associations Liaison Day.

To consider any items of business which the Chairman has had prior notification and considers to be urgent pursuant to section 100B (4)b) of the Local Government Act 1972.  The reason for the urgency shall be recorded in the minutes.

There were no urgent items.

To move the exclusion of the press and public for the following item in view of the likely disclosure of exempt information within the meaning of paragraph 3 of schedule 12A to the Local Government Act 1972 (as amended).

The public and press will be asked to leave the meeting whilst the item of business is considered.

There was no exempt business.