Apologies for absence were received from Mr G Conde and Mr C Parsons. Mr  M Oxley attended as a substitute for Mr C Parsons.

To confirm the record of the meeting of the Adults & Health Scrutiny Panel held on 28 June 2018 (previously circulated).

The minutes of the meeting of the Adults and Health Scrutiny Panel held on 28 June 2018, copies of which had been previously circulated, were confirmed as correct and were signed by the Chairman.

In accordance with the Regulations, Members are invited to declare any personal or prejudicial interests they may have and the nature of those interests in respect of items on this Agenda and/or indicate if Section 106 of the Local Government Finance Act 1992 applies to them.

No declarations of interest were received.

To receive any petitions, deputations and questions received from Members of the Public in accordance with the provisions of Procedure Rule 217.

The total time allowed for this item shall be 30 minutes.  Petitions, declarations and questions shall be dealt with in the order in which they are received.  Questions may also be submitted at short notice by giving a written copy to the Committee Administrator 15 minutes before the start of the meeting.

The total time allowed for questions at short notice is 15 minutes out of the total time of 30 minutes.  Any petitions, deputations and questions that have been submitted with prior formal notice will take precedence over questions submitted at short notice.  Any questions that are not considered within the time limit shall receive a written response after the meeting and be the subject of a report to the next meeting.

No petitions, deputations or questions from members of the public were received.

To consider any questions with notice from Members received in accordance with the provisions of Procedure Rule No 219 and No 219A.

No questions were received from Members.

To consider any Notices of Motion from Members submitted in accordance with the provisions of Procedure Rule No 220.

No notices of motion were received from Members.

To consider any matter referred to the Panel for a decision in relation to call in of a decision in accordance with Procedure Rule 206.

No matter was referred to the Panel for a decision in relation to a call-in of a decision in accordance with Procedure Rule 206.

To receive Report No.168/2018 from the Director for Public Health.

Report No. 168/2018 was received from the Director of Public Health. The purpose of the report was to inform the Panel of the process and development of the new Joint Strategic Needs Assessment (JSNA) and to seek views in relation to, areas where further analysis would be helpful in the future and the draft recommendations made.

During discussion the following points were noted:

·         The JSNA was in essence an encyclopedia of information that helped to inform the Council’s decision making.

·         The draft chapters had already been presented at the Health and Wellbeing Board meeting on 18 September and the Children and Young People Scrutiny Panel meeting on 20 September 2018. Discussions at these meetings had highlighted the need to add to the chapters any available data which could indicate whether Rutland residents were getting equity of access to provision or not, as currently the chapters referenced LPT (Leicestershire Partnership Trust) services.

·         Members at previous meetings had also requested that the Ageing Well chapter focused on more positive aspects and that the mental health chapter be developed further by including information regarding the use of and access of mental health services by residents of Rutland.

·         After general comment on the age of the data included in the draft JSNA, the Director of Public Health assured Members that the most up to date available data would be included in the final document.

·         Officers would try to include some specific data on those who first language was not English and how this potentially impacted on them accessing both mental and physical health services. The Director for People (DAS) and the Portfolio Holder for Health would seek reassurance that the CCG service providers were sensitive to this fact.

·         The employment figures cited on page 95 of the Mental Health chapter were incorrect and would be amended.

·         Members felt that Rutland residents employed in agricultural services should be highlighted as a vulnerable group in the Mental Health chapter.

·         Any numbers less than 5 should be suppressed in order to avoid any potential identification of individuals.

·         Officers would ask the LPT what the government’s ambition to eliminate inappropriate out of area placements for those in need of a mental health acute bed would mean in practice for Rutland residents and whether they would get equity of access with Leicestershire residents.

·         Support for deaf and hearing impaired residents had been identified as an unmet need in the mental health chapter but no reference had been made to those with sight disabilities. A sight disability could mean that screening and health appointments were missed if letters were not supplied in large print. The impact of not being able to drive and having to rely on often inadequate public transport also affected the day to day lives and therefore physical and mental health, of those with a sight disability.

·         The mental health of grieving families was not referenced in the report, particularly for those affected by suicide or a sudden death of a loved one. The Director of Public  ...  view the full minutes text for item 306.

To receive Report No.169/2018 from the Director for People.

Report No. 169/2018 was received from the Strategic Director for People, and introduced by Kelly McAleese, Principal Social Worker and Lucy Beesley, Senior Practitioner, Targeted Intervention (Early Help). The purpose of the report was to provide an update on the impact of the ‘Many Years’ Intergenerational Project which was undertaken jointly by Adult Social Care and Early Years  and which ran between April and May 2018. The project brought together adults living in residential care and children from a local nursery for periods of structured activity with the objective of building positive relationships between the generations.

During discussions the following points were noted:

·         This type of intergenerational activity was very common in Europe and America where often nurseries and care homes were co-located.

·         The purpose of the project was to improve happiness so officers did not want to measure any other improvements and equally did not want to pressurise the children.

·         The normal work of officers in this field was drawn towards aspects of process but this project had showed the importance of relationships and allowed officers to get to know the adults rather than performing an assessment of them.

·         In order to champion excellence in Rutland, the Council wanted to promote personalization as the project had been a very valid experience for all those involved and the model (having structured sessions with a theme) had been shown to work.

·         Some of the positive aspects of the scheme had been mentoring for the children and the normalization of disability for the adults.

·         Heavy assessment based models were usual for both age groups; children had continual educational assessments and adults often had risk assessments in care homes. Behaviours and resistance to this could be matched at both ends of the age spectrum.

·         Although the project was encouraging it was sad that the UK seemed to have a cultural issue that led to a divide between the generations.

·         Sometimes attempts to help the elderly just re-enforced the issues and the boundaries that sat around it. For example, groups of older people often just reflected on how old they were and the perceived limitations of that.  Officers needed to consider the bias that they put on their practices, in conjunction with that imposed by individuals themselves. The project offered a huge insight in how work in the community should be undertaken.

·         Six weeks for the project had been considered an appropriate amount of time for the professionals working on it to give up their valuable time but also it was long enough to get a valid understanding of the learning outcomes.

·         The Early Years and Childcare Provider (EYCP) grant scheme was used to run play sessions led by early years’ practitioners. The intention was to extend that idea and have Scallywaggs stay and play sessions held at Rutland Care Village where residents would be able to join in with the structured activity.

·         Now that there was a blueprint for this type of activity there were plans to roll out the scheme further  ...  view the full minutes text for item 307.

To receive Report No.170/2018 from Robert Lake, Independent Chairman of the Leicestershire and Rutland Safeguarding Adults Board.

Report No. 170/2018 was received from the Independent Chair of the Leicestershire and Rutland Safeguarding Adults Board (LRSAB)

The purpose of the report was to seek the views of the Panel on the draft Annual Report 2017/18 for the LRSAB. Any comments or proposed additions would be addressed in the final report before it was presented to the LRSAB at its meeting on 25 October 2018 and subsequently published.

During discussion the following points were noted:

·         One of the current safeguarding risks was around financial abuse.

·         The snapshot of Rutland contained within the report showed that for its size, Rutland had a significant number of safeguarding alerts. Although the number of these alerts had risen, the number that actually met the threshholds had fallen.

·         Members expressed concern that having threshholds for the referrals would mean that some people at risk would drop through the net. The Chairman of the LRSAB responded that any service would need to triage referrals and have thresholds in place and that these thresholds were clearly defined under the Care Act 2014, sections 9 and 42. However, having a threshold for a safeguarding intervention did not mean that individuals were not offered any other help. Officers of the Council confirmed that within Adult Social Care as well as having a rapid response team that could go out and which acted as a safety net, the team took a very pro-active preventative approach.

·         The data and typographical errors in the draft that had been pointed out by Members would be corrected before the final report was approved by the LRSAB at its meeting on 25 October.

·         Members noted with regret the poor attendance from the Prison Service and the National Probation Service at the Safeguarding Adults Board meetings.

·         Anyone who was resident in a care home should be subject to a DoLS (Deprivation of Liberty Safeguards) order if they were not able to confirm that they were content to be in the care home. The Government was proposing that care home managers would be able to decide on someone’s mental capacity but there was a consensus that it would not be a good idea to have someone who had a financial incentive determining whether someone stayed in the home or not. This opinion would be put forward to the Government as a region so that it had more weight.

·         The statement regarding the number of people in Rutland whose day to day activities were limited was too generalised and it would be useful to have more information on age groups and the individual’s restrictions and disabilities. Members felt the statement needed quantifying so that relevance to safeguarding was highlighted.

·         Officers warned against the imposition of CCTV in care homes as they felt it was important to remember that these were people’s private homes and residents should not feel that they had to restrict their activities in any way. Those that could manage should be able to do so and the risk could be managed in alternative ways.  ...  view the full minutes text for item 308.

To receive a verbal update on the group’s progress from Mr Gary Conde, Chairman of the Mental Health Task & Finish Group.

As Mr Conde was unable to attend the meeting, the update on the Mental Health Task and Finish Group’s progress would be deferred until the next meeting of the Adults and Health Scrutiny Panel.

To receive Report No.135/2018 from the Strategic Director for Resources.

(Report circulated under separate cover)

Report No. 135/2018 was received from the Director for Resources, for information only.

AGREED:

The Panel NOTED the report.

To consider the current Forward Plan and identify any relevant items for inclusion in the Adults and Health Scrutiny Panel annual work plan, or to request further information.

Copies of the Forward Plan will be available at the meeting, and can be found on the website using the following link:

https://rutlandcounty.moderngov.co.uk/mgListPlans.aspx?RPId=133&RD=0

During discussion of the Annual Work Plan and review of the current Forward Plan the following comments were noted:

·         Councillor Cross informed the Panel that recent figures had been released which showed that the area’s three clinical commissioning groups (CCGs) had failed to meet national cancer treatment waiting time targets last month and that this was something that should be investigated and considered for the Panel’s work plan.

·         Councillor Waller requested that the East Midlands Ambulance Service (EMAS) item that had been included on the work plan specifically included more detail on the ‘treatment closer to home’ options and that the EMAS way forward plan that had been presented to the Leicestershire and Rutland Joint Scrutiny Committee last month be circulated with the agenda.

AGREED:

The Panel AGREED that items on the East Midlands Ambulance Service and cancer treatment waiting times would be included in the Panel’s Annual Workplan.

To receive any other items of urgent business which have been previously notified to the person presiding.

Councillor Waller had put forward a request to provide an update to the Panel on the Consolidation of Intensive Treatment Units (University Hospitals of Leicester - UHL) which had been previously considered at the RCC Adults and Health Scrutiny Panel meeting on 5 April 2018 (A copy of the UHL presentation and the minutes for this meeting can be found here) A further update had been discussed at the Leicester, Leicestershire and Rutland Joint Health Scrutiny Panel on 4th September and this meeting had been reconvened for 28 September 2018.   Ahead of her attendance at this meeting Councillor Waller wished the Panel to consider only the statutory requirement to consult rather than revisit the appropriateness of the plan to amalgamate all intensive care onto the Royal Infirmary site.

During discussion the following comments were noted:

·         Previously UHL had argued that because the matter was urgent there would not be a need to consult with Rutland residents.

·         The Panel had not objected to the proposal when it was presented earlier in the year but consulting with the Panel did not negate the need to consult with the Public.

·         The Chair felt strongly that the lack of public consultation would set a negative precedent which could in the future adversely affect Rutland residents.

·         There was consensus among members of the Panel that going forward UHL and the CCG should conduct thorough public consultations that fulfilled their statutory obligations.

Thursday 29 November 2018 at 7pm.

Proposed items to include:

East Midlands Clinical Senate

Winter Pressures

Adult Services Key Performance Indicators

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Thursday, 29 November 2018 at 7pm.

Proposed items to include:

East Midlands Clinical Senate

Adult Services Key Performance Indicators

East Midlands Ambulance Service

Cancer treatment waiting times in Leicestershire

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The Chairman declared the meeting closed at 9.15pm.

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