Agenda and minutes

RESOLVED – That Councillor Donoghue be appointed Chair for the remainder of the Municipal Year 2021/22.

There were no declarations of interest reported at the meeting.

RESOLVED – That the Minutes of the Adults Scrutiny Committee held on 24 August 2021, be accepted as a correct record, with the exception of Minute AD12/Aug/21 to read ‘renewable energy’ not ‘renewal energy’.

Assistant Director – Commissioning, Performance and Transformation

The Service Manager, Contracts and Brokerage provided a verbal update on the ongoing response to the Covid-19 pandemic, specifically in relation to care providers.

It was reported that there were Covid outbreaks at six Older Peoples Care Homes and two Care Homes for Disabled Adults (Mental Health/Learning Difficulties) care homes at the time of the meeting – 24 residents and 26 staff either have had or currently have been Covid positive and these outbreaks were being managed and contained by the closure of the homes to visitors and admissions and the Homes being advised to undertaken risk assessments in relation to an admissions.

There was also an outbreak in one of the Extra Care Schemes currently (Mayflower Court) – This was being contained within the scheme with a suspension on group activities such as meals in dining room and activities. 

With regard to vaccinations, it was reported that 97 per cent of staff in Care Homes have had their first vaccination and  92 per cent of staff have had their second dose and residents are now being offered their Covid Boosters and 442 booster jabs had been administered in Old Person Homes. 628 flu vaccines had also been administered across all care homes but it was anticipated that as homes come out of outbreaks this number will increase.

The Service Manager outlined the continued pressures experienced by Local Domiciliary Care Providers operating under Business Continuity Planning arrangements and the general staffing issues that are being experienced across the whole of Social Care, nationally and regionally.  Members questioned what support was being offered to the staff in Care Homes and were advised that Business Continuity Plans were put in place in the Homes with staff shortages to prioritise workload.

RESOLVED – That the content of the update be noted.

Presentation by Paula Swindale, Head of Commissioning and Strategy, NHS Tees Valley Clinical Commissioning Group; Joss Harbron, Assistant Director Adult Social Care, Darlington Borough Council; and Dr. Ewan Tevendale, Consultant, County Durham and Darlington NHS Foundation Trust.

Members of this Scrutiny Committee received a presentation to update Members on the Frailty Pathway System from Paula Swindale, Head of Commissioning and Strategy, NHS Tees Valley Clinical Commissioning Group, Joss Harbron, Assistant Director Adult Social Care, and Dr Ewan Tevendale, Consultant, County Durham and Darlington NHS Foundation Trust.

The presentation outlined the four Strategic Plans that had been in place since 2014 namely the Health and Well Being Strategies Priorities for Older People; the Better Care Fund; South Integrated Care Partnership Frailty Pathway; and Ageing Well.

Frailty priorities were outlined including strategic outcomes to optimise the quality of care for those people admitted to hospital and the transformation ambitions to discharge people as close to home and ensure they had the right support to avoid re-admission.

The definition of frailty was outlined and the ways in which the Responsive Integrated Assessment Care Team (RIACT) supported people presenting with frailty was highlighted in the presentation, including the wider Social Care support to ensure interventions happen at an early stage to avoid admission to hospital; and outlined the Acute Frailty developments at Darlington Memorial Hospital (DMH) and the acute services offered,  seven days a week, with the support of the private sector, Rapid Response, Care Homes and domiciliary provision.  It was also highlighted that enhanced care in Care Homes was also a priority with more direct interventions to promote independence within Care Homes.

The presentation provided a set of data (from 100 patients) to show the flow and length stay outcomes for patients with frailty at DMH and feedback from patients, and it was also reported that over 2000 referrals had been seen by the Acute Frailty Team from April 2021 to October 2021; detailed how people were being supported at discharge, including the Trusted Assessment relationships between health and social care within Darlington; and outlined the future plans which included within the Ageing Well Strategy,  refreshing the Health and Well Being Board priorities; and highlighted some of the challenges faced including the workforce and Covid impact on delivery, recruitment and retention.

Members’ questions from the presentation were in relation to the outcomes between care within the home compared to being in a Care Home; how frailty had been affected by the lack of face-to-face at General Practitioners; how the Team link in with other preventative services within the home, ie. home insulation/fuel poverty; monitoring of re-admissions to hospital; changes to the service due to the Covid Pandemic; and issues arising from delays in the Ambulance Service.

RESOLVED – That Paula Swindale, Dr Tevendale and Joss Harbron be thanked for their interesting and informative presentation.

Report of the Group Director of People

The Group Director of People submitted a report (previously circulated) to inform Members of the outcome of the quality standards assessment for 2020-22 and the level of compliance against the quality standards will determine the fee levels for the current year.

It was reported that the current agreement for the provision of Residential Care for Adults and Older People with a Mental Health Problem commenced 1 April 2015 and will remain in place until 31 March 2023 due to an extension of the Agreement agreed by all of the providers.

It was also reported that the Covid-19 pandemic which resulted in a national lockdown on 23 March 2020 had a significant impact on the care home sector and the monitoring visits into care homes was postponed and an alternative process was developed.

The Committee were informed that there had been an improvement in the number of homes who had achieved an A Grade, with 15/19 (79 per cent) achieving an A Grade compared to 11/19 (61 per cent) in 2019; no homes achieved less than eight standards which was an improvement on 2019, 4/19 (21 per cent); and overall, all but one of the previous A Graded homes had maintained this grade and five homes had improved on previous gradings.

Members enquired about the reasons for two Care Homes achieving two grades higher and how the issue with nutrition was being addressed in Care Homes; and expressed some concern about self-assessment and were advised about the mechanism in place for the local authority to amend a self-assessment grading, if required.

RESOLVED – That the information provided within the submitted report be noted. 

Report of the Group Director of Operations

The Group Director of Operations submitted a report requesting that Members gave consideration to the Work Programme items scheduled to be considered by this Scrutiny Committee during 2021/22, and to any additional areas that Members would like to be included.

The Democratic Officer advised Members that the MTFP had been added to the agenda of the Ordinary Meeting of this Committee scheduled for 21 December 2021, in consultation with the Chair; and the deferral of the Review of the Adult Social Care Performance Framework in light of the national changes to Adult Social Care Legislation to the Ordinary Meeting of this Committee on 21 December 2021.

RESOLVED – That the contents of the report be noted.