Agenda and minutes

There were no declarations of interest reported at the meeting.

RESOLVED – That the Minutes of the meeting of this Committee held on 18 June 2024, be approved as a correct record.

Presentation by the Assistant Director, Adult Services

The Assistant Director, Adult Services, provided an update on the Care Quality Commission (CQC) Assurance Framework which reminded Members of the new regulatory powers granted to the CQC under the Health and Care Act to assess local authorities, the role of the CQC, and the four themes and nine underlying quality statements contained within the assessment framework.

Members received further information in relation to the Care Act Principles, an anticipated timeline of activity in terms of local assessment, the status of inspections across the North-East as at July 2024, and the work undertaken in terms of Darlington’s self-assessment, including an analysis of current strengths and areas of development.

Discussion ensued on the criteria and selection process for the cases to be inspected by the CQC, the additional workload that shifting timescales would create, the learning opportunities from those authorities which had gone through the inspection process, and the work undertaken to improve accessibility and presence on the Council’s website.

RESOLVED – That the content of the update be noted.

Presentation from the Head of Adults and Service Manager (Safeguarding and ACT)

The Head of Service – Adults provided an update on the services which have come out of the Executive Strategy process (ESP) during 2023-24 (which included a large nursing and residential home, a residential care home for individuals with learning disabilities, and a contacted in-reach service supporting an individual living with a learning disability), the services currently within Executive Strategy, and an ESP case study.  

Members were informed of a Risk Notification Pilot undertaken to reduce the quantity of inappropriate safeguarding concerns being received by Adult Social Care which did not meet the threshold of safeguarding. It was reported that the pilot initially included four care homes, however Members were advised that this had been increased by one further care home and one domiciliary care agency. The Head of Service – Adults stated that Risk Notifications could be submitted for witnessed and unwitnessed falls, medication errors, peer on peer verbal or physical altercations, and, in the case of the domiciliary care agency, missed or late calls.

Members were advised of the Risk Notifications received during the pilot period, alongside a breakdown of the Risk Notifications per provider, the outcomes of the pilot, and identified next steps.   

Members entered into discussion on the Risk Notification Pilot, noting that one provider appeared to have a large number of falls, though it was noted that many of the falls were attributed to one individual, and it was acknowledged that some conditions had a greater propensity for falls and that it was not possible to remove all barriers. It was suggested that the Risk Notification process would need to be introduced across the sector in a staged manner, and it was hoped that the process would provide confidence to report and be a mechanism for improvement, rather than reprimand. Members enquired whether the local authority could assist in bridging any gaps in training with agency staff.

Discussion ensued on whether poor personal hygiene care could generate a Risk Notification. Members received reassurances that all care homes were monitored, not just those selected for the Risk Notification Pilot, and that any concerns would be addressed by the Contracting Team or the Safeguarding Adults Team.

Members sought greater clarification of the guidance in terms of the definition of ‘No Harm’ in a safeguarding context, and were keen to understand whether there was a framework of acceptable providers and the level of control the Council had in terms of ensuring the quality of safeguarding with our providers.

Discussion returned to the volume of witnessed and unwitnessed falls, and it was noted that it was important to recognise any patterns in relation to multiple falls and the actions attempted to address these. A subsequent discussion took place on the reasons for redacting the identity of the providers.

RESOLVED – That the content of the presentation be noted.

Presentation from the Head of Adults and Service Manager (Safeguarding and ACT)

The Service Manager (Safeguarding and ACT) provided a presentation on current safeguarding arrangements, based on the principles of Making Safeguarding Personal (MSP), which focused on placing the individual at the centre of the process concentrating on the outcome that they would like to achieve, and examining the risks and concerns in the context of the individual’s well-being.

Members were informed in relation to the duties placed upon the Council by Section 42 of the Care Act 2014, and were advised of the safeguarding triage tool used to gather relevant information. It was explained that the tool provided guidance on specific aspects, such as contacting an individual safely in domestic abuse concerns, patterns of behaviour and repeat concerns, and that practitioners were encouraged to use the tool to aid decision-making and promote MSP.

A number of steps to enable the Council to be preventative in its approach to individual’s well-being, safety and overall need were outlined, including a Risk Notification Pilot, continued professional development across Adult Social Care, improved links with contracted services within the Safeguarding Adults Team, and information sharing meetings with partners and agencies.

Members entered into further discussion on the Risk Notification pilot, whether a similar approach had been adopted by other local authorities, and whether the pilot was comparable with work undertaken by other local authorities.

RESOLVED – That the content of the presentation be noted. 

Report of the Assistant Director, Adult Services

The Assistant Director, Adult Services, submitted a report (previously circulated) to provide Members with performance data against Key Performance Indicators for 2023-24.

The submitted report outlined performance information in line with an indicator set and Scrutiny Committee distribution agreed by the Monitoring and Coordination Group on 4 June 2018, and subsequently agreed by Scrutiny Committee Chairs. It was stated that the indicators were aligned with key priorities. Twelve indicators were reported to this Committee, ten on a six monthly basis and two annually.

It was reported that, of the eight of the twelve indicators that were reported at the end of Quarter 4 of 2023/24, one of the indicators showed performance consistent to the same period last year (ASC 019); three of the indicators demonstrated that performance had declined in comparison to the same period last year (ASC 002, ASC 003, and ASC 049) and that these continued to be monitored and managed; one indicator remained the same as this time last year (ASC 050); and that three indicators were not comparable as they were reviewed at a point in time (ASC 208, ASC 209 and ASC 211).

It was reported that the two indicators recorded annually (ASC054 - The proportion of people who use Adult Care services who find it easy to find information about services – and ASC055 - The proportion of people who are carers who find it easy to find information about services) were not included within the report as the results would be released towards the end of 2024, and that these would be included in the Mid-Year Scrutiny Report.

It was noted that due to recent ASCOF/CLD (Client Level Data) changes there were two indicators that were no longer reported on (ASC 045 – Proportion of adults with a learning disability who live in their own home or with their family - and ASC 046 – Proportion of Adults with learning disabilities in paid employment).

Members entered into discussion on whether there was sufficient signposting to information and support available for those on direct payments who wished to contract in their own services, particularly in the case of elderly carers.

Discussion ensued on the number of younger adults placed in care homes, whether there was more younger adults from out of the Darlington area accessing our care home, the appropriateness of mixing younger adults with complex needs with elderly residents, and whether there was a need for more specific appropriate homes for younger adults requiring care.

Concerns were raised around the non-reporting on ASC 046, and Members were informed that this had been a decision at a national level. Comparisons were drawn with regional figures, and a discussion took place on some of the potential reasons for and the anecdotal evidence around the regional differences.   

Clarification was sought in terms of the Direct Payment Policy, which was provided to staff as a practice guidance document, and the potential requirement for a future review of the Performance Indicators provided to the Scrutiny Committee.

RESOLVED –  ...  view the full minutes text for item AD12

Report of the Assistant Director, Adult Services

The Assistant Director, Adult Services, submitted a report (previously circulated) which provided an overview of the updated Adult Social Care Transport Policy.

The submitted report stated that the Adult Social Care Transport Policy had been redesigned and developed with the Transport Team in relation to changes needed as the last Adult Social Care Transport Policy does not comply with current legislation, including the Care Act 2014 and the national eligibility framework for adults and carers; to meet the requirements of the Health and Social Care Act 2022, which states that local authorities must meet and provide for people’s needs and the promotion of health, independence and well-being; and a review of transport eligibility needs, which should be underpinned by strength-based practice approaches and promoting independence, including access to Reablement, and enable people to decide their own travel options through provision and support.

The submitted report expanded on the strategic overarching aims of the Policy, highlighted that the Policy met the ambitions of the Council Plan, and outlined the options available to assessors, with the initial option of looking at the potential for independence and use of community resources, and short-term support. The submitted report also explored commissioning and charging arrangements.

Members welcomed the support available for unpaid carers within the revised Policy and were keen to understand any additional costs that might be incurred as a result of the updated Policy.   

RESOLVED – That the changes to the revised Adult Social Care Transport Policy 2024, be noted.   

Report of the Assistant Director, Law and Governance

The Assistant Director, Law and Governance, submitted a report (previously circulated) which requested that Members gave consideration to the Work Programme items scheduled to be considered by this Scrutiny Committee during 2024/25, and to any additional areas that Members would like to be included.

RESOLVED – That the content of the report be noted.