Agenda and minutes

Councillor Anderson declared a non-pecuniary interest in Minute AD26 below, as an employee of the Tees, Esk and Wear Valley NHS Foundation Trust.

RESOLVED – That the Minutes of the meeting of this Committee held on 22 October 2024, be approved as a correct record.

Report of the Assistant Director, Adults

The Assistant Director, Adults, submitted a report (previously circulated) to update the Adult Scrutiny Committee on the progress made to date in relation to the National Autism Strategy and the subsequent actions within Darlington. The submitted report provided a joint position statement from the Integrated Care Board (ICB), the Tees, Esk and Wear Valley NHS Foundation Trust and the Council. 

The submitted report defined Autism, provided an overview of the national context, outlined the priority areas of focus for the National Autism Strategy 2021-26, explained the aim of improving understanding and acceptance of Autism within society, identified the work being undertaken to prevent mental health crisis for people with Autism and the support provided to encourage more Autistic people into employment.

The submitted report also outlined the work being done across the Borough to tackle health and care inequalities for autistic people, and in terms of building the right support in the community and supporting people in inpatient care.

Members welcomed the involvement of ‘Inclusion North’ in the development of the strategy, and were keen to invite representatives to a future meeting of the Scrutiny Committee.

Discussion ensued on the number of residents in the North-East who had received an autism diagnosis, and how many of these residents were accessing Mental Health services. Members were also keen to know how the numbers on the waiting list for a diagnosis compared to one year ago, and whether the number of inpatients with autism, and the number of inpatients suspected of having autism, but who did not have a diagnosis, was monitored.

Concerns were also raised in relation to the contrast between the target to reduce waiting lists alongside the increased identification of people suspected of being autistic. Members were also keen to ensure that the support for the local working group had been budgeted for in light of the Medium Term Financial Plan.   

RESOLVED – That the content of the report be noted and that progress be reviewed on an annual basis.

Report of the Assistant Director, Resources

The Assistant Director, Resources, submitted a report (previously circulated), which invited Members to give consideration to the Medium Term Financial Plan (MTFP) for 2025/26 to 2028/29, and forward any views, in particular those in relation to the services and finances which were specifically within the remit of this Scrutiny Committee.

The submitted report stated that the MTFP had been agreed by Cabinet on 3 December 2024 as the basis for consultation, and Members were asked to discuss and consider the overall contents of the MTFP, however, with particular emphasis on those services and finances within the MTFP which specifically related to those areas within their remit, and forward any views to a Special Meeting of the Economy and Resources Scrutiny Committee, to be held on 20 January 2025, for consideration. It was reported that the Economy and Resources Scrutiny Committee would then agree a formal response to Cabinet on behalf of all the Scrutiny Committees, as part of the consultation.   

A briefing was delivered to Councillors on 11 December 2024 which provided an overview and highlighted key points in the plan. It was noted that since the MTFP had been published for consultation, the Council had received notification of the draft financial settlement for 2025/26, with an update on the draft financial settlement provided to Members.

Concerns were raised in relation to the use of reserves to balance the budget, and whilst it was acknowledged that the proposed additional funding received as part of the draft financial settlement was welcomed, it was noted that the Council’s reserves would still run out prior to the end of the proposed plan should circumstances remain the same.

Members also recognised the additional pressures created by the increase in National Insurance contributions, and the concerns raised by suppliers, however noted that the Council did not have the resource to support the uplift.  

Discussion ensued on the position in other authorities and Members cited examples where authorities were not in the position to budget for such a lengthy period, and speculated on the manner in which funding might be distributed in a fairer way in future.

RESOLVED - (a) That the report be noted, and that the Chair of this meeting, in consultation with the Lead Scrutiny Officers supporting this Scrutiny Committee, be given authority to agree the Minutes of this Ordinary Meeting of the Scrutiny Committee, in order to enable the Minutes to be considered at a Special Meeting of the Economy and Resources Scrutiny Committee, scheduled to be held on 20 January 2025.

(b) That the minority view of this Scrutiny Committee is that it could not support the MTFP in its current form due to the proposed use of all reserves prior to the end of the proposed MTFP.

Report of the Assistant Director, Adults

The Assistant Director, Adults, submitted a report (previously circulated) to update Members on the CQC Assurance Framework.

The submitted report stated that the CQC Assurance Framework for Local Authorities in England, introduced by the Care Quality Commission (CQC), was a structured approach to evaluating the performance of local authorities in delivering Adult Social Care services.  It was stated that the Framework was aligned with the goals of the Health and Care Act 2022, which aimed to ensure high-quality, equitable, and sustainable care for individuals in need.

The submitted report updated Members on the requirements of the CQC Assurance Framework, the duties and responsibilities of the Local Authority and provided an updated timeline for the forthcoming inspection.

Members welcomed the update from the Assistant Director, Adults, and questioned the possible delay between inspection and the publication of the final report within the timeline, and whether there was any redress in terms of this.

Discussion ensued on the national context as regard to the new inspection regime, the logistics in terms of the CQC establishing the inspection structure, and the potential for reflection and targeted inspections at the conclusion of the initial inspection process. Members felt that it was encouraging that staff retention had vastly improved in Darlington, that the Council maintained a positive workforce, and hoped that this would be reflected in the CQC outcome.

Clarification was sought in relation to the selected areas for improvement or development in terms of the self-assessment, with Members advised that the self-assessment reflected the Council’s own interpretation, with some specific areas prioritised for completion.  

RESOLVED – That the contents of the update provided be noted.

Report of the Assistant Director, Adults

The Assistant Director, Adults, submitted a report (previously circulated) to provide an overview of the requirements on the Local Authority to support hospital discharges and to provide an update on how Darlington is performing in terms of hospital discharges.

The submitted report stated that local authorities (LAs) played an essential role in supporting hospital discharges to ensure that people transitioned smoothly from hospital care to appropriate community or home settings. It was explained that this involved close collaboration with the NHS to prevent delayed discharges and to support people's recovery and well-being after their hospital stay. 

It was stated that LAs’ involvement in hospital discharges was part of the broader health and social care integration effort in the UK, which aimed to provide joined-up, patient-centred care across settings. The key duties of LAs in this process were summarised within the submitted report.

Members reflected on the difference between services in Darlington and other areas, noting that the services provided upon discharge in Darlington were markedly better than those experienced in other areas.

Discussion ensued on the number of patients involved in delayed transfers of care (DTOC) from acute physical health settings, with Members noting that these figures were extremely low, and any such cases were as a result of systemic failures rather than by the local authority.

Further discussion took place on the progress of the work being undertaken with Housing to identify opportunities to utilise an Extra Care Housing (ECH) property, with the ability to provide short term stays for people unable to return home due to inappropriate housing, awaiting adaptations or no fixed abode, to support a period of assessment outside of a bed-based health and/or care environment to determine long term needs and next steps. 

RESOLVED – That the contents of the report be noted, and that an update report be submitted to this Scrutiny Committee on an annual basis.

Report of the Assistant Director, Education and Inclusion, and the Assistant Director, Adults

The Assistant Director, Adults, and the Assistant Director, Education and Inclusion, submitted a report (previously circulated) to provide an update on the responsibilities for the Local Authority in relation to support young people with Special Educational Needs and Disabilities (SEND) in preparation for adulthood.

The submitted report stated that the Care Act 2014 placed several duties on Local Authorities in England to ensure young people with care and support needs are well-prepared for adulthood. This included young people with disabilities or those who may need ongoing care as they transition from Children’s to Adult Services.

The submitted report summarised the key areas for preparing young people for adulthood and the key SEND duties of Local Authorities, both of which aimed to give young people a stable, supportive framework for moving into adult life, with a focus on well-being, independence, and meaningful community engagement.

Members entered into discussion on the process of reassessment and annual review and it was noted that there were a number of overdue adult reviews. Members were assured that a risk management approach had been adopted with those with the greatest need/complexity being reviewed first.

RESOLVED – That the contents of the report be noted.

Report of the Assistant Director, Adults

The Assistant Director, Adults, submitted a report (previously circulated) to provide an update on the recommendations submitted to this Scrutiny Committee on 16 April 2024, by the Adult Social Care during the Coronavirus Pandemic Task and Finish Group.

The submitted report stated that the purpose of this Task and Finish Group was to assess the view of both Adult Social Care (ASC) staff (both Darlington Borough Council employees and commissioned staff) and end users in terms of the changes that were required due to Covid and the associated lockdowns.

It was reported that the Task and Finish Group gave consideration to the new methods of working that staff and care recipients particularly liked, so that the Council could consider whether they should continue to be used / offered as an option after the Covid lockdowns had ended. The recommendations of the Task and Finish Group, together with the actions undertaken since the final report of the Task and Finish Group was submitted to the Committee, were outlined within the submitted report.

Members noted that there were some recommendations outside the sphere of the Council’s remit and were unable to directly influence care settings, however Members were pleased that the Council maintained a commitment to liaising with such settings. Members also noted the impact that the pandemic was continuing to have in terms of waiting lists.

Members received assurances that the Council’s website and the Living Well website had been updated, that residents were being encouraged to access the website via the netcall service, and that those with additional eligible needs were being signposted in accordance with the Council’s duty to do so.

RESOLVED – That the contents of the report 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.

Members requested that the Council’s Environmental Protection Officer be invited to the Ordinary Meeting of the Adults Scrutiny Committee on 25^th February 2025, in relation to the item on ‘Hoarding and Self-Neglect’.

RESOLVED – That the content of the report be noted.