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 7 January 2025, be approved as a correct record.

Report of the Assistant Director, Adults

The Assistant Director, Adults, submitted a report (previously circulated) to update and inform this Committee on the CQC assurance framework and inspection activity in January 2025.

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, and 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 outlined the assessment criteria, the methods of evaluation, the outcome ratings, and the focus on continuous improvement by identifying strengths and areas for development. The submitted report updated Members on the inspection undertaken between 20th January 2025 and 24th January 2025.

The Chair reported that he had met with the Senior Leadership Team, thanked the team for their work in preparing for the inspection, and stated that he was reassured that there should be no unforeseen issues arising from the inspection.

Members felt that the inspection represented a refreshing approach, and sought clarification over the scoring system. Members were made aware of the recent final report received by Middlesbrough Council and enquired whether there had been any feedback from colleagues on their report.

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 overview of self-neglect, including the local picture, for the period

2020-2024, as reported into Darlington Safeguarding Partnership, along with the trends, themes and key learning points.

The submitted report outlined that the Darlington Safeguarding Partnership was aware that self-neglect continued to be a challenge with numbers of reported concerns highlighting a steady increase year on year. It was stated that a key priority for the Partnership was to ensure partner agencies improved awareness and understanding of adult self-neglect to ensure early identification was achieved and, wherever possible, prevent serious injury or the death of adults at risk who appear to be self-neglecting.

In addition to the submitted report, the Safeguarding Partnership Business Manager gave a presentation which provided an overview of the local picture of adult self-neglect, and the definition and description of self-neglect. Particular focus was given to the Safeguarding Adult Review referrals and data reported into the Partnership relating to self-neglect, which highlighted there has been an upward trend, locally, regionally and nationally.

The presentation covered the themes, trends and key learning points identified, and the work that the Darlington Safeguarding Partnership has undertaken in response to support those working with adults who self-neglect.

Members welcomed the report and were pleased to note that self-neglect and hoarding were not considered ‘a lifestyle choice’, and questioned the level of work that the Partnership could undertake with those who privately rented and with private landlords. Discussion ensued on the work undertaken by Environmental Health, and the mechanism for referrals to General Practitioners. It was noted that hoarding may be viewed as a mental health condition, however was usually found alongside another primary diagnosis.

Members entered into discussion on the perceptions and misconceptions around hoarding, and use of the ‘Clutter Tool’. Members were keen to understand the information sharing arrangements with safeguarding partners, particularly in relation to the Fire Service, where early intervention and a shared Fire Safety Plan may result in lives being saved.

RESOLVED – (a) That this Committee encourage that discussions in relation to information sharing between partner agencies be expedited to ensure, where possible, that those vulnerable people with a record of hoarding and self-neglect have greater access to fire safety services at the earliest opportunity;  

(b) That the understanding of self-neglect and the key learning points identified by Darlington Safeguarding Partnership to date, be noted.

(c) That this Committee is assured that the Safeguarding Partnership is effectively coordinating multi-agency safeguarding practice relating to self-neglect in Darlington for adults with care and support needs.

Report of the Assistant Director, Adults

The Assistant Director, Adult Services, submitted a report (previously circulated) to provide Members with performance data against key performance indicators for Quarter 2 of 2024-25.

The submitted report provided 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, and the performance of eight of the twelve indicators as at the end of Quarter 2 2024/25, were reported on.

It was reported that, of the eight indicators reported at this point, two of the indicators showed performance better than at this time last year (ASC002 and ASC003); two indicators were comparable with the same time last year (ASC019 and ASC050); one indicator showed a lower performance than at this time last year (ASC049), and three of the indicators were not comparable and were reviewed at a point in time (ASC208, ASC209 and ASC211).  

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 2023-24 results would be released towards the end of the year, and would appear in the 2024-25 Quarter 3 Scrutiny report.

Discussion ensued on younger adults residing in older persons settings, the use of personal assistants to help those wishing to undertake self-directed care and payments and how this could be better promoted, and the reasoning why ASC045 (Proportion of adults with a learning disability who live in their own home or with their family) and ASC046 (Proportion of adults with learning disabilities in paid employment) were no longer reported on.

The Chair reported that he had recently contacted Darlington Association on Disability (D.A.D) with a view to extending an invitation for a representative to attend a meeting in the new Municipal Year and provide an overview of the support that the organisation provides, and a further discussion ensued on the cost effectiveness of direct payments compared to commissioned services.

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

Report of the Assistant Director, Adults

The Assistant Director, Adults, submitted a report (previously circulated) to provide the Committee with an overview of the requirements on the Local Authority to support our statutory duties regarding organisational safeguarding under The Care Act 2014.

The submitted report outlined the process and considerations in relation to Executive Strategy, and stated that since the previous six-monthly report to this Committee, the Council only had two providers within Executive Strategy Procedures (ESP).

It was reported that the first provider (a nursing home) entered ESP on 17 December 2024, following concerns in relation to increased individual Safeguarding concern referrals, concerns relating to medication omissions following audits, whistleblowing concerns received, CQC inspection identifying clinical oversight concerns, and environmental health concerns relating to infection control and establishment hygiene. The submitted report outlined the actions that had been put into place to support immediate improvement. It was noted that the Council continued to work closely with the CQC and our contracting and commissioning partners and the Integrated Care Board, as well as the provider, to support ongoing improvements.

The submitted report stated that the second provider (a residential care home) had entered ESP in November 2023, following increased individual Safeguarding concern referrals, concerns relating to medication omissions following audits, CQC inspection identifying clinical oversight concerns, environmental health concerns relating to infection control and establishment hygiene, concerns relating to self-neglect and acts of omission, and concerns held around the lack of care planning, risk assessments and physical safety. It was reported that, although the service remains in ESP, the provider had undertaken improvements across the last 14 months and was currently progressing with the action plan with the local authority and partner agencies to make the necessary improvements, and that a further meeting had been arranged to ensure that the improvements were now sustainable with clear embedded governance processes before closing the ESP.

Members welcomed the report, and expressed the view that it was reassuring that the two providers were receiving additional support to improve. Discussion ensued on how such cases are identified, and whether concerns can also be raised by whistleblowers from within an organisation or relatives.

RESOLVED - (a) That the contents of the report be noted.

(b) That this Scrutiny Committee continue to be updated on a six-monthly basis on care homes/services in Executive Strategy measures.

Report of the Assistant Director, Adults

The Assistant Director, Adults, submitted a report (previously circulated) to enable Adults Scrutiny Committee to receive and comment upon the Annual Report of the Darlington Safeguarding Partnership (DSP) for the period 2023/24. The Annual Report was appended to the submitted report, and introduced at the meeting by the Independent Chair of the DSP.

Members requested further information on the house fire that had resulted in two deaths in May 2023, and clarified whether partnership working extended to the Probation Service, in relation to domestic violence. Concerns were raised in relation to ‘cuckooing’, and Members hoped that new legislation would be forthcoming to protect vulnerable adults from being abused in this manner.

RESOLVED – (a) That the contents of the DSP Annual Report for 2023/24, be noted.

(b) That the thanks of the Adults Scrutiny Committee be extended to the Independent Chair of the DSP, following the announcement that she would be stepping down this year.

(NOTE: The Chair exercised his power to vary the order of the Agenda, and Minute AD39 above was taken directly following Minute AD34 at the meeting).

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.

The Chair reported on a request from the Health and Housing Scrutiny Committee, that this Committee give consideration to the Carbapenemase-producing Enterobacterales (CPE) data in respect of Care Homes and Domiciliary Care, and in doing so suggested that the Committee gave consideration to including a wider piece of work on infection control in Care Homes and within Domiciliary Care on the Work Programme for the Municipal Year 2025/26.

RESOLVED – That the content of the report be noted.