Agenda and minutes

Resolved – That Councillor Nick Martin be Vice-Chair of this Committee for the Municipal Year 2019/20.

Members are reminded that at the start of the meeting, they should declare any known interests in any matter to be considered and also during the meeting if it becomes apparent that they have an interest in the matters being discussed.

The Chair reminded Members of the need to declare any known interests in any matters to be considered at the meeting. No declarations were made.

See explanatory note below.  Please phone the Committee Officer whose name and number appears at the top of this agenda if you need further guidance. 

No public questions were asked or submitted for this meeting

To receive the minutes of the meeting held on 5^th March 2019.

Resolved – That the minutes of the meeting held on 5^th March 2019, be confirmed and signed as a correct record.

The Committee considered a report by the Chief Legal Officer regarding the appointment of Co-optees to the Adults’ Health, Adults’ Care and Housing Overview and Scrutiny Committee for the Municipal Year 2019/20.

Resolved –

1.    That the appointment of the following non-voting representatives be confirmed:

·         Michelle Howard (Equalities Advisory Forum)

·         Phil Matthews (Tenant Scrutiny Panel)

·         Carol Willis (Healthwatch)

·         Rosemary Curtis (Homeless Organisations Standing Together in Swindon -HOSTS).

Ms Julie Kerry, Director of Nursing, Avon and Wiltshire NHS Partnership Trust (AWP), submitted a report updating the Committee on the performance and key issues relating to the organisation. She gave a presentation and drew the following key issues to Members’ attention:

·         The Care Quality Commission’s good rating following a recent inspection and how this reflected improvements made in a range of services including health-based places of safety and substance misuse services.

·         The Health and Safety Executive’s improvement plan for the service included recruitment and implementing and delivering new mandatory training for all staff.

·         Work undertaken by the AWP  to address low rooflines across some AWP buildings and how this work was financed.

·         AWP’s strategic objectives for 2019/20 included three main priorities: getting basics right, undertaking the work identified by the CQC, embedding quality improvement.

Following the introduction of the report, Ms Kerry, together with Mr Alex Chesterton, Operations Manager for Swindon, responded to members’ questions and comments in respect of the following matters:

• How the in-patient services provided for people with a learning disability or autism were being reviewed by a multi-agency project board following the findings by the CQC.
• How the current workforce model structure was set up to address staff concerns, staff turnover and health and safety matters resulting from these pressures. 
• The progress on dealing with the high number of external placements and how Swindon only had two patients requiring out of borough support.
• The distance relatives had to travel to support family members receiving out of borough treatment and the actions taken by AWP to ensure patients were kept in-borough as a family support network was essential to patient well-being.
• How the ethnically diverse population of Swindon was supported, particularly by access to translation services organised by NHS England, ensuring access to good quality care. 

Resolved –

1.    That the Director of Nursing and the Operations Manager for Swindon, be thanked for their informative report and presentation.

The Cabinet Member for Housing and Public Safety with the Head of Housing submitted a joint a report updating the Committee on the performance of Housing Services. The Head of Housing explained that the report had been structured to highlight key statistics and headlines reflecting successes of the work undertaken. The report provided a performance summary in relation to the following key issues:

·        The creation of affordable specialist assisted living housing developments through the use of the Housing Revenue Account.

·        The implementation of a Homelessness Programme to assist those sleeping rough.

·        The ongoing challenge to collect rent from Council tenants. 

·        Regular review of the Council’s processes and procedures in relation to fire safety.

·        Actions taken to reduce the turnaround time for Council Housing voids.

·        The success of Housing Repairs and improvements, which saw 98.88% of Council housing stock comply with the Decent Homes Standard and that this standard was regulated by Homes England.

Following the officer’s introduction of the report, Councillor Cathy Martyn, Cabinet Member for Housing and Public Safety with the Head of Housing and Councillor Brian Ford, Cabinet Member for Adults and Health, responded to members’ questions and comments on the following issues:

·         How, together with the Fire Service, high rise buildings were inspected to ensure that effective fire safety measures were in place and operational. 

·         That new internal fire doors were fitted in all high rise buildings and in collaboration with tenants, the front entrance doors were regularly inspected to ensure that the integrity of the compartmentation is maintained.  

·        The current financing of affordable housing through Section 106 funding and that whilst some projects include the collaboration of housing associations, some affordable housing projects were contracted directly with housing developers.

·        The collaboration between the department and Adult Social Care in rolling out 35 assisted living bungalows, and how the occupants were supported by both services.

·        The percentage of affordable housing built and how this would be determined by the Planning department.

·        That as responsible landlords, Council’s tenancy agreements did not allow “sofa surfers”.

·        The success of the Haven Project due to the work being undertaken by a number of partners. 

·        The plans to expand the Haven Project enabling it to offer long-term provision to a higher number of the town's rough sleepers.

·        The range of provision offered by the Haven Project over the winter and summer months and how various method of engagement were used to ensure participation by rough sleepers.

·        How the submission of the “Reducing Rough Sleepers Strategy”to the Health and Wellbeing Board would provide up to date data for the borough. http://sbcvpwmmgv02:9070/documents/s109778/Rough%20Sleeprs.pdf

·        Details of lobbying Central Government for funding and the requirement for some bids to be submitted annually for consideration.

·        How the department engaged with contractors to undertake the housing repair function and the void process.

·        The effectiveness of the digital service for repairs as reflected in the higher number of tenants using the services over the past months. 

·        Confirmation that tenants unable to access the digital service to report  ...  view the full minutes text for item 7.

Ms Nicki Millin, NHS Swindon Clinical Commissioning Group (CCG), presented a report providing the Committee with a performance update and a summary of key issues in relation to the planning and provision of health and social care services within the Borough. These included:

·         The continuing implementation of recommendations made by the CCG following concerns identified by them in 2016 and 2017 regarding health based places of safety (PBPoS) at Avon and Wiltshire Mental Health Partnership NHS Trust (AWP).

·         An update on discussions being undertaken with the five doctors’ surgeries affected by the withdrawal of Integral Medical Holdings in Swindon. 

·         The urgent treatment centre to be located adjacent to the Great Western Hospital Accident and Emergency department from December 2019.

·         Provision of services at the walk–in centre for those patients unable to get an appointment with their general practitioner 

Following the introduction of the report, Ms Millan responded to members’ questions and comments on the following issues:

·        How a walk in Treatment Centre had diagnostic capabilities whereas a walk in Care Centre only dealt with treating symptoms and not underlying causes.   

·         Addressing diabetes issues to ensure preventative rather than reactive measures were taken.

·         Addressing recruitment issues following the retirement of a number of clinicians.

·         Concerns that patients affected by the withdrawal of Integral Medical Holdings were asking to join other practices and how this was placing pressures on other surgeries in the area.

·         The future tendering of service to replace Integral Medical Holdings.

Resolved:-

(1)  That the update of performance and key issues relating to Swindon Clinical Commissioning Group, be noted.

(2)  That the Executive Nurse at NHS Swindon Clinical Commissioning Group be requested to include an update on the diabetes indicators at the next meeting of the Committee.

(3)  That the Executive Nurse at NHS Swindon Clinical Commissioning Group be requested to circulate an update on:

a)    The number of surgeries currently holding training contracts in Swindon

b)    The Hawthorn surgery.

Mr Kevin McNamara, Director of Strategy, Great Western Hospital (GWH) NHS Foundation Trust, submitted a report providing the Committee with a performance update and a summary of the following key issues in relation to the planning and provision of health and social care services provided by the hospital:

• The consultation undertaken with staff and other stakeholders to develop a five year plan.

·         The current financial position.

·         Main pressures on the service included the timely progress of patients within the Emergency Department, the need to reduce waiting list sizes and ensuring cancer treatment was started within 62 days of urgent GP referral.

Following his introduction of the report, Mr McNamara, together with the Head of Housing responded to Members’ questions and comments on the following issues:

• The purchase of land by the hospital enabling it to provide an Integrated Front Door facility where patients may undertake intensive medical rehabilitation. 

·         The financing and ownership of the proposed Integrated Front Door facility. 

·         The regular conversations with CCG and the Walk-in Centre at Carfax Street regarding service provision for the benefit of the community following the withdrawal of Integral Medical Holdings from Swindon. 

·         How medical staff spot, diagnose  and treat patients with sepsis.

·         Capacity within the private facility, which benefits NHS patients in the Emergency Department.  

·         Liaison between ambulance staff, paramedics and Emergency Department staff enabling them to recommend a range of choices available for the patient to consider when deciding the best place to receive treatment.

·         The actions taken across the NHS to improve recruitment.

·         The current provision of key worker housing in Swindon and the benefit of GWH liaising with the Council’s Housing and Planning department regarding the provision of key worker housing in Swindon.

Resolved:-

1.    That the report providing the Committee with a performance update of the key issues in relation to the planning and provision of health and social care services provided by the hospital, be noted.

2.    That the Director of Strategy, Great Western Hospital (GWH) NHS Foundation Trust be requested to include information in his report to be submitted at the next meeting of this Committee regarding:

a)    Previous and current Emergency Department attendance trends.

b)    An update on discussions held with the Council’s Housing and Planning Department regarding key worker housing.

Councillor Brian Ford, the Cabinet Member for Adults and Health, presented a report that provided an update on performance and key issues relating to Adult Social Care commissioning.  The Cabinet Member for Adults and Health introduced the Acting Director of Health and Director of Social Care.  He explained that the report had been structured to highlight the strengths and challenges of the work undertaken.  The following key issues were drawn to members’ attention:

·         The pressure placed on the department by patients discharged from hospital requiring admittance to residential homes or returning home with care packages.

·         The ongoing focus to align spending on learning disability services with those in similar authorities through service re-design.

·         Work being undertaken to embed the new adult safeguarding model across the service.

·         Care home providers’ support to drive quality improvements.

·         The regular and substantial support provided to carers included timely reviews and assessments.

·         The importance of driving the Healthy Weight and Active Lifestyle initiatives.

·         Successful reduction of smoking prevalence in Swindon

Following the introduction of the report, the Cabinet Member for Adults and Health, with the Director of Health, responded to members’ questions and comments on the following issues:

• The provision of social care and support for the homeless and how this was undertaken with the support of Great Western Hospital and the Housing department.
• The work undertaken to address the number of out of area placements and how this would benefit the patient as they would be closer to relatives.
• Current recruitment of staff across various social care areas including the reablement service and support in care homes.
• The computer systems being used by Social Care Service were currently not compatible with other Health Services’ systems.  

Resolved:-

1.    That the report updating the Committee on performance and key

issues relating to Adult Social Care Commissioning and performance, be noted.

2.    That the Director of Social Care be requested to circulate information regarding the out of area placements for Adult Social Care.

3.    That the Director of Social Care be requested to present a report

reflecting the work undertaken to date regarding reducing out of area placements.

4.    That further to 3.24 of the report, the Director of Adult Social Services be requested to include an update on how future provision of social care services was being planned and would be financed.

The Committee considered a report by the Chief Legal Officer on the results of the work programme consultation and the suggested priorities for the work for the Municipal Year, 2019/20. The Committee reviewed the work programme and requested that it be updated to reflect actions contained in this report and recommended by the Committee.

Resolved:–

1.    That the details and activities included in the work programme for

2019/20, be noted.

2.    That the Committee thanks all the contributors who had suggested

topics for inclusion in the Committee’s Work Programme for the Municipal Year, 2019/20.

3.    That the work programme be updated to include receipt of reports on

the following:

       a) A review of the Empty Homes policy.

       b) The benefits of reducing out of borough placements.

       c) The collection and disposal of needles and sharps.

d) The provision of suitable local housing for those with special needs

       e) The role of Healthwatch in the Integral Medical Holdings project.