Members are asked to consider whether they have personal or prejudicial interests in connection with any item(s) on this agenda and, if so, to declare them and state what they are.

Members are reminded that they should also declare, pursuant to paragraph 18 of the Overview and Scrutiny Procedure Rules, whether they are subject to a party whip in connection with any item(s) to be considered and, if so, to declare it and state the nature of the whipping arrangement.

Members were asked to consider whether they had a personal or prejudicial interest in any matters to be considered at the meeting and, if so, to declare them and state what they were. Members were reminded that they should also declare, pursuant to paragraph 18 of the Overview and Scrutiny Procedure Rules, whether they were subject to a party whip in connection with any matter to be considered and, if so, to declare it and state the nature of the whipping arrangement.

Councillor McLaughlin declared a personal interest in minute 52 (Adult Social Services - Charging Policy) due to her friendship with an interested party.

This minute was subsequently amended by the Committee on 25 March, 2010 (minute 57 refers) to correct Councillor Roberts’ declaration of interest to read:

Councillor Roberts declared a personal interest in minute 52 (Adult Social Services - Charging Policy) due to her being referred to in the report.

To receive the minutes of the Health and Well Being Overview and Scrutiny Committee held on 10 November, 2009.

Also attached is a note giving an update on the situation regarding Co-opted Members (see minute 29 - 10/11/09).

Members were requested to receive the minutes of the meeting of the Health and Well Being Overview and Scrutiny Committee held on 10 November, 2009.

In connection with minute 30, Karen Livesey, Community Engagement Team, Voluntary and Community Action Wirral, had submitted an update on the situation with regard to Co-opted Members. The role’s description had been circulated via Wirral Voluntary and Community Sectors’ Network, the carers Network and the Wirral Black and Racial Minority Partnership for expressions of interest. Responses had been requested by 18 January 2010 with interested parties being asked to submit a nomination form containing a 100 word statement about their skills and suitability for the position. This would then be circulated with election papers with a four week deadline to return with recruitment to the positions ending on Monday 1 March.

Resolved – That the minutes be approved as a correct record.

Presentation by Sue Drew, Deputy Joint Director of Public Health, NHS Wirral.

Kim Ozano, Senior Health Improvement Advisor, NHS Wirral and Mike Donnelly, Smoking Programme Manager, NHS Wirral, gave a presentation to the Committee on the ‘Your Reason, Your Way – Stop Smoking Campaign’.

They outlined how the marketing campaign would work, the aim of which was to achieve an additional 5000 quitters from the more disadvantaged areas in Wirral. Details were given of the different methods of reaching the target group with the campaign, such as a mobile support unit to meet people face to face and web based support. A number of organisations were sponsoring the campaign and quitters of 4 weeks or more were able to enter a prize draw. They also informed the Committee of the results of a smoking prevalence survey which had elicited a 90% response rate from 3400 households. NHS Wirral had provided a budget of £436,839 for the campaign which with 5000 quitters would average a cost of £87 per quitter.

Both Kim Ozano and Mike Donnelly, in response to comments from Members, outlined how young people would be targeted and the mix of methods used to reach people. Part of the aim of the campaign was also to de-normalise smoking.

Resolved – That both Kim and Mike be thanked for their presentation and an update on the campaign be brought back to the Committee in six months time.

The Director of Adult Social Services submitted a copy of the Care Quality Commission’s, Annual Performance Assessment Report for 2008/09 of the Adult Social Services Department. The overall judgement of the CQC was that Wirral Council was performing well, which was defined as ‘consistently delivering above the minimum requirements for people’. The report would be presented to Cabinet at its next meeting on 4 February, 2010. The seven outcomes in the CQC’s report were rated as follows:

1. Improved health and well-being – The Council is performing well

2. Improved quality of life – The Council is performing well

3. Making a positive contribution – The Council is performing well

4. Increased choice and control – The Council is performing adequately

5. Freedom from discrimination and harassment – The Council is performing well

6. Economic well being – The Council is performing well

7. Maintaining personal dignity and respect – The Council is performing adequately

Responding to Members’ comments, the Director stated that performance had continued to improve over the last 12 months and the department had been and was continuing to go through a period of huge change. In respect of adults’ safeguarding, he reported that the Government had just announced that there would be legislation for this and he would welcome Members’ support regarding training. Training had been offered to all staff and the target for 2009/10 had already been exceeded. Gaps in service provision were being addressed and an outline was given of ‘end of life’ care offered with a specialist palliative care team in place.

With the permission of the Chair, the Cabinet member addressed the Committee and stated that the report needed to be seen in the context of the department having, over 10 years ago, been in special measures and looking forward to where it needed to be.

The Director reminded the Committee that the CQC report dealt with the period up to April 2009 and that the overall judgement was of ‘performing well’. The expectations were to achieve an ‘excellent’ rating in all areas.

On a motion by the Chair, seconded by Councillor Roberts, it was –

Resolved (6:4) – That the Committee notes the judgement from the CQC and anticipates that all the issues will be addressed and services improved and a report be brought back to the Committee in 6 months time.

Presentation by the Director of Adult Social Services.

The Director of Adult Social Services gave a presentation on the interim performance and a financial review. Outlining what was working well, he reported the following:

• Equipment delivered within 7 days (target 93%, projected 99%)
• Support Packages commencing within 4 weeks of assessment (95.26%). Good performance compared to North West Local Authorities
• Rehabilitation & Intermediate care - 89.5% of people receiving this support were still at home 90 days later.
• Number of people whose care package was reducing as a result of HART (now 769 people, against a target of 750)
• Increase take up of Assistive Technology (601 new people this year, target 562)

Areas for improvement included:

• Self directed support – the target was 15% which was unlikely to be achieved due to extension of Personal Budgets pilot.
• People with learning disabilities in settled accommodation – the target was 52%, now at 20.6% (improving slowly due to delays in reviews, and recording issues)
• People with learning disabilities and mental health in employment and settled accommodation - regional work was commencing to establish guidance and baseline of performance.
• Carers receiving help - showing signs of deterioration. (LAA target was 21.5%, currently 20.2% unless improved Wirral would be low in LA Group. An improvement plan was being developed.

In respect of financial pressures this remained at £3m, although with targets agreed to deliver further efficiencies of £500,000, there was a projected overspend of £2.5m.

The Director responded to Members’ comments on a number of issues raised in connection with the presentation in the light of an increasingly older population.

Councillor Clarke expressed her thanks to the Director on behalf of her local carers’ group which he had visited and who appreciated the way in which personal budgets were being introduced.

Resolved – That the presentation be noted.

In connection with the financial review, the Committee considered the minute of the Council Excellence Overview and Scrutiny Committee of 16 September, 2009 (minute 25 refers) which had been requested to consider the serious concerns with regard to the projected overspend in Adult Social Services.

Resolved – That the concerns be noted.

The Director of Adult Social Services submitted a report which provided information on the progress being made on personal budgets in Wirral. It provided information on the lessons learnt from phase 1 of implementing personal budgets in Wirral and details of phase 2 of implementation. Phase 2 of Wirral’s personal budget project would run until July 2010. The intention for phase 3 would be to roll out the new system and processes from August 2010.

Responding to Members’ comments, the Director reported that there were a number of support networks available for people with personal budgets and financial safeguards were in place. It would be possible for people to operate personal budgets on a trial basis but for those who didn’t want them they could have a self-directed service. The money made available by the Department of Health, through the social care reform grant, was to support councils in the transformation of adult social services and not just for the transition to personal budgets. For those people who were keen to start using personal budgets the department was open for business.

Resolved – That Committee notes the report and the current progress of implementing personal budgets in Wirral.

The Directors of Adult Social Services and Children’s Services submitted a report which detailed proposals to develop a Transitions Team with staff co-located from Children’s and Adult Services, as a further step to improving the experience of young people with disabilities as they moved from children’s services into adult services. It was proposed that the new team would take social care casework responsibility from the age of 16 and support joint planning from the age of 14. The team, drawn together as of 1 January 2010, would be based at Westminster House. In the following 3 month period, a more detailed Service Development plan would be developed, which would confirm the team’s working relationship with Connexions and other key parties.

Responding to Members’ comments the Director confirmed that the team would support young people under the broad remit as defined by Government guidance which defined disabled children as including young people with special educational needs in its broadest terms as those young people who received support at a school action and action plus level besides those in receipt of a statement.

On a motion by the Chair, duly seconded, it was –

Resolved –

(1) That this Committee notes the report, and the formation of a new Transitions Team.

(2) That further discussions be held with the Connexions service on joint working arrangements.

(3) That a further report be brought to the Committee in 12 months time on the outcomes for young people and their carers.

The Director of Adult Social Services submitted a report which updated the Committee on the progress made towards achieving the objectives of the Commissioning Strategy for Carers, which was approved by Cabinet in July 2009. The report gave details of progress against the 8 key outcomes:

  (i)  Carers know how to access advice and information when they need it.

  (ii)  Carers receive relevant and appropriate information to enable them to make choices and remain independent.

  (iii)  Carers feel confident that, should anything happen to them in an emergency, the person they care for will be supported.

  (iv)  Carers feel appreciated and that their contribution in the caring role is valued and recognised.

  (v)  Carers are consulted and involved at a local level in the development and evaluation of services designed to meet their needs, and the needs of people they care for.

  (vi)  Carers are able to participate fully and equally as citizens.

  (vii)  Carers from black and racial minority groups are pro-actively engaged, and supported to access culturally appropriate support services which meet their needs.

  (viii)  Carers are supported to remain in employment or participate in training to promote future employment prospects.

The Director responded to Members’ comments on various issues raised including the need for shared practice and the need for people to know what to expect on all sides, particularly when organising short breaks. The current strategy did concentrate on carers of 18+ years of age, but the needs of younger carers were recognised. Befriending services were also available for carers.

Resolved – That the report be noted.

The Chief Executives of NHS Wirral and of Wirral University Teaching Hospital NHS Foundation Trust, Kathy Doran and Len Richards respectively, submitted a report which informed the Committee of discussions held across NHS organisations on Wirral and the Local Authority with the aim of exploring how NHS and Local Government could work together in the light of current and future financial challenges in order to identify potential savings as a result of collaborative working.

The Chief Executives of the Council and the four NHS organisations, together with the Directors of Adult Social Services and Children’s Services had agreed to continue to meet on a regular basis to ensure co-ordination across workstreams and to maintain momentum in taking forward discussions. The aim would be to produce a programme of targeted savings which could be implemented over the next three to four years. As proposals were put forward there would be a need for wider discussion across organisations and with the public in the spring of 2010.

The report also set out the purpose and scope of the recently established Joint Collaboration Board formed between the Countess of Chester and the Wirral University Teaching Hospitals. The purpose of the Board was to explore and examine all potential opportunities for the two Trusts to work together to develop safe, high quality services that would be sustainable in the long term and would derive benefits for patients and support the strategic direction of the two organisations.

Len Richards responded to comments from Members and assured the Committee that there was no intention of creating a ‘super’ hospital, as both hospitals wanted to remain as two fully functioning local hospitals. He would be bringing back regular reports on the progress of the joint working.

The Chair commented on the recent bad winter weather and thanked all health and social care staff for their hard work during this difficult time. She suggested that a report on the affect on services be brought to the next meeting of the Committee.

Resolved – That Committee notes the collaborative working and seeks further regular updates on progress and a report be brought to the next meeting on the winter weather and its affect on services.

The Chair submitted a draft protocol for joint working between Wirral Health and Well Being Overview and Scrutiny Committee and the Wirral Local Involvement Network (LINks).

LINks had been set up across the country to give local communities a stronger voice in how their health and social care services were delivered. In Wirral, the local group had been extremely active in creating an effective organisation and developing a work programme. Although the Health and Well Being Overview and Scrutiny Committee and LINks had different priorities, it was clearly beneficial that both groups worked together constructively. Many Councils and LINks were developing protocols to help develop positive relationships.

Resolved – That the Committee approve the draft protocol, as detailed in the appendix to the Chair’s report.

Further to the deferral of this item at the last meeting (minutes 37 and 39 refer – 10/11/09) the following reports are submitted for the Committee’s consideration together with the resolution of the Audit and Risk Management Committee of 25 November, 2009.

(a)  Report of the Chief Internal Auditor

  Adult Social Services – Charging Policy – Service Users Residing at "In House" Supported Living Units during the period 1997 to 2003

(b)  Statement from Mr M Morton

(c)  Report of the Director of Adult Social Services

  Charging Arrangements for Supported Living in Wirral 1997 – 2003

Further to the deferral of this item at the last meeting (minutes 37 and 39 refer – 10/11/09) the reports of the Chief Internal Auditor on Adult Social Services – Charging Policy, the Statement from Mr M Morton and the report of the Director of Adult Social Services on Charging Arrangements for Supported Living in Wirral 1997 – 2003, were submitted for the Committee’s consideration together with the resolution of the Audit and Risk Management Committee of 25 November, 2009.

The Director also circulated his report, ‘Residents of Bermuda Road, Curlew Way and Edgehill Road’ the recommendations of which were approved by Cabinet on 14 January, 2010.

Resolved – That the reports and recommendations be noted.

The Chair has requested that this report, considered by Cabinet on 26 November, be placed on the agenda for the Committee’s consideration. Also attached are the 8 recommendations made by Cabinet.

The 6 appendices to the report (which number some 370 pages) can be viewed at the following hyperlink, at item 206:

http://wir06metrognome/ieListDocuments.aspx?CId=121&MId=732&Ver=4

A copy will be also be available to view in the Members’ Room.

At the request of the Chair the Committee considered the Director of Adult Social Services’ report to Cabinet on 26 November, on ‘Options for Change – Towards a Strategy for Care Services’. Also attached were the 8 recommendations made by Cabinet. The Director expanded on the progress made against a number of the recommendations and responded to Members’ comments.

Resolved – That the report and recommendations be noted.

The Committee received an update on its work programme, which included the proposed outline meeting schedule for the current municipal year, and progress on the in-depth panel review.

A Member suggested that an addition to the work programme could include a small group of Members visiting pupils of 18/19, with learning difficulties, in their schools who were at the transition stage to adult social services.

Resolved – That the report and addition to the work programme be noted.