The Chair welcomed attendees and viewers to the meeting and reminded everyone that the meeting was webcast and retained on the Council’s website for two years.

The Chair gave a statement in relation to the real living wage and clarified that Wirral Council offered the real living wage to all contractors.

No apologies for absence were received.

Members are asked to consider whether they have any disclosable pecuniary interests and/or any other relevant interest in connection with any item(s) on this agenda and, if so, to declare them and state the nature of the interest.

Members were asked to declare any disclosable pecuniary interests and any

other relevant interest and to state the nature of the interest.

The following declarations were made:

To approve the accuracy of the minutes of the meeting held on Thursday 3^rd March 2022.

Resolved – That the minutes of the meeting held on 3March 2022 be approved and adopted as a correct record.

No public questions, statements or petitions had been received.

The Lead Commissioner, Integrated Services, introduced the report of the Director of Care and Health which gave members of the Adult Social Care and Public Health Committee an oversight of the commissioning activity for Quarter 2 of financial year 2022/2023.

It was reported that Wirral has 329 existing units of Older People Extra Care Housing Accommodation which had been developed as an alternative to residential care. The two new schemes at Green Heys and Spinnaker House increased the number of operational units to 485 by the end of 2023. The intention to achieve 725 units by 2026.

To ensure local demand could be met, it was outlined that the council would be entitled to 100% nomination rights on the first let of a property and 100% nomination rights for subsequent re-letting of void properties.

Members welcomed the report and progress and highlighted the benefits of Extra Care housing.

It was noted that to achieve the target, sites and a programme were needed.

In response to a member's query, officers clarified that tenders could not be excluded from providers solely because they did not pay the Real Living Wage.

Resolved - That 

(1)  the commencement of the tender process for the procurement of care and support at home services for the two new Extra Care Housing Development schemes at Green Heys in Liscard and Spinnaker House in Rock Ferry with an agreed contract length of 5 years from the start date of the respective schemes be authorised.

(2)  the Director of Care and Health be authorised to award the contract to the highest scoring tender within the approved budget following the tender process.

Due to a disclosable pecuniary interest, Councillor Angela Davies left the meeting for the duration of the consideration of the item.

The Director of Care and Health introduced the report which described the plans for an All Age Disability service review and transformation. The report outlined how the programme would contribute towards budget savings with a £1M efficiency target required for 2023/24. It was reported that a greater alignment of services and more creative responses to people’s needs, and aspirations would likely lead to a reduction in future demand and in cost pressures relating to more expensive and intensive forms of care.

Wirral supported 1112 people with a Learning Disability with a funded package of care and support and had 133 working age young people with complex needs placed in long term care which was higher than expected and the Council aimed to change this and ensure a full range of services were in place to support people to live in their own homes and natural communities rather than care home settings.

It was reported that there was a particular focus around younger adults and ensuring that services were in place to support them as they enter adulthood, and it was recognised that these services could be improved significantly. The Review of All Age Disability would identify gaps in the services and help officers to understand what they are and how to meet them. The Review would entail working with families and where appropriate, collaborating with health colleagues about clinical areas that had been highlighted and were missing.

Members recognised that transitions between services were a concern, as the NHS had different ages at which children were considered adults depending on the service and that the transition should be seamless and service users should be unaware of the transition. A joint workshop with the Children, Young People and Education Committee was requested to explore this further.

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

Resolved -That

(1)  the commencement of an All Age Disability review be approved.

(2)  the approach to the review be approved and a further update report detailing progress made and the recommendations following the review be brought to the September Committee and a final report be brought to November Committee.

The Director of Public Health introduced the report which provided the Adult Social Care and Public Health Committee with an update on the progress of delivery of three grant funded programmes which aimed to reduce the impact of substance misuse within the borough. The three programmes were: Wirral ADDER (Addiction, Diversion, Disruption, Enforcement and Recovery) Accelerator programme; Inpatient detox funding and the Individual Placement Support (IPS) programme. The report outlined the Wirral ADDER programme plan for 2022/23, including underspend, and requested the committee to approve the planned use of funding.

in January 2021, the Government announced an additional £148m of funding to reduce drug related crime and health harm. Wirral was one was 12 areas to be highlighted to receive significant additional funding. It was reported that the main service, Wirral Ways to Recovery made very strong use of people in recovery and had apprentices, volunteers and recovery champions and emphasised a focus on healthcare rather than criminal justice.

A Member commented that they were pleased to see the change from using the criminal justice system to recovery and felt that changing attitudes were making a huge difference as well as collaborative working with the police.

Resolved - That

(1)  the progress in mobilising and delivering the three national grant funding programmes (Wirral ADDER accelerator programme, inpatient detox funding and individual placement support funding be endorsed.

(2)  the proposal to utilise the predicted extension of the provision of additional funding to deliver the national drug strategy until the end of the 2024/25 financial year be approved.

(3)  the proposed utilisation of the ADDER programme grant for the 22/23 period (£1.4m) and proposed utilisation of the underspend carried forward from 2021/22 funded by Home Office and Office for Health Improvement and Disparities (OHID), formerly Public Health England be approved.

(4)  the payment of £106K of in-patient detox grant for 2021-22 to CGL/Wirral Ways to Recovery, as part of a contract variation, to re-imburse the additional expenditure on detox placements they have made this year to this amount be approved, in addition to their budgeted capacity due to it being accrued as part of delivering the Inpatient Detox Grant Programme.

(5)  the continuation of the Individual Placement Support Grant (£135,000) for 2022-23 be approved.

The Director of Care and Health introduced the report which set out the financial monitoring information for the Adult Social Care and Public Health Committee and provided members with an overview of budget performance for this area of activity. The financial information in the report detailed the year-end revenue and capital outturn position as reported at quarter 4 2021/22.

It was outlined that the year-end position was aligned with forecast reports brought to Committee with the outturn position of £1.059m favourable against a budget of £113.6m. At the start of the previous financial year, £4.5m of savings had been identified and of this, £4.3m were achieved. The savings were primarily achieved through an ongoing review of care packages and more independent support available to people.

It was highlighted that COVID 19 funding and NHS support to discharges from hospital had reduced the pressure on the Council. The Council benefitted from £1.6m of funding from the Clinical Commissioning Group (CCG) and had been able to keep running costs relatively low which enabled the focus to be on support packages in the community.

Resolved – That the year-end revenue outturn position of £1.059m favourable and the performance of the capital programme, as reported at quarter 4 (Apr-Mar) of 2021/22 be noted.

The Director of Care and Health introduced the report which detailed how the 2022/23 budget would be monitored through the Committee system which allowed Policy and Services Committees to take ownership for their specific budgets. The report emphasised the need to stay within budget and the requirements which had been set out across the Council. It was outlined that budget reports would be brought to Committee on a quarterly basis and a monthly budget monitoring panel would monitor the progress.

The Director of Care and Health highlighted that social care legislation was due to change significantly in 2023 as a result of national funding reforms and work was being undertaken to understand the impact of those changes.

The Chair highlighted the impact that the cost of living crisis could have on the Council’s budget performance.

Resolved That –

(1)  the process for in-year monitoring of the 2022/23 budget be noted.

(2)  the 2023/24 budget setting process.

(3)  a budget monitoring panel comprised of the Committee Chair and Spokespersons be established and appointed to, in line with section 3.12 of the report with sessions to be led by the relevant Director/Assistant Director.

(4)  budget workshops as detailed in section 3.26 of the report be held, the outcome of which to be reported back to Committee in September 2022.

The Principal Social Worker and Safeguarding Lead introduced the report of the Director of Care and Health which provided a performance update in relation to Adult Social Care and Health. The report was designed based on discussions with Members through working group activity in 2020 and 2021.

It was reported that a new system had been implemented in the quality improvement team and a business plan was being produced to improve care homes across the borough. It was outlined that collaborative work with a provider called Partners for Change had been undertaken to change the culture of social work to a more relationship therapeutic base, Phases 1 and 2 of the programme had been completed and showed promising results and developed a positive change in social care and work in Wirral.

In response to queries from members in relation to the limited number of people receiving reablement care, it was reported that the figures may have been affected by changes to hospital discharge protocols following the implementation of the Coronavirus Act 2020. A workshop to inform new members of the committee on performance data was proposed.

Following a discussion on the work being undertaken to develop business and improvement plans for the care homes who's Care Quality Commission rating was not good or outstanding, the Chair requested that the Committee remained appraised on the improvement process.

Resolved – That the content of the report be noted.

The Director of Regeneration introduced the report of the Director of Care and Health which set out the performance of the Home Adaptation Team for the year 2021/22 and highlighted trends in performance, obstacles that had been encountered and any remedial action taken to address this as well as an update on new initiatives and successes. Officers felt that it was a positive update and a good example of collaborative working that had been developed across the Committees and directorates.

The key performance indicators (KPI’s) were set out in a service level agreement (SLA) in 2019 and covered a wide range of works from grab rails to larger extensions of the homes of disabled clients. Performance of delivery of adaptations during 21/22 was robust, particularly minor works and Disabled Facilities Grants (DFG) with 100% of targets hit and 2750 adaptations delivered. Time critical adaptation grants had been introduced for people with terminal diagnoses or those in hospital unable to return home, with the resources having to be increased to meet an increasing demand for the adaptations.

A discussion ensued with members querying the KPI target of 12 months from approval for the completion of major DFG’s and whether this could be revised or improved to get DFG’s completed earlier. It was outlined that this was a national target that Local Authorities were mandated to report on. The vast majority of jobs were rapid adaptation grants and the target for this was 50 working days from receipt of the application and were completed within target.

In response to queries from members regarding time critical adaptations it was outlined that this was something that was being constantly reviewed. The service was focussed on fast tracking applications and in instances where the adaptation did not go ahead it was due to factors out of officers control. Attention was drawn to the appearance of the adaptations by the Chair who noted that they often looked clinical and could be distressing if it reminded clients of their time in hospital.

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

Resolved – That

(1)   the performance of the Home Adaptations Service in 2021/22 be noted.

(2)  A review of the current service level agreement and the KPI’s that accompany it be undertaken by officers.

The Director of Public Health introduced the report which provided the Committee with an update on key areas of development in relation to Wirral’s COVID-19 response and delivery of the Local Outbreak Management Plan.

It was reported that the National Contingency Framework for Living with Covid-19 was still to be published. The prevalence of Covid-19 was reported on with the Office for National Statistics reporting that 1 in 70 people in England were infected, and the Director of Public Health outlined that infection prevention control measures would be introduced to respond to various waves of infections.

Resolved – That the contents of the report and the progress made to date in the continued COVID-19 response, and the wider emerging health protection priorities and plans to protect the health of Wirral residents be noted.

The Principal Social Worker introduced the report of the Director of Care and Health which provided an overview and analysis of all Adult Social Care complaints received during the reporting period 1^st April 2020 to 31^st March 2021. This included the number of complaints received, the key themes, responses to complaints including performance data against statutory requirements and an overview of complaints escalated to the Local Government and Social Care Ombudsman.

The Social Care Complaints Annual Report was a statutory requirement and provided a mechanism by which the Council could monitor the quality and effectiveness of the services provided. It was reported that there had been an 8% reduction in complaints across the year and almost 50% of complaints received were regarding commissioned services. The complaints team had worked closely with providers to ensure responses drafted were fully quality assured prior to release. The key themes of complaints were financial charging issues and standard of care and services, with outcomes from investigations into these two areas used to determine whether service improvements could be made.

During the reporting period, 91% of complaints were resolved by the local resolution stage. On average, 50% of complaints were fully or partially upheld and 20 complaints were escalated to the Ombudsman with 12 upheld. The council was 100% compliant with recommendations from the Ombudsman and no public reports were issued against the council.

A discussion ensued where members queried how the key themes of complaints were shared with staff and the lack of root cause analysis in the report. It was stated that the team were constantly reviewing the key themes and that a review was undertaken of the Revenue and Benefits service looking at policies and procedures. A new system had been implemented whereby the recommendations from the local ombudsman could be tracked, shared with the professional standards team who would then share this with front line colleagues. It was further outlined that around 30% of complaints are deemed as serious or complex and that these were assigned to trained complaints investigators who drilled down into the details of the complaint and compared the experience to what should have happened and so a root cause analysis was undertaken.

It was clarified following a member query that the reason only 7.4% of complaints had been responded to within 6 months was that a number of cases had stalled for various reasons such as information being with the coroner or the police. Another member noted that the word concluded would be more appropriate than responded to.

On a motion by Councillor Yvonne Nolan, seconded by Councillor Mary Jordan it was

Resolved – That

(1)  the contents of the Annual Complaints Report (Appendix 1) relating to statutory Adult Social Care service delivery be noted.

(2)  complaint reviews, learning and impact on practice be included in future reports.

Due to a disclosable pecuniary interest in the item, Councillor Angela Davies left the meeting for the duration.

The Deputy Chief Executive of Cheshire and Wirral partnership (CWP) introduced the report which provided a background and summary of the activity undertaken within Cheshire and Wirral in respect of delivering the NHS Long Term Plan ambitious targets for community mental health. It was reported that on both a national and local scale, community mental health services needed to be modernised. The community transformation framework consisted of a new place based multi-disciplinary service which joined health and social care and community, voluntary and faith sector organisations. This aligned to the primary care network and broke down the artificial barriers between primary and secondary care and focussed not only on diagnosis but also the complexities that individuals presented with.

It was outlined that the transformation created opportunity for joined up care and a whole person approach which would ensure that individuals had access to mental health care when and where they needed it to help them to manage their own condition and move towards recovery on their own terms. The Cheshire and Wirral Community Wellbeing Alliance had been developed which was a representation of a range of partners that had come together to ensure that people across Wirral and Cheshire had good mental health support. Within Wirral, 34 organisations had joined the alliance and a number of grants had been awarded to build upon and enhance local community assets.

The community mental health transformation was a long term transformation programme which would span a number of years. It was recognised that there was still much more work to be done but CWP were pleased with the engagement of partners up to this point.

A discussion ensued with members querying the limited support for patients with mental health in the community and how to get from the current position to the service that is envisaged. The Deputy Chief Executive of CWP outlined that members had identified the core issues and reasons why the transformation programme was being implemented, there had been engagement with primary care networks across Wirral and CWP were keen to engage with primary care and the general public to ensure that the model was correct. It was reported that Health Education England had provided training and development around psychological interventions and CWP had linked in with education establishments for a pipeline of nurses, occupational therapists and other allied health professionals. It was recognised that services needed to modernise and transform and that there were national challenges around workforce.

The Committee was informed of services available to those in crisis who had threatened to commit suicide, a 24 hour crisis line that was open which was staffed by qualified nurses and practitioners and that there had been great feedback from this service. The police may also be involved to ensure that the individual is taken to a place of safety so that an assessment of needs could be undertaken and there was  ...  view the full minutes text for item 15.

The Head of Legal Services introduced the report of the Director of Law and Governance which enabled the Adult Social Care and Public Health Committee to appoint Members and named deputies to serve on the Discharge from Guardianship by Wirral Council under the Mental Health Act 1983 Panel and the Joint Strategic Commissioning Board Sub-Committee (JSCB) as well as appoint a Member Champion for Domestic Abuse.

It was clarified that the Discharge from Guardianship Panel comprised of 3 or more members and that political proportionality was not applied in the same way as Sub-Committees.

On a motion by Councillor O’Hagan, seconded by Councillor Walsh it was

Resolved – That

(1)  the Monitoring Officer as proper officer be authorised to carry out the wishes of the Group Leaders in allocating Members to membership of the Statutory and Advisory Committees, Sub-Committees and Panels detailed within the report and to appoint those Members with effect from the date at which the proper officer is advised of the names of such Members.

(2)  Councillor Yvonne Nolan be appointed as Member Champion for Domestic Abuse.

The Head of Legal Services introduced the report of the Director of Law and Governance which sought adoption of the two protocols for the establishment of Joint Health Scrutiny Committees, and nominations to serve on the Committees.

In response to the proposed establishment of Integrated Care Systems in England under the Health and Care Act 2022, Chief Executives across Cheshire and Merseyside agreed to progress work to establish a standing Cheshire and Merseyside Joint Health Scrutiny Committee for an initial period 18 months with Knowsley Borough Council as the lead local authority.

A Joint Health Scrutiny Working Group was established to draft the necessary documentation for the Standing Joint Health Scrutiny Committee, and the protocol for the Committee could be viewed in Appendix 1. As part of the work, it was proposed that the existing protocol for local Joint Health Scrutiny Committees be amended to accord with the new standing Joint Health Scrutiny Committee, and the revised protocol was available in the document marked Appendix 2.

Resolved – That

(1)   the Cheshire and Merseyside Integrated Care System Joint Health Scrutiny Committee protocol be adopted.

(2)   the revised Joint Health Scrutiny Committee protocol be adopted.

(3)  the Monitoring Officer as proper officer be authorised to carry out the wishes of the Group Leaders in allocating Members to membership of the Joint Health Scrutiny Committees detailed

The Head of Legal Services introduced the report of the Director of Law and Governance which provided the Committee with an opportunity to plan and review its work across the municipal year.

The Committee was invited to consider its work programme so that it only included items of business that required a decision, relate to budget or performance monitoring or which were necessary to discharge their Overview and Scrutiny function, in line with the recently revised Constitution.

It was proposed that a Task and Finish Group to comment on the Cheshire and Wirral Partnership Community Mental Health programme be established and added to the work programme as well as a Performance workshop and a joint workshop with the Children, Young People and Education Committee on All Age Disability.

Resolved – That

(1)  the Adult Social Care and Public Health Committee work programme for the remainder of the 2022/23 municipal year be noted