The Chair welcomed everyone to the meeting as well as those watching the webcast.

Apologies had been received from:

Councillor Julie McManus, who was substituted by Councillor Paul Jobson

Councillor Kathy Hodson, who was substituted by Councillor Colin Baldwin

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. No interests were declared.

To approve the accuracy of the minutes of the meeting held on 5 March 2024.

Resolved – That the minutes of the meeting held on 5 March 2024 be agreed.

A question had been received from Carl Mannion. The Chair read the question out and provided the answer to two representatives of Mr Mannion who were present. The question was from a private sector agency employing care teams which pointed out that the Couuncil had set up their own care teams paying more per hour than the private sector with additional contractual benefits. It asked that the rate paid to providers be increased in real terms to reflect their equivalent status.

The Chair answered that the inhouse AbleMe Service was approved by Committee in June 2023 with a focus on prevention of hospital admissions. It was a new service and did not compete with or replace the commissioned reablement service which used private domiciliary care agencies. The workforce are trained to a level where autonomy and accountability were expected with extended call durations, setting goals with the individual. Their roles had been subject to the Councils Human Resources Job Evaluation process and the pay level determined as appropriate for the skill, experience, qualifications and knowledge required, with an hourly rate between £14 and £15.32. 

A supplementary question was asked which was what was the criteria that the privately employed staff have to meet to get the extra level of pay as they are qualified and work in collaboration with professionals.

The Chair confirmed that the answers would be provided in writing. 

(the answer sent subsequently was:

The criteria for the Care and Support at home service, and staff qualification requirements are set out in the service specification. The rate for this service is agreed on an annual basis, following fee rate engagement, and was approved in Adult Social Care and Public Health Committee in March 2024 for fees payable 2024/2025.

The committee report, Outcome of annual rates, and fees engagement exercise can be found here https://democracy.wirral.gov.uk/ieListDocuments.aspx?CId=908&MID=10134#AI69540)

The Head of Integrated Services presented the report of the Director of Adults, Health and Strategic Commissioning which requested approval of the mandatory Section 75 pooled fund arrangement for 2024/25, between Cheshire and Merseyside Integrated Care Board (ICB) and the Council and give delegated authority to the Director of Law and Corporate Services in consultation with the Director of Care and Health to sign off the agreement. This report describes how these arrangements will achieve the government’s priorities for the Better Care Fund (BCF) Plan 2023/25. It was noted that the funding allocation was predetermined nationally and the agreement was a statutory one.

Resolved – That –

(1) the continuation and endorsement of the value of the pooled fund arrangement between the Council and the ICB for 2024/25, as set out in section 4.0 be approved;

(2) the Director of Law and Corporate Services in consultation with the Director of Adults, Health and Strategic Commissioning be authorised to enter into an agreement pursuant to Section 75 of the National Health Service Act 2006 with the NHS Cheshire and Merseyside ICB for 2024/25.

The Head of Integrated Services presented the report of the Director of Adults, Health and Strategic Commissioning which provided an update on the outcome of the extension of the contractual arrangements via a section 75 agreement with Cheshire and Wirral Partnership NHS Foundation Trust (CWP) and made recommendations as to the future delivery of the services. The service was judged to be performing well and was rated good by the Care Quality Commission, with a stable workforce and low volumes of complaints. Further extensions of three years and two years were recommended to allow for action or review to deal with changes in legislation and other issues. It was noted that recruitment of staff was an ongoing issue nationally.

Resolved – That – 

1. The outcome of the review of the CWP social work delivery Section 75 agreement, subject to the outcome of any consultation entry into a further Section 75 agreement with CWP for a 5-year extension with a 3 year, plus a two-year option, at a projected cost of £32,172,645 for the 5-year extension, be approved.

2. The Director of Adults, Health and Strategic Commissioning be authorised to commence joint, formal consultation with CWP regarding entering into a further Section 75 agreement with CWP on a long-term basis for 5 years with options to extend the agreement for a further period of 3 years and then a further period of 2 years.

3. Subject to the outcome of the consultation delegated responsibility be given to the Director of Adults, Health and Strategic Commissioning, in consultation with the Chair and Spokespersons of Adult Social Care and Public Health Committee to authorise entering into a further Section 75 agreement for 5 years with ability to extend for 2 additional periods of 3 years and 2 years.

This PDF may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices. Please contact karensmith1@wirral.gov.uk if you would like this document in an accessible format.

The Assistant Director, All Age Independence introduced the report of the Director of Adults, Health and Strategic Commissioning which presented the draft Supported Employment Strategy 2024 - 2029 for approval. The Strategy had been co-produced with partners who were directly or indirectly involved in the support of adults with learning disabilities, and/or autism, into employment. The Strategy was important as Wirral had seen marginal improvements in helping adults with learning difficulties into employment but needed to do more to reach national averages and benefit from the cost and health benefits for individuals of supported employment. The implementation of the Strategy would be monitored and overseen by a Board.

Members asked about terminology in the report and the transitioning from Children’s Services.

Resolved – That the draft Supported Employment Strategy 2024-2029, as noted in Appendix 1 to this report, be approved and further collaboration with members of the Children and Young People and Education Committee on the issues raised be looked forward to.

This PDF may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices. Please contact jeanstephens@wirral.gov.uk if you would like this document in an accessible format.

The Assistant Director, All Age Independence introduced the report of the Director of Adults, Health and Strategic Commissioning which presented the draft All Age Autism Strategy 2024-2029 for approval. The strategy formed part of a work programme as an outcome of All Age Disability review which was approved by the Adult Social Care and Public Health Committee on 13 June 2023. the proportion of people registered with their GP as autistic was 5% on Wirral which was above the national average.

Members asked about employment support and the referral pathways.

Resolved – That the draft All Age Autism Strategy 2024-2029, as set out in Appendix 1 to this report, be approved and progress in dealing with the barriers identified and issues raised be looked forward to.

The Head of Integrated Services presented the report of the Director of Adults, Health and Strategic Commissioning which described the co-production activity to procure and award the Learning Disability and Autism Short Break Service, which was due to end on 16 April 2026 after the current contract extension. The estimated costs of the new service was £756,756 per year. It was anticipated that the new co-produced service would be commissioned for 5 years, resulting in a predicted cost of £3,783,780 between 2026 and 2031.

Members asked about the assessment of carers.

Resolved – That –

1. the re-specification and procurement be approved by way of a competitive process of a new Learning Disability and Autism Short Break Service using co-production and co-design processes with people who use the service, their families and supporters for a contract terms of 5 years

2. the award of the contract for new service, to start in 2026, be delegated to the Director of Adults Care and Health at an indicative cost of £756,756 per year.

The Public Health Principal Officer presented the report of the Director of Public Health which provided an update on the current Single Front Door for Volunteering service commissioned by Public Health, which was operated by CVS.

Members enquired about non-digital versions of documentation, volunteer development, funding and safeguarding.

Resolved – That the information contained within this report be welcomed and the Committee express its appreciation of the programme of activity offered to support residents in the borough.

This PDF may not be suitable to view for people with disabilities, users

of assistive technology or mobile phone devices. Please contact

helenstott@wirral.gov.uk if you would like this document in an

accessible format.

The Director of Public Health presented his report which provided an update on the partnership work undertaken to date to deliver Wirral’s Health Protection Strategy. The Wirral Health Protection Strategy had been approved at Committee on 23rd January 2023 and sets out the refreshed collective approach for ensuring that Wirral has a resilient health protection system and response. Progress on the Strategy was shown in the report. It was noted that interest in public health had increased since the Covid-19 pandemic.

Members asked questions about vaccinations, water pollution.

It was noted that the project “System collaboration to reduce the impact of Antimicrobial Resistance (AMR) and strengthen Infection Prevention and Control by improving the diagnosis and management of Urinary Tract Infections (UTI) and hydration” won the Infection Prevention Society for Excellence Impact gold award.

Resolved – That the progress made to date in the implementation of the Wirral Health Protection Strategy 2023 – 2027 be welcomed, and that national recognition of Wirral’s progress in the areas now reported be noted and, when convenient, an update on the lessons learned from the report of the recent inquiry into COVID be brought.

The Head of Finance-People presented the report of the Director of Adults, Health and Strategic Commissioning which provided a summary of the year-end revenue and capital position for the Adult Social Care and Public Health Committee for the 2023/24 financial year as at the end of March 2024. The year-end revenue outturn for 2023/24 represented an adverse variance against the Committee revenue budget of £1.192m, which was a £0.757m deterioration from the quarter 3 forecast.

Resolved - That

1. the draft, unaudited 2023/24 outturn adverse Directorate variance of £1.192m, which has been managed corporately by utilising the contingency budget, savings from reduced energy costs and use of flexible use of capital receipts be noted;

2. the progress on delivery of the 2023/24 savings programme be noted;

3. the transfer to and use of earmarked reserves, as detailed in table four be noted;

4. the draft, unaudited 2023/24 capital outturn position detailed in table five be noted.

This PDF may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices. Please contact markgoulding@wirral.gov.uk if you would like this document in an accessible format.

The Head of Finance-People presented the report of the Director of Finance which set out how the 2024/25 budget was to be monitored through the Committee system, which will facilitate the Policy and Services Committees (the Committees) to take ownership of their specific budgets and present appropriate challenge and scrutiny of Officers on the management and performance of those budgets. The concurrent activity of budget setting for 2025/26, and how this was to be approached, was also set out in the report. Also included was a requirement for a Budget Oversight Panel for the Committee.

Resolved – That

1. the process for in-year monitoring of the 2024/25 budget be noted.

2. the proposed approach to 2025/26 budget setting and the key assumptions that will be used be noted.

The Head of Finance-People presented the report of the Director of Adults, Health and Strategic Commissioning which set out the financial monitoring information for the Committee as at Quarter 1 (30 June) of 2024/25 as well as virements resulting from an administration change. There was a reported adverse position of £2.5m on the Committees net revenue budget of £142.4m at that point. It was noted that the forecast was for demand and costs in services to older people to increase, leading to an expected overspend of 2.5m at year end.

Resolved – That

1. the adverse position presented at Quarter 1 be noted.

2. the progress on delivery of the 2024/25 savings programme at Quarter 1 be noted.

3. the forecast level of reserves and balances at Quarter 1 be noted.

4. the budget virement due to administrative change in the allocation of Service budgets between directorates, as detailed in paragraph 3.17 be noted.

5. the capital position at the end of Quarter 1 be noted.

This PDF may not be suitable to view for people with disabilities, users

of assistive technology or mobile phone devices. Please contact

nancyclarkson@wirral.gov.uk if you would like this document in an

accessible format

The Director of Adults, Health and Strategic Commissioning presented the report of the Chair which provided a performance report in relation to Adult Social Care and Public Health. The report had been designed based on discussion with Members through working group activity in December 2022. It was noted that demand was increasing, including both the numbers of care homes and the numbers of people accessing residential and nursing care, partly because of successful work in transferring people out of hospitals.

Members noted that the Council had shown leadership in supporting the Wirral Place Based System in supporting the NHS ICB in its urgent and emergency care and recovery challenges through the Transfer of Care and Home First programmes. This in turn had generated significant demand pressures, particularly characterised by the complexity and frailty of persons cared for within community Social Care settings and beyond the available resources the council had within its budget.

Members asked questions about the quality of care homes and it was noted that there was general improvement following the quality improvement work and noted that the Council still aspired to see further improvement in the quality and standards of care homes.

The Committee noted the appropriate nature of payments to recipients through the direct payments system.

Resolved – That

1. the pressures that the authority faces in securing appropriate discharges from hospital and the impacts of the work undertaken but still needed to improve the standards in our care homes be noted, and
2. the appropriate nature of payments to recipients through the direct payments system be noted, and

3.  the other matters covered in the report be noted.

This PDF may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices. Please contact christinemorley@wirral.gov.uk if you would like this document in an accessible format.

The Head of Legal Services presented the report of the Director of Law and Corporate Services (Monitoring Officer) which reviewed the continuing need for various panels, statutory / advisory committees and working parties, and was to appoint Members and named deputies to serve on those (including the statutory committees and panels) that were to be retained in 2024/2025, as well as appoint a Member Champion for Domestic Abuse.

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 Kathy Hodson be appointed as Member Champion for Domestic Abuse.

3.  Councillor Mary Jordan be appointed as Member Champion for Dementia.

4.  a cross party working group of Members formed of Chair and Spokespersons be appointed to conduct a policy development review in accordance with the approach outlined at Appendix 3 of the report.

The Head of Legal Services introduced this report which presented the future work programme of the Committee.

It was noted that the Quarter 2 finance report would move to November 2024.

A request for an update on the lower rate of uptake of Direct Payments was suggested to be produced as a Briefing Note.

Resolved – That subject to the changes noted above, the proposed Adult Social Care and Public Health Committee work programme for the remainder of the 2023/24 municipal year be noted.