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 consider whether they had 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 what they were.

The following declarations were made:

To approve the accuracy of the minutes of the meeting held on 18 January 2021.

Resolved – That the accuracy of the minutes of the meeting held on 18 January 2021 be agreed.

The Head of Legal Services informed the Adult Social Care and Health Committee that no public questions, or requests to make a statement had been received.

Simon Garner, Health and Care Lead Commissioner, introduced the report of the Director of Care and Health, which set out the standards and design requirements to provide appropriate Extra Care Housing schemes in Wirral that will support Wirral residents with eligible needs.

The report detailed the need for additional units of Extra Care Housing within the borough with the Strategic Housing Market Analysis identifying a need for 2,985 further units up to the period of 2035, as well as the commitments to further developments of extra care housing outlined in the Wirral 2020 Plan. The report outlined how having a model which sets out the Council’s expectation to developers and care providers would contribute to the quality of those forthcoming developments.

The need for further sites within the Borough was discussed and the benefits of identifying future potential sites in advance were reinforced. Members were informed that close working arrangements were in place between colleagues in Adult Social Care and Regeneration to help identify potential sites for Extra Care Housing.

The Committee was further kept apprised of how it would be ensured that the model would be adhered to, with care providers commissioned in accordance with the Care and Support framework and the requirement to be registered with the Care Quality Commission. A joined-up approach was taken across the Council to consider developments and manage them going forward, which included contributions from Revenue and Benefits, Housing, Care and Social Work.

Members emphasised the importance of the location of Extra Care Housing to ensure residents could remain in their communities and welcomed the approach of having community and family facilities integrated within extra care sites.

Resolved – That the Extra Care Housing Model be agreed.

Jayne Marshall, Community Care Lead Commissioner, introduced the report of the Director of Care and Health which sought the Committee’s approval to re-tender the Care and Support services within the existing Extra Care Housing schemes in Wirral.

The report outlined that there were 250 existing units of Extra Care Housing in Wirral across five sites, the contracts for which were due to end. The proposed retendering of the services was proposed to take place using the Liverpool City Region Extra Care Housing Flexible Purchasing system which enabled providers from across the city region to be used, but also included the current providers. The proposed duration of the contract was five years, with providers able to apply for one or more of the schemes, but only up to a maximum of three schemes in order to spread the risk across the market and ensure equity within the car market to support sustainability.

Members expressed their preference for a provider who would commit to paying the Real Living Wage. It was reported that all of the existing providers had signed up to pay the Real Living Wage and it was anticipated that any future provider would also commit to paying it.

Members felt that payment of the Real Living Wage should be a requirement of the tendering process and therefore an additional recommendation was proposed, moved by Councillor Michael Collins and seconded by Councillor Kate Cannon.

‘That the Committee would wish to see that one of the criteria for eligibility to tender for Extra Care Housing would be that the provider would pay the Real Living Wage, subject to legal advice.’

Councillor Tom Usher declared a pecuniary interest by virtue of his employment with Autism Together and left the meeting.

The motion was carried unanimously.

Resolved – That

1.  the commencement of the procurement process for the Care and Support contracts for the existing Extra Care Housing schemes be agreed.

2.  delegated authority be given to the Director of Care and Health to award the tender to the successful bidder following the tender process.

3.  the Adult Social Care and Public Health Committee would wish to see that one of the criteria for eligibility to tender for Extra Care Housing would be that the provider would pay the Real Living Wage, subject to legal advice.

Jayne Marshall, Community Care Lead Commissioner introduced the report of the Director of Care and Health, which detailed the proposed recommission of the Wirral Local Healthwatch and the Independent Health Complaints Advocacy Service.

The report outlined the statutory requirement for Local Authorities to contract the provision of a local Healthwatch service, which went live in Wirral in April 2013 and extended to 2020. The Independent Health Complaints Advocacy Service had been transferred to the incumbent Healthwatch provider in April 2018 and it was intended that this service would be recommissioned in conjunction with the main Heathwatch commission.

Members discussed the financial arrangements for funding the local Healthwatch service and the services provided for that cost.

Resolved – That

1.  the progression of the tendering of the Local Healthwatch and Independent Health Complaints Advocacy Services be approved.

2.  delegated authority be given to the Director of Care and Health to award the tender of the Local Healthwatch contract to the successful bidder.

Graham Hodkinson, Director of Care and Health introduced the report which set out the financial monitoring information for the Adult Social Care and Health Committee and provided an overview of budget performance for the area of activity for quarter 3 of the 2020/21 financial year.

It was reported that as at the end of December 2020, the forecast year-end position for Adult Care and Health was an adverse variance of £0.036m against a net budget of £106.627m. The Director of Care and Health outlined the key challenges in budget monitoring in that period, which included steadily increasing client numbers, particularly in Domiciliary care, alongside increasing average cost of care packages. However, access to the Government’s additional Covid-19 funding helped to offset the significant amount of additional costs the Council faced.

Members queried when the Committee would see the savings proposals from Wirral Evolutions, and it was confirmed that the proposals were in development and would be reported back to the Committee as soon as possible as part of the consultation process. Members further reinforced the need for the Budget Monitoring Panel to be introduced and align with the committee schedule.

Resolved – That the projected year-end revenue forecast position of £0.036m adverse and the performance of the capital programme, as reported at quarter 3 (Apr-Dec) of 2020/21 be noted.

Jason Oxley, Assistance Director of Care and Health introduced the report of the Director of Care and Health, which provided an update on performance in relation to Adult Social Care and Public Health.

The report detailed a number of performance indicators relating to Adult Care and Health, and the Committee was informed that the number of care home residents remained stable as did the vacancy rate which sat at approximately 16%. The number of people in long term residential care was 1536, with a number of new placements resulting from hospital discharge. Members were advised that the priority of the Adult Social Care team was to enable people to return home when they were able to, and there had been a gradual reduction of new placements with a focus on reablement.

The Committee discussed Care Quality Commission inspections of care homes and the approach taken to undertake these during Covid-19 restrictions. It was reported that some inspections had been taking virtually whilst others were in-person, with an emphasis on in-person attendance to focus on specific areas of underperformance.

Members further discussed the key performance indicators relating to safeguarding and the data behind notifiable incidents.

Resolved – That

1.  the content of the report be noted.

2.  the Director of Care and Health be requested to include further information regarding Care Quality Commission care home visits and patterns relating to notifiable incidents in future performance reports.

Simon Banks, Chief Officer NHS Wirral Clinical Commissioning Group introduced the report which provided the Committee with a summary of the key proposals set out in the Government White Paper, ‘Integration and Innovation: working together to improve health and social care for all’, and the response to the Government’s proposals by NHS England/Improvement.

The key measures included in the White Paper were outlined, these included:

·  The NHS and local government coming together legally as part of Integrated Care Systems;

·  Reduction in requirement to tender healthcare services to only when it would lead to better outcomes; and

·  New measures to deliver on specific needs in the social care sector including updated legal framework to enable person-centred models of hospital discharge.

The Committee was advised that the White Paper proposed greater integration within the NHS, but also greater integration between the NHS and local government. This would be done firstly with the introduction of an Integrated Care System Health and Care Partnership made up of the NHS, local government and other partners to support integration and develop a plan to address the systems health and care needs. Secondly, there would be the introduction of an Integrated Care System NHS body responsible for the day to day running of the Integrated Care System. The intention was also that place level commissioning within an Integrated Care System would align geographically to a local authority boundary.

Members expressed their preference for maintaining existing relationships with staff with a working knowledge of Wirral.

Resolved – That

1.  the report be noted.

2.  the Director of Care and Health be requested to submit a report to the next meeting detailing the implications of the White Paper “Integration and Innovation: working together to improve health and social care for all” from a Council perspective.

Julie Webster, Director of Public Health, introduced the report which provided the Committee with an update on the Council’s Covid-19 response and the delivery of the Outbreak Prevention and Control Plan.

Members were advised that the in the 7 days to 24 February 2021 there were 318 cases, with a 7 day incidence rate per 100,000 people reducing from 115 to 98 and the positivity rate reducing to 3.7%. Covid-19 admissions to Arrowe Park Hospital stood at 29 as of 1 March 2021, down from 42 the previous week and 279 as of 22 January 2021. The Director of Public Health welcomed the data moving in the right direction, but urged caution given that the case rate still remained at 98 per 100,000 residents and advised that she would wish to see that rate reduce to approximately 25 per 100,000 before any lockdown measures were eased.

The report further detailed the work being undertaken to support the easing of restrictions and the measures in place to deal with outbreaks. It was reported that the Outbreak Prevention and Control Plan was being updated and would be brought back to the Committee alongside a new testing strategy. Details of the vaccination programme within Wirral were also provided.

Members shared their positive experiences of the vaccination programme and expressed their thanks to the staff and volunteers involved. Further discussions were had around the use of lateral flow tests for care home visits and the uptake of vaccinations for the BAME community and care workers.

Resolved – That

1.  the contents of the report and the progress made to date be noted and the ongoing Covid-19 response be supported.

2.  the Director of Public Health be requested to submit a report to a future meeting detailing the work being undertaken to support the Black and Minority Ethnic community in accessing Covid-19 vaccines.

The Chair introduced the report of the Director of Care and Health which outlined the Committee’s work programme.

The Chair outlined that the commitment to only considering agenda items relating to Budget, Covid-19, Local Plan/Regeneration or Recovery to enable officers to focus on Covid-19 response remained in place, therefore the Committee would not yet be agreeing to future items for consideration.

Resolved – That the proposed work programme be noted.