The Chair opened the meeting and reminded everyone that the meeting was being webcast and a copy is retained on the Council’s website.

Apologies were received from Councillor Moira McLaughlin.

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.

Councillor Mary Jordan declared a personal interest as she worked for the NHS, her son worked for the NHS and she was a Trustee of Incubabies.

Councillor Damian Walsh declared a personal interest as he had a family member who worked for NHS.

Councillor Clare O’Hagan declared a personal interest as she worked for the NHS.

To approve the accuracy of the minutes of the meeting held on 8 September 2021.

Resolved -  

That the minutes of the meeting of the Adult Social Care and Public Health Committee held on 8 September 2021 be approved and adopted as a correct record.

Two questions had been received in relation to item 9 on the agenda (review of day care services contract for people with a learning disability delivered by Wirral Evolutions).

Question 1 – Christine Rothwell

[Read by Cllr Yvonne Nolan]

We are aware that independent review was undertaken, can the Committee confirm it is the recommendation of this that a further review will be undertaken. Although this report recommends a further review, there is no detail as to who will undertake the review, when it will be, or that key stakeholders will be consulted. It makes no reference to the most important people in this: those that use the service. Can the Committee give the assurance that their views will be taken into account?

Answer: [Cllr Yvonne Nolan] I most certainly can give that assurance.

Question 2 – Steve McGreal (for Susan Smailes)

Parent carers from the Council convened family engagement group applaud the recent decision of the Adult Social Care and Public Health workshop, to provide Wirral Evolutions with an opportunity to develop the detail of their transformation model. Our goal is to see the best possible service provided to the disabled citizens of Wirral, regardless of provider, but we and the general public need to see that any decision is made objectively [and] in the light of all relevant information. We note that Graham Hodkinson has been - or may be - tasked with producing a report which undertakes a value for money review as to whether Wirral Evolutions offers sufficient added value to the Council, and that the delivery of the contract for day services for people with learning difficulties to justify the additional costs of running an arm’s length company. My question is can we have your assurance that parent carers will be involved in the production of this report, and that any other delivery model, including any in-house provision, will be fully costed and its services specified to allow full consideration, transparency and fairness in decision making?

Answer: [Cllr Yvonne Nolan] I’m actually going to ask Graham to confirm, but certainly from this Committee’s perspective, yes you can have an assurance of the involvement of all of the stakeholders in the report that Graham’s going to complete for us. We do take decisions with transparency, they are open, they are taken in this open public Committee and our reports are published. So I hope that will assure you but I will pass onto Graham.

[Graham Hodkinson] I would certainly confirm my commitment to involving the carers group in the terms of reference for the report and including your views in relation to value. There’s more to value than just the financial elements of the service and clearly the scope there in terms of value added as well, in relation to the model. So I’m very happy to talk to you about that and make sure your views are taken into account as part of that process.

Supplementary Question

The original justification for Wirral Evolutions was  ...  view the full minutes text for item 42.

Graham Hodkinson, Director of Adults' Care & Health & Strategic Commissioning, presented his report which had followed on from a Members’ workshop exploring in detail all available options for future provision of Day Services for people with a learning disability, including the potential for bringing services back ‘in-house’ to address the financial challenges currently facing the service. The service had been provided by Wirral Evolutions, which had been created with the aim of having a Local Authority Company that could develop a more sustainable day support model; to potentially increase its income opportunities expand business; and to expand its customer base outside of the Wirral Council Day Services Contract.

Members questioned aspects of the review and the potential options, and were reassured that there were no existing plans to close any centres or reduce staff numbers.

Resolved – That

(1)  the decision of the Shareholder Board to hold a workshop with Wirral Evolutions to address governance issues be supported;

(2)  the value of the contract with Wirral Evolutions be extended in the sum of up to £500,000 for the year 2021/22 in order to enable further time to consider and assess the company’s proposals to modernise the current operating model and reduce the operating costs to ensure delivery of the service within the existing budget/contract value;

(3)  the request made by Wirral Evolutions to defer payment of the pension strain costs and the costs of support services bought from the Council relating to 2020/21 to support the cashflow of Wirral Evolutions Limited be agreed, such deferment to continue until the end of the current financial year or such longer period as may be determined by the Director of Resources in consultation with the Director of Care and Health;

(4)  at this stage the proposals submitted by Wirral Evolutions should not be further implemented pending the Governance Workshop between the Shareholder Board and the company and a further report being brought back to this Committee; and

(5)  the Director of Care and Health bring a further report back to this Committee following the Director undertaking a value for money review as to whether Wirral Evolutions offers sufficient added value to the Council in the delivery of the contract for day services for people with learning disabilities to justify the additional costs of running an arms-length company.

Jayne Marshall, Lead Commissioner, Community Care Market presented the report of the Director of Adults' Care & Health & Strategic Commissioning which provided a summary of the outcome of the review of the Shared Lives Model on Wirral and requested a review of the current fee model. The report included an officer recommendation for future service delivery. The service was ambitious to grow over the following 18 months to include day care and increase short breaks for carers, on the basis of an in-house team co-ordinating external providers. Any new service would have a regulation framework and be Care Quality Committee (CQC) registered.

Members asked questions which established:

·  That there was an aim to grow day care services to older people and those with dementia.

·  The aim was to double staff numbers over the 18 months.

·  Shared Lives carers were to have access to Council organisational development facilities and services as if they were employees.

Resolved: That

(1)  approval to develop In House Shared Lives Model with a complimentary framework of external providers to support growth in the in -house service be authorised;

(2)  a further, future report to Committee be approved, to provide detail on the developed option with a request for a decision to proceed with the new service model during financial year 2022/2023;

(3)  the review of the current banded fee model to an alternative model as part of the annual rates and fees negotiations be supported.

Jayne Marshall, Lead Commissioner, Community Care Market presented the report of the Director of Adults' Care & Health & Strategic Commissioning which updated Members on Quarter 3 commissioning activity for Adult Social Care in relation to the procurement of short break beds for carers support. Prior to the Covid-19 pandemic, there were 15 commissioned short break beds. During the pandemic, people preferred to stay at home, but as recovery was undertaken there had been an increase, particularly for older people. Officers thought 11 beds would be sufficient but they wished to have a short term contract to allow flexibility and review.

Resolved - That

(1)  authority be delegated to the Director of Health and Care to undertake for a tendering exercise to procure short break beds to support carers; and

(2)  authority be delegated to the Director of Care and Health to grant tender to the successful bidders following a tender process for the Short Break Beds service, for a contract length of 1 year, plus a 1 year extension option, and at a maximum cost of £641,576.

Jayne Marshall, Lead Commissioner, Community Care Market presented the performance report of the Director of Adults' Care & Health & Strategic Commissioning which had been designed based on discussions with Members through working group activity in 2020 and 2021.

Jayne reported that there was a continued reduction in the numbers of people in placement with a 19.9 % vacancy rate. Seven care homes had closed due to covid infections.

Members questioned details in the report and established:

·  That although half of care homes had been rated less than good, residents remained safe and that the service worked closely to intervene and put action plans in place to improve results.

·  That the 66 alters to CQC, 44 are abuse or serious injury, were safeguarding referrals and would have been investigated.

Resolved: - That the content of the report be noted.

Graham Hodkinson, Director of Adults' Care & Health & Strategic Commissioning, presented his report which provided an overview of budget performance for this area of activity, including the projected year-end revenue position, as reported at quarter 1 (Apr-Jun) 2021/22.

The forecast had a positive variance of 0.61m, but the pandemic had not ended and Winter pressures on health and social care services were yet to begin.

Members expressed concern at the capital programme process but it was clarified that there were many elements out of control of officers, and alternate models for extra care housing were being investigated.

Resolved - That

(1)  Note the projected year-end revenue forecast position of £0.61m favourable, as reported at quarter 1 (Apr – Jun) of 2021/22 be noted

(2)  progress on the achievement of approved savings and the projected year end forecast position at quarter 1 (Apr – Jun) of 2021/22 be noted

(3)  the reserves allocated to the Committee for future one-off commitments be noted

(4)  the projected year-end capital forecast position of £3.2m favourable, as reported at quarter 1 (Apr – Jun) of 2021/22 be noted

(5)  the current activity profiles from 2018 to quarter 1 (April – Jun) of 2021/22 be noted.

Jayne Marshall, Lead Commissioner, Community Care Market presented the report of the Director of Adults' Care & Health & Strategic Commissioning which provided the outcome of a review of reablement provision on Wirral, including analysis of potential alternative models. A project had been undertaken comparing existing provision with other local authorities. It became clear that the current operating model was relatively sufficient and cost effective, and that other models appeared to have additional costs. The existing contract was for five years and included reviews. Oher areas appeared to have different criteria so it had been difficult to make direct comparison and more research could help with this.

Members were aware of the psychological damage that resulted when people came off intensive care which highlighted the need for the reablement services.

Councillor Jason Walsh proposed that officers moved toward a more Council led model.

This was seconded by Councillor Cannon.

It was clarified by officers that this would be done within the period of the existing contract.

Resolved – That

consideration be given to a developing an alternative future model for delivery of reablement services in Wirral which was more Council led.

Graham Hodkinson Director of Adults' Care & Health & Strategic Commissioning, presented his report which provided an update on surveillance data and key areas of development in relation to Wirral’s COVID-19 response and delivery of the Local Outbreak Management Plan. It was noted that 94% of care staff have had their first Covid-19 vaccination which was higher than anywhere else in the Liverpool City Region.

Resolved – That the contents of the report and the progress made to date be noted and the ongoing COVID-19 response be supported.

Vicki Shaw, Head of Legal Services introduced the report of the Director of Adults' Care & Health & Strategic Commissioning which provided the committee with an opportunity to plan and review its work across the municipal year.

Members made suggestions for additional items.

Resolved – That the work programme be noted, subject to the addition of:

1.  Extra Care Housing growth obstacles and ideas;

2.  A review of the opening of urgent care facilities in Arrowe Par Hospital.