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 thanked officers for their hard work and contribution over the year. The Vice Chair echoed the sentiments and also extended thanks to the Chair for her hard work.

No apologies for absense were recived

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 31 January 2023.

Resolved – That the minutes of the meeting held on 31 January 2023 be approved.

A question was received from Mark Sutton on behalf of shared lives. The question asked, as the shared lives model was returning back into council ownership, could the committee clarify how they came to the decision on only offering a 5% uplift in pay when the current rate of inflation is over 10%  which has been granted to the rest of the carer sector on Wirral.

The chair responded to say that the Council had proposed a 5% uplift on the placement rate in line with other specialist service offers and were moving to a banded funding model agreed at committee in June 2022. Where Shared Lives carers are currently offered individual support hours these will increase to Real Living Wage level £10.90 per hour, so an increase of 10.1%.

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

The Director of Public Health presented the report which updated Members on the progress in the delivery of three grant allocations from central Government to tackle drug-related harms as part of the National Drug Strategy (2021).

These are:

• The ADDER (Addiction, Diversion, Disruption, Enforcement and Recovery) Programme
• Inpatient Detox funding
• The Individual Placement Support (IPS) programme (an employment support programme).

This report also briefed Members on the continuation of the Inpatient Detox, and IPS programmes and confirmed funding allocations for 2023/24, and the replacement of the ADDER grant with the Supplementary Substance Misuse Treatment and Recovery grant (SSMTR) for 2023/24 and 2024/25.

In addition, under the National Drugs Strategy local areas have been mandated to establish Combatting Drugs Partnerships to oversee and co-ordinate local delivery of the national strategy. The report updated committee on the successful establishment of the Wirral Combatting Drugs Partnership and provided an update on the work underway to produce a drug strategy for Wirral, which will shape future work to reduce drug-related harm.

Members noted the word being done in Wirral to reduce drug harm, and queried partnership work in the Community, especially in Primary Care as well as support offered to younger teenagers. Members were informed that the service provider, Wirral Way to Recovery have clinics in 8 General Practices as well as having coverage in all primary care networks in Wirral. Regarding children and young people there is a response service available, and officers were working with colleagues in Children and Young Peoples service to expand and strengthen this offer.

Also queried was the level of mental health treatment offered and it was confirmed that more focus had been given on those with mental health needs. 

Resolved – That

1. the Supplementary Substance Misuse Treatment and Recovery (SSMTR) grant funding of £2,267,750 for 2023/24 from the Office for Health Improvement and Disparities (OHID) be accepted and the proposed delivery plan for this funding be approved.

2. the proposed utilisation of the 2023/24 Inpatient Detoxification (IPD) grant of £111,364 be approved.

3. the continuation of the Individual Placement Support Grant of £145,800 in 2023/24 and £151,632 in 2024/25 be approved.

4. the Director of Law and Governance be authorised to finalise the legal documentation arising from the acceptance of the grant funding referred to in recommendations 1 to 3.

The Director of Public Health presented the report which sought agreement to progress the commissioning intentions for Sexual and Reproductive Health Services in Wirral.

Wirral Council is legally obliged to provide, and make arrangements for the provision of, open access to Sexual and Reproductive Health Services.

Commissioning arrangements expired at the end of the financial year 2023/24. Good sexual and reproductive health is an important component of overall health and wellbeing, and a pillar of wider work to reduce health inequalities in Wirral.

Members queried waiting times and noted that a next day consultation service would be helpful. Also observed was the importance of being able to access a non-judgemental service.

Resolved – That

1. the Director of Public Health be authorised to commence the re-commissioning of the Sexual and Reproductive Health Services for an initial period of five years (1st April 2024 – 31st March 2029) with the option of two one-year extensions. The expenditure for the services will be no more than £20,300,000 (£2,900,000 per annum) over the seven-year term.

2. the Director of Public Health be delegated to formalise the agreement with the successful party/ies following the commissioning process

Appendix 2 below may not be suitable to view for people with disabilities, users of assistive technology or mobile phone devices. Please contact caroljones@wirral.gov.uk if you would like this document in an accessible format.

Members received an update on the Wirral Adults Carers Strategy. A report had previously been submitted in July 2022, in which approval was granted to co-produce a new Wirral Adult Carers Strategy and establish a Carers Partnership Board, which will oversee the development of Carers Strategy.

The Adult Social Care and Public Health Committee had requested that the renewal of the Wirral Adults Carers Strategy be co-produced and were confident that the final Wirral Adult Carers Strategy provides a good starting point from the co-production events. The Carers Partnership Board will update the strategy as it is developed further and undertake an annual review of progress.

The 2021 Census information on unpaid Carers was expected to be released in January 2023and it is important to include some of the local data before finalising the Strategy. Although only partial data had been released so far, the data on the age, gender, geographical location etc. would be included in future refreshed versions once released. Members were informed that the Wirral Adult Carers Strategy was ready for consultation with key stakeholders.

Councillors raised concerns about unidentified carers in Wirral, including access to training and benefits advice – as well as GPs being aware of patients who are acting as carers. It was noted that the communications for this should be robust, especially around support services and respite services. Also discussed were frailty and social prescribing services.

Committee also queried how many carers attended the co-production events and asked officers if the strategy could be written in a way that addresses carers directly. Officers commented that the board, once established would include carers champions.

Resolved – That the final Wirral Adult Carers Strategy 2023-2026 be approved, recognising there will be continuous development with stakeholders, to be overseen by the Carers Partnership Board.

This report provided Members with the outcome of the annual engagement exercise with the Local Community Care Market for fee rates paid to care providers for 2023/2024.

The service areas that the rates and fees cover are Residential and Nursing care, Supported Living, Extra Care, Care and Support at home, Direct Payments, Shared Lives and Specialist residential placements. The report also took in to account the National Fair Cost of Care Market sustainability exercise which requires the Council to undertake a cost of care exercise with its community care market. The result of the exercise has been shared with the Department of Health and Social care. Members were informed that the fair cost of care in subsequent years will be determined by the level of funding received each year.

Resolved – That the rates as set out in sections 4.2, 4.3 and 4.4 of this report be approved and applied, with effect from 1 April 2023, to services commissioned by Wirral Council and jointly commissioned services between Wirral Council and NHS Cheshire and Mersey Integrated Care Board (Wirral Place), in relation to Residential and Nursing Care, Supported Living, Extra Care, Care and Support at Home, Direct Payments and Shared Lives.

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

Further to a report brought to Committee in November 2022, a draft Quality and Suspension Policy had been prepared for Commissioning, Contracts and Quality Monitoring of Providers for agreement by Committee.

The Policy identified how Wirral Council ensured its compliance with its duty under the Care Act 2014 to commission care services of a good quality. In that, those services which do not have a good quality rating from either the Care Quality Commission (CQC) or from the Councils Independent Quality Assessment - Provider Assessment and Market Management Solutions (PAMMS), will be suspended and have restrictions on new referrals for placements from Wirral Council, until such time that they have a good quality rating or show an improving direction towards a good rating. As there were often capacity issues in the market, especially in the right place to meet carer needs, Providers that Require Improvement (RI) Care Quality Commission (CQC) rated services would need to be commissioned to allow for people to receive the type of care that they require. However, this was to be ordered on a case-by-case basis, and with close contractual and social care monitoring of the new placement. In addition, the Policy identified that Wirral Council will publish the details of any provider that is suspended to new placements. This is seen as an important factor in providing quality information to people and their families before making a decision regarding placing their relative in a home.

Members gave their approval of the suspension policy, and the move to a system that was more transparent. In regard to the ratings issue, and the possibility that ratings may be available to the public. Members were informed that the recommendation gave officers the ability to take action. It was noted that providers went through a legal process with the CQQ in terms of their ratings.

Resolved – That the principles set out in the Draft Quality and Suspension Policy (Appendix 1) covering Commissioning, Contracting and Quality Monitoring of Providers be agreed, the suspension of those Providers/Services without a good quality rating be supported, and the Director of Care and Health be authorised to agree the final version of the Policy.

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

The Assistant Director for Care and Health presented the report which updated Members on a report brough to committee on 11 January 2023 regarding social care services currently delivered by Wirral Community Health and Care NHS Foundation Trust (WCHCFT).

Members were presented with an update regarding arrangements required after the Council had made an offer of a short-term extension to the arrangements and included subsequent correspondence from WCHCFT.

Members were updated of the transfer progress so far, including a robust programme of work. The transfer date identified as the earliest possible date is 1^st July. The appendix of the report set out the workstreams. The staff consultation was undertaken by the Community Trust and once the staff list for transfer was confirmed, consolation would commence. The transfer will be under Transfer of Undertakings (protection of Employment) (TUPE). Areas of focus were I.T kit, as well as estate requirements as staff were co-located. Both of these areas were flagged as complex areas of work. Comprehensive communications plans are supplemented by single point contacts. The themes are collated and questions and answers and sent out to staff for information. There was still outstanding confirmation required regarding pensions, but costs for this has been factored in.

Members queried the costings of the project, as well as the challenges of undertaking the transfer with shorter time scales than originally requested. Concerns were raised that patient’s welfare should not be adversely affected and sought assurances that the transfer would not compromise this.  

On a motion by Councillor Nolan, seconded by Councillor Davies it was -

Resolved (9:2) – That

1. the planned arrangements for the service transfer and the project plans as detailed within the report and its appendices be endorsed.

2.  the Director of Care and Health be authorised to make the necessary arrangements for the transfer.

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

This report provided information regarding the Social Care Policy Review. Members were informed that the Council had a current Adult Social Care charging and financial assessment policy which came into effect on 1 April 2015.

It covered charging information for both residential care and non-residential care. This report set out the result of an officer review of the provisions of the current policy. Further to the review, it was proposed that Adult Social Care should operate with two key charging policies.

The current policy was split in two and strengthened to include more information which allows for a clear and transparent approach to charging, the two key policies drafted are:

·  Residential Charging Policy – Appendix 1

·  Community Services Charging Policy (previously referred to as Non-Residential) – Appendix 2

The adoption by the Council of a revision to current policy is recommended. Both charging policies will be subject to public consultation, therefore this was an in-principal decision, pending feedback from the consultation process. The new policies do not fundamentally change existing policy, they do however provide significantly more detail to enable people to make decisions regarding charging. Examples were provided to help make the policy  more understandable to people that contribute towards their social care costs. The new policy did not directly impact current charging arrangements.

Members noted the complexity of the charging policy and requested that any future documents be presented in an accessible, readable format.

Resolved – that

1.  the draft charging policies, as set out in Appendix 1 and 2 of the report  be approved and the Director of Care and Health be authorised  to undertake public consultation on both policies.

2. the Director of Care and Health be authorised, in consultation with the Chair and Spokespersons to finalise both policies following receipt of any feedback from the public consultation.

.

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

The director of Care and Health presented the report which set out the financial monitoring information for the Adult Social Care and Public Health Committee as at Quarter 3 (1 Apr – 31 Dec) 2022/23.

The report provided Members with an overview of budget performance for this area of activity, including progress on the delivery of the 2022/23 saving programme and a summary of reserves which enabled the Committee to take ownership of the budgets and provide robust challenge and scrutiny to Officers on the performance of those budgets.

Managing a budget requires difficult decisions to ensure that a balanced position could be presented. Regular Member engagement, which this report formed part of, was considered essential to deliver effective governance and financial oversight. At the end of Quarter 3, there is a forecast adverse position of £0.603m on the Committees net revenue budget of £114.962m with mitigations to balance the budget at year end. This position was based on activity to date, projected trends in income and expenditure and potential mitigation to offset areas of adverse variance.

Table 1 set out areas under pressure, with activity data in section 3 showing that there had been a significant increase in demand for services for residential and nursing services and a shortfall in domiciliary care provision and a growth in extra care housing.

Resolved – that the report be noted.

The Appendix 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 Assistant Director of Care and Health presented the report, which provided Members with a performance update, further to input from Members regarding the design and content and covered the Quarter 3 period of October-December 2022.

Members were informed that overall, people accessing services had increased to 8,664 which was reflected by pressure in the system. Care Home placements were noted as higher at 1,856, which had been a consistent feature over the past 6-12 months. Domiciliary care was highlighted, with a light increase month on month. It was noted that this was a challenging part of the sector. Careers in domiciliary care were being promoted. Another area of note was Assistive technology, with the total number of people accessing these services increasing to 4,405 people. 

Queries were raised regarding bed occupancy, which was at 89% and if there was any correlation between length of hospital stays, especially over 21 days. It was confirmed that whilst there are some patients who stay in hospital awaiting care packages, intermediate care beds are expected to be at  high occupancy at all times.

Members requested that ‘good news stories’ be considered to make domiciliary care a desirable career. Also discussed was the ‘no criteria to reside’ classification as well pressure on services including patients waiting in Hospital for care services. A query was also raised regarding the response time for Home First.

Resolved – that the report be noted. 

The Assistant Director of All Age Independence presented the report of the Director of Care and Health.

The report provided Members with a progress update on the engagement and planned design of an in-house Reablement Service Model, working collaboratively with Wirral Community Health and Care (WCHC) NHS Foundation Trust, in line with the Adult Social Care and Public Health Committee on 11 October 2022 resolution relating to this matter.

The review focused on gaining a greater understanding of how individuals were supported through the reablement system, generating greater understanding of the evidence relating to what works best and meets people’s expectations. This report described the in-house Reablement Service Design Model in three phases:

 · Scoping Phase - This provided an overview of the scope of work and guiding principles to frame the model.

· Engagement and Planning Phase – This provided an overview of the key stakeholders identified, engaged with, and planned, providing valuable insight to enable greater alignment of services to improve outcomes for people accessing or in need of  reablement.

· Service Modelling Phase – This will provide the in-house Reablement Service Design Model, based on robust data analysis, financial modelling, assumptions, risks, constraints, and interdependencies that added value to a person’s experience.

Members were asked to note the update and advised that they would receive a final report in June.

Resolved – that the report be noted.

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

The Assistant Director for All Age Independence presented the report of the Director of Care and Health. Members were informed that it was a statutory requirement for the Council to produce an Annual Report about complaints made by, or on behalf of people who receive support or services from Adult Social Care.

The Annual Report also provided a mechanism by which the Council can monitor the quality and effectiveness of our services. The report provided an overview and analysis of all complaints received during the reporting period 1 April 2021 to 31 March 2022 including:

· Numbers of complaints received.

· Key themes identified.

· Responding to complaints (including performance data against statutory requirements).

· Overview of complaints escalated to the Local Government and Social Care Ombudsman.

· Learning from complaints.

Members were informed that three themes had been identified in 2021/22 and these were, standards of care delivered by commissioned providers, financial and charging concerns and Social Work concerns. 89% of these complaints were resolved at local complaints resolution stage and the response time had slightly increased from 62 to 64 days due to the complexity of investigations. 64% of complaints were either partially or fully upheld, which is similar to previous years. Based on recommendations by committee, a list of 41 learning points had been recorded.

Members noted that the number of complains had reduced over the past few years and queried what work is being done to respond to complaints in a timely manner. Also queried was the number of ombudsman complaints upheld, and the themes found within these complaints.

Resolved – that the report be noted.

The Assistant Director for All Age Independence presented the report of the Director of Care and Health, which provided Committee with a progress update on the All-Age Disability Services review that was presented to the Adult Social Care and Public Health Committee on 14 June 2022.

The aim was to conduct a comprehensive review of all age learning disability and/or autism support. The review focussed on gaining a greater understanding of how individuals are supported through the system across their life course.

The report described the All-Age Disability Services review in three phases: -

· Scoping Phase - This provides an overview of the scope of work and guiding principles to frame the review.

· Initiation, Planning and Engagement Phase – This provides an overview of the key stakeholders identified, engaged with, and planned, all providing valuable insight to enable greater alignment of services to improve outcomes throughout the life course journey of a person that best meet their needs and aspirations.

· Implementation Phase – This provides an overview of the work to co-produce a plan which details the outcomes of the review, provides a set of recommendations and actions for improved outcomes for people with a disability that is likely to lead to a reduction in demand and contribute to the efficiency target set of £1M.

Members were informed that the final plan would be brought to committee in June and requested that a joint workshop be held in April 2023 to assist officers with the implementation plan. A spotlight was shone on the engagement plan and highlighted the need for early information and informed decision making for service users. It was noted that the use of technology for younger people can be empowering and give reassurance to parents and carers. An example was provided of a service user not being presented with the option of college when they left school. 

Resolved – that the report be noted.

The Head of Legal Services presented the work programme update report which in co-operation with the other Policy and Service Committees, was responsible for proposing and delivering the annual committee work programme. The work programme aligns with the corporate priorities of the Council, in particular the delivery of the key decisions which are within the remit of the Committee.

Members requested briefings be circulated to Members regarding Children’s drug services and under 18 Mental Health.

Resolved – that the Adult Social Care and Public Health Committee work programme for the remainder of the 2022/23 municipal year be noted.

RECOMMENDATION: That, under section 100 (A) (4) of the Local Government Act 1972, the public be excluded from the meeting during consideration of the following items of business on the grounds that they involve the likely disclosure of exempt information as defined by paragraph 3 of Part I of Schedule 12A (as amended) to that Act. The Public Interest test has been applied and favours exclusion.

Resolved – That, under section 100 (A) (4) of the Local Government Act 1972, the public be excluded from the meeting during consideration of the following item of business on the grounds it involves the likely disclosure of exempt information as defined by paragraph 3 of Part I of Schedule 12A (as amended) to that Act. The Public Interest test has been applied and favours exclusion

Resolved – That the exempt appendix be noted.