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

No apologies had been 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. Councillor Mike Sullivan declared a personal interest as his oldest daughter was a doctor in the NHS. Councillor Kieran Murphy declared a pecuniary interest in item 7 on the agenda.

To approve the accuracy of the minutes of the meeting held on 15 October 2024.

Resolved – That the minutes of the meeting held on 15 October 2024 be agreed by assent.

Notice of question to be given in writing or by email by 12 noon, Thursday 21 November 2024 to the Council’s Monitoring Officer via this link: Public Question Form and to be dealt with in accordance with Standing Order 10. The question to be put at the meeting shall not exceed 100 words in length.

For more information on how your personal information will be used, please see this link: Document Data Protection Protocol for Public Speakers at Committees | Wirral Council

Please telephone the Committee Services Officer if you have not received an acknowledgement of your question by the deadline for submission.

No public questions had been received.

Statements

Notice of representations to be given in writing or by email by 12 noon, Thursday 21 November 2024 t to the Council’s Monitoring Officer (committeeservices@wirral.gov.uk) and to be dealt with in accordance with Standing Order 11.1.

Petitions

Petitions may be presented to the Committee three working days prior to the Committee. The person presenting the petition will be allowed to address the meeting briefly (not exceeding three minutes) to outline the aims of the petition. The Chair will refer the matter to another appropriate body of the Council within whose terms of reference it falls without discussion, unless a relevant item appears elsewhere on the Agenda. Please give notice of petitions to committeeservices@wirral.gov.uk in advance of the meeting.

No statements had been received.

A petition was presented by Cllr Kieran Murphy on behalf of the lead petitioner Mr Paul Clark. The petition was from the attendees of Highcroft Day Centre in Bebington who would like a minibus. Highcroft Day Centre was for people with disabilities who were of working age and attended the day service to receive training and to participate in leisure activities. A minibus was needed as without that they could not get out of the centre to engage in any activity. The petition was acknowledged and an update would be given to this committee.

The Interim Assistant Director, Integrated Services and Commissioning, Wirral Council presented the report of the Director of Adults, Health and Strategic Commissioning which outlined the co-production activity to procure and award the Early Intervention, Prevention and Carers Support service which was due to end on 1 March 2027 after the current contract extension. The report described the co-production and co-design work that would be undertaken during the extension period to prepare a new specification for a new service and requested that the award of the contract for the new service (in 2026) was delegated to the Director of Adults, Health, and Strategic Commissioning.

Some of the services that the commission currently delivered included support for older people, mental health support, support for carers and support for people with visual or hearing impairment and support for people with long term conditions. It was highlighted that under the Care Act 2014 Wirral Council were required to provide early intervention to support not only to those people who were eligible for care but also to those who were on the cusp of needing care under the Care Act. The service was very well supported and the risk of removing an early intervention service was that people may require services from the Council earlier and at a higher level.

Members asked about the projected costs of the service, national insurance and minimum wage increases and whether the projected funding took into account demand increases.

Resolved - That

1. The re-specification and commissioning of a new Early Intervention, Prevention and Carers Support Service using co-production and co-design processes with people who use the service, their families and supporters be approved.

2. The carrying out of a procurement process and award of the contract for new service, to start in 2027, be delegated to the Director of Adults, Health, and Strategic Commissioning at an indicative cost of £2,362,847 per year.

Councillor Kieran Murphy left the committee room for this item due to a pecuniary interest.

The Interim Assistant Director, Integrated Services and Commissioning, Wirral Council presented the report of the Director of Adults, Health and Strategic Commissioning which provided a description of the co-production activity to procure and award the Adult Social Care Advocacy Service which was due to end on 8 June 2027 after the current contract extension. The report described the co-production and co-design work that would be undertaken during the extension period to prepare a new specification for a new service and requested that the award of the contract for the new service (in 2026) was delegated to the Director of Adults, Health, and Strategic Commissioning.

The Council had a statutory duty under the Care Act to provide independent Mental Capacity Act advocacy, Mental Health Act advocacy and Care Act Advocacy to support people going through the assessment processes. It was highlighted that the Hub would be able to assist and promote non-statutory services which included encouraging individuals or groups to represent themselves and peer advocacy organisations could be supported to bring forward ideas.

Members asked about funding for non-statutory services and the use of a 2.2% inflation figure in the calculations.

Resolved - That

1. The re-specification and commissioning of a new Adult Social Care Advocacy Service using co-production and co-design processes with people who use the service, their families and supporters be approved.

2. The carrying out of a procurement process and award of the contract for new service, to start in 2027, be delegated to the Director of Adults, Health, and Strategic Commissioning, at an indicative cost of £391,016 per year.

Councillor Kieran Murphy returned to the meeting.

The Interim Assistant Director, Integrated Partnerships and Strategic Commissioning introduced the report of the Director of Adults, Health and Strategic Commissioning which provided an update on Extra Care Housing in Wirral. The report set out the plan to provide appropriate Extra Care Housing schemes in Wirral that would support Wirral residents with eligible needs. These were needs that were assessed as eligible under the Care Act 2014.

Extra Care Housing had been a priority for a number of years. It was highlighted that Spinnaker House had recently opened with 102 apartments which was the biggest scheme to date. The term extra care describes developments of housing that support people with eligible needs under the Care Act and this was in excess of what would normally be considered to be sheltered housing options. There were schemes for older people aged 55 and over and also specialised extra care was provided for people aged 18-64 with either learning disabilities, autism or a mental health need. It was reported that four schemes were now in the developmental phase which would support the decommissioning of old style supported living and provide extra care own front door living for residents.

There was a pipeline scheme in Moreton for a further 80 apartments for extra care. It was reported that in September 2024 there were 55 people in extra care and 56 people on the specialist extra care waiting list and140 referrals had been made to Spinnaker House for extra care. It was planned to bring a report to March 2024 Committee around New Models of Care which would look at more updated models of care and consider how to deliver them.

Members discussed bringing in new housing related projects and it was agreed to circulate the gap analysis to Members. Members asked about the eligibility criteria which was assessment under the Care Act. It was acknowledged that extra care housing was a more cost-effective way to deliver support with housing and this was discussed.

Resolved - That

1. Further plans for both the development of Extra Care Housing and new models of housing with care as set out within this report be endorsed.

2. A timeline of developments of appropriate sites be brought forward and work with Housing Officers to secure and develop Extra Care Housing be continued.

The Head of Finance-People, Wirral Council, introduced the report of the Director of Adults, Health and Strategic Commissioning which set out the financial monitoring information for the Adult Social Care and Public Health Committee as at Quarter 2 (30 September) of 2024/25. The report provided an overview of budget performance, including progress on the delivery of the 2024/25 savings programme and a summary of reserves and balances. At the end of Quarter 2, there was an adverse position of £6.527m on the Committee’s net revenue budget of £142.24m. The full Council position was forecasting an overspend of £21.56million against Directorate spend. After utilisation of contingency budgets and just under £3million of flexible use of capital receipts the adverse position at Council level stood at £14.8million. The Council faced a severe financial challenge that demanded immediate action and a Council wide spending freeze was implemented on the 9 September 2024. The majority of the overspend was a consequence of increased demand and costs for social care services. The Director continued to engage proactively with the NHS around a whole systems based approach. It was forecast that there would be £5.9million of reserves remaining at the end of the year all of which were ringfenced with specific conditions limiting their use.

It was clarified to Members that there was an overachievement of £1.3million in people paying care charges against the budgeted figure and the total figure brought in from care charges would be circulated to Members. It was confirmed that £6million of savings had been made this financial year following the soft launch of the Able Me service in relation to hospital discharge.

Members discussed the Adult Social Care adverse position and other mitigations. Winter pressures on hospitals were also discussed and the need for increased funding.

Resolved – That

1. The adverse position presented at Quarter 2 and the urgent need to examine all available options to address the position be noted.

2. The Director of Finance has contacted the Ministry of Housing, Communities & Local Government (MHCLG) to make them aware of the Council’s overall financial position be noted.

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

4. The forecast level of reserves and balances at Quarter 2 be noted.

5. The capital position at the end of Quarter 2 be noted.

The Director of Adults, Health and Strategic Commissioning presented the report which provided a quarterly performance report in relation to the Council Plan: Wirral Working Together 2023-27. The key theme for Adult Social Care and Public Health Committee was the ‘Promoting independence and healthier lives’ theme. The report provided a focus on updating on measures that had changed in the Quarter 2 period, June to September 2024 and included performance context and mitigations in place where underperformance was identified. It was highlighted that some of the targets were annual targets, particularly around public health and would therefore remain the same.

At the time of the previous report Wirral was performing under the target of 94% of people living at home 91 days after discharge from hospital. The performance had slipped due to the pressure on hospitals and there was a need to make sure that discharge was supported. This was to be looked at on a system wide level with the aim of keeping people well and out of hospital for longer. The average weekly cost of supporting people through nursing care was highlighted and it was likely there would be a further cost increase in the next year due to market inflation.

Members asked about the monitoring of the number of people with learning disabilities living in their own home or with families.

Resolved – That the content of the report be noted and be referred up to Policy & Resources Committee.

The Interim Assistant Director, Integrated Partnerships and Strategic Commissioning presented the report of the Director of Adults, Health and Strategic Commissioning which provided a performance report in relation to Adult Social Care and Public Health. The report was designed based on discussion with Members through working group activity in December 2022. Areas of significant interest in the report were highlighted. There was an increase between Quarter 1 and Quarter 2 of people in receipt of a service. It was explained that the slight decrease in the number of nursing and residential placements reflected the opening of the two extra care housing schemes at Spinnaker and at Sycamore House and the development of the Home First Service working with the Community Trust and the increase in domiciliary care. It was highlighted that there was still over 6percent capacity in the market.

It was pointed out that of the three homes listed as inadequate by CQC, one home was empty, another had no contract with the Council but the Council was still continuing to monitor the people there and CQC continued to monitor the service which had been bought by another provider. The third home had been recently inspected by CQC and had received a rating of good.

Members asked about the percentage of people choosing to opt for a prepayment card and this was discussed. The move from analogue to digital services was also discussed.

Resolved – That the content of the report be noted.

The Director of Adults, Health and Strategic Commissioning presented this report which set out the current financial position as of Quarter 2 2024 to provide assurance to the Adult Social Care and Public Health Committee that the budget was balanced and posed no risks to the Council. The Section 75 arrangements for 2024/25 between Cheshire and Merseyside Integrated Care Board (ICB) and the Council for the Better Care Fund (BCF) were approved by the Adult Social Care and Public Health Committee on 18 July 2024. This Better Care Fund enabled the right care at the right time in the right place, capacity planning, the management of demand and the reduction in the cost of care, provided clear accountability and governance arrangements and ensured collective resilience between the Local Authority and the NHS. The Pooled Fund was £69,894989 this financial year and to date no adverse variance was reported.

Members discussed the disabled facilities grant. It was acknowledged that a case would need to be made to Government to ensure that adequate funding was available to reflect the growing demand.

Resolved – That the current Better Care Fund position as of Quarter 2 2024 be noted.

The Chair of Adult Social Care and Public Health Committee introduced this report which presented the future work programme of the Committee.

The following items were added to the work programme:

·  Review of Fees and Charges report in January 2025.

·  Dentistry note.

·  Update report on the Reintegration of Wirral evolutions into the Council and the costs.

Resolved – That subject to the changes noted above, the proposed Adult Social Care and Public Health Committee work programme for the remainder of the 2024/2025 municipal year be noted.