Agenda and minutes

To consider any appeals in accordance with Procedure Rule 25* of the Access to Information Procedure Rules (in the event of an Appeal the press and public will be excluded).

(* In accordance with Procedure Rule 25, notice of an appeal must be received in writing by the Head of Governance Services at least 24 hours before the meeting).

There were no appeals.

1.  To highlight reports or appendices which officers have identified as containing exempt information, and where officers consider that the public interest in maintaining the exemption outweighs the public interest in disclosing the information, for the reasons outlined in the report.

2.  To consider whether or not to accept the officers recommendation in respect of the above information.

3.  If so, to formally pass the following resolution:-

RESOLVED – That the press and public be excluded from the meeting during consideration of the following parts of the agenda designated as containing exempt information on the grounds that it is likely, in view of the nature of the business to be transacted or the nature of the proceedings, that if members of the press and public were present there would be disclosure to them of exempt information, as follows:

  No exempt items have been identified.

There were no exempt items.

To identify items which have been admitted to the agenda by the Chair for consideration.

(The special circumstances shall be specified in the minutes.)

There were no formal late items, however the following supplementary information was distributed to at the beginning of the meeting in relation to Item 11, Leeds Health and Care Plan Update (Minute 79 refers.)

-  Local Care Partnerships: A Model for Leeds

To disclose or draw attention to any disclosable pecuniary interests for the purposes of Section 31 of the Localism Act 2011 and paragraphs 13-16 of the Members’ Code of Conduct.

There were no declarations of disclosable pecuniary interests.

To receive any apologies for absence and notification of substitutes.

An apology for absence was received from Dr John Beal.

To approve as a correct record the minutes of the meeting held on 15 January 2019.

RESOLVED - That the minutes of the meeting held on 15th January 2019 be agreed as a correct record, subject to an amendment to a job title throughout.

To consider a report from the Head of Governance and Scrutiny Support introducing the Leeds Safeguarding Adults Board 2017/18 Annual Report and a progress update for 2018/19.

The Head of Governance and Scrutiny Support submitted a report that introduced the Leeds Safeguarding Adults Board (LSAB) 2017/18 Annual Report and a progress update for 2018/19.

The following was appended to the report:

-  LSAB Progress Report (April 2019)

-  LSAB Annual Report 2017/18

-  LSAB Strategic Plan 2018/19

-  LSAB Executive Board Report (February 2019)

The following were in attendance:

-  Richard Jones, Independent Chair, Leeds Safeguarding Adults Board

-  Shona McFarLane, Deputy Director, Social Work & Social Care Service, Adults and Health

The Independent Chair introduced the report, setting out the future priorities and objectives of the Leeds Safeguarding Adults Board.

Members discussed a number of matters, including:

·  Leeds and York Partnership Foundation NHS Trust (LYPFT) Data Collection System. Members queried whether it was acceptable that LYPFT did not have systems in place whereby safeguarding information can include a breakdown by ethnicity, and the limitations this is likely to have on understanding matters impacting on specific communities. The Board heard that one of the LSAB’s key priorities for future work was engagement with BME communities, and accepted that improved data collection will form part of that work.

·  Executive powers. Members were concerned that the LSAB did not hold any executive powers to exercise in response to concerns about any of the partnership organisations. The Board was informed that the partnership model of the LSAB was intended to enable partners to hold one another to account, as they have a shared set of objectives and intent.

·  Referrals progressing to Safeguarding Adult Reviews (SARs). Members sought clarity regarding the lack of SARs during the reporting period, despite the high volume of referrals made during that time. Members heard that following support received through initial intervention, most clients subsequently report they feel safe and a review is not required.

·  Prosecution. In response to queries, Members were informed that following referrals to the police, there was some inconsistency in the level of information Social Care teams are provided with regarding the progress of criminal investigations. While there was no evidence of harm arising from any communication issues, Members highlighted the need for greater consistency in information sharing between agencies represented through the partnership. .

·  Evidence within the report. Members commented that the report was lacking in detail, and specifically noted that the report did not include any statistics or other data which limited the reader’s understanding of the context.

·  Assurance processes. Members sought clarity around the LSAB’s process for seeking assurance from the partnership organisations, particularly in relation to the support and training provided to frontline staff. Members were informed that the LSAB review assurances carried out by partner organisations.

·  Links to third sector. Members commented that many vulnerable adults do not access to mainstream services, and requested more information around the LSABs approach to engaging with the charitable organisations and community groups. The Scrutiny Board was informed that LSAB worked directly with Voluntary Action Leeds (VAL) and Advonet, and intended to bring feedback on this area of work to  ...  view the full minutes text for item 75.

To consider a report from the Director of Adults and Health on the Care Quality Commission Inspection Outcomes for Adult Social Care providers in Leeds for the period November 2018 to January 2019.

The Director of Adults and Health submitted a report on the Care Quality Commission Inspection Outcomes for Adult Social Care providers in Leeds for the period November 2018 to January 2019.

The following was appended to the report:

-  Inspection Outcomes (November 2018 - January 2019)

The following were in attendance:

-  Councillor Rebecca Charlwood, Executive Member for Health, Wellbeing and Adults

-  Cath Roff, Director, Adults and Health

-  Mark Phillott, Head of Commissioning Contracts and Business Development, Adults and Health

The Executive Member for Health, Wellbeing and Adults addressed the meeting and acknowledged the role of the Scrutiny Board and its contribution to bringing sustained concentration and focus on the issue of quality within Leeds’ care homes which has brought about some sustained improvement. 

The Executive Member also acknowledged there was more to do in order to embed a consistent culture of excellence across the health and care sector.

The Head of Commissioning Contracts and Business Development introduced the report, highlighting to Members that 7 providers had improved their rating, 20 had remained the same, and 6 had received a poorer rating. A decrease in ‘good’ rated older people’s care homes was also noted, and Members were informed this was largely within the nursing home sector.

Members discussed a number of matters, including:

·  The standard of inspections and demands on providers. Arrangements in place for the Council and Clinical Commissioning Group to help providers continuously improve and/or maintain ‘good’ CQC inspection ratings.

·  ‘Requires Improvement’ ratings. Members were concerned that some providers had not improved their ‘Requires Improvement’ rating in a number of domains. The Board was informed that this was a broad category, and often the largest contributor was high turnover in management / leadership and care staff.

·  Nursing Homes. Members sought clarity regarding the decrease in nursing homes rated as ‘Good’, and were informed that the relatively small number of nursing homes within the City meant that a slight change affects the percentage considerably. Members were also informed that there are recruitment issues for nursing homes.

·  Best practice. Work being undertaken to consider establishing ‘teaching’ nursing homes in the City, in order to support the whole sector and share best practice. 

RESOLVED – That the comments made at the meeting, alongside the contents of the report and appendices be noted.

Councillor S Lay left the meeting at 2:55pm during discussion of this item.

To consider a report from the Director of Adults and Health providing an update on the developments in commissioned home care services since the previous report in September 2018.

The Director of Adults and Health submitted a report that provided an update on the developments in commissioned home care services since the previous report in September 2018.

The following were in attendance:

-  Councillor Rebecca Charlwood, Executive Member for Health, Wellbeing and Adults

-  Cath Roff, Director, Adults and Health

-  Mark Phillott, Head of Commissioning Contracts and Business Development, Adults and Health

The Head of Commissioning Contracts and Business Development introduced the report, providing an update on individual home care providers along with the progress of a number of projects.

Members discussed a number of matters, including:

·  Performance of the homecare contract. The Board was advised the current contract arrangements were not operating as planned or expected, largely due to the current and ongoing market conditions of the care sector.

·  Cost of Discharge Service. Members commented on the high cost of the discharge service, and sought assurance regarding its success. Members were advised that the expense was relative to the ‘Leeds Pound’, and the investment and innovation had improved outcomes for service users.

·  Retention of staff. In response to a query, Members were informed the issue of staff retention was multi-faceted; particularly as the City was reaching ‘full employment’.  Competition from other sectors, including the retail sector, provided a difficult employment environment for the home care sector. It was noted that the commitment to better terms and conditions of employment, including pay, was aimed at bringing a higher degree of stability to the employment landscape across the care sector.  .

·  Good management. Members were keen to understand the level of support for providers in relation to good management, and were informed that work is being progressed with providers and the appropriate unions to increase the stability of the sector.

RESOLVED – That the contents of the report be noted.

Councillor J Elliot left the meeting at 3:15pm during discussion of this item.

Councillor G Harper left the meeting at 3:25pm at the conclusion of the discussion of this item.

To consider a report from the Head of Governance and Scrutiny Support introducing the Care Quality Commission’s report following its review of the local health and care system in Leeds; alongside the associated action plan.

The Head of Governance and Scrutiny Support submitted a report that introduced the Care Quality Commission’s report following its review of the local health and care system in Leeds; alongside the associated action plan.

The following was appended to the report:

-  Local System Review Report, December 2018

-  Local System Review Action Plan

The following were in attendance:

-  Councillor Rebecca Charlwood, Executive Member for Health, Wellbeing and Adults

-  Cath Roff, Director, Adults and Health

-  Paul Bollom, Head of Leeds Plan, Adults and Health

The Head of Leeds Plan introduced the report, informing Members of the outcomes of the Local System Review and actions for improvement.

Members discussed a number of matters, including:

·  Consultation with Elected Members. Members sought clarity as to plans for engagement with elected members for individual Local Care Partnerships (LCPs), and were assured that there were plans to appoint elected members to LCPs through the Community Committees during the 2019/20 municipal year.

·  The Role of the Scrutiny Board. The Chair highlighted the Scrutiny Board’s role in maintaining oversight of Leeds health and care system and holding system leaders to account.  The Chair expressed disappointment this was not better reflected in the improvement action identified by the Care Quality Commission.  However, the Chair requested that the Scrutiny Board’s role be reflected in the system’s action plan and improvement actions – and specifically the governance flowchart outlined in the action plan.

·  Dashboard of Performance Indicators. Members sought more information on the plans to produce a data dashboard, and were advised that this will include a small number of key indicators that are largely derived from people’s experiences of care. The Board was also assured that there will be opportunity for Members to comment on the dashboard as it is developed.

RESOLVED –

(a)  That the contents of the report and appendices be noted.

(b)  That the Chairs comments on the Scrutiny Board’s role in holding system leaders to account and being part of the overall governance framework be noted and reflected in the system’s action plan and improvement actions.

To consider a report from the Director of Adults and Health on progress against the Leeds Health and Care Plan and the development of Local Care Partnerships.

The Director of Adults and Health submitted a report detailing progress against the Leeds Health and Care Plan and the development of Local Care Partnerships.

The following was appended to the report:

-  Local Care Partnerships: A Model for Leeds (presentation slides)

The following were in attendance:

-  Councillor Rebecca Charlwood, Executive Member for Health, Wellbeing and Adults

-  Paul Bollom, Head of Leeds Plan, Adults and Health

-  Becky Barwick, Head of Programme Delivery (System Integration), NHS Leeds Clinical Commissioning Group

The Head of Leeds Plan introduced the report, highlighting the key areas of focus within the plan. The Head of Programme Delivery also provided Members with a brief update regarding Local Care Partnerships (LCPs).

Members discussed a number of matters, including:

·  Future Commissioning Responsibilities of LCPs. Members sought clarity as to whether there were intentions for LCPs to commission local services in the future. The Board were advised that the model would hopefully evolve in this way, however, full devolution of powers was not expected.

·  GP Provision in Inner City Wards. Members noted the lack of GP provision within city centre wards and hoped that this would improve with relationships built through LCPs. The Board was assured that the approach maintained focus on priority neighbourhoods, and that the vision embedded in the plan is expected to attract GPs to working in Leeds, along with new and varied roles within the overall workforce.

·  Neighbourhood Networks. Members commented on the disparity between Neighbourhood Networks across the city, and queried how this might impact on the development of LCPs and how this was being addressed. The Board heard that all geographical areas in the city were covered, and that variation in effectiveness could be tackled through engagement with local communities and Elected Members. 

RESOLVED – That the contents of the report and the responses provided at the meeting be noted.

To receive an update from the Chair on scrutiny activity since the previous Board meeting, on matters not specifically included elsewhere on the agenda.

The Board considered a report from the Head of Governance and Scrutiny Support that provided an opportunity for the Chair of the Scrutiny Board to outline some areas of work and activity since the previous Scrutiny Board meeting in January 2019.

The Chair provided an update to the Board regarding a number of matters, including:

·  Proposed changes to service locations for Urgent Dental Care from 1 April 2019. The Chair advised the Scrutiny Board that a response to her letter from NHS England had been received. This would be shared with members of the Scrutiny Board and was due to be considered by the West Yorkshire Joint Health Overview and Scrutiny Committee at its forthcoming meeting; which would be reported to the Board at its next meeting.  .

·  Community Dentistry. Leeds Community Healthcare NHS Trust’s intention to commence public consultation regarding proposed site changes for community dentistry. With consultation due to start on 13^th May 2019, the Board will receive an update on any early key messages arising from the public consultation and have the opportunity to consider and comment on the detailed proposals early in the new municipal year.

·  The ‘Women’s Health in Leeds’ report, including the option for the Board to consider the position and progress on the report findings one year on, to coincide with International Women’s Day 2020.

RESOLVED – That the contents of the report and the verbal update be noted and reflected in the development of the Board’s work schedule.

To consider the Scrutiny Board’s work schedule for the 2018/19 municipal year.

The Head of Governance and Scrutiny Support submitted a report which invited Members to consider the Board’s work schedule for the remainder of the 2018/19 municipal year, and suggestions for areas of focus next municipal year. The Principal Scrutiny Adviser introduced the report and outlined the areas within the report and associated work schedule.

RESOLVED –

(a)  With the addition of matters highlighted during the meeting, the latest iteration of the 2018/19 work schedule presented at Appendix 1, be agreed.

(b)  Dementia be highlighted as a priority area for the forthcoming municipal year.

(c)  The draft minutes of the joint health scrutiny meeting (presented at Appendix 2) be endorsed and that the ongoing work associated with the provision of mental health services for adults and older people in Wetherby be reflected in the Board’s statement on mental health.

(d)  The assurance provided in relation to the Hyper Acute Stoke Unit at Leeds Teaching Hospitals NHS Trust (presented at Appendix 3) be noted.

(e)  The update provided in relation to Bereavement arrangements, including the details set out in the letter presented at Appendix 4 be noted.

(f)  A fuller and more formal report regarding Bereavement arrangements to be presented to the next meeting of the Scrutiny Board – to help the Board sets out its formal position by the end of the municipal year.

(g)  The intention to present the Board’s draft formal response to the proposed development of Urgent Treatment Centres to the next meeting of the Scrutiny Board on 23 April 2019, be noted.

(h)  The proposed joint approach with HealthWatch Leeds to consider local NHS healthcare providers Quality Accounts for 2019 be agreed and that it be noted this will be the mechanism for providing any joint comments or commentary for inclusion in each of the providers draft Quality Account.

(i)  The minutes of the meetings of other Boards / Committees detailed in paragraph 3.31 and appended to this report (Appendix 5, 6 7 and 8), be noted.

(j)  The arrangements for developing work programmes for the new municipal year across all Scrutiny Boards be noted. 

(k)  For planning purposes the proposed meeting arrangements for the successor Scrutiny Board, as set out in paragraph 3.38 be agreed.

(l)  The matters currently identified as ‘unscheduled’ be carried forward and presented to the successor Scrutiny Board by way of a draft work schedule for consideration in the new municipal year.

(m)  The intention to present a draft work schedule for 2019/20 to the next meeting of the Scrutiny Board, that reflects the outcome of the Board’s discussion, be noted. 

Tuesday, 23 April 2019 at 1:30pm (pre-meeting for all Board members at 1:00pm).

Tuesday, 23 April 2019 at 1:30pm (pre-meeting for all Board members at 1:00pm).

The meeting ended at 4:40pm.