Agenda and minutes

Apologies were received from Councillor Sean Gibbons

Councillor Derek Smith declared a nonpecuniary interest in Agenda Items No.6 and 7, by virtue of his wife who works for RDasH but not directly involved in any services to be discussed.

Cllr Mark Houlbrook declared a nonpecuniary interest in Agenda Items No.6 and 7, by virtue of his employment within the prison service when discussing mental health or suicide prevention within a prison environment.

The minutes of the Health and Adult Social Care Overview and Scrutiny Panel meeting held on the 27th September 2018 was agreed as a true record with the following changes;

Page 5, Paragraph 5 – that “late” be changed to “line”

Page 6, under “Children and Young People’s Mental Health: Eating Disorders”, to include the following sentence; “A Member asked the question on why obesity wasn’t treated with the same parity as bulimia and anorexia in terms of focus and funding. Is Obesity not an eating disorder?”

Page 8, change of paragraph under “Day Opportunities” to read; “Members were assured that there was a focus on investment as well as on the improvement of quality. Members recognised that steps were still being taken to consider different models and business needs.”

[A period not exceeding 20 minutes for

Statements from up to 5 members of the public on

matters within the Panel’s remit, proposing action(s)

which may be considered or contribute towards the

future development of the Panel’s work programme].

There were no public statements made.

DONCASTER CARING

The Panel received a presentation that provided an overview of a model for approaches to mental health prevention in Doncaster.  The areas covered included the following;

•           A prevention framework for Doncaster

•           Assets and strengths

•           Create the conditions

•           Community infrastructure

•           Health and care services

•           What needs assessment tells us about mental health in Doncaster?

•           Prevention Concordat for Better Mental Health

The Panel held a  discussion that covered the following areas;

Well North – A Member asked whether this scheme was going to be expanded into other geographical areas.  Members were informed that this was being considered to see if it would add any more value to what was already being done within communities.

Suicide and Peer Support - A Member talked about their own personal experience of a family member who had committed suicide and how it was felt that the persons spouse had not received enough peer support. The Panel was informed that this area was being looked into and conversations were at an early stage.

Gambling – Members were informed that public health were formally consulted to advise on the health and well-being implications of any proposed premises where licensed gambling would take place.

Community Structure – References were made to the support and co-creation of alliances to address specific challenges such as a Mental Health Alliance. It was explained that MIND (in partnership with Changing Lives) had been commissioned to deliver a community crisis support service from April 2019.

Members were also informed about the social café model with hubs being located in Mexborough, Thorne, Bentley and Doncaster town centre.  It was commented that this model provided an alternative for individuals to go to and work was being undertaken with local communities to identify suitable premises to mobilise that project. 

Doncaster Practice Model and Guidelines – This was about using strength based approaches, motivational interviewing, asset based community development, trauma informed practice, Making Every Contact Count together with life course specific approaches including patient activation and self-management.

Access to Services - A Member raised concerns about lengthy waiting times to access professional services which could prove demoralising for individuals who needed that support.  Members were informed that there were a number of proposals being considered by RDasH to improve front end access and waiting times

Training - A Member stressed the importance of supporting arm’s length organisations. Members were assured that targeted training was viewed as a priority and would be made available to contracted staff as well as Council employed staff.  It was added that low level training provided by SAFETALK and Mental Health First Aid training would be offered to a diverse group of people to ensure that they were trained to a certain level.

Data and Information - It was commented that the Joint Strategic Needs Assessment showed that Doncaster was average and it was about identifying risk factors and any underlying issues.  Members were informed that the Doncaster Mental Health Needs Assessment should be completed  ...  view the full minutes text for item 20.

DONCASTER CARING

A report was provided to Members alongside South Yorkshire and Bassetlaw data that gave an update on suicide prevention work in Doncaster in 2018, following a previous report to Overview and Scrutiny in 2017.

It was outlined that the suicide rate in Doncaster had remained more or less stable since 2001; however, since 2013 the suicide rate for men had risen slightly, whilst for women the rate has fallen. There were approximately 20 to 30 suicides in Doncaster per year and the Doncaster rate was similar to the national rate, at 10.1 per 100,000 of population. In an update to the Panel, it was explained that there had been 4 suicides of young women under 18 across Yorkshire which were extremely rare and that a rapid response meeting had taken place that would engage with public health.

A Member raised concern around the impact of bullying and social media.  Members were informed that the challenge would be taking forward a life course approach whilst taking into consideration social media and emerging trends.  

There was a brief discussion around South Yorkshire and Bassetlaw comparison table that indicated where Doncaster was in comparison to Doncaster’s compartments.  It was reported that Yorkshire and Humber average was 10.4 and Doncaster was in the middle at 10.1.

Areas where Doncaster was worse in significant to England included;

•        Emergency hospital admissions for self-harm,

•        Successful completion rate of drug users – opiate users and other drugs with the individual ageing whilst within the service, the alternative was that if users came out of the system they could overdose and die as a result.  It was added that Doncaster was positioned better than the Yorkshire and Humber average.

Risk Factors that were worse than Yorkshire and Humber average included the following:

•           Looked after children (under 18 population)

•           Children in the youth justice system aged 10 to 18

•           Long term unemployment: proportion of working age population

Of the above risk factor “children in the youth justice system aged 10 to 18”, reference was made to the work being undertaken within the Youth Justice Plan, in particular, with first time entrants. 

And finally, better than Yorkshire and Humber average;

•           Statutory homelessness

•           Adult carers who have as much social contact as they would like

A Member commented that similar to adult carers having as much social contact as they would like, that young people also needed further encouragement to have this and should be treated with the same parity as with adult carers.  It was added that the Lesbian Gay Bisexual Transgender and Questioning (LGBTQ) group could be more adversely affected.  Members were provided with assurances that the LBTQ group was well-attended and had demonstrated some positive views about this issue.

Regarding adult carers, it was felt that there were links to those in long term unemployment and mental health problems.  A Member commented that within the workplace, individual contracts of employment and staff handbooks provided organisational support for domestic crisis and  ...  view the full minutes text for item 21.

DONCASTER CARING

Members were informed how the Doncaster All Age Carers’ Charter was to enable Team Doncaster to publicly show and reaffirm their commitment to carers.

Members were informed that in Doncaster there were 33,000 carers (of all ages) as reported in Doncaster’s Carers Strategy (census 2011), however, in reality only approximately 4,000 was known about at this present time.  This was because individuals did not always identify themselves as a carer and on that basis it was considered that it was easily double that figure.

Members were told how engagement of the proposal had taken place with voluntary community sector groups and carers. It was explained that carers who wanted to be involved in the process had wanted something simple producing and this had been taken on board.

Members were pleased to hear that engagement of the proposal had taken place with the voluntary and community sector and was currently being shared out in the public domain as well as through partners.  Members heard that the charter was being taken through the Doncaster Chamber to ensure that further engagement takes place with businesses as 1 in 9 workers were identified as carers.  It was also stated that carers needed to be further identified through the workforce so that they could access the available support. 

In terms of Veterans, it was stated that they were often the carers or being cared for and it was questioned how they could holistically be supported within the community.

Further to Doncaster Council signing up to the Motor Neurone Disease (MND) Charter, a Member stated that they would like to see other areas rolled out to ensure that a wider reach was undertaken.

A Member requested a breakdown of ward data of carers, it was explained that such information might not necessarily represent all carers.  It was added that as the Council started to build preventative services, there was now a point of contact for carers.  It was commented that the Charter would reinforce the commitment to carers across all ages, which would allow the Council to understand carers more.

Young Carers - A Member referred to the number of 700 young carers and enquired about pastoral care in schools and academies.  Assurances were sought that those young carers had access to services.

Members heard how the Young Carers Card might incorporate a traffic light system to reflect where the young person was emotionally on that particular day through a visual means without having to articulate it further.  It was explained that it was a new development which would go out to every school.

A Member asked whether the card could be used for people in the workplace. Members were advised that the card needed to be rolled out for young people successfully first before being considered for use in the workplace for employees who were carers.

During the meeting, a Member questioned how carers known to services were monitored, maintained or identified as no longer requiring support as a carer.  Members were informed  ...  view the full minutes text for item 22.

DONCASTER CARING

This report provided an update of the Compares Doncaster’s Care Quality Commission (CQC) ratings published on the 12th September 2018, for regulated services against the national and regional picture of performance. It also outlined current contract monitoring activity to support providers with less than an adequate CQC rating.

There was a brief discussion around the national home care provider, Allied Healthcare who had appeared in the media. Concerns had been raised around whether Allied Healthcare was financially viable and what was the impact of recent events on the delivery of its services. 

It was reported that Doncaster Council and the Doncaster NHS CCG worked closely together during this period of uncertainty.  It was explained that the organisation was now in a stable position, although there were no guarantees around what may happen later.  Members were also informed that contingency plans were currently in place

It was outlined that Allied Healthcare would not be continuing its services and that the Council had been able to look at a transition plan.  Assurances were provided that packages were still being continued and that staff will TUPE to the strategic lead provider which was being facilitated by the Council. 

It was explained that the report did not include day services that were not regulated by CQC. 

The number, percentage and outcome of all active Adult Social Care Services by South Yorkshire Authorities - The following areas were highlighted to Members;

·         Positive that there has been an increase in providers that had been rated as outstanding and good. 

·         Doncaster continued to have the lowest percentage of providers rated as “requires improvement”.

·         Doncaster had the highest percentage of Providers rated as “Good” by CQC.

·         Three Providers in Doncaster had been rated as inadequate, all of which were care homes.  It was explained that of these 3, 1 was inactive as they had not had any residents for over a year, however, the CQC would not re-inspect that home for that reason.

The number, percentage and outcome of Community Adult Social Care Services by South Yorkshire Authorities: The information provided for Community Services included domiciliary care, supported living and extra care services. There had been some positive increases and decreases across South Yorkshire Community Services. It was recognised that although information around community services was largely positive.  Members were informed that of Doncaster contracted providers that 25 (86.2%) were considered as good. Members were assured that the Council would maintain oversight of those services by continuing to offer support, advice and guidance.

The number, percentage and outcome of Residential & Nursing Care Homes in Adult Social Care Services by South Yorkshire Authorities – It was reported that one nursing home was classed as being inadequate and that Doncaster had the highest percentage of nursing homes achieving good, an increase from the previous CQC report. Members were informed that there had been an increase in homes classed as inadequate and the Council provided support to those providers.

CQC - It was commented that the CQC was under  ...  view the full minutes text for item 23.

The Panel received a report updating Members on the Panels work plan for 2018/19. A copy of the work plan was attached at Appendix A of the report taking account of issues considered at the Health and Adults Social Care Overview and Scrutiny workplanning meeting held on the 11th June, 2018.

Members were advised of the following changes to the Overview and Scrutiny Workplan;

•           March – addition of Better Mental Health Plan on workplan

•           JHOSC – will be later than the proposed date of 28th Jan 2019

RESOLVED that the Panel note the Health and Adult Social Care Overview and Scrutiny Workplan 18/19 - November 2018 update.