Agenda and minutes

The Committee are asked to approve the minutes of the last meeting, held on 14 June 2022 (attached).

The minutes of the last meeting held on 14 June 2022 were approved as a correct record.

Presentation from Steph Downey, Service Director, Integrated Adults and Social Care.

Steph Downey, Service Director, Integrated Adults and Social Care, provided the OSC with an update on workforce and digital inclusion place - based approaches.

Steph advised that the NE&NC ICS has a population of approximately 3 million and a workforce of around 270,000. Within the ICS there are four sub – regional integrated care partnerships (ICPs) and Gateshead is part of the north ICP.

Steph explained that local authorities and partners within the ICS system have a number of shared priorities and carrying out work to develop an integrated workforce is one such priority.

Steph advised the OSC that currently there are a number of challenges across the NHS and Social care in terms of shortages in the workforces and significant recruitment challenges not just in relation to social care front line workers in care homes but also in relation to recruitment of social workers and doctors and nurses.

Steph explained that parts of the system have an ageing workforce who may leave the workforce in the not-too-distant future. This is set alongside increased levels of demand and need.

Steph advised that a further challenge is that of in sector recruitment and that social care jobs are currently not viewed as attractive There has also been a large exodus of staff from the care sector during the pandemic which has created a knock on effect.

Steph advised that work had commenced pre-pandemic to try and address some of the workforce challenges but this had halted to focus on keeping people safe. This work had recommenced in the last three to four months and was looking at how a career in the health and social care sector. As part of this work there is a particular focus on developing career pathways.

Steph advised that there is a big emphasis on apprenticeships in Adult Social Care utilising the apprenticeship levy and similarly for OT’s and the plan is to work with NHS colleagues to build a joint career path.

Steph advised that a particular area of challenge was workforce planning and data sets as social care has not had the same level of data analysis as the NHS. However, Steph advised that the LGA and Health Education England had been trialling some tools for such analysis in Gateshead with the aim of rolling this out nationally in the future.

Steph advised that work was also taking place in relation to health and social care shared career and job events with the local authority and NHS providing a joint offer.

Staff retention was another key area which was being looked at with a view to better integrating the training and wellbeing offer for staff.

There was also a focus on training leaders and developing a new course to help everyone think as a system.

The OSC queried whether recruitment efforts are being targeted towards people working in other fields who might be thinking of changing careers.

Steph stated that this was happening with recruitment events seeking to target different groups. There had  ...  view the full minutes text for item CHW13

Report of Dale Owens, Strategic Director, Integrated Adults and Social Care.

Steph Downey, Service Director, Integrated Adults and Social Care provided the OSC with an update on the preparation being undertaken for the new Adult Social Care (ASC) CQC Assurance Framework which is due to be implemented from April 2023.

The OSC noted that the Health and Social Care Bill gives CQC the power to assure/inspect Local Authorities in respect of their Adult Social Care duties, and the newly formed Integrated Care Systems.

It was noted that Gateshead Adult Social Care ( ASC) was last inspected by CQC in 2010 and the Assurance framework being developed for implementation in April 2023 has the following 4 key themes

·       Working with people - assessing needs (including unpaid carers), supporting people to live healthier lives, prevention, well-being, information and advice

·       Providing support - markets (including commissioning), workforce equality, integration and partnership working

·       Ensuring safety - safeguarding, safe systems and continuity of care

·       Leadership and workforce - capable and compassionate leaders, learning, improvement, innovation

Each of the themes has several quality statements and ‘I’ statements within it which demonstrate expectations around the level/ quality of care. The draft framework is expected to be signed off soon and CQC is recruiting into roles to facilitate new duties and is procuring the web portal that will enable LA’s to submit their evidence.

All 12 NE local authorities are completing a draft self – assessment and Gateshead’s self -assessment was submitted a couple of weeks ago. Mini reviews are planned with an ex - Director of Adult Social Services and Gateshead’s will take place tomorrow.

Regional working groups providing support network for LA’s on inspection preparation

Steph explained that Gateshead has implemented the ADASS top tips for preparation for CQC assurance as per the report circulated to OSC which outlined the activity which had taken place so far aligned to the recommended areas. Policies and procedures are were also being updated.

In terms of next steps the Council would obtain feedback from the self- assessment and mini review and would then update the self - assessment and maintain and update it on a quarterly basis. Improvement workstreams would be ongoing and there would be regular briefings to leaders, members and the workforce.

The OSC queried what the position was in relation to the “I” statements for those who might have cognitive impairments. Steph advised that CQC would adapt the approach dependent on individual’s cognitive needs and will also be looking at whether local authorities are providing information in easy read formats and whether information might be accessible to carers

The Vice Chair noted that at a recent OSC Steph had reported on the capacity pressures across the social care system and asked how CQC would apply their assurance as nationally most local authorities have significant waiting lists for assessments and packages of care.

Steph advised the OSC that CQC have to assess against the framework and can’t take account of the workforce crisis but will look at how local authorities are managing risks and will ask the  ...  view the full minutes text for item CHW14

Report of Steph Downey, Service Director, Integrated Adults and Social Care

The OSC was advised that during 2021/22 55 complaints had been received regarding Adult Social Care Services which was a 34% increase on complaints received during 2020/21 (where there were 41). However, 74% (274) of representations made during 2021/22 were compliments and only 26% (97) were expressions of dissatisfaction.

The OSC noted that the majority of complaints related to assessment and personalisation and there were two key themes lack of service and quality. The OSC noted that this was the first time that there had been complaints relating to lack of service highlighting the challenges being faced in Adult Social Care.

OSC received information on the timeframes for dealing with complaints; Health and Social Care Joint Investigations; complaints referred to the Local Government and Social Care Ombudsman; Equalities monitoring and learning from complaints.

The OSC asked whether in terms of equalities monitoring, the Council has a common monitoring form for complaints.

Steph advised that she would check the position on this with the ASC Complaints manager and provide the OSC with this information in due course.

The OSC asked Steph how the Council gauges whether a complaint is vexatious.

Steph advised that all complaints are treated fairly and equally and given due consideration. However, there is a process in place should a complaint be taken to extremes.

RESOLVED  (i)       That the information in the 2021/22 annual

report be noted.

(ii)      That the OSC is satisfied with the performance of Children Adults and Families (now Integrated Adults and Social Care) in responding to complaints and ensuring that this results in continuous service improvement.

Presentation by John Costello, Gateshead System Integration Manager.

John Costello, Gateshead System Integration Manager, provided the OSC with an overview of the NENC Integrated Care Board (ICB), the NENC Integrated Care Partnership (ICP) and Area ICPs and the NENC Integrated Care System (ICS) and outlined how the ICB and ICP interfaces with the Gateshead Health and Care System (Gateshead Cares).

The OSC queried whether the NE & NC ICS was too big. John advised that there were significant advantages in operating at scale such as in the areas of heart surgery, workforce and digital where it was more effective to work at a regional level. However, John acknowledged that operating at this scale also presents challenges in terms of communication and John stated that this is why the four area sub ICPs, although not statutory bodies, will play an important role in acting as a link to the statutory ICP. John stated that it is too early to say how well all the structures will knit together but if the ICB achieves a truly population health approach this would be a significant achievement.

John advised that there is a Joint OSC for the NE& NC ICS and North and Central ICPs which is chaired and hosted by Gateshead Council so there is regular scrutiny which includes updates on the ICB and ICP.

The OSC raised concerns that the needs/ priorities of Gateshead might be lost in the new structures.

John advised that the ICB/ ICP are committed to primacy of place and the Gateshead System has built good relationships with clinicians and the ICB is maintaining the teams that local authorities worked with when CCGs were still in existence. In addition, Gateshead has a councillor representative on the System Board to help ensure relationships are maintained and work for Gateshead.

Steph advised that the rationale around the size of the patch relates to patient flows. The size of the ICS has been raised by local authorities who have asked that it is recognised by the system that they have very different geographies.

Steph advised that one of the most challenging aspects is that the CQC will be inspecting local authorities and ICS and here we have one huge ICS with 13 local authority “places” and 8 provider trusts. However, in another area there is one local authority and two ICS so there is a mismatch.

RESOLVED            That the information be noted.

Report of Dale Owens, Strategic Director, Integrated Adults and Social Care

John Costello, Gateshead System Integration Manager, provided the OSC with an update on the work of the Gateshead Health and Wellbeing Board during the six month period April to September 2022 which covered:-

·       Development of an approach and plan for implementation of the Health and Wellbeing Strategy

·       The NE& NC ICS development and implications for Place systems.

·       Endorsement of the Climate Change Strategy for Gateshead

·       Support for the Anti-Social Behaviour Review

·       Support for the People@theHeartProgramme which is focusing on people with multiple and complex needs and how they can best be met across the system.

·       Consultation on proposed changes to the Housing Allocations Policy and Tenancy Strategy

·       Consultation on the Gateshead Pharmaceutical Needs Assessment for 2022

·       Consideration of regular updates on the work of Gateshead Cares System Board

The OSC also noted that as part of the Board’s assurance role it had also :-

·       Received regular updates on the Covid 19 response and the vaccine rollout in Gateshead /consideration of Gateshead’s Covid 19 Control Plan

·       Considered the way Gateshead’s health protection system provides leadership and a co-ordinated/consistent approach to outbreak control/infection prevention and the treatment and management of disease.

·       Considered the annual report of the Local Safeguarding Children Board (LSCB)

·       Endorsed the Better Care Fund end of year return for 2021/22

·       Considered the proposed arrangements for the CQC Assurance Framework

·       Signed off the Children and Young People Local Transformation Plan refresh.

RESOLVED            That the progress made by the Health and Wellbeing

Board during April to September 2022 be noted.

Report of the Chief Executive and Strategic Director Corporate Services and Governance.

The OSC received a report setting out changes to the provisional work programme for the municipal year 2022-23 as set out in the appendices to the report.

RESOLVED            i) That the information be noted

ii) That further reports on the work programme be brought

to Committee to identify any additional policy issues  which the Committee may be asked to consider.