An apology for absence was received from Pat Harris who was represented by Kevin Dixon, Chair of Healthwatch.

It was reported that, in accordance with the wishes of the Conservative Group, the membership of the Sub-Board had been amended to include Councillors Tolchard and Fellows in place of Councillor Bryant and the Conservative vacancy.

To confirm as a correct record the minutes of the meeting of the Adult Social Care and Health Overview and Scrutiny Sub-Board held on 21 December 2023.

The minutes of the meeting of the Sub-Board held on 21 December 2023 were confirmed as a correct record and signed by the Chairman.

To consider a report on Adult Social Care self assessment in readiness for the Care Quality Commission Inspection.

(Note: presented by Jo Williams, Director of Adult and Community Services, Torbay Council and Cathy Williams, Strategic Lead for Adult Social Care Quality and Assurance,Torbay Council).

The Strategic Lead for Adult Social Care Quality and Assurance presented the submitted report which provided Members with an update and information in relation to self-assessment and the new Care Quality Commission’s inspection of Adult Social Care.

Members were informed that as part of the Health and Care Act 2022 the Care Quality Commission (“CQC”) had been given additional responsibilities and powers to review, assess and report on Council regulated adult social care functions.

The self-assessment was an open document and would be reviewed quarterly.  It had been subject to external scrutiny by partners in health and care, who had given a positive response.  The Council was currently working with the South West Association of Directors of Adult Social Services and the CQC to check and challenge each other on aspects of self-assessment, for example, the position with carers.  As a result of learning from the self-assessment process,  work had been undertaken to produce the Adult Social Care Strategy and webpages for Adult Social Care had been refreshed on the Council’s website.

It was explained that the self-assessment document set out, in broad terms, some information about Torbay to help inspectors understand the complexities which were unique to Torbay.  The document was modelled on the CQC framework around four main themes:

·         working with people;

·         providing support;

·         ensuring safety; and

·         leadership and workforce.

Members were informed that strengths against the themes were outlined in the submitted report and generally included:

·         integrated working;

·         excellent community and voluntary sector partnerships;

·         very strong carer services which had been co-produced for many years;

·         quick access for domiciliary care those individuals discharged for hospital who required extra support at home;

·         learning and opportunities presented by being part of a Joint Safeguarding Board with Devon County Council;

·         quality checking process which provided feedback about the safeguarding process;

·         good leadership and governance of complex arrangements;

·         commitment to investing in services that supported wellbeing and prevention under the Health and Care Act 2022; and

·         having a clear co-produced Carers’ Strategy and improvement plan.

Areas for improvement had been identified as:

·         services for people with learning disabilities;

·         direct payments;

·         the reablement offer;

·         equality and diversity;

·         the contracts and contract management process;

·         the deprivation of liberty waiting list;

·         developing a local work force strategy;

·         exploring further ways in which to provide support and early intervention;

·         strengthening the complaints system, ensuring that feedback was fed through into practice; and

·         working with health colleagues to improve cost, quality and productivity.

The Chairman wished to expressly acknowledge the progress made over the last year and in particular the hard work which ensured that the Council was in a good position in terms of readiness ahead of CQC inspection.

Members received responses to the following questions:

·                     How much notice would the Council be given that an inspection was due to take place and when?

·                     How was the inspection conducted?  Would it be computer based and what was the grading system?

·                     Would the inspectorate receive service user feedback?

·                     In terms of domiciliary care how many individuals  ...  view the full minutes text for item 26.

To consider a report detailing an overview on residential and nursing care homes.

(Note: presented by Jo Williams, Director of Adult and Community Services, Torbay Council and Lee Baxter, Divisional Director, Adult Social Care,Torbay Council).

The Divisional Director of Adult Social Carepresented the submitted report which provided Members with an update in relation to Residential and Nursing Care Homes and an overview of how the care home market currently supported the Local Authority in meeting individual needs together with achievements and challenges.

Members were informed that it was important to recognise that the Local Authority retained accountability for the market but the regulator for Adult Social Care was the Care Quality Commission (CQC).

It was explained that there were 76 care home providers within the Torbay area commissioned by the Integrated Care Organisation (“ICO”).  There was very good performance around discharge from hospital to assessment which was really focused on working with partners to assess people’s needs.  A current piece of work being undertaken was to engage with people and families who had been transferred into care homes in Torbay to better understand how co-designed processes could be improved enabling a better experience.

Members were informed that from a market overview perspective there had been an increase in demand, some of which was due to hospital discharges.  It was also important to keep costs under review since they had escalated probably due to the Covid response originally together with the way the market had changed and the increased pressures on the NHS to discharge people quickly.  Challenges included workforce as rates of pay were not competitive when compared with other parts of the sector.  The need for residential nursing care was also higher and a large number of individuals were entering residential care with complex long term needs.  This required highly skilled staff, so it was important for the Council and the ICO to find ways of making systemic change that prioritised upskilling staff alongside structural development within the sector.

It was explained that moving forward it was important to have a clear plan as a Local Authority, in terms of how to develop the market and explore other options, for example, how the domiciliary care market linked in with the Housing Strategy; how to align the Joint Strategic Needs Assessment plan with the Strategy; ensuring a clear pricing strategy; how to develop the specialist high end area of the market with emphasis on more rehabilitation, focussed on returning people home as soon as possible; reducing waiting list times for the wider sector and working with providers to ensure that quality was at the heart of delivery.  It was also important to have the opportunity to create space so that the market was competitive on price and quality and remained strength based around contracts with NHS partners and others.

Members received responses to the following questions:

·         Did all care home residents have access to digital support and interactions such as Skype and Facetime?

·         Was any work being carried out engaging with care homes about information and advice available for family members as the voluntary sector could assist people?

·         Was it possible to increase staff with a higher range of skills?

·         What was the difference  ...  view the full minutes text for item 27.

To receive an update on the implementation of the actions of the Sub-Board and consider any further actions required (as set out in the submitted action tracker).

The Sub-Board noted the submitted action tracker.