Agenda and minutes

To note the attendance at this meeting of any duly appointed Reserve Members.

RESOLVED:  To note that there were no Reserve Members in attendance at this meeting.

To receive declarations of interest (if any) from Members of the Sub-Committee arising from business to be transacted at this meeting.

RESOLVED: To note that there were no declarations of personal or prejudicial interests made by Members of the Sub?Committee arising from business transacted at this meeting.

To consider whether any of the items listed on the agenda should be considered with the press and public excluded on the grounds that it is thought likely, in view of the nature of the business to be transacted, that there would be disclosure of confidential information in breach of an obligation of confidence or of exempt information as defined in the Local Government (Access to Information) Act 1985.

RESOLVED:  That (1) agenda item 14 – Domiciliary Care Services, be considered before agenda item 10a – Report of the Executive Director;

(2)  in accordance with the Local Government (Access to Information) Act 1985, the following item be admitted late to the agenda by virtue of the special circumstances and grounds for urgency listed below:-

(3) all items be taken with the press and public present.

That the signing of the minutes of the Special meeting held on 24 July 2003, the joint meeting of the Health and Social Care and Lifelong Learning Scrutiny Sub-Committees held on 17 September 2003, and the ordinary meetings on 18 September and 8 December 2003 be signed as correct records; and the minutes of the Special meeting held on 5 February 2004 be deferred until printed in the next Council Bound Minute Volume.

RESOLVED:  That (1) the minutes of the Special meeting held on 24 July 2003, of the joint meeting of the Health and Social Care and Lifelong Learning Scrutiny Sub?Committees on 17 September 2003, and of the ordinary meetings on 18 September and 8 December 2003, having been circulated, be taken as read and signed as correct records;

(2)  the minutes of the special meeting held on 5 February 2004 be deferred until printed in the next Council Bound Minute Volume.

To receive questions (if any) from local residents/organisations under the provisions of Overview and Scrutiny Procedure Rule 8.

RESOLVED:  To note that no public questions were put at the meeting under the provisions of Overview and Scrutiny Procedure Rule 8.

To receive petitions (if any) submitted by members of the public/Councillors under the provisions of Overview and Scrutiny Procedure Rule 9.

RESOLVED:  To note that no petitions were received at the meeting under the provisions of Overview and Scrutiny Procedure Rule 9.

To receive deputations (if any) under the provisions of Overview and Scrutiny Procedure Rule 10.

RESOLVED:  To note that no deputations were received at the meeting under the provisions of Overview and Scrutiny Procedure Rule 10.

Report of the Executive Director (Organisational Development).

The Sub-Committee received a report of the Executive Director (Organisational Development), which detailed the Scrutiny Review of Delayed Transfers of Care.

Members were informed that the report had been shared amongst Harrow PCT, North West London Hospitals Trust and the Central and North West London Mental Health NHS Trust for comment, which adhered to the locally agreed protocol for NHS scrutiny. 

It was stated that all the medical bodies detailed above had not commented at this stage on the report and its recommendations. 

Members’ attention was drawn to Recommendation A2 in the officer report, initiated by the Head of Community Care, which asked that the wording be reconfigured to refer to intermediate care services rather than intermediate care beds, in order to reflect the full extent of intermediate care; Members agreed to this.

The Chair thanked all the Members and officers involved in the review and indicated that the Sub?Committee looked forward to feedback received from health partners in six months’ time.

RESOLVED:  That the Sub-Committee (1) adopt the report of the Scrutiny Review Group;

(2)  adopt the change to Recommendation A2 put forward by the Head of Community Care;

(3)  request that Organisations to which the recommendations have been made respond to the report within eight weeks of its receipt, and that an update from them be provided to the Sub?Committee in six months’ time; and

(4)  refer the report to the Portfolio Holder for Social Services for her consideration and that the report be placed on the Cabinet Information Circular.

Report of the Executive Director (People First).

The Sub-Committee received a report of the Social Services Portfolio Holder, which outlined the key areas of responsibilities and strategies for 2004/07 in the People First directorate.  The report had been provided at the request of the Chair in order to inform the Sub?Committee’s discussions on its work programme for 2004/05.   

It was emphasised to Members that the report represented areas concerning People First for both Education and Social Services, so would be put forward to the Lifelong Learning Scrutiny Sub-Committee as well.  The report was summarised for Members.

During the discussion, a Member asked why the Best Value indicators that related to Children Services illustrated that performance was going down rather than up.  The Portfolio Holder responded by stating that there were problem areas concerning  equipment and moving on services, but insisted that children services were improving, and there was a great deal to be proud about, such as the stability of children’s placements, which used to have a drift, as well as the stayed in placements.

The Director of Children Services re-emphasised the progress that had been made thus far in children services, and stressed that the services offered by the authority were good and that it remained one of the best in the country for the stability of children’s placements.  It was indicated that improvements were needed in relation to management and financial tracking, but training programmes for managers were in place to address those areas. 

A Member expressed concern over the lack of progress in relation to service integration with Harrow PCT.  The Portfolio Holder responded by saying it was disappointing that Harrow PCT could not formally enter into a financial integration agreement with the Council, but indicated that work was on-going with the PCT in other areas.  Dr Ahmad, Advisor to the Sub?Committee, informed Members that the PCT’s Interim Chief Executive was committed to Section 31 and it was anticipated that the new Chief Executive would be too.  

A Member asked what work was planned to reduce teenage pregnancy.  Dr Ahmad responded by saying that Harrow PCT was aware of the problem and work was under way to acquire some primary data to identify trends.   Members were informed that out of the London boroughs, Harrow had the second lowest rate of teenage pregnancy, so the rise should be considered against that background, but it was re?emphasised that Harrow PCT was taking teenage pregnancy seriously and would be looking into the matter.

RESOLVED:  That the information be noted.

The Portfolio Holder will be present at the meeting to answer questions relating to Social Services, which might inform the Sub-Committee’s deliberations in respect of the Work Programme for 2004/05.

The Social Services Portfolio Holder answered the following questions presented by Members:

Q:         There appears to be several problems with the quality and quantity of Domiciliary Care, which is being provided by the Council's preferred partner.  Will Councillor Davine explain the steps being taken to allay the concerns expressed?

A:         The Portfolio Holder indicated that agenda item 14 - Domiciliary Care Services, would answer that question.

Q:         Does not the Portfolio Holder think that the meals on wheels service needs to be looked at and explain her answers?

A:         The Portfolio Holder responded by saying she was not aware of there being a problem with the service.  It was indicated that the comments received by users were positive and gave the Authority encouragement to keep the service.  It was mentioned that there had been a problem with the number of fresh Indian vegetarian meals requested but that had been solved and there was no longer a waiting list. 

A supplemental question was asked which related to the cost and the supplier of the Indian vegetarian meals.

A:         The Head of Community Care Services responded by saying that people who had special dietary requirements were given specific meals. It was highlighted that the cost of Indian vegetarian meals were on par with Kosher ones produced. However, it was noted that work was still on going in that area to generally reduce costs.

Q:         An independent financial review of the Government's "Supporting People" initiative has raised a question mark on whether it represents value for money.  Please comment specifically regarding Harrow.

A:         The Portfolio Holder answered that this was a national problem and not unique to Harrow.  It was stated that the Supporting People team had made a prudent and secure bid, which was achieved.  It was highlighted that out of the bid the Government wanted a 2.5% efficiency saving, which was disappointing; however, there was sufficient money to process work.  It was also mentioned that some of the providers were costly and these would be reviewed in due course.

Q:         Could the Social Services Portfolio Holder explain why the Blue Revenue and Capital Budget Book for 2003/4 relating as well to 2004/5 is useless as a management tool and the Department's financial controls are a total mess?

A:         The Portfolio Holder responded by saying the book was not designed to be a management tool, its purpose was to inform the public of the Council’s budget arrangements. The Head of Community Care Services added that quite a lot of authorities were in similar situations.  It was noted by Members that work was being done to bring Harrow Social Services’ financial systems up to date, but there was still a great deal of work to do to make it accessible and transparent.

Q:         Please highlight a most significant improvement in Children Services. 

A:         The Portfolio Holder indicated that the most notable one would be the number of continued and sustained improvements in that area, which in turn had created confidence by officers and  ...  view the full minutes text for item 140.

Report of the Head of Community Care.

The Sub-Committee received a report of the Head of Community Care, which detailed the position of Domiciliary Care Services.  Members also received a tabled reference from the Cabinet meeting held on 16 March 2004, which requested that the Sub-Committee undertake a review of these services, and set out proposed terms of reference for the review.

During the discussion a Member expressed concern over point A in the proposed terms of reference, saying that it had recently been reviewed and could impact upon the current charges levied.  Other Members argued that a holistic approach had to be adopted in the review in order to make it legitimate, and it was emphasised that the Sub-Committee’s findings would not dictate what charges would be levied.

Members considered the report and agreed to the recommendations, but indicated that  the deadline date of September 2004 was not sufficient time to undertake a thorough review, and therefore would await a scoping report before specifying a deadline date.

RESOLVED:  That (1) a review of Domiciliary Care Services be undertaken and the proposed terms of reference be agreed; and

(2)  a scoping report of the review be created and circulated to members in advance of the next meeting, which would determine the deadline date.

The Sub-Committee received a report of the Executive Director (Organisational Development) which detailed the Sub-Committee’s provisional work programme for 2004/05. 

The Chair advised that in the light of the Domiciliary Care Services review, which was anticipated to be lengthy, it was thought more appropriate to have mini reviews that would consist of inviting individuals to meetings, rather than two big reviews that ran simultaneously.

The following topics for were put forward and agreed by Members for the Sub-Committee’s work programme for next year (04/05):

In-depth review: 

• Domiciliary Care

Mini reviews:  

• Access to GPs

• and Access to Dentists (NHS context and to include access by Young People)

Individual agenda items:

• Patients’ Forums
• Supporting People in Housing
• Inequalities in Health Provision (Obesity)
• Improving Life Expectancy and Low Birth Weight
• Redevelopment of Northwick Park Hospital and St Mark’s Hospital

Members also indicated that they would like to invite the Interim Chief Executive of Harrow PCT and the Chief Executive of Royal National Orthopaedic Hospital NHS Trust to a future Sub-Committee meeting.

The Chair explained to the Sub-Committee that she had no issues relating to the proposed process for the preparation and publication of the annual report.  Members were advised to contact the Scrutiny Officer if they had any issues that they would like to place particular emphasis on within the report on the Health and Social Care Scrutiny Sub-Committee.

RESOLVED:  That (1) the Sub-Committee’s draft work programme, as amended to include the items outlined above, be agreed; and

(2)  the proposed process for the preparation and publication of the annual report for 2003?04 be agreed. 

Report of the Acting Head of Community Care (People First).

The Sub-Committee received a report of the Head of Community Care, which was presented by the Community Care Development Manager.

During the discussion, a Member queried assessment targets and timescales.  The Manager responded by saying it took three months to carry out an assessment, which was a real improvement when compared to a year ago when it was nine months.  It was also projected that 80.2% of jobs were carried out within 21 days after the assessment.

The Chair asked whether written information could be provided outside of the meeting on the timescales of work carried out, and officers undertook to do this.

RESOLVED:  That the information be noted.

At 9.50 pm, during discussion of the above item, the Chair drew the attention of the meeting to the time.

RESOLVED:  That, under the provisions of Overview and Scrutiny Procedure Rule 6.7(ii)(b), the meeting be extended to 10.15 pm.

Report of the Acting Head of Community Care (People First).

The Sub-Committee received a report of the Head of Community Care, which was presented by the Community Care Development Manager.

Members noted the progress made in the Best Value review.  A Member queried whether the leaflets produced were in plain English, and asked to see copies.  The Manager stated that leaflets were in plain English, and indicated that Members would receive a copy for information.  Another Member emphasised that carers were important, and equally required support.  It was explained that carers were given support and forums were organised to address any difficulties that they might have.

RESOLVED:  That the progress made be noted.

Report of the Head of Community Care (People First).

(Note: The above report was submitted to Cabinet on 16 March 2004.)

The Sub-Committee received a report of the Head of Community Care, which documented the SSI Inspection. 

The background of the report was explained to Members.  The Sub-Committee was informed by the Head of Community Care that the inspectors’ results were disappointing, but action was in place to address points raised within the report. 

The Chair requested that the progress made against the action plan be inserted in italics for Members’ information and circulated outside of the meeting, which was agreed by the Head of Community Care.

RESOLVED:  That the information be noted.

[Members are reminded that Scrutiny’s role in Best Value is to pick out key targets from the Improvement Plan for progress monitoring.]

RESOLVED:  That Councillor Lavingia attend the Environment and Economy Sub?Committee meeting on behalf of the Sub?Committee on 9 June 2004 to monitor the progress made in the Your Home, Your Needs Improvement Plan.