Agendas, reports and minutes

Minutes of Meeting of the Health, Social Care and Wellbeing held in the Council Chamber, Council Headquarters, Glenurquhart Road, Inverness on Wednesday, 12 February 2020 at 10.30am.

Present:

Mrs Jennifer Barclay, Mr Bill Boyd, Mrs Biz Campbell, Mrs Muriel Cockburn, Mrs Margaret Davidson, Mr John Finlayson, Mr Andrew Jarvie, Mr Derek Louden, Mrs Deirdre Mackay, Mr Willie Mackay (via VC), Mrs Isabelle Mackenzie, Mrs Linda Munro, Mrs Margaret Paterson, Mr Denis Rixson, Mr Karl Rosie, Ms Emma Roddick, Miss Nicola Sinclair (via VC), Mr Callum Smith

Non-Members also Present:

Mr B Lobban, Mrs A MacLean, Mr D Macpherson             

Officials in attendance:

Ms L Weber, Executive Chief Officer, Health and Social Care
Mrs K Lackie, Executive Chief Officer, Performance and Governance
Mrs F Malcolm, Interim Head of Health, Health and Social Care
Mr B, Porter, Head of Resources, Education and Learning
Ms K Ralston, Interim Head of Children’s Services, Health and Social Care
Ms D Ferguson, Senior Ward Manager, Chief Executive’s Office
Mr I Kyle, Children’s Planning Manager, Health and Social Care
Ms J Jennett, Area Care and Learning Manager, Health and Social Care
Ms S Russel, Principal Officer – Nursing, Health and Social Care
Ms G Ward, Housing Policy Officer, Property and Housing
Mrs L Dunn, Principal Administrator, Chief Executive’s Office
Miss M Zavarella, Administrative Assistant, Chief Executive’s Office

An asterisk in the margin denotes a recommendation to the Council. 

All decisions with no marking in the margin are delegated to Committee.

Ms Linda Munro in the Chair

1. Apologies for Absence
Leisgeulan

There were no apologies for absence

2. Declarations of Interest
Foillseachaidhean Com-pàirt

Ms L Munro declared a financial interest in relation to any items which might arise during discussion in regard to Self-Directed Support on the grounds that she was a specialist advisor for Self-Directed Support but, having applied the test outlined in Paragraphs 5.2 and 5.3 of the Councillors’ Code of Conduct, concluded that her interest did not preclude her involvement in the meeting.

3. Good News/Outstanding Achievements
Naidheachdan Matha/Coileanaidhean Air Leth

The Committee NOTED the verbal update on the following good news items:-

• A short video was shown to celebrate the remarkable achievements of Grace Brian who was Highland Council’s oldest and longest-serving foster carer having looked after over 250 children over the past 40 years.  In recognition of the valuable role of foster carers, Highland Council had recently agreed a 20% fee increase and revised the payment structure providing a fee per child;
• there had been a multi-agency approach to create a series of training videos, which were available on YouTube, to support understanding Autism;
• the Christmas for Care-Experienced Young People had been a great success and the event had helped young people to create a sense of belonging; and
• the Council would be celebrating National Care Day on 21 February 2020 with events being held at Eden Court and an open invite was extended to Children and Young People, professionals and Corporate Parents to attend.  In addition, Eden Court would also be broadcasting ‘Instant Families’ at 5.45pm on 24 February 2020 and Members were invited to attend and support this event.

4. Role and Remit of Health, Social Care and Wellbeing Committee
Raon-ùghdarrais Comataidh na Slàinte, a’ Chùraim Shòisealta agus an t-Soirbheis

There had been circulated Report No HCW/01/20 dated 3 February 2020 by the Executive Chief Officer, Performance and Governance. 

During discussion, a progress update was sought and provided on the NHS Partnership Agreement as well as clarity regarding the deadline for finalisation of the Integration Scheme documentation.  In addition, the need for the scrutiny sub groups to be open and transparent and to add value was emphasised.

The Committee NOTED the report. 

5. Refugee Resettlement Programme
Prògram Ath-àiteachaidh Fhògarrach

There had been circulated Report No HCW/02/20 dated 20 January 2020 by the Acting Head of Policy.

During discussion, the following main points were raised:-

• Members commended staff and partners for their work and dedication in the successful delivery of the Programme.  Local communities were praised for being so welcoming and Members were encouraged to provide an ambassadorial role to ensure that families felt welcomed, cared for, and supported;
• Further information was sought and provided on the support provided to the four families that had been relocated from Kinlochleven;
• In regard to overcoming the supply of interpreters out with the Inner Moray Firth area, it was queried whether these services could be provided by existing Syrian families that had been located across the Highlands and also whether the ESOL classes could be provided by video link which could help maximise resources;
• Although families were happy to be in Scotland, the frightful journey that they had gone through and losses endured was emphasised.  In addition, the families that had been resettled were extremely worried about family members that had been left behind and further information was provided on the complex Family Links process;
• Further information was sought and provided on employability and supporting family members, many of whom were qualified professionals, into work;
• The challenges, as referenced in the report, in delivering a successful Programme were recognised but it was felt that availability of housing stock was the most significant.  Further information was requested on future requirements and how housing needs for refugees could be incorporated into new build developments.  It was further suggested that reports should be submitted to Area Committees to examine the housing options available at a local level; and
• In conclusion, the Chair expressed appreciation to staff, third sector partners, and communities for their collaborative working and vital support in ensuring the successful delivery of the Refugee Resettlement Programme and the positive outcomes that had been achieved for families resettling in Highland.

The Committee:-

1. NOTED the significant efforts by communities and partners which had delivered a successful Refugee Resettlement programme in Highland;
2. NOTED the unreserved support from all Highland Council services and partners to continue to be involved in future phases; and
3. AGREED to welcome around 25 further refugees to Highland in 2020/21 under the new Global Refugee Resettlement Programme with a further recommendation to come forward once more information was known about the future programme.

6. Chief Social Work Officer Report: 2018/2019
Aithisg Prìomh Oifigear Obrach-sòisealta: 2018/2019

There had been circulated Report No HCW/03/20 dated 27 January 2020 by the Executive Chief Officer, Health and Social Care.

During discussion, the following main points were raised:-

• Concern was expressed at the level of fuel poverty across the Highlands, which it was felt was difficult to measure, and confirmation was provided that further information would be provided to Councillor Jarvie on the criteria used.  It was also indicated that a significant proportion of the Council housing stock within Caithness did not have access to gas central heating and it was queried whether external funding was available to support and accelerate the upgrade of replacement of Council house heating systems;
• In terms of poverty, the Scottish Index of Multiple Deprivation (SIMD) was not effective at identifying rural deprivation and it was suggested that the Socio Economic Performance (SEP) Index should also be used.  The good practice of collaborative working at a local level was recognised but assurance was sought that sufficient work was being undertaken at a strategic level with the third sector to identify gaps and improve joint working;
• Although the recent increase and agreement to pay a fee per child was welcomed, concern was expressed that the current Foster Care fee rates were not sufficient to meet a child’s needs and there was a requirement for this to be increased to a fair and competitive rate.  Although the need for all relevant and legal checks to be undertaken were recognised, it was queried whether it would be feasible to speed up the foster carer appointment process.  A further query was raised on whether the provision of appropriate accommodation was an issue for foster carers.  It was further recognised that housing was a cross-cutting issue which could help overcome a number of challenges and it was therefore suggested that a joined-up approach was required with the Housing and Property Committee;
• It was highlighted that Community Payback was working well with reduced reoffending rates and this positive outcome was welcomed;
• Concern was expressed at the increasing recruitment challenges and the  limited and competing workforce between Care at Home and Home Carers and it was queried how this labour pool could be expanded.  Assurance was sought that implementation of the Living Wage was not the reason for the reduction in the weekly Care at Home package from 9.6 hours to 7.6 hours.  In addition, concern was expressed at the significant increase in Delayed Discharge and whether this was also the result of a workforce issue;
• Concern was expressed that the report indicated that Mental Health Care capacity would reduce by between 40-50% over the next three years whilst service demand was increasing, and it was queried what training was being undertaken to replace retiring staff.  Given the position, a request was made for periodic updates and the Chair proposed that there should be an update to each Committee on Mental Health; and
• It was highlighted that the number of Prospective Adopters and Permanence Orders were very low and the Child Protection data set outlined in Page 51 of the papers was useful but it was a short timeframe and it was therefore requested that year on year comparators be provided to monitor trends.

The Committee NOTED the issues raised in the annual report and AGREED that:-

1. Year on year comparators be provided in respect of the Child Protection data set outlined on Page 51 of the papers; and
2. There be updates to each Committee on Mental Health.

7. Review of the Highland Practice Model
Ath-sgrùdadh air Modal Cleachdaidh na Gàidhealtachd

There had been circulated Report No HCW/04/20 dated 3 February 2020 by the Executive Chief Officer, Health and Social Care.

During discussion, the following main points were raised:-

• The review of the Practice Model was felt to be vital and the likelihood of any potential liability was queried following the legal ruling on the Named Person Scheme.  Although the aims of the scheme, i.e. to support the wellbeing of children and young people and provide early intervention were recognised,  concern was expressed that the scheme assessed parenting and nurturing skills against a Government approved checklist and lacked sufficient emphasis on measuring tangible outcomes.  In addition, it was felt that the scheme was fundamentally flawed as it had been indicated that the scheme operated on a consensual basis but there was no provision to opt out.  It was critical to learn from the review to ensure that an accountable and transparent system was developed and an effective model implemented which targeted resources to where they were most needed;
• The Getting it right for every child (GIRFEC) approach had led to positive results and families understood the system including the purpose and their role in developing a Child Plan.  The Highland Practice Model was being used as a blueprint across the country and positive feedback had been received with  professionals indicating that it made it easier for them to help children and families and improved the assessment of children’s needs which was the core purpose of the model; 
• Both practice models (GIRFEC and the Named Person Scheme), had been effective and supported families whilst providing opt out options for parents.  The purpose of the GIRFEC model was to provide a system which enabled early intervention and quick communication between agencies and professionals whilst providing the best possible support for young people; and
• The need to reflect and evaluate was recognised and the key aim was to achieve positive outcomes and provide the best support for children and young people across the Highlands.

The Committee NOTED:-

1. the background to the proposed review of the Highland Practice Model and Named Person Scheme in Highland; and
2. plans for the review of the Highland Practice Model and Named Person Scheme in Highland.

8. The Development of the Integrated Children’s Service Plan 2020
Leasachadh Plana Sheirbheisean Chloinne Amalaichte 2020

There had been circulated report No HCW/05/20 dated 24 January 2020 by the Executive Chief Officer – Health and Social Care.

The Committee NOTED progress being made in the drafting of the Integrated Children’s Service Plan.

9. Partnership Arrangements with NHS Highland
Ullachaidhean Com-pàirteach le NHS na Gàidhealtachd

There had been circulated Report No HCW/06/20 dated 4 February 2020 by the Executive Chief Officer, Health and Social Care.

During discussion, the following main points were raised:-

• The report indicated that there were no Risk implications for the Council which was difficult to understand given that there was a significant risk that increased resources would be required.  However, the Executive Chief Officer Health and Social care explained that there was no risk whilst work continued in relation to the review of the partnership agreement for the delivery of Adult Social Care.  The report also indicated that work might not necessarily be articulated within the Integration Scheme and further clarity was sought on this along with assurance that Members would be informed of the changes.  In addition, further assurance was sought that Members would be consulted on the review of the partnership arrangements and whether the documents would be submitted to this Committee or full Council for approval prior to sign-off;
• In terms of the workstreams, concern was expressed that Workforce Planning had been designated as Priority Level 2 given the discussions raised earlier in the meeting in regard to recruitment challenges and it was felt that this should be assigned as a Level 1 priority.  With regard to the Assessment Process, it was thought that a single point of contact system was already operated and confirmation of this was sought.  The 3 conversations model was welcome and it was indicated that there were a number of good examples of this already taking place across local communities;
• Clarity was provided in regard to the intentions of reducing service users by signposting whereby the Executive Chief Officer Health and Social care explained that a single point of contact system was in operation by way of a phone number, but that a single door or hub system would mean someone could seek advice and support to first level queries from a range of professions;
• The establishment of the Health, Social Care and Wellbeing Committee was welcomed and would enable Members to have a dedicated focus on Adult Social Care.  The purpose of Integration was to maximise resources and improve outcomes and staff were commended for the significant progress and improved collaborative working since commencement of the Partnership in 2012.  The seamless working that was now in place was highly praised.  However, the demand led pressures to deliver Adult Social Care services to an increasing elderly population over a remote and rural area continued.  Therefore, further work was required including detailed information on the financial position as well as the implications going forward and associated timescales; there needed to be a co-ordinated approach to income maximisation; the role of Community Planning Partnerships was vital but the capacity and resource issues had to be addressed to enable them to achieve their potential; and new models and roles were required in order to address the workforce planning constraints whilst maximising service delivery;
• It was essential that the Council had meaningful scrutiny of service delivery and this had to be delivered as part of the review process; and
• Concern was expressed that there was a lack of communication with Members and at a local level with communities and this was impacting on the ability to work collaboratively.  However, the Chair explained that the Council and NHS Highland had emphasised their desire to work collaboratively and she provided an assurance that she was fully committed to ensuring that appropriate communication measures were in place.

The Committee NOTED and APPROVED the current position and the proposed approach.

10. Minutes
Geàrr-chunntas

The Committee:-

1. NOTED the Minutes of the Highland Child Protection Committee held on 20 August 2019;
2. NOTED the Minutes of the Highland Violence Against Women Partnership Group held on 28 August 2019;
3. NOTED the Minutes of the Highland Community Justice Partnership held on 19 September 2019;
4. NOTED the Minutes of the Highland Council/NHS Highland Joint Monitoring Committee held on 27 November 2019; and
5. APPROVED the Minutes of the Adult Services Development and Scrutiny Sub-Committee held on 28 November 2019 and 16 January 2020.

The meeting ended at 12.55pm.