Agendas, reports and minutes

Minutes of Meeting of the Adult and Children’s Services Committee held in the Council Chamber, Council Headquarters, Glenurquhart Road, Inverness on Wednesday 19 February 2014 at 10.05 am.

Present:

Highland Council:

Dr D Alston, Mrs I Campbell, Mr A Christie (Chair), Mrs M Davidson, Ms J Douglas, Mr B Fernie, Mr K Gowans, Mr J Gray (Substitute), Mr M Green, Mr C Macaulay (Substitute), Mrs D Mackay, Mr G MacKenzie (Vice Chair), Ms L Munro, Mrs M Paterson, Mr M Rattray, Mrs F Robertson, Mr G Ross, Ms J Slater, Ms K Stephen

NHS Highland:

Mrs M Duncan, Mrs G McCreath, Dr M Somerville

Religious Representatives:

Ms M McCulloch, Mr G Smith

Non-Members also present:

Mrs J Barclay, Mr A Baxter, Mr B Clark, Mr B Lobban, Mr T MacLennan, Mr B Murphy, Mr A Rhind, Mr G Rimell, Mr H Wood

In attendance:

Mr H Fraser, Director of Education, Culture and Sport

Mr B Alexander, Director of Health and Social Care

Mr R MacKenzie, Head of Support Services, Education, Culture and Sport Service

Mr J Steven, Head of Education, Education, Culture and Sport Service

Ms S MacLeod, Head of Health, Health and Social Care Service

Ms F Palin, Head of Social Care, Health and Social Care Service

Mr R Campbell, Estate Strategy Manager, Education, Culture and Sport Service

Mr E Foster, Finance Manager, Finance Service

Ms K Mackay, Infant Nutrition Adviser, NHS Highland

Mr C Munro, Highland Children’s Forum  (Third Sector)

Ms V Gale, Care and Learning Alliance (Third Sector)

Ms M Wylie, Highland Third Sector Interface (Third Sector)

Miss J Maclennan, Principal Administrator, Chief Executive’s Office

Miss M Murray, Committee Administrator, Chief Executive’s Office

Mrs R Daly, Committee Administrator, Chief Executive’s Office

Also in attendance:

Mr K Steele, Chief Executive Officer, Highland Hospice

Ms C MacLean, Chief Officer, CHIP+

Ms C Ferguson, on behalf of CHIP+

Mr S Hay, Local Senior Officer for Highland, Scottish Fire and Rescue Service

An asterisk in the margin denotes a recommendation to the Council.  All decisions with no marking in the margin are delegated to the Committee.

Mr A Christie in the Chair

Business

1. Apologies for Absence

    Leisgeulan

Apologies for absence were intimated on behalf of Mr B Gormley, Mr D Hendry, Mr E Hunter, Mr N MacDonald, Mrs B McAllister, Ms G Ross, Ms M Smith, Rev C Mayo and Miss A Taylor

2. Declarations of Interest

    Foillseachaidhean Com-pàirt

The Committee NOTED the following Declarations of Interest:-

Item 4 – Ms J Douglas, Mr K Gowans (non-financial) Mrs G McCreath, Mr G Smith (financial)

Item 10 - Mr A Christie (non-financial)

Item 12 - Mr A Christie (non-financial)

Item 15 - Mr A Christie (non-financial)

Item 16 - Ms J Douglas and Mr K Gowans (non-financial)

Item 17 – Ms J Douglas, Mr K Gowans (non-financial)

Mr C Macaulay declared a financial interest in those items which might raise discussion relative to the employment of his partner as an employee of the Education, Culture and Sport Service and advised that if there was any specific discussion in relation to their employment he would leave the room.

Dr D Alston declared a non-financial interest in those items relating to integrated health and social care services as a Board Member of NHS Highland but, in terms of the dispensation granted by the Standards Commission, remained to participate in discussion.

3. Presentations

    Taisbeanaidhean

i. Highland Hospice Strategic Plan

   Plana Ro-innleachdail Hospice na Gàidhealtachd

There had been circulated Report No ACS-16-14 (15kb pdf) dated 9 February 2014 by the Director of Health and Social Care which introduced a presentation by the Chief Executive Officer of the Highland Hospice in relation to the Highland Hospice Strategic Plan.  It was explained that while there was no responsibility on Highland Council in relation to the Highland Hospice services, as a significant provider of health and social services, the Hospice considered it important to share strategy and plans with the Council.  The Hospice’s annual running costs were approximately £4m which comprised a grant of approximately £1.4 m from NHS Highland and the remainder being generated through charitable fundraising.

Referring to the Highland Hospice Strategic Plan Mr K Steele, Chief Executive Officer, highlighted the Plan’s two clear priorities: to upgrade the physical care environment and to extend the reach and equity of care across remote and rural areas.  He went on to inform Members of arrangements in place to achieve these strategic priorities and how this work would contribute to the bigger picture of services across the area for the wellbeing of Highland people.

It was explained that Highland Hospice was the only Hospice serving adults in the Highlands of Scotland.  As specialists in palliative care, the Hospice focused on the control of pain and other symptoms, on the reduction of suffering and on the enhancement of the life that remained.  It was the aim to enable patients to live out their life with dignity and to offer support to their families and friends, both during the patient’s illness and into bereavement.  All care was provided free of charge. However, it cost approximately £3.9 million every year to provide the services, 36% of which came from an NHS grant the remaining £2.4 million being generated through fundraising.

The strategic drivers were geographical challenges, 20% increase in palliative care needs, care at home and expectations and regulatory compliance.  Two key objectives were to increase equity of care and to improve the quality of the physical care environment.  The priorities for equity were care at home, creating a virtual Hospice, extending the use of volunteering and the co-ordination of Services.

Although the Hospice was renowned for providing a high standard of care, this was increasingly despite its current building and not because of it.  A description of current infrastructure provisions was given together with the plans in place for a new Hospice.  It was explained that the Hospice would decant to the Invergordon Community Hospital during the period of the works which it was expected would begin in April 2015.

During discussion, Members raised the following issues:-

• it was unclear to what extent the use of information technology in services was being used in a joined up way as the make-up and expectations of communities would change over coming years; 

• it was not understood whether officers had been involved in discussions regarding the sustainability of communities; 

• in terms of providing equitable services, it was not explained whether this might extend to providing services for children; 

• there were now different approaches to palliative care for people with multiple complex conditions as opposed to malignant conditions and it was queried how this might impact on services; and 

• it was important to recognise the acknowledge the great work undertaken by the Hospice throughout the Highlands. 

Thereafter, having thanked Mr Steele for his presentation, the Committee:-

i. NOTED the position;

ii. AGREED that a briefing note be put together to advise Members of what

   was currently being done to address information technology developments;

   and

iii. AGREED that a briefing note be presented to the Local District Partnership

   addressing the decant of the Hospice to the Invergordon Community

   Hospital.

ii. CHIP+: 20 Years On

   CHIP+: Às Dèidh 20 Bliadhna

There had been circulated Report No ACS-17-14 (11kb pdf) dated 9 February 2014 by the Director of Health and Social Care which introduced a presentation by Ms C MacLean, Chief Officer of CHIP+, to celebrate the organisation’s 20-year anniversary, focusing on the key strands of the charity’s work over the past 20 years and the issues it currently faced.

CHIP+ had been established by a group of parent/carers and representatives of organisations working with children with disabilities throughout Highland. The initial aim had been to provide a source of good quality and easily accessible information for both parents and professionals.  Since its inception information requests had moved towards Education-related matters particularly following the introduction of the Additional Support for Learning legislation in 2004.  As a result of CHIP+’s most recent evaluation of service users, the need to address a sense of isolation experienced by service users had become apparent.  In addition, there was increasing pressure on the services provided by CHIP+ from the growing number of very complex enquiries, often involving parent/carers in distress over a range of difficult situations.

In support of this presentation, Ms C Ferguson provided a brief description of her personal experience of being a single parent to children with additional support needs and how the services of CHIP+ had provided information and been significantly empowering.

Members thanked Ms MacLean and Ms Ferguson for their very informative and hugely powerful presentations. It was acknowledged that having children with additional support needs risked parents feeling isolated from others. It was also important to acknowledge that there could also be isolation felt within a family setting.  Members applauded the work undertaken by CHIP+, particularly around listening to parents and addressing the needs for children’s transitions from primary to secondary education.

The Committee NOTED the position.

4. Revenue Budget 2013/14 - Monitoring

    Buidseat Teachd-a-steach 2013/14 – Sgrùdadh

Declarations of Interest:

Ms J Douglas and Mr K Gowans declared non-financial interests in this item on the grounds of being Directors of High Life Highland but, having applied the test outlined in Paragraphs 5.2 and 5.3 of the Councillors’ Code of Conduct, concluded that their interests did not preclude their involvement in the discussion.

Mrs G McCreath declared a financial interest in this item as a foster carer and advised that if there was any specific discussion in relation to fostering she would leave the room.

Mr G Smith declared a financial interest in this item on the grounds of being a supply teacher and left the room.

There had been circulated joint Report No ACS-18-14 (226kb pdf) dated 10 February 2014 by the Directors of Education, Culture and Sport and Health and Social Care which set out the Revenue Budget monitoring position for the nine months to 31 December 2013 and the year-end outlook position.

In relation to Health and Social Care (HSC), it was confirmed that the projection at the end of December for the year-end was £135.731m, as set out in Appendix One of the report, which would involve an underspend of £0.238m. This represented an improvement of £0.002m on the November monitoring position.  All savings measures had been accounted for, albeit vacancy management was being used to achieve £0.025m of savings that had not been possible through charging for Mental Health Officer Services.  The report drew particular attention to out of authority placements, the overall number of which had reduced over the past 20 months, albeit with an increase in the last three months of 2013.

Referring to Education, Culture and Sport (ECS), it was explained that the current year-end estimated position was a projected over-spend totalling £0.603M, an improvement on the figure reported to the Committee on 15 January 2014 of £0.681M.  Further management actions were being progressed which might reduce this figure further during the remainder of the financial year.  The main budget pressures, details of which were provided in the report, related to Additional Support Needs (ASN); School Transport; and Catering, Cleaning and Facilities Management.  The report provided commentary on the underlying issues that contributed towards the projected over-spend and other factors which might adversely impact on the year-end outturn position.  Details of mitigating actions were provided, together with an update of management actions being taken to address the non-availability of supply cover teachers and proposed improvements in the administrative arrangements for securing absence cover in schools.

During discussion, where Members welcomed the merger of both ECS and HSC Revenue monitoring into the one report, a number of issues and questions were raised as follows:-

• at Appendix 2, items 24 and 37 relating to absence management and income generation respectively, there appeared to have been no savings achieved and it seemed unclear why these entries were listed as amber and not red; 

• at paragraph 4.1 on ASN, it was concerning that more information had not been included in relation to how, in the interim period, the service demands were being looked at and how they were being listed so as to achieve an accurate picture of what the funding gap might be.  This brought into question activity during the time between when pressures had been identified and before the review would begin.  There was a need for a full picture of the costs and an accurate level of needs in schools; 

• there were major predictable and quantifiable pressures on budgets, however the budget for 2014/15 had already been set which included a 2% reduction in the ASN budget for next year.  It would be interesting to hear whether there been any feedback from schools as to how this might impact on them and how they would address this; 

• what reassurances were there that, for the transitional period, those with modest and medium needs would be met given that there was a budget decrease but an increase in need for services; 

• it was unclear why there was a predicted underspend in nursing services at the year end.  It was queried whether this might be due to vacancies and, if so, what were the timescales for filling them and what operational challenges might be faced in the interim; 

• clarification was sought as to a suggestion that to register as a supply cover teacher there was a £15 administrative charge which would act as a disincentive; 

• the commentary provided on Out of Authority placements was welcomed as this was an area of overspend; 

• progress had been made in addressing supply cover for teachers, resulting in expressions of interest from 52 teachers who were currently going through the recruitment process.  The pilot “out of hours” service to contact supply teachers to cover absences provided by High Life Highland for 4 associated school groups was also a welcome step; 

• regarding arrangements to increase capacity in St Clements School, it had been hoped that the funding to provide additional staffing resources would have already been identified particularly as the proposal had raised expectations locally; 

• regarding the sourcing of supply teachers for rural schools, the current system appeared to pose a disincentive to teachers applying for supply staff posts in these schools.  It was unclear if this was the case and, if so, how the Council proposed to remove this disincentive; and 

• regarding filling teacher posts, there were instances of some pupils having had numerous different teachers within the same academic year which posed a problem for the education of those pupils.

The Chairman explained that, relating to ASN, the Council in December 2013 moved to a longer-term strategy for financial planning and budget setting.  The Administration had always taken the view to be child centred and focused and would ensure that the resources were in place to meet the needs for each child identified as needing additional support needs.  Moving to a longer-term strategy meant a period of transition and that would be taken into account with regular reports to the Committee.  The transition would be dealt with in time and the March meeting of the Council would make reference to this again.  It was acknowledged that at the moment the needs and pressures were understood from Nursery to Primary levels but it would only be in May this year that returns from schools on the allocation model would be available.  The full information was not available at present.  Next year’s budget would be discussed at the Council in March.  It had always been the Council’s aim to fund a child-centred approach and this would continue.  Plans for services to be put in place would be refined throughout the period once returns had been received on the allocation model and throughout the year there would be continual budget feeds to provide the required services.

In relation to increased capacity for St Duthus and St Clements Schools, mechanisms would be found to fund these projects. In addition to this, Drummond School was being considered for expansion and it would form part of the overall plan to ensure that these schools were fully staffed to meet needs.

The Committee:-

i. APPROVED the monitoring statements and NOTED the current year-end

   position and the commitment to identify further compensatory savings in

   order to further improve upon the reported position;

ii. NOTED the management actions being progressed to increase the size of

   the supply cover teacher pool in Highland and the initiatives to improve the

   related administrative arrangements; and

iii. NOTED the progress being made with achievement of budget savings in the

   current financial year.

5. Capital Expenditure 2013/14

    Caiteachas Calpa 2013/14 -  Sgrùdadh

There had been circulated separately joint Report No ACS-19-14 (203kb pdf) dated 11 February 2014 by the Directors of Education, Culture and Sport and Health and Social Care which updated Members on progress to date with the Education, Culture & Sport (ECS) and Health and Social Care (HSC) Capital Programmes and provided monitoring reports on expenditure as at 31 December 2013 along with an update on work being undertaken on fire safety and other health and safety Capital works within the HSC Programme and the major projects underway within the ECS Programme.

The report also identified a number of new ECS capital projects that were recommended for approval and provided an update on the Sustainable School Estate Review (SSER), including indicative dates of when related reports would be brought to this Committee during 2014.

In relation to Health and Social Care, the budget for 2013/14 was £3.914M and expenditure as at 31 December 2013 was £2.059M, representing 53% of the budget.  At this stage in the financial year, it was anticipated that the budget would show an underspend of £0.060M, further details of which were provided in the report. The Chairman clarified that section 2.2 of the report referred specifically to Invernevis House. In addition, he provided an update to section 3.2 relating to the Caol Joint Campus for which the contract was intended to be awarded and letters issued to those who had tendered advising them of the decision.  The contract would be formally awarded in early March. This information had recently been provided to a joint Lochaber Ward Business meeting and all Local Members had been in agreement on this course of action.

With regard to ECS, details of expenditure to the end of December 2013 were provided in the report.  The estimated final year end position was an underspend of £1.500M, largely due to delays to the projects at Invergordon Leisure Centre, Thurso Swimming Pool, Central and Cromarty Primary Schools and Black Isle Education Centre, as well as the revised programme for the Wick Joint Campus. This has been offset to some extent by good progress on Lochaber High Phase 3 and additional expenditure from the Roll Pressures budget on accommodation requirements in schools and works for pupils with Additional Support Needs that had been required this year.

During discussion, Members raised the following issues:-

• in relation to the Caol Joint Campus project, it was appreciated that £38M was being spent on Lochaber schools including the upgrading the all-weather pitch at Lochaber High School. In the event that there might be any savings on the original tender, it was queried whether the surplus funding allocation could be directed towards upgrading the Lochaber pitches, an issue which would also be considered at the next meeting of the Lochaber Area Committee.  Assurances were also sought that the Council would open up the sporting facilities at Lochaber High School, including the two grass pitches;  

• specific assurance was also sought that a report would be brought back to Committee in May on the outcome of the site selection process for Tain Royal Academy ASG; 

• clearer information and timescales in relation to the planning application process and when work might start at St Duthus school was requested; 

• the report showed a £100,000 variance on the Aviemore Primary School project and it was queried whether there might be sufficient funds to finish the project and when would it be completed; 

• Caledonian Economics had reported recently to the Area Committee with their draft report on the Plockton ASG, however, the additional two classrooms planned for Auchtertyre School did not feature in the Capital Programme and clarification was sought on when this would appear; 

• it was unclear what dialogue and feedback was being undertaken at Ward level on the Capital Programme – specifically there had been no feedback on work to improve security at Stratherrick Primary school, the feasibility study on Balnain Primary School or the potential use of ring-fenced monies for Glenurquahart School at Ward level; 

• a report on public access facilities had been requested some time ago and information was sought as to when this would be forthcoming; 

• further clarification was requested on the future arrangements for both Duthac House and Urray House; and 

• Members welcomed the progress made in relation to the following projects:-

- provision of the three additional classrooms at Milton of Leys Primary

  school and the commitments that had recently been given to

  parents.  It was commented that this should be finished for academic

  year 2014-15.  Judging from feedback from the pupils, the

  experience of having conjoined classes in one room had been positive

  and enjoyable for them as it permitted interaction with a wider circle

  of pupils within the learning environment;

- the replacement games hall floor at Tain Royal Academy had been a

  success; 

- the conversion of the former dental unit at Millbank Primary School

  into a nurture room would bring benefits for the whole of the ASG

  and was testament to the preventative spend which would improve

  the life chances for young vulnerable children;

- the refurbished toilets and nursery classrooms at Duncan Forbes

  Primary had been a great achievement; 

- it was welcomed that work had begun on the Wick North Primary

  School; and

- the removal of portacabins at St Clements School was welcomed.

Continuing, the Chairman confirmed the following:-

• he would discuss with Mrs B Campbell the current arrangements for the Plockton ASG and classrooms planned for Auchtertyre School; 

• a briefing for Local Members and Members of the Committee in relation to progress with arrangements and timescales for work at St Duthus Primary School would be provided; 

• arrangements for a representative from the Project Board Asset Management team to attend the Ward Business Meeting to explore a range of issues in relation to future investments for care of the elderly and infrastructure requirements at Duthac House; 

• an update briefing on the future of St Clements School and Urray House; and 

• that he would investigate and ensure clear communication with Members on the Capital Programme through Ward Business meetings.

Thereafter, the Committee:-

i.  NOTED the status of the 2013/14 HSC capital programme at the end of

    December 2013 as detailed in Section 2 and Appendix 1 of the report;

ii.  NOTED the status of the 2013/14 ECS capital programme at the end of

    December 2013 and the ECS major capital projects, all as detailed in Section

    3, Appendix 2 and Appendix 3 of the report;

iii. AGREED the list of proposed new ECS capital projects, all as detailed in

    Section 4 and Appendix 4 of the report;

iv. NOTED the status of the Sustainable School Estate Review as detailed in

    Section 5 of the report;

v. AGREED that a briefing for Local Members and Members of the Committee

    be provided in relation to work underway at St Duthus Primary School

    including associated timescales;

vi. AGREED that a representative from the Project Board Asset Management

    team should attend the Ward Business Meeting to explore a range of issues

    in relation to the future of Duthac House; 

vii. AGREED that a briefing update be provided to Members on the future of

    St Clements School and Urray House; and

viii. AGREED the need for clear communication with Members on the Capital

     Programme through Ward Business meetings.

6. Draft Local Fire and Rescue Plan for Highland 2014-2017

    Dreachd Plana Smàlaidh is Teasairginn Ionadail airson na

    Gàidhealtachd 2014-2017

There had been circulated Report No ACS-20-14 (976kb pdf) dated 10 February 2014 by the Local Senior Officer for Fire and Rescue which, together with the attached Draft Local Fire and Rescue Plan for Highland 2014-2017 (the Plan), set out the key priorities, actions and outcomes within Highland based on the local risk profile.  The report also recognised the importance of providing fire and rescue services in partnership through the Community Planning Partnership in line with outcomes identified in the Single Outcome Agreement 2013-2019.

The report explained that the key elements of the Plan included local risk management and preparedness; reduction of accidental dwelling fires; reduction of fire casualties and injuries; and a reduction of deliberate fire setting.  Following agreement and adoption of the Plan, an Annual Operating Plan detailing the delivery of risk reduction activities within Highland communities would be created by the Local Senior Officer. These activities would recognise the value of partnership working and information sharing, ensuring a more effective and efficient delivery of service for those most in need.

In addition to the report, a Briefing Paper by the Head of Policy and Reform was tabled which set out a number of areas where it was suggested that clearer targets and performance measures relating to local priorities were required.  The Depute Leader of the Council explained that there had been a significant and welcome shift in the contribution of the Fire and Rescue Service over the past 10 to 15 years in that it was now recognised that fires occurred not at random but where there were risks and those risks could be identified.  In so far as the Adult and Children’s Services Committee was concerned, there were two particular areas on which greater emphasis on targeted action to prevent fires was required, namely, vulnerable older people and the misuse of alcohol, particularly when coupled with smoking or chip pans.  It was suggested that wider issues regarding targets be debated when the Plan was considered by the Community Safety, Public Engagement and Equalities Committee.

During discussion, Members raised the following issues:-

• more people died in fires in Scotland than anywhere else in Europe and those most at risk had disabilities and/or lived alone.  Prevention was essential and it was requested that consideration be given to integrating sprinkler systems with telecare services and that sprinklers be installed in all social housing built in the future; 

• it would be helpful to formally consult NHS Highland on the Plan to make links with health improvement work and other elderly care issues; 

• as well as older people, many vulnerable young people were living alone or in smaller groups and it was necessary to think about how well they were protected in terms of fire prevention; 

• an assurance was sought that establishments such as hostels, schools and supported accommodation had sprinkler systems installed.  If not, it was suggested that this be incorporated in the risk register for the appropriate Service; 

• the importance of home visits by the Fire and Rescue Service in terms of identifying fire hazards was emphasised; 

• consideration should be given to the installation of sprinkler systems in new properties being made a condition of planning consent; and 

• reference was made to a recent fire in Inverness and it was highlighted that some flats had communal areas such as bin enclosures that were very poor in terms of fire safety.  A co-ordinated approach by the Fire and Rescue Service and the Council’s housing officers was necessary to ensure that risks were minimised.

Following discussion, the Chairman confirmed that it was likely that only new build schools had sprinkler systems installed.

* Thereafter, the Local Senior Officer for Fire and Rescue having responded to the issues raised, the Committee AGREED TO RECOMMEND to the Council the inclusion of the points raised in discussion in the Council’s response to the Local Fire and Rescue Plan 2014-2017.

7. Children’s Services

    Seirbheisean Chloinne

i. Performance Report

   Aithisg Dèanadais

There had been circulated Report No ACS-21-14 (148kb pdf) dated 9 February 2014 by the Director of Health and Social Care which provided an update on the performance framework for Children’s Services.

The report explained that the performance framework had been agreed by the Council and NHS Highland as part of the lead agency arrangements and the performance report was presented to both organisations.  Commentary was provided on a number of measures where performance was not broadly on target or was otherwise of note.

During discussion, Members raised the following issues:-

• reference was made to a previous report that had stated that breastfeeding was a prime example of early intervention and preventative spend and it was important to invest in it to improve outcomes later in life.  Information was sought as to whether preventative spend and NHS Highland monies were being allocated to breastfeeding and how it was intended to achieve the targets; 

• in relation to performance measure 8b (Allocation of Health Plan Indicator at 6-8 weeks from birth), clarification was sought as to why there was no data from February 2013; 

• the Family Nurse Partnership was having great success working with vulnerable young mothers to increase breastfeeding and this would be reported to Committee in due course; 

• an update was sought on the provision of health services to Looked After Children placed out of authority; 

• with regard to peer support, telephone contact was not enough to deliver the improvements needed and face-to-face support was necessary; and 

• in Highland, 60% of mothers were breastfeeding at birth and it was important to find ways to sustain that and make breastfeeding the norm.

Thereafter, the Committee:-

i. NOTED the performance information; and

ii. AGREED that a report on the breastfeeding peer support service be

   presented to a future meeting of the Committee.

ii. Assurance Report – Lead Agency Delivery of Children’s Services

    Aithisg Barrantais – Lìbhrigeadh de Sheirbheisean Chloinne le

    Buidhnean Stiùiridh

There had been circulated Report No ACS-22-14 (119kb pdf) dated 9 February 2014 by the Director of Health and Social Care, the purpose of which was to provide assurance to NHS Highland in relation to services commissioned and delivered through Highland Council.  The report would be presented to the appropriate strategic committee of NHS Highland.

The report explained that for each service there was a broad service descriptor which was reviewed annually with revisions agreed between the Child Health Commissioner and the Head of Health. This had already taken place for 2013/14.  Improvement plans for elements of the service had been developed at transition to the Lead Agency Model and these had been acted upon. Improvement priorities for 2014 onwards would be incorporated into the work of the Improvement Groups and reported on as part of the For Highland Children’s Service Plan (FHC4).

The report drew particular attention to the Health Visiting Service, School Nursing, Allied Health Professionals, the Primary Mental Health Worker service, Child Protection Advisory Service, Looked After Children Health Service, Learning Disability Nursing Service, Health Improvement/Health Promotion and the monitory value of the Commission.  The performance framework for commissioned services was detailed, together with commissioned improvement priorities and governance and risk management arrangements.  Exception reports in relation to looked after children assessments and breastfeeding were also included.

During discussion, Members raised the following issues:-

• a timescale was sought in relation to the staffing difficulties and recruitment to vacant school nursing and health visiting posts referred to in the report; 

• the report indicated that the new format of the Child’s Plan was not accessible on Care First and information was sought on the extent of the problem and the steps being taken to address it; and 

• in relation to Allied Health Professionals, information was sought on equity of service based on caseloads and it was confirmed that an analysis of caseloads could be provided to Members in a briefing.

Thereafter, the Committee NOTED the position.

8. Progress in Implementation of Health and Wellbeing Initiatives

    Adhartas ann an lìbhrigeadh de dh’Iomairtean Slàinte is Sunnd

There had been circulated Report No ACS-23-14 (20kb pdf) dated 19 February 2014 by the Director of Education, Culture and Sport which provided an update on progress made with two Scotland-wide Health and Wellbeing initiatives:-

• the High Five Health and Nutrition programme; and 

• the government target of two hours of PE in Primary Schools and two fifty minute periods up to the end of S4 in Secondary Schools.

The report explained that youth was a unique and critical period for influencing future health outcomes.  Supporting young people's health and wellbeing was at the core of Curriculum for Excellence (CfE). Physical education could have a very positive impact on a pupil's health, educational attainment and life chances and should now form a key element of a school’s plan to deliver the broad health and wellbeing outcomes and experience contained within CfE.  In 2010, the Scottish Government had set targets for interventions to promote healthy weight in children between 2 and 15 years of age. Schools provided the ideal opportunity to promote and deliver child healthy weight interventions, whilst also improving the health and wellbeing of children who were not overweight.

The Committee NOTED the terms of the report as circulated.

9. Implementation of 600 hours Early Learning and Childcare

    Lìbhrigeadh de 600 uair a thìde Tràth-ionnsachadh is Cùram-

    chloinne

There had been circulated joint Report No ACS-23A-14 (105kb pdf) dated 10 February 2014 by the Directors of Education, Culture and Sport and Health and Social Care which formed part of the regular reporting to Members and presented recommendations regarding changes to the local authority nursery staffing structure in order to meet the requirement to deliver 600 hours of funded early learning and childcare across Highland from August 2014.

The report explained that, due to the short timescale for initial implementation, the Scottish Government had acknowledged that it was not going to be possible to expand choice and flexibility of provision from August 2014.  It was therefore important that an effective, affordable and ‘fit for purpose’ platform was established across the authority in August 2014.  The report addressed the necessary changes to local authority staffing and models of delivery and took account of the fact that the staffing model would require additional hours of childcare to be delivered for greater numbers of children not only for 2014 but also for the years ahead.  It also addressed the existing staffing structure and models of delivery and brought forward two options for consideration as follows:-

• Option 1: Extend both sessions to 3 hours per day in term time plus 2 additional weeks staffed by one full-time team of staff 

• Option 2: Extend morning and afternoon sessions to 3 hours 10 minutes, as in single session nurseries, each staffed by a dedicated team

Details of management considerations and the consultation process undertaken were provided.  In addition, the projected cost of implementing the changes in 2014/15 for both options was also outlined.  The Scottish Government had confirmed the funding for the Early Learning and Childcare element of the Children and Young People Bill for next year.  The revenue allocation for Highland in 2014/15 would be £2.375m, with an additional £81K for looked after 2 year olds. There was also a capital amount of £1.467m each of the next 3 years.

During discussion, Members raised the following issues:-

• the proposals involved significant change for staff and concern was expressed that the report was recommending a platform that was fit for purpose when it was not entirely clear what future needs would be; 

• recruitment would not finish until the end of May and concern was expressed regarding the possibility that fully qualified staff would not be in place for August 2014 and that they would be training on the job.  Information was sought on the impact this would have on children’s learning; 

• concern was expressed regarding the tight handover time in double session nurseries where there were two separate teams and clarification was sought as to how this would be managed; 

• nursery staff were trained professionals who were keen to deliver early years learning and the proposals regarding 23 hour contracts and the provision for 12 hours additional deployment in Option 2 were vague and unsettling; 

• in relation to Appendix 1, the weighted scores that had been applied to various objectives when comparing Options 1 and 2 were questioned; 

• Option 2 would work well for some nurseries but not for others and a more flexible approach was required in what was a transitional year; 

• it was vital that additional management time was embedded from the start; 

• it was essential that accommodation issues, such as access for cleaning staff and other activities, were addressed; 

• the proposals were progressive, based on good practice, evidence and understanding of what was required and formed a good starting point; 

• the approach would be reviewed and there would be continual dialogue between the Council and nursery staff.  In particular, the proposal to provide one to one meetings for all staff in double session nurseries and any other staff who requested it was welcomed; 

• the proposals gave a degree of comfort to staff in that nobody would have their hours or salary reduced and the additional hours would lead to more jobs being created; 

• the proposal to upgrade nursery auxiliaries to the same level as nursery assistants so that there was a one-tier structure was welcomed; 

• the additional funded hours would save families approximately £350 per year and would allow parents, particularly single parents, the opportunity to get back in to employment, training or education and address their life balance; 

• the extra hours would provide additional structured learning in children’s formative years which fed in to the preventative spend agenda; 

• the proposed establishment of a career pathway for nursery staff through the creation of a senior post of Early Years Practitioner was welcomed; 

• delivering additional funded early learning and childcare was, and would continue to be, a complex issue and thanks were expressed to all staff involved; 

• it was important to get the model right for children and parents; 

• the potential for unintended consequences was significant and it would be helpful to have sight of the risk register for the project; 

• further information was sought in relation to the statement in the report that, in the future, the focus needed to be on rationalisation of provision; 

• the proposals were a significant step forward that had come about as a result of support from the UK Government, the Scottish Government, the Council and partner agencies; 

• each area had different challenges that needed to be understood and Option 2 would enable the service to be developed sensibly in a way that was sensitive to local needs; and 

• in some areas, there was still a feeling that a different model could be used to deliver the 600 hours and it was suggested that a review should be carried out prior to implementing changes that did not suit all local needs.

Thereafter, Ms J Douglas, seconded by Mrs M Davidson MOVED that, in this transitional year, the approach should be one of local flexibility to allow nurseries to deliver the 600 hours according to their own circumstances via Option 1 or Option 2 and in consultation with their communities.  This would allow further clarification of future provision and a clear view of staffing needs and structure.

As an AMENDMENT, Mr A Christie, seconded by Mr G MacKenzie, moved the recommendations in the report.

On a vote being taken, the MOTION received 8 votes, the AMENDMENT received 14 votes and there was 1 abstention, the votes having been cast as follows:-

For the Motion:

Campbell, I; Davidson, M; Douglas, J; Somerville, Dr M; Fernie, B; Green, M; Robertson, F; Ross, G (W14).

For the Amendment:

Alston, D; Christie, A; Gowans, K; Gray, J; Macaulay, C; Mackay, D (W5); MacKenzie, G; Smith, G; McCreath, G; McCulloch, M; Munro, L; Rattray, M, Slater, J; Stephen, K.

Abstention:

Duncan; M.

Thereafter, the Committee APPROVED the following staffing recommendations with regard to the delivery of 600 hours early learning and childcare by August 2014:-

i.  the current staffing model of Nursery Assistant and Nursery Auxiliary move

    to an Early Years Practitioner model where both staff were on the same

    grade;

ii.  single session nurseries be extended the session to 3 hours 10 minutes in

    term time with all staff on 23 hour contracts;

iii. double session nurseries be extended, both sessions to 3 hours 10 minutes

    per day in term time with all staff on 23 hour contracts and therefore only

    responsible for delivery of one pre-school education session per day (Option

    2); and

iv. an additional 0.1 FTE allowance for all double session nurseries from August

    2014.

10. Additional Support Needs Review – Progress Report

      Ath-sgrùdadh air Feumalachdan Taice a Bharrachd – Aithisg

      Adhartais

Declaration of Interest: Mr A Christie declared a non-financial interest in this item as General Manager of Inverness and Badenoch and Strathspey Citizens Advice Bureau but, having applied the test outlined in Paragraphs 5.2 and 5.3 of the Councillors’ Code of Conduct, concluded that his interest did not preclude his involvement in the discussion.

There had been circulated joint Report No ACS-24-14 (76kb pdf)  dated 10 February 2014 by the Directors of Education, Culture and Sport and Health and Social Care which provided an update on the progress made thus far by the six subgroups working as part of the Additional Support Needs Review.  It was explained that the aim of the review was to identify the range of needs, identify principles and structures that made the most effective and efficient use of resources to meet those needs and, in doing so, achieve the best outcome for children and young people.  The review had involved an extensive period of consultation which had been widened to take account of the proposed new Care and Learning Service integrated structure.  Six subgroups had taken responsibility for the various aspects of the review.

The total number of school pupils reported to have additional support needs in Highland was growing. This was in keeping with figures from across Scotland and the United Kingdom. Some of the reported rise was due to better recording of these figures and some was due to a real rise in specific groups of children with identified needs. The introduction of personalised support and integrated service models allowed a greater skills mix and range of resources to be utilised.  It also required a robust management structure to ensure that effective support could be provided and that better outcomes for children and young people could be achieved. The ASN Review process would continue with its work towards clear recommendations for an ASN structure within the Care and Learning Service.

During discussion, Members raised the following issues:-

• it was important to acknowledge that there was a risk to the Council if the ASN data was not used to plan for a range of future services; 

• a report on transitions was sought as soon as possible and the Chairman confirmed that this would be presented to the Committee on 21 May 2014; and 

• an assurance was sought that, at the full Council on 13 March 2014, there would be a clear position statement on the ASN budget for the next financial year and future years.

Thereafter, the Committee:-

i. NOTED the progress to date and the next steps proposed by the review

   group; and

ii. AGREED that a report on transitions be presented to the Committee on 21

   May 2014.

11. Self Directed Support

      Taic Fèin-stiùirichte

There had been circulated Report No ACS-25-14 (1152kb pdf) dated 9 February 2014 by the Director of Health and Social Care which set out the critical issues that needed to be considered by the Council as part of the implementation of Self Directed Support.

The report explained that the Social Care (Self-directed Support) (Scotland) Act 2012 was to be fully implemented from April 2014. This new legislation had raised the profile of Self Directed Support (SDS), and required NHS Highland and The Highland Council to actively promote the take-up.  Highland Council had already committed to do this within its Programme.  Direct payments had been available for support to children with disabilities since the introduction of the Direct Payment legislation in 1996. The implementation of SDS from April would continue to focus on this group of children, including those in transition to adulthood.

Details were provided on the resource allocation system, the challenges of implementation and the release of resources in terms of child care, support work, residential and family based respite, home-based respite, fieldwork and care at home.  Regarding financial implications, there was still work to be done to keep the SDS budget within the resource available and it would be necessary to agree a limit for Indicative Budgets to reflect the Health and Social Care element of the RAS.  Additionally, an emerging budget strategy would be required to manage this process, taking account of the issues set out in the report.

 During discussion, Members commented that the implementation of SDS legislation would have a significant impact on both children and adult services.  It was important to raise awareness in the wider community and it was highlighted that SDS Awareness Week commenced on 3 March 2014.

Thereafter, the Committee:-

i.  NOTED the issues raised in the report;

ii. AGREED to progress the release of resources; and

iii. AGREED to seek further reports as the various activities were taken

    forward.

12. Alternatives to Out of Authority Placements

      Roghainnean a bharrachd airson Suidheachadh Thar Ùghdarrais

Declaration of Interest: Mr A Christie declared a non-financial interest in this item as General Manager of Inverness and Badenoch and Strathspey Citizens Advice Bureau but, having applied the test outlined in Paragraphs 5.2 and 5.3 of the Councillors’ Code of Conduct, concluded that his interest did not preclude his involvement in the discussion.

There had been circulated joint Report No ACS-26-14 (33kb pdf) dated 25 January 2014 by the Directors of Education, Culture and Sport and Health and Social Care which provided an update on further exploratory activity that had taken place to date to define the scope of the programme to find alternatives to out of authority placements for Highland children.

The report explained that, as had previously been reported to the Committee, the term “out of authority placements” no longer reflected the full use of this budget.  In addition to the continued use of spot-purchased placements in residential schools there were spot-purchased placements in new, independent children’s units in Highland as well as commissioned placements in these units.  There were currently 67 placements funded from the out of authority placements budget, a breakdown of which was provided.  Detailed information was provided on placement exit plan assessment; provisions and services for returning young people from placements; provisions and services for avoiding placements, utilising existing council properties/services to return young people to Highland; the Children and Young People (Scotland) Bill; and new provisions and services.

The Chairman referred to the refurbishment of a former school house in Inverness to enable a young person to return from an out of authority placement.  They would receive support to manage the tenancy until considered able to move to an unsupported tenancy or throughcare and aftercare supported accommodation.  This would not only provide a better outcome for the young person but would save the local authority an estimated £150,000 per annum in revenue costs.  Members were urged to consider, at Ward Business Meetings, whether there were any local properties that could be utilised in the same way.

During discussion, Members welcomed the report and the creative thinking being applied to finding alternatives to out of authority placements. However, the real alternatives to out of authority placements were earlier adoption, increased kinship care and specialist fostering. It was important to provide early intervention in a planned expansive way, thereby improving outcomes for children and young people, and information was sought on the thinking being applied in that regard.

Thereafter, the Committee AGREED to endorse the further scoping work undertaken to date to identify alternatives to out of authority placements for the young people of Highland.

13. School Office Review

      Ath-sgrùdadh Oifis Sgoile

There had been circulated Report No ACS-27-14 (125kb pdf) dated 4 February 2014 by the Director of Education, Culture and Sport which explained that the School Office Review had commenced in July 2013 under the governance framework of the Corporate Business Support Project Board.  The report summarised progress to date and the next steps, including the governance and establishment of the project; the work carried out so far and main themes established; the next phase of work around those themes; and the communication and engagement plan.

The report explained that school offices were highly valued by school staff, parents and pupils and were often the first port of call for issues arising in and around the school.  School office staff displayed great commitment and loyalty to their schools and there was a real sense that they were an integral part of the school community.  However, there had been little change to post roles and staffing structures for some time and the Shared Business Support Service review had provided a catalyst for undertaking a similar review of the school office support function.

A number of other major projects were ongoing that would impact on the school office function including SEEMiS (the new school Management Information System referred to at item 14 on the agenda), the integrated payroll and personnel system in Resource Link and the corporate Information Management Project.  It was important that the school office review recognised and reflected the potential system and process changes arising from these other projects.  The Project Initiation Document, approved by the Corporate Business Project Board in December 2013 and set out in Appendix 1 of the report, provided details of the project rationale, objectives, benefits, outcomes and risks.