Agenda and minutes

There were no apologies for absence.

There were no declarations of interest.

RESOLVED: That the minutes from the meeting on 28 November 2018 be approved as an accurate record, subject to including that Members noted that there was a material mistake on the Universal Credit flyer, which formed appendix 9 of agenda item 5.

To be added to the minutes from 28 November 2018:

Members noted that in appendix 9, the Universal Credit flyer, there was a material mistake as it indicated that Hillingdon would accept new claims/change of circumstances for Universal Credit from 24 October 2018 for single newly unemployed people. The error was that the requirement to claim UC was extended from that date from single individuals to all new benefit claimants and those with changed circumstances (except the limited exceptions such as those over retirement age).

It was confirmed that there were no Part II items and that all business would therefore be conducted in public.

Prior to the start of the meeting, the Children in Care Council delivered a private presentation to Members of the Social Care, Housing and Public Health Policy Overview Committee. Members welcomed the presentation and found it insightful to see what recent activities children and staff had been undertaking. Members noted that there had been varied opportunities for young people to engage with Council processes and activities such as taking part in recruitment interviews. Members were pleased with the presentation and were keen to hear more from the Children in Care Council in the near future. The Chairman updated Members on development of the Corporate Parenting Panel, which would come before the Committee in due course to consider, noting the wish to also engage young people in how the Panel is chaired.

For the major review, the Committee heard from the following witnesses:

Heather Brown – Director and Barbara Maccauley – Policy Manager from the Citizens Advice Hillingdon

Ms Brown took Members through a presentation and provided a number of additional information documents.

Members noted the key points as detailed below.

During 2017 – 18, 35 % of the advice and information given to clients at the Citizens Advice (CA) was in relation to benefits and tax credits, 23% in relation to debt and 9 % was in relation to housing matters. From a CA perspective, the main aim of their service is to provide advice to people and improve policies and practice that affect people’s lives. A lot of work had been undertaken by the CA to ‘fix universal credit’ which included the removal of the seven waiting days at the start of a claim, making the UC helpline free of charge and trying to make UC claims less complicated.

According to the CA, some of the unintended consequences highlighted from UC include UC pushing people into debt, only 30 % of people getting through the identification verification process first time, budgeting difficulties and digital issues especially for middle aged with learning difficulties.

When people are referred, staff at the CA make gateway assessments of client needs and provide telephone advice, arrange appointments with financial advisors and appointments with form fillers. 109 initial claims were recorded in the last six months from July to December 2018. The gateway assessments could also be undertaken over the telephone via a telephone call back.

Following Member questions, it was confirmed that the CA used Somali speaking volunteers to communicate with people who were unable to properly speak English. When the volunteers were unavailable, translators were then arranged and used. People with mental health concerns were targeted and staff had had specific training on how to make adjustments and be flexible, such as arranging appointments in the evening if people were on meds in the morning. It was also felt that staff had had relevant training as this was not a new topic, this had been a targeted project for some time and a number of adjustments have been made with updated training. The telephone call back highlighted by the CA were also free to mobiles.

It was explained that claimants were frightened about UC as they did not know what to expect. A recent letter sent out by the Council caused panic. The Chairman informed Members that those Members who had undertaken the site visit had already been made enquiries about this letter and it would be referenced in the review.

There was an issue with clients applying too early and as a result, losing transitional rights.

Other CA services would not be compromised as a result of numbers projected as advice sessions were linked and benefit advice sometimes interlinked with debt advice. Capacity may be an issue if there are a lot of people with complex problems after they are in payment for  ...  view the full minutes text for item 57.

 Gary Collier - Health and Social Care Integration Manager and Nina Durnford - Head of Business Delivery and Support presented the 2016/17 Hospital Discharge Review Update report.

Caroline Morrison - Managing Director from Hillingdon CCG, Imran Devji - Director of Operational Performance and Vanessa Saunders - Deputy Director of Nursing, Safeguarding, workforce and Clinical Standards both from Hillingdon Hospital were also in attendance.

The report provided an update on progress with delivering the recommendations following the review of the hospital discharge process that was taken by the previous POC in 2016/17. The review examined the discharge process for people aged 65 and over who were admitted to Hillingdon Hospital. Eight recommendations were made, which were approved by Cabinet and the report provided an update on the current position for each of them.

Some of the key points noted during Members questions are detailed below in summary.

Members questioned how staff knew a patient was ready to be discharged as there were concerns that some patients may just say it without really being ready. It was confirmed by external partners that when care was provided a relationship was developed between the patient and carer, and ultimately a patient had a right to exercise choice in being discharged. Another key consideration was the capacity of a person and their ability to make this choice.

Members commented that the report was helpful and demonstrated the good progress that had been made. Regarding delayed transfers of care (DTOCs), the Committee was advised that it was unlikely that this could ever be reduced to zero as there were often complexities arising from family dynamics.  It was noted, however, that the implementation of the discharge to assess model meant that people were being discharged much earlier and therefore reduced the number of DTOCs arising.

It was confirmed that a CQC re-inspection would take place later this year. It is likely that this will be unannounced. In relation to recommendation 7, Members asked when this would take place. It was confirmed that Mr Collier will discuss this with Healthwatch Hillingdon and update the Committee.

Members thanked attendees for speaking to the report. Members encouraged officers to not lose sight of the recommendations and commended them for the positive progress made thus far.

RESOLVED: 

1.    That the Committee noted the progress made following the 2016/17 review.

2.    That the Committee thanked officers and partners for their attendance and progress.

Iain Watters - Financial Planning Manager, Peter Malewicz - Finance Manager and Andy Goodwin - Financial Planning Accountant were in attendance at the meeting to introduce the 2019 / 2020 budget proposals for services with the remit of the Committee. Members heard that the budget was presented in the context of the next four years, and during this period £48.155m total savings were required.

The Committee noted that Cabinet would consider the budget proposals on 14 February 2019 and the report would include comments from POCs.

The Committee was informed that the underlying savings requirement for 2019/20 has fallen to under £20m due to a reduction in the financial gap within social care and a Council Tax increase, although Council Tax for the over 65s remained frozen. Mr Watters noted that there was still no reduction in service levels, and any savings were made by efficiencies. Mr Watters detailed the contingency items relating to services with the remit of the POC, providing £3,756k additional funding to meet the costs of service delivery in 2019/20 over and above operating budgets.

It was confirmed that savings proposals were focused on increased efficiency and effectiveness, rather than reducing services. It was highlighted that a number of savings totalling £749k had been identified and built into the proposed budget, which included savings from the outsourcing of the Telecare service.

Members heard that any fees and charges for services were benchmarked against neighbouring local authorities, or competitive if the fees were commercial.

The concerns about the pressures on social care exceeding budget proposals and the challenge of recruiting and retaining professional social work staff was noted. 

RESOLVED:

1)    That the Committee noted the 2019/2020 budget proposals for services within the remit of the Social Services, Housing and Public Health Policy Overview Committee.

2)    That authority be delegated to the Democratic Services Officer to finalise the Committee’s comments with approval of the Chairman and the Labour Lead.

RESOLVED: That the forward plan be noted.

RESOLVED: That the work programme be noted.