Agenda, decisions and minutes

Resolved: the committee agreed the minutes of the last meeting as a true record with the following amendment: After paragraph 8.15 remove the text “Resolved: the committee noted the report”.

Resolved: the committee agreed the minutes of the last meeting as a true record with the following amendment: After paragraph 8.15 remove the text “Resolved: the committee noted the report”.

Councillor Susan Wise is a governor of King's College Hospital NHS Foundation Trust.

Councillor Susan Wise is a board member of Lewisham Homes.

Councillor Susan Wise is an adult learner at Adult Learning Lewisham.

Councillor Paul Bell is a member of King’s College Hospital NHS Foundation Trust.

Councillor Jacq Paschoud has a family member in receipt of a package of adult social care.

Resolved: the committee noted the information presented and invited Lewisham Speaking Up and Lewisham People’s Parliament to present future findings to the committee.

Colin Finch (Advocacy coordinator, Lewisham Speaking Up) and Aisha Edwards (Lewisham People’s Parliament Rep) introduced the report. The following key points were noted:

4.1       Health treatment for people with a learning disability is not always equal and many deaths among people with learning disability are avoidable. There have been a number of upsetting stories in the media, including that of a young man with Down’s syndrome who died from constipation. An inquest into the death found significant failures at almost every stage of his care.

4.2       The Lewisham People’s Parliament looked at the everyday experiences of using healthcare services for people with learning disability. It found that the experiences were mixed but that taking some simple steps in three key areas can make a big difference. These areas are: good communication, good staff attitudes, and the right reasonable adjustments.

4.3       Following a series of workshops, it was recommended that:

·         There is wider use of hospital passports, health action plans and annual health checks, this includes promoting these tools among people with learning disability.

·         There is more training for staff on how to communicate well with people with learning disability and how to treat them equally.

·         There are more reasonable adjustments for people with learning disability.

·         Shorter waiting times and longer appointments would make using health services easier for people with learning disability.

• There is a better understanding from health professional that people with learning disability have the right to make their own decisions about health care.

4.4       Lewisham Speaking Up is now working with Lewisham CCG to make sure that people have annual health checks. It is also helping the CCG with how they review what happened when someone with a learning disability dies.

4.5       In response to a query from the witnesses, the independent Chair of the Lewisham Safeguarding Adults Board (LSAB) noted that Lewisham has not yet received any referrals about the death of a person with learning disability. There are some that have been completed elsewhere in England and the LSAB Chair offered to make the learning from these report available to Lewisham Speaking Up. The LSAB Chair also invited Lewisham Speaking Up to a safeguarding adults board meeting to present their concerns and seek reassurance as to the arrangements being put in place to prevent early deaths.

4.6       One committee member noted their experience of support workers being unwilling to intervene in relation to poor diet. The member noted that this can lead to weight gain and poor health and queried what could be done without restricting individual freedoms.

4.7       The LSAB Chair noted that it is important that care workers are appropriately trained, aware of issues such as mental capacity and that family members are involved and listened to. The Chair noted that support workers can be interventionist and make safeguarding personal.

4.8       Council officers noted that they will be auditing support plans and looking more in depth at how personalised they are.

4.9       The committee noted that an annual update from the Lewisham People’s  ...  view the full minutes text for item 4.

Resolved: the committee noted the report and invited the Chair of Lewisham Safeguarding Adults Board to present the 2017/18 annual report to committee later in the year.

Professor Michael Preston-Shoot (Independent Chair, Lewisham Safeguarding Adults Board) introduced the report. The following key points were noted:

5.1       The independent Chair of the Lewisham Safeguarding Adults Board (LSAB) noted that is strong partnership working within and across agencies with roles and responsibilities for adult safeguarding.

5.2       The HCSC Chair noted that the South London and Maudsley NHS Foundation Trust was running a drop-in service for hoarders to meet a firefighter and hear about the dangers of hoarding.

5.3       Lewisham has applied for funding to create a hoarding support scheme for Lewisham. Officers are looking at creating something that is focused on the individual. Croydon’s buddy scheme was referred to as an example of innovative work going on in other local authorities. Lewisham has received more referrals on hoarding since the Grenfell tower fire in 2017. Professor Preston-Shoot explained the need to understand the reason for hoarding, which could have its origins long ago.

5.4       The LSAB has also developed a self-neglect and hoarding policy and procedure to provide further support and guidance on what to do in such cases.

5.5       The 2017/18 annual report for the Lewisham Safeguarding Adults Board is expected to be available by September.

Resolved: the committee noted the report and invited the Chair of Lewisham Safeguarding Adults Board to present the 2017/18 annual report to committee later in the year.

Resolved: the committee noted the report.

Danny Ruta (Director of Public Health, LBL) and Marc Rowland (Vice-Chair, Lewisham Health and Wellbeing Board) introduced the report. The following key points were noted:

6.1       The Health and Wellbeing Board uses a health and wellbeing dashboard to monitor progress. This is included with the agenda papers.

6.2       The dashboard shows improvement in a number of areas, such as male and female life expectancy, low birth weight, excess weight in children reception years, and delayed transfers of care.

6.3       There are also, however, some areas that have not improved, such as excess weight in children in year 6, maternal obesity, and the number of smokers.

6.4       Once adjusted for deprivation, most of Lewisham’s health and wellbeing indicators are where expected.

6.5       The Vice-Chair of the Health and Wellbeing Board noted that the current abortion rate shows a contraception failure. Teenage pregnancy rates have reduced to the national average, but more contraception is still needed in primary care. Better use of contraception such as condoms would also help prevent chlamydia.

6.6       Lewisham works closely with Lambeth and Southwark on sexual health. Lambeth and Southwark have much higher needs and expert commissioners and commission jointly on Lewisham’s behalf. The joint sexual health strategy been successful. In the last two years there has been a 45% reduction in new HIV cases. This number was rising previously.

6.7       There will soon be a consultation on a new sexual health strategy. This will focus on four main areas: Chem-sex; Sexual education in schools; Contraception; and living with HIV.

6.8       One committee member suggested that Lewisham should consider a strategy to advise people to avoid meat and dairy. The member noted that there are lots of studies which show that this can increase life expectancy.

6.9       The Vice-Chair of the health and wellbeing board noted that the evidence on meat and dairy is not clear cut. There is evidence to support the advice to reduce or avoid certain meats, but the evidence on dairy is less clear.

Resolved: the committee noted the report.

Resolved: the committee noted the report.

Gerald Jones (Service Manager, Adult Learning Lewisham) introduced the report. The following key points were noted:

7.1       In 2017 Adult Learning Lewisham (ALL) achieved a student satisfaction rating of 97%, placing it 40th highest in the country (out of 800 providers).

7.2       Ofsted carried out a new inspection and awarded the service a grade 2 rating, this is second time in a row that the service has received a grade 2 rating.

7.3       Ofsted appreciated that the service is looking at how it help to meet the long term hopes and ambitions of learners, not just the number of people enrolled on courses.

7.4       Online enrolment was introduced in 2017 and since them 25% of learners have enrolled online.

7.5       All ALL staff completed Prevent training and are now updating their relevant safeguarding training.

7.6       The devolution of skills funding to the GLA poses some risks, such as the potential to lead to a narrower focus only on skills related to employment.

7.7       In response to concerns that the ALL prospectus is only available online, for those not able to get online there is advice and guidance about courses available through a hotline and a reception team.

7.8       ALL is keen to be involved in social prescribing initiatives in the borough as being enrolled in a class can have a significant positive impact on a learner’s wellbeing.

7.9       Given that there are significantly more female than male learners, the committee queried what was being done to raise awareness of courses among men.

7.10    The number of male learners is about average when compared to similar services nationally, but more men are being included in ALL’s publicity material. The attainment levels among men and women are almost the same.

7.11    ALL is working to map its partnerships in the borough. In the north of the borough, for example, it works closely with community organisations and charities involved in employment-related training. This partnership working allows ALL to reach people who are unable to access the facilities in Lewisham town centre.

Resolved: the committee noted the report.

Resolved: the committee noted the report.

Danny Ruta (Director of Public Health, LBC) introduced the report. The following key points were noted:

8.1       The topic of focus of this year’s public annual report is mental health.

8.2       The report has been published as a website, which is targeted more towards residents and people at risk of developing mental illness, rather than towards professionals.

8.3       It includes information about mental health first aid and other training to help improve the understanding of mental health. The more detailed data usually included in the annual report is still available.

Resolved: the committee noted the report.

Resolved: the committee noted the report.

Resolved: the committee noted the report.

Resolved: the committee noted the report.

Resolved: the committee noted the completed work programme for 2017/18 and suggested a number of items that could be considered by the committee in the next administration, including the efficiency of the flu vaccine, an update on social prescribing, and the Lewisham, Southwark and Lambeth sexual health strategy.

Resolved: the committee noted the completed work programme for 2017/18 and suggested a number of items that could be considered by the committee in the next administration, including the efficiency of the flu vaccine, an update on social prescribing, and the Lewisham, Southwark and Lambeth sexual health strategy.

There were no referrals to Mayor and Cabinet.