Agenda item

RESOLVED:

·         that the report be noted, along with the comments made by the Committee.

Tom Brown (Executive Director for Community Services) and Joan Hutton (Director of Adult Social Care) presented this item to the Committee. The following key points were noted:

4.1. This was the first draft of the Adult Social Care Strategy and officers wanted to take this forward in a co-productive way. It was discussed that partnerships were really important in delivering this strategy, this included partnerships within the system and partnerships with residents.

4.2. The vision for the strategy was to work jointly with residents, carers, partners and providers to co-produce it in order to enable the right care to be provided to residents.

4.3. It was noted that Lewisham was due to be inspected by the CQC (Care Quality Commission) and that the Council was preparing for that by doing mock inspections and by being part of a peer review in February 2024.

4.4. Officers highlighted the key objectives detailed in the report to the Committee that the Adult Social Care strategy would focus on, including:

·         Independence and safety- working together to enhance Quality of Life and maximising independence for residents.

·         Motivated and sustainable workforce- working towards Lewisham being a place that people want to work in and developing, supporting and motivating staff to feel empowered to make the right decisions.

·         Ensure a sustainable and diverse care market

·         Co-production and collaboration- working jointly with citizens, carers, partners and providers to co-produce and provide the right support to residents, as close to home as possible.

·         Improvement and innovation- focusing on innovation and improvement, in readiness for CQC and wider ASC reforms.

·         Equality and accessibility- ensuring equality and accessibility by improving access and simplifying and streamlining communications, data, processes and systems.

·         Effective budgets and resourcing- delivering value for money, making the best use of resources across the system.

The Committee members were invited to ask questions. The following key points were noted:

4.5. Nigel Bowness (Healthwatch Lewisham) stressed the importance of a corporate ‘One Lewisham’ approach to co-production with an agreed definition of what co-production means in Lewisham context. Councillor Paul Bell shared a helpful definition of co-production with the Committee and agreed that a corporate approach was required. The definition stated- “Co-production refers to a way of working where service providers and users work together to reach a collective outcome. The approach is value-driven and built on the principle that those who are affected by a service are best placed to help design it”. Officers reported that Social Care Institute for Excellence (SCIE) had been commissioned to help better understand the co-production approach in Adult Social Care but learning from that would be applicable to wider Council areas as well.

4.6. It was noted that the equalities implications in section 6 were helpful as broad statements, but it was suggested that they should place a clearer emphasis on the barriers to hearing residents’ voices and the mitigations required to overcome those barriers.

4.7. Councillor Jacqueline Paschoud attended the meeting as the Committee’s guest and highlighted residents’ concerns about inconsistent reviews of their care packages. Some residents had also reported not fully understanding their financial assessment letters. In advance of raising this point, Councillor Paschoud declared a personal interest in the issue as she had a close family member in receipt of a care package from Lewisham Social Care.

Officers acknowledged the importance of timely care package reviews and suggested a co-production approach to involve residents in improving the process.  Residents were advised about the financial charges in the initial stages, but officers expressed a willingness to explore process improvements.

4.8. The importance of adhering to the ‘Nothing about us without us’ principle in delivering appropriate care to individuals was emphasised during the discussion. The co-production work undertaken by SCIE aimed to align with this principle, establishing an effective co-production model in Social Care that could subsequently be extended to other Council areas.

4.9. Lewisham had around 50 vacancies for in-home wellbeing carers, one of the lowest counts in the region.

4.10. A Committee member raised the issue of arranging transport for elderly residents attending GP and hospital appointments. It was clarified that funding transport for GP appointments fell under the NHS’s purview, not Adult Social Care. Nevertheless, it was stressed that the Council should actively promote the available community offer around transport to facilitate residents’ access to services. Additionally, it was highlighted that individuals with disabilities had the option to apply for a ‘Disabled Person’s Freedom Pass’ for free public transport.

4.11. Councillor Paul Bell stated that there was a home care provider that offered training for ‘direct payments’ and that he would share the name of that provider with the Committee.

4.12. The discussion emphasised that having a diverse workforce wasn’t equivalent to having a culturally competent one. Training for a diverse workforce was necessary to ensure culturally sensitive service delivery.

4.13. In the budget table on page 31 of the agenda pack, the term ‘Client contributions’ was used, and a Committee member enquired about changing it to ‘Client charges’. Officers explained that they used the terminology from the National Contribution Framework but stated that ‘Client contributions/ charges’ could be used going forward.

4.14. It was discussed that digitalisation of services could pose a barrier to access for certain individuals. Officers reassured the Committee that digitalisation of services would not involve moving all services online and that face-to-face elements would still be retained where necessary.

4.15. The significant role of unpaid carers in providing care in the borough was discussed, with the suggestion to include a reference to them in the strategy.

4.16. The value of the Council’s enablement service was acknowledged, and it was proposed that the strategy should highlight some of its achievements. Additionally, it was discussed that the strategy should recognise partnerships with other Council departments responsible for broader health determinants.

4.17. The Committee Chair recommended including a note in the strategy’s current landscape section to highlight that adult social care offered a ‘7 days-a-week’ service.

4.18. The need for timelier corporate data publishing was recognised.

4.19. Councillor Paul Bell informed the Committee that the ‘Shared Lives Service’ had recently retained its ‘Good’ CQC rating and efforts were underway to further promote the service. He also emphasised the significance of loneliness in impacting people’s wellbeing and suggested its inclusion in the strategy.

4.20. It was discussed that this strategy was still in the very early stages of development and that it would be revisited by this Committee in the future.

RESOLVED:

·         that the report be noted, along with the comments made by the Committee.