The following disclosures were made in the interest of transparency:

(i)            Councillor Bacon disclosed that she was contracted to work for Bradford District Care Trust, Bradford Teaching Hospitals NHS Foundation Trust and Airedale Hospital NHS Foundation Trust as part of her employment with Unison.

(ii)          Councillor T Hussain disclosed that he was a Governor of Bradford District Care NHS Foundation Trust.

(iii)         Councillor Shaheen disclosed that she worked for an organisation that cared for people with disabilities.

ACTION:       City Solicitor

Recommended –

That the minutes of the meeting held on 28 July 2016 be signed as a correct record (previously circulated).

(Palbinder Sandhu – 01274 432269)

Resolved –

That the minutes of the meeting held on 28 July 2016 be signed as a correct record.

There were no appeals submitted by the public to review decisions to restrict documents. 

The Chair introduced the item by explaining that a number of parents of children with learning disabilities were present at the meeting in order to make representations in relation to the proposed changes to the Contributions Policy. 

Parent 1

·        Her child lived in supported accommodation.

·        Bradford Council had been proactive in the past for people with learning disabilities.

·        The large budget cuts were acknowledged.

·        The Council’s response had been disappointing.

·        There was no evidence of any alternate ways to manage the deficit.

·        Vulnerable people were an easy target.

·        The response from Council officers at the consultation had been shocking and was indicative of the underlying negative attitude towards people with learning disabilities.

·        It had been stated that people would pay what they could reasonably afford.

·        Her son’s contribution would increase four fold, it would take 100% of his disposable income and he would be left with a deficit.

·        Her son played learning disability rugby, which was very important to him, however, this would have to stop if he could not afford the £30 insurance.

·        There was no other situation where there would be a 100% increase to the cost.

·        The proposals would impact on her son’s behaviour, self esteem and health.

·        There would be an increasing likelihood of abuse.

·        A review had been undertaken and the charges did not have to be imposed.

·        The amount of the charge should be reconsidered.

Parent 2

·        He had a Down’s syndrome child.

·        How would anyone feel if they could not afford to participate in any social activities?

·        He could not understand the proposal to increase the contribution by 100%.

·        His child would not have a life and have nothing to look forward to.

Parent 3

·        She was a parent and carer for two sons with severe learning disabilities who lived in supported accommodation.

·        Socialising was very important for her sons.

·        Her sons required one to one support when they went out and the costs of the persons supporting them had to be covered.

·        Doctors had stated that her sons needed to be kept active with swimming.  If they could not attend they could end up wheelchair bound and this would not be good for their health.

·        Current staff were excellent, however, if cuts were made then a situation similar to Winterbourne View could arise.

Parent 4

·        His son had severe learning disabilities and had left the education system at the age of 19.

·        He had two other able bodied sons.

·        After a long process his son had entered into supported accommodation and everything had changed for the better.

·        His son had joined a football team and undertook 3 days voluntary work.

·        The activities his son participated in were not expensive.

·        If the increases came into effect his son would not be able to partake in voluntary work, play football as much or socialise.

·        He had found out about the consultation process by accident and had been horrified when he had recalculated his son’s budget.

·        His son was currently living a normal life and  ...  view the full minutes text for item 28.

Healthwatch Bradford and District spoke to people affected by the proposed changes to the contributions policy, to gain an understanding of the potential impact on individual service-users and carers, and to add depth to the Council’s own consultation.

Healthwatch Bradford and District will submit Document “G” which provides case studies highlighting the potential impact on people’s lives if the Council adopts the proposed Adult Social Care Contributions Policy.

Recommended –

That the concerns highlighted in the report and case studies be noted.

(Victoria Simmons – 01535 665258)

The Manager of Healthwatch presented Document “G” which detailed case studies that highlighted the potential impact on people’s lives if the Council adopted the proposed contributions policy and aimed to allow Members to consider the impact.  It was noted that Healthwatch had become involved in the process following the first public consultation meeting and had raised significant concerns, which had resulted in the consultation date being extended.  The documents provided had also been highlighted as an issue, due to the complex information and that they were challenging for those most affected by the proposal , therefore, the Council had stated that they would work with organisations in order to rectify the matter.  Some people had not taken part in the consultation process and a separate study had not been undertaken.  The Manager of Healthwatch stated that they had wanted the Council to hear real people’s issues and had worked with service users, using Council examples, in order to document the impact on their lives.  Members were informed that there would be significant increases for vulnerable people.  Individual incomes had not been assessed and people were anxious that they would not be able to make ends meet.  It was acknowledged that expenses would be funded by the Council, however, these would not cover all eventualities and many people’s care plans did not include all their expenses.  The Manager of Healthwatch reported that the Council’s Equality Impact Assessment showed that the proposals would have a medium impact on those people with low income, but feedback received by Healthwatch indicated that the impact it would be disproportionately felt by that group.  Members noted that five detailed case studies had been provided that detailed a clear impact on service users.  The people most affected were the most vulnerable in society and there would be a potential loss of preventative support.  The loss of disposable income would result in a deterioration of the person’s situation and eventually place more demand on the Council.  In conclusion it was recommended that the impact on service users was taken into consideration.

The Chair then thanked Healthwatch for an excellent report. 

The Health and Wellbeing Portfolio Holder acknowledged the importance of the issue and the concerns raised, however, she indicated that the matter should be looked at in context.  There would be potential losers and there would be others that would benefit from the proposed changes, such as older people.  It was noted that the 2% additional council tax would not meet the demands of the social care budget and the Council had been forced into this position.  The Health and Wellbeing Portfolio Holder reported that meetings had been undertaken with Healthwatch and parent representatives.  She confirmed that the minimum income guarantee had been set by the Government and the Council had added 25% to the basic benefit amount.  The issues in relation to Care Plans had been recognised and it was accepted that they would have to be revised.  It was explained that arrangements were in place to  ...  view the full minutes text for item 29.

From 1^st April 2015 statutory guidance on charging for care and support under the Care Act is provided in The Care and Support (Charging and Assessment of Resources) Regulations 2014. The new law for adult care and support sets out a clearer approach to charging and financial assessments with one of the drivers of the Care Act 2014 being the portability of care and financial assessments; this would be better achieved if Bradford was to adopt the standard alternative.

Prior to any changes being made to the Policy, the Council is required to carry out a formal consultation on the proposed change.  The Interim Strategic Director of Adult and Community Services will submit Document “H” which details the outcome of that consultation.

The report also suggests that consideration should be given to including charges for the Shared Lives Scheme in the Contributions Policy. It also suggests introducing charges for other services not currently charged for under the Policy.

Recommended –

That the Committee considers the feedback received to date as part of the consultation on changes to the Contributions Policy and that this Committee requests that the views and comments raised by Members be included in the final report to Executive on 20 September 2016.

(Bev Tyson – 01274 431241)

The Interim Strategic Director, Adult and Community Services introduced Document “H” which detailed the outcome of the consultation on the proposed changes to the Council’s Contributions Policy for non-residential services.  He explained that all Local Authorities had the ability to make charges to recover social care costs and that Bradford’s current system was unique in that it favoured those with the most available income.  It had been agreed that a consultation be undertaken on the Contributions Policy with the aim that the more money that could be recovered, the more services that could still be provided.  The funds raised through charges would be spent on people with support needs, however, if the proposals did not go ahead then there would be cuts to social care services.  The Interim Strategic Director, Adult and Community Services stated that a wide consultation had taken place and it had been identified early on in the process that the information was not easy to understand.  He confirmed that the Council had worked with Healthwatch and other organisations and had extended the consultation process.  The Council was looking at a full cost recovery and needed to identify the real costs of a person’s care.  It was proposed that charges for the Shared Lives Scheme be included in the Contribution Policy in line with all other services.  In relation to the Supported Living service, it was noted that if a person was only in receipt of this service the proposals would result in them being assessed to make a contribution.  The Strategic Director, Adult and Community Services reported that the responses to specific questions asked on the questionnaire were detailed in the report.  He indicated that the proposals had not been well received.  Each individual would have a financial assessment that would consist of two elements, a benefit check and a review of the support plan and any changes or effect on the service user’s contribution would be identified on their completion.  The Strategic Director, Adult and Community Services informed Members that if approved the planned roll out would be over six months and there would be a review or appeal process.

Members then made the following points:

·        If the standard alternative was accepted by the Executive, would all services users be assessed?  Was the charging formula used nationally or just by Bradford Council.

·        Was the Council going up to the full 10% that it could charge on top?

·        There would always be winners and losers when changes were implemented, but 40% of service users would be affected which was a significant amount.  Could individual reviews be undertaken if necessary, as the most vulnerable people in society would be affected?

·        Would the old charge be retained until a review had been undertaken?  How long would the review process take?  Would the charges be backdated if the review was not successful?

·        The issues on both sides were understood and everything would be undertaken to ensure that there was equity.  

·        Service users had not understood the consultation process, so  ...  view the full minutes text for item 30.

The Director of Public Health will submit Document “I” which briefs Members on the review of 0-5 Health Visiting (HV) and Family Nurse Partnership (FNP) Services and sets out the proposals for a new model which supports and contributes to the Councils vision 'For every one of our children to have the best possible start in life' through the commissioning and delivery of an evidence based service which considers the needs of our local communities.

The review for both services has been informed by key national and local policy and strategy, the needs of young children aged 0-5 years as well as consultation and engagement with key stakeholders including strategic leads from within the Council, service users, Primary Care, Clinical Commissioning Groups, NHS, Voluntary and Community sector and other partners. This report highlights the key findings from the review, details the draft service model and requests approval from the Overview & Scrutiny Committee to proceed with commissioning a new service model which is fit for purpose and based on these recommendations. 

Recommended –

(1) That the Committee considers the Business Case for the Health Visiting (HV) and Family Nurse Partnership (FNP) and:

(i)            Provide any feedback and/or raise any queries or comments for clarity.

(ii)          Support Public Health to proceed with the development of the proposed service model and service specification/s, based on the high level service principles, and to procure the service through a competitive tender process. The length of the contract and the procurement approach and timescales will be agreed with the BMDC Commercial Team.

(Shirley Brierley/Ruksana Sardar-Akram – 01274 432767)

Please note that a combined debate was undertaken in relation to this item and the item on Joint School Nursing Service Review (Document “J”) (see below).

The Director of Public Health will submit Document “J” which provides information on the commissioning review of the School Nursing service. 

The report highlights the key findings from the review and provides an overview of the proposed service model.

Recommended –

(1) That the Committee consider the Business Case for the School Nursing Service and;

(i)   Provide any feedback and/or raise any queries or comments for clarity;

(ii)  Support Public Health to proceed with the development of the proposed service model and service specification/s, based on the high level service principles, and to procure the service through a competitive tender process. The length of the contract and the procurement approach and timescales will be agreed with the BMDC Commercial Team.

(Shirley Brierley/Linda Peacock – 01274 435316)

Please note that a combined debate was undertaken on this item and the item on 0-5 Health Visiting and Family Nurse Practitioner Service Review (Document “I”).

The Senior Commissioning Manager, Public Health, presented Document “I” and “J” and explained that comprehensive reviews had been undertaken on both services, which were crucial to safeguard the health of children.  The findings of the Health Visiting Service had indicated that overall it was a good service.  The District had a growing young population and the transition from the Family Nurse Partnership to Health Visiting Service was not always smooth.  It was noted that access to interpreters within services needed to be considered.  In relation to the Family Nurse Partnership Service, the Senior Commissioning Manager stated that it had been reviewed nationally and was a valuable service that improved parenting support.  The Council wished to continue with the Service, however, it would have to wait for the national recommendations to be published and consider these in light of the District’s needs.  Members were informed that a new Health Visiting and Family Nurse Partnership Service models had been proposed.

The Senior Commissioning Manager reported that a comprehensive study had been carried out for the School Nursing Service review.  The Service provided an important role in schools and safeguarding, which was based in schools and the local community.  It was a year round service and had links to primary and secondary care.  Members noted that a new service model had also been proposed.

Members then made the following comments:

·        Parents were best placed to be champions.

·        ‘Better Start Bradford’ provided packages.

·        Communication must be maintained with parents and children.

·        What type of work was being undertaken with people with Learning Disabilities?

·        What age range was covered by the Health Visiting Service?

·        Many children were home educated.  Did the service continue to work with them?

·        Could it be ensured that the access to a School Nurse was instant?  School nurses should be accessible.

·        How were children prepared for school?

·        Were the systems used by each service the same?  Were there separate systems for different Local Authorities and Districts?

·        Some safeguarding issues had been missed in the past.  How confident was the Service now?

·        Would the Health Visiting and School Nurse roles be integrated?

Members were informed that:

·        The resources required to progress issues would be considered.

·        The issue of communication had been identified during the consultation.  The role of the School Nurse was to work with people and there was no stigma attached to being helped by the Service.

·        The School Nurse Service was a specialist provision and had been reviewed with support from Clinical Commissioning Groups and other key stakeholders.

·        The Health Visiting Service covered children up to 5 years old.

·        Children that were being home educated were identified and it was ensured that they were visited.

·        The Health Visiting and School Nurse Services were based within the community and not in GP practices.  The School Nurse Service had their own appointment system.

·        The  ...  view the full minutes text for item 32.

At its meeting of 29 October 2015 the Committee considered a report of the Chair and resolved ‘That the West Yorkshire Joint Health Overview and Scrutiny be supported’.  It also nominated two members from within its membership to sit on the Joint Committee. 

As the Committee has since been reconstituted, there is now a need to appoint two new members to sit on the Joint Committee.

Recommended –

That the Committee nominates two members from within its membership to sit on the West Yorkshire Joint Health Overview and Scrutiny Committee.

(Caroline Coombes – 01274 432313)

Resolved –

That Councillor Greenwood and Councillor Gibbons be nominated to sit on the West Yorkshire Joint Health Overview and Scrutiny Committee.

Action: City Solicitor/Overview and Scrutiny Lead

The City Solicitor will submit Document “K” which presents the work programme 2016/17.

Recommended –

That the information in Appendix A and B of Document “K” be noted.

(Caroline Coombes – 01274 432313)

The Overview and Scrutiny Lead presented Document “K” and provided Members with an update.  

Resolved –

That the work programme be noted.

Action: Overview and Scrutiny Lead