Local democracy

Agenda, decisions and minutes

Venue: Committee Room 1 - City Hall, Bradford

Contact: Palbinder Sandhu/Jane Lythgow 

Items
No. Item

43.

DISCLOSURES OF INTEREST

(Members Code of Conduct - Part 4A of the Constitution)

 

To receive disclosures of interests from members and co-opted members on matters to be considered at the meeting. The disclosure must include the nature of the interest.

 

An interest must also be disclosed in the meeting when it becomes apparent to the member during the meeting.

 

Notes:

 

(1)       Members may remain in the meeting and take part fully in discussion and voting unless the interest is a disclosable pecuniary interest or an interest which the Member feels would call into question their compliance with the wider principles set out in the Code of Conduct.  Disclosable pecuniary interests relate to the Member concerned or their spouse/partner.

 

(2)       Members in arrears of Council Tax by more than two months must not vote in decisions on, or which might affect, budget calculations, and must disclose at the meeting that this restriction applies to them.  A failure to comply with these requirements is a criminal offence under section 106 of the Local Government Finance Act 1992. 

 

(3)       Members are also welcome to disclose interests which are not disclosable pecuniary interests but which they consider should be made in the interest of clarity.

 

(4)       Officers must disclose interests in accordance with Council Standing Order 44.

 

Minutes:

(i)            Councillor A Ahmed disclosed, in the interest of transparency, that she was a Governor for the Bradford District Care NHS Foundation Trust (Minute 51) and that two members of her family were employed as nurses at Bradford Royal Infirmary (Minute 49 and Minute 50).

 

(ii)          Councillor Shabbir disclosed, in the interest of transparency, that he had a relative who lived in one of the care homes listed in the Care Quality Commission report (Minute 48).

 

(iii)         Councillor Riaz disclosed, in the interest of transparency, that he was a Governor for the Bradford District Care NHS Foundation Trust (Minute 51) and a director of a care home in Bradford (Minute 48).

 

ACTION: City Solicitor

44.

MINUTES

Recommended –

 

That the minutes of the meeting held on 4 October 2018 be signed as a correct record (previously circulated).

 

(Palbinder Sandhu – 01274 432269)

Minutes:

That the minutes of the meeting held on 4 October 2018 be signed as a correct record.

45.

INSPECTION OF REPORTS AND BACKGROUND PAPERS

(Access to Information Procedure Rules – Part 3B of the Constitution)

 

Reports and background papers for agenda items may be inspected by contacting the person shown after each agenda item.  Certain reports and background papers may be restricted. 

 

Any request to remove the restriction on a report or background paper should be made to the relevant Strategic Director or Assistant Director whose name is shown on the front page of the report. 

 

If that request is refused, there is a right of appeal to this meeting. 

 

Please contact the officer shown below in advance of the meeting if you wish to appeal. 

 

(Palbinder Sandhu - 01274 432269)

 

Minutes:

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

46.

REFERRALS TO THE OVERVIEW AND SCRUTINY COMMITTEE

Any referrals that have been made to this Committee up to and including the date of publication of this agenda will be reported at the meeting.

Minutes:

There were no referrals made to the Committee.

47.

HEALTH AND SOCIAL CARE OVERVIEW AND SCRUTINY COMMITTEE WORK PROGRAMME 2018/19 pdf icon PDF 62 KB

The City Solicitor will present the Committee’s Work Programme 2018/19 (Document “U”).

 

Recommended –

 

That the information in Appendix A of Document “U” be noted.

 

(Caroline Coombes – 01274 432313)

Additional documents:

Minutes:

The Overview and Scrutiny lead presented the Committee’s Work Programme 2018/19 (Document “U”).

 

Members were reminded that a joint meeting with the Children’s Services Overview and Scrutiny Committee was scheduled for 5 February 2019 to consider Young People’s Mental Health; and that a report was due to be submitted to the Committee on 21 March 2019 on Cancer and Lung Cancer and therefore this area was not covered in the Respiratory Health report (Document “X”).

 

Resolved –

 

That the information contained in Appendix A to Document “U” be noted.

 

NO ACTION

48.

AN UPDATE FROM THE CARE QUALITY COMMISSION pdf icon PDF 62 KB

Previous reference: Minute 87 (2016/2017)

 

The Inspection Manager, Adult Social Care, Care Quality Commission, will submit a report (Document “V”) which provides an update of their inspection activity across Adult Social Care.

 

Recommended –

 

That the report be noted.

 

(Sarah Drew – 0300 0616161)

Additional documents:

Minutes:

The Inspection Manager, Adult Social Care, Care Quality Commission, submitted a report (Document “V”) which provided an update of their inspection activity across Adult Social Care in Bradford district.

 

The inspection Manager provided an overview of the current services being provided in the Bradford district as outlined in Document “V” and stated that the latest published ratings were available on the CQC website.

 

In response to Members’ questions, she stated that:

 

·         In 2017 a new protocol had been introduced for the CQC to work closely with providers who had continued to receive a ‘Requires Improvement’ rating, to help them improve.  This involved reviewing the management of the care home.

·         CQC officers met with providers to discuss the outcome of their inspection and worked with the local authority to provide advice and guidance.

·         Overall, performance across the district had improved as there were three ‘outstanding ‘ care homes whereas a year ago there had been only one; there had also been an increase in the number of care homes rated ‘good’.

·         Care homes that performed well often demonstrated strong leadership and management.

·         There was a high number of care homes in the Bradford district due to the fact that approximately 86% of those providers were small family run businesses.

·         An advantage of having a high number of care providers meant that reliance was not placed upon a small number of large providers.

·         Page 7 of Appendix 1 to Document “V” showed the number of care homes that had de-registered with the CQC within the last 31 days and the reasons for this varied.

·         A care home that had de-registered with the CQC could still be operating as a care home if it had registered under a different name e.g. following a change in ownership.

·         The CQC recognised that a lot of progress had been made with the introduction of the Improvement Boards and forums to help providers get to where they needed to be.

·         The best providers demonstrated they were ‘people centred’ around the individuals they cared for.

·         It was often the case that if a care home performed strongly in ‘well-led’ it would perform well overall.

 

The Strategic Director of Health and Wellbeing addressed the Committee and stated that the Contracts Compliance Team from her department worked closely with providers to help them improve.  She informed Members that there were two Improvement Boards (one for residential care and the other for nursing care) which the CQC attended and that events were regularly organised to bring providers together in order to share best practice.  She also alluded to peer support from within the sector to highlight that support was offered to providers in a number of different ways.

 

The Chair requested that a report on the Improvement Boards be submitted to the Committee in the 2019/2020 municipal year. 

 

A Member commented that the services inspected by the CQC affected the quality of many peoples lives and she was pleased to see that the overall picture was improving and that  ...  view the full minutes text for item 48.

49.

CARE QUALITY COMMISSION INSPECTION REPORT: BRADFORD TEACHING HOSPITALS NHS FOUNDATION TRUST pdf icon PDF 68 KB

The Care Quality Commission (CQC) carried out inspections of Bradford Teaching Hospitals NHS Foundation Trust (the Trust) in January and February this year.  The Trust was rated ‘Requires Improvement’.

 

The City Solicitor will submit Document “W” which presents the CQC Inspection Report (Appendix 1) and the report of the Director of Governance and Corporate Affairs at the Trust on the compliance actions required by the CQC and the Trust’s action plan (Appendix 2).

 

Recommended –

 

That Members receive the information provided in Appendix 1 and Appendix 2 of Document “W” and consider any comments and recommendations they wish to make.

 

(Caroline Coombes – 01274 432313)

Additional documents:

Minutes:

The Care Quality Commission (CQC) carried out inspections of Bradford Teaching Hospitals NHS Foundation Trust (the Trust) in January and February 2018.  The Trust was rated ‘Requires Improvement’.

 

The City Solicitor submitted Document “W” which presented the CQC Inspection Report (Appendix 1) and the report of the Director of Governance and Corporate Affairs at the Trust on the compliance actions required by the CQC and the Trust’s action plan (Appendix 2).

 

The Director of Governance and Corporate Affairs expressed her disappointment at the outcome of the inspection and stated that not all of the Trust’s core services were inspected.  She informed Members that the Trust anticipated another inspection by the end of May 2019 plus one unannounced inspection.

 

She outlined the actions the Trust must take to improve, as stated in the inspection report (Appendix 1) following inspection of the following core services: maternity, urgent and emergency care, medicine and care of older people and surgery.  She assured Members that good progress had been made with the Compliance Action Plan (Appendix 2) and reported that:

 

Mandatory training – was now at a 97% compliance rate whereas previously it was below 84%.  Compliance with high priority training was at 83% and 88% for induction refresher training.  The annual staff appraisal rate was at 86.7% and the Trust would be moving to an ‘appraisal season’ so that staff appraisals were anticipated at the same time every year and not left until the end of the year when service pressures were at their highest.

 

Policies and guidelines – the inspection had found that there were a number of corporate and local policies that were past their date for review.  The Trust had 1,197 local guidance documents and the inspection had found that 93.7% of them were in date.  The target compliance rate had been set to 100% so that all areas were held to account.  All polices and guidelines in maternity services were now fully up to date.  HR policies tended to take longer to update but the Trust was confident that they would be up to date by December 2018. 

Equipment safety checks – a standard checklist had been created for resuscitaires which would be audited regularly and there were now areas demonstrating 100% compliance.

 

She stated that all actions were expected to be put in place by the end of December 2018 and the Trust was also focusing on cultural changes within its organisation.

 

The Chair queried why the Trust did not carry out follow-up work on areas it was rated ‘Good’, to aim for ‘Outstanding’.  In response, the Director of Governance and Corporate Affairs stated that the improvement work was carried out on identified risk areas.  She also stated that one of the areas the Trust was proud to have been rated ‘good’ was for being well-led.

 

A Member referred to the part of the inspection report which stated that “the respiratory service did not have access to a specialist respiratory consultant at the weekend or during bank  ...  view the full minutes text for item 49.

50.

RESPIRATORY HEALTH IN BRADFORD DISTRICT pdf icon PDF 201 KB

Previous reference: Minute 94 (2016/2017)

 

Respiratory disease is an important cause of ill health and early death in Bradford District. The District performs relatively poorly compared to other areas in England. Recognising this, partners across the District, including the local authority and NHS, have prioritised respiratory health with the aim of improving health outcomes and reducing inequalities.

 

The Strategic Director, Health and Wellbeing will submit Document “X” which provides an overview of respiratory health in Bradford District and outlines what partners across the NHS and local authority are doing to improve outcomes for people in the District. There is a specific focus on prevention and on asthma and chronic obstructive pulmonary disease (COPD), as these conditions account for a significant amount of the ill health and subsequent costs associated with respiratory disease in the District.

 

Recommended –

 

That the Committee note the information provided in the report and support on-going work seeking to address the main challenges going forward.

 

(Toni Williams – 01274 434071)

Minutes:

Respiratory disease is an important cause of ill health and early death in Bradford district. The district performs relatively poorly compared to other areas in England. Recognising this, partners across the district, including the local authority and NHS, have prioritised respiratory health with the aim of improving health outcomes and reducing inequalities.

 

The Strategic Director, Health and Wellbeing submitted Document “X” which provided an overview of respiratory health in the Bradford district and outlined what partners across the NHS and local authority were doing to improve outcomes for people in the district. There was a specific focus on prevention and on asthma and chronic obstructive pulmonary disease (COPD), as these conditions accounted for a significant amount of the ill health and subsequent costs associated with respiratory disease in the district.

 

The Consultant in Public Health provided an overview of the work being undertaken in Bradford as part of the Bradford Breathing Better Programme, and in Airedale, Wharfedale and Craven (AWC) through the AWC Respiratory Action Plan Group.  It was highlighted that; whilst 13,154 people in the district had been diagnosed with COPD, it was estimated that the actual figure was closer to 19,300 due to an estimated undiagnosed rate; 41,858 people across the district had been diagnosed with asthma and this number was also likely to be an underestimate too; the prevalence of smoking had fallen from 22.2% in 2016 to 18.9% in 2017 but smoking in pregnancy rates (13.8%), although declining, were higher than the national average (10.7%).  Services to support people to stop smoking, and activities to prevent people from smoking, as outlined in Document “X”, were outlined.  It was reported that there was a focus on de-normalising smoking to prevent people from taking up smoking.

 

A Member stated that he was an asthmatic smoker and his last three asthma check-ups with his GP had been over the telephone.  He considered more could be done to interact with patients to explain what support was available to stop smoking.  In response it was stated that this issue had already been raised by patients and the variations between practices was being reviewed as every patient with a respiratory condition should have an action plan developed, have their inhaler usage monitored and be reviewed regularly.  It was stated that many of the programmes in place were aiming to change the culture of smoking and view it as a long term health condition.

 

A discussion took place with regard to the uptake of the flu vaccine.  Members were informed that the uptake varied between at risk groups and that it was particularly low for two to three year olds but uptake rates were good for people aged 65 and over.  It was reported that there were many organisations involved in commissioning or providing the vaccine such as schools, GP practices and care homes and, in order to address the uptake rates, a comprehensive flu vaccination plan had been developed.  Members were informed that this had been presented as part of Self Care  ...  view the full minutes text for item 50.

51.

BRADFORD DISTRICT CARE NHS FOUNDATION TRUST CQC INSPECTION: OUTCOME AND RESPONSE pdf icon PDF 112 KB

Previous reference: Minute 80 (2017/2018)

 

Following an inspection of nine, out of fourteen, core services, in February 2018 the CQC published an updated report on Bradford District Care NHS Foundation Trust.  The Trust was rated as ‘Requires Improvement’ overall which was a deterioration from the previous rating of ‘Good’.  Community services were rated as ‘Good’ with some aspects of care rated ‘Outstanding’.  Mental health services were rated as ‘Requires Improvement’.  An action plan was developed, in response to the CQC’s findings, and the Committee requested that a progress update be provided.

 

The Trust will submit Document “Y” whichoutlines that the Trust Board has overseen delivery of the action plan and has recently approved the introduction of a formal Quality Improvement System, throughout the Trust, which will deliver long term, sustainable, staff-led improvements to the quality of its services.

 

The next CQC inspection is expected in early 2019.

 

Recommended –

 

That the Committee notes the progress made, during 2018, by Bradford District Care NHS Foundation Trust, in response to its February 2018 CQC report and the Trust Board’s commitment to long-term, sustainable improvement via the implementation of a formal Quality Improvement System. 

 

(Dr Andy McElligott - 01274 228293)

Minutes:

Following an inspection of nine out of fourteen core services, in February 2018, the CQC published an updated report on Bradford District Care NHS Foundation Trust.  The Trust was rated as ‘Requires Improvement’ overall which was a deterioration from the previous rating of ‘Good’.  Community services were rated as ‘Good’ with some aspects of care rated ‘Outstanding’.  Mental health services were rated as ‘Requires Improvement’.  An action plan was developed, in response to the CQC’s findings, and the Committee requested that a progress update be provided.

 

The Trust submitted Document “Y” whichoutlined that the Trust Board had overseen delivery of the action plan and had recently approved the introduction of a formal Quality Improvement System, throughout the Trust, which would deliver long term, sustainable, staff-led improvements to the quality of its services.  The next CQC inspection was expected in early 2019.

 

The Medical Director, Bradford District Care NHS Foundation Trust, provided a brief summary of the progress against the action plan as outlined in his report. 

 

A Member commented that she was pleased to see that personalised care plans were being developed following the recent move to SystmOne.  The Medical Director stated that this had been a big improvement on the previous care plans and that they were easier to read and use.  As the information was shared during a hospital admission it meant that patients did not have to repeat information and the handover of the patient was more seamless.

 

A discussion took place about work being undertaken with the Yorkshire Ambulance Service to ensure that patients with a mental health crisis were accessing better places for help than undergoing an Accident and Emergency admission at a hospital, as this was rarely the best option for them. 

 

In response to Members questions, the Medical Director reported that:

 

·         The Trust did not know what areas of its organisation would be inspected by the CQC.

·         Whilst the CQC rating was disappointing, it was important to learn from it to put things right and ensure there was a continuous cycle of improvement.

·         Two of the biggest causes of staff sickness were stress and musculoskeletal conditions.

·         A range of health and wellbeing support services were offered to staff and there were early signs of success, as sickness rates had decreased.

 

A Member asked a question in relation to barriers for staff to undertake mandatory training.  In response the Medical Director explained that there was a range of mandatory training for staff to undertake and it was often difficult to find time to do it.  He also stated that there was a capacity issue as some trainers could not meet the demand for the training as well as practical difficulties such as obtaining suitable training venues and glitches in the statistics due to attendance at training sessions not being recorded correctly.  Members were assured that mandatory training performance was increasing and the 95% target was considered achievable.

 

A discussion took place about the Committee’s next steps.  It was noted that the Trust  ...  view the full minutes text for item 51.