The report of the Strategic Director, Health and Wellbeing, (Document “AB”) outlines progress made and proposed plans in the implementation of the integrated system vision Happy, Healthy and at Home, in relation to accommodation and support services for older people.

Recommended –

1.    That the Committee note and comment on Document “AB”.

2.    That the Committee note and comment on Section 2.4 of Document “AB” – the proposed plan to develop integrated needs assessments based on wards and constituencies across the Bradford District to be used by the Council, National Health Service and other partners as the basis for planning housing developments for older people and market development of the care market.

The needs assessment will map:

·         demographic profile – older people, learning disabilities, physical disabilities, mental health

·         health needs profile by locality

·         GP practice location/population

·         current provision of social care paid for by the local authority, support at home, extra care nursing and residential care and day services

·         voluntary and community service assets, including community capital assets owned by the Council.

(Lyn Sowray – 01274 432902)

The report of the Strategic Director, Health and Wellbeing,

(Document “AB”) outlined progress made and proposed plans in the implementation of the integrated system vision Happy, Healthy and at Home in relation to accommodation and support services for older people.  The report revealed that the a Care Quality Commission (CQC) system review had been completed in February 2018 and had found that there was a clear shared and agreed purpose, vision and strategy described across the system.  The vision was articulated throughout all levels of the system. The CQC had observed that the next steps for the system would be to translate the vision into detailed modelling and operational practice.

The background to Document “AB” explained that the Council Executive had approved the establishment of the Great Places to Grow Old Programme at the meeting held 15 January 2013. The Transformation Programme was a joint plan with the NHS and incorporated the work commenced in 2009 to develop a strategy for the Council’s in-house residential and day services. 

It was reported that the Bradford District had performed well in relation to other areas and, in response to questions; Members were advised that Bradford’s performance was in the top quartile nationally.  Residents were not being delayed in hospital and services were available for them when they returned to their homes.  Visits were made to hospitals to work with partners to assess cases and ways which delays to hospital discharge could be minimalised.  

Members were advised that the Bronte development in Keighley would be completed shortly.  The 50 bedded residential unit would accommodate dementia specialist services currently based at Holmewood, Keighley.  The unit would provide short-term care for both assessment and intermediate care in partnership with health services. 

The report revealed that, following a tender process using the Yortender framework, the contract for the project had been awarded to Wildgoose Construction at a significantly lower cost than expected.   In response to questions it was explained that the lower tender figure accepted was a result of a change to building costs from the original estimated figure.  It was confirmed that the costs had been budgeted for in the capital investment plan for a Great Place to Grow Old budget and any surplus would remain in that budget.

The confidence that the development would be completed on time was questioned and it was explained that at a site visit conducted very recently all the lower ground flats had their kitchens and balconies installed.  Assurances had been received that these would be completed by the end of March 2019 and the residential unit completed between April and May 2019.

Potential procurement issues because of the Brexit proposals were discussed and Members were assured that procurement law was enshrined in UK law and should not be affected by Brexit.  It was explained that the tender process considered quality and other factors as well as financial costs.

A Member questioned the ability to retain and recruit staff as he believed that the health sector was struggling with those issues and training needs were not being met.  In response details of the Health and Social Care Partnership’s One Workforce Programme, to be launched in spring 2019, were provided.  The programme would encourage apprenticeships and work with schools to attract people to work and train in the health sector.  It was expected to be mid 2020 before the One Workforce Academy was formally opened for business.

The report disclosed that modelling work undertaken by Public Health suggested 168 community beds were required in the Bradford area and 66 in Airedale and it was questioned if those figures would be met.  In response it was explained that the modelling referred to short terms beds and that the modelling exercise had been carried out by Public Health two years previously. Those figures had been met although a number of the beds were in acute hospital environments. An additional audit was now being conducted and the figures were being refined.  

The length of time to complete the Neville Grange development was questioned and Members were advised that the initial proposal was to use land owned by InCommunities and the Council.   Incommunities subsequently made a decision to withdraw from the partnership and it was now anticipated that the development would be operational in late 2019.

Members welcomed that the local authority and CCGs had worked together with providers to improve the quality of care and support and that the number of providers who were assessed by the CQC as ‘inadequate’ across the district had reduced from 12% top 3.4%.  It was questioned how that improvement had been achieved and Members were advised that a lot of work had been undertaken and providers pay had been increased.  The issues which had led to inadequate ratings had been investigated; additional training had been provided and a lot of joint working with partners had been developed.  Recent funding had allowed officers to lead on work with care homes and domiciliary care providers had worked together to support providers.

A Member questioned the number of residents who were waiting for long term residential care.  She raised concerns about some of her constituents who were suffering from dementia and were waiting for assessments.  She was afraid that they may not be well enough to be living independently.  In response it was confirmed there were no significant waiting lists for people to be assessed or a shortage of residential beds.  It was explained that when an approach for assistance was received short term support would be provided whilst long term needs were assessed.  Measures such as ‘Just checking’ would be utilised to allow people to remain in their homes where possible.  If longer term assistance was required people would be allocated social worker support.  The Member who had raised concerns was asked to provide details after the meeting to ensure that short term support could be provided, if required, to residents in those circumstances 

The numbers of people from Black and Minority Ethnic (BME) backgrounds waiting for high needs support was questioned as a Member believed that there was very little provision of extra care for people of BME backgrounds in Keighley.  The validity of a perception that people from BME backgrounds did not utilise social care was questioned and it was confirmed that families from BME backgrounds did require and utilise services to support older people.  Beckfield, located on Bolton Road, did focus on the BME community.  Two separate units were available for elderly Asian residents and the Eastern European community.  There had been a reduction in need but specialist provision was still available.

A Member suggested assessing demographics for future service provision and that mapping the needs of the BME community would be useful.

It was questioned if the reduction in available beds had been because of a lack of funding and Members were assured that reduction in the provision of long term beds was due to more people being supported to stay in their own homes.

Resolved –

1.    That the report be noted.

2.    That the Strategic Director, Health & Wellbeing, be requested to provide a progress report at a time to coincide with the presentation of the work on the Service Improvement Boards.

ACTION: Strategic Director, Health and Wellbeing