Agenda and minutes

To approve the record of the meeting held on 18 August 2011.

The record of the meeting held on 18 August 2011 was agreed and signed by the Chairman as correct. 

Apologies of absence were received from Councillors Griffin and Hewett.

An apology of absence was also received from Mrs Lancaster from the Carers Support Group and a member of the committee would be asking a question on her behalf under item 6 (Carers’ support). 

The Chairman will announce any late items which do not appear on the main agenda but which he/she has agreed should be considered by reason of special circumstances to be specified in the report. 

There were none. 

(a)               Personal interests under the Medway Code of Conduct.

A Councillor who declares a personal interest in a matter, including the nature of the interest, may stay, speak, and vote on the matter.

(b)               Prejudicial interests under the Medway Code of Conduct.

A Councillor who declares a personal and prejudicial interest in a matter, including the nature of the interest, must withdraw from the room and take no part in the debate or vote on the matter.

Councillors who have declared a personal and prejudicial interest may make representations, answer questions and give evidence before leaving the room but only if members of the public are allowed to attend for the same purpose.

If an interest is not declared at the outset of the meeting, it should be disclosed as soon as the interest becomes apparent.

(c)               Whipping – the Council’s constitution also requires any Member of the Committee who is subject to a party whip (ie agreeing to vote in line with the majority view of a private party group meeting) to declare the existence of the whip and the nature of it before the item is discussed.

Councillor Avey declared a personal interest in any reference to Medway NHS Foundation Trust as he had substitute as a governor of the Trust for Councillor Etheridge. 

Shirley Griffiths declared a personal interest in any reference to the following organisations, of which she was a member: -

·        Medway NHS Foundation Trust

·        South East Coast Ambulance Service NHS Foundation Trust

·        Medway Older People’s Partnership

·        Kent and Medway Vulnerable Adults Group

Councillor Christine Godwin declared a personal interest in any reference to the Medway Older People’s Partnership as she chaired the partnership.

Councillor Adrian Gulvin declared a personal interest in any reference to Kent and Medway Towns Fire Authority, of which he was a member.

Councillor Igwe declared a personal interest in mental health services and the prison service as he worked as a mental health practitioner for the NHS in the prison service.

Councillor Kearney declared a personal interest in any reference to Medway NHS Foundation Trust and the South East Coast Ambulance Service NHS Foundation Trust, as she was a member of both trusts.

Councillor Murray declared a personal interest in any reference to maternity services as her daughter worked for the service.

A powerpoint presentation will be given on changes to dementia support services.  The report includes a completed protocol questionnaire setting out the details of the changes. 

Decision:

The committee received a presentation from NHS Kent and Medway, which detailed the changes in dementia support services.  The changes would provide significantly improved outcomes for carers and patients and the approach would: -

·        Include options that meet fluctuations in need and progression of the disease;

·        Be focused on prevention;

·        Be flexible and innovative and;

·        Be based around the needs of the individual and their carer.

The committee then questioned the officers on the proposals; including:-

·        The specialist provision at Littlestone Lodge and its location out of Medway;

·        The changes to provision and accessibility of patients to Darland House;

·        The role of GPs in early diagnosis and treatment;

·        Primary Care Memory Assessment services, including primary care based dementia nurses, which was to be piloted in one area first, possibly in the Gillingham and Rainham area;

·        The ability of carers to have the necessary specific skills to support dementia patients at home;

·        Communication strategies to advertise services;

·        The location of 550 new care housing units – officers undertook to report back to members on this outside of the meeting;

·        The use of the drug ‘aricept’ for dementia patients.

In response NHS colleagues explained that the provision at Littlestone Lodge was a very specialist service, which could not be provided in Medway in a financially viable way.  NHS Kent and Medway had therefore purchased three beds at the provision, with other beds being commissioned by West Kent PCT.  It was anticipated that approximately eight Medway patients would use the three beds over the course of one year, with a maximum stay of five months.  Carers understood that the use of the provision was specialist and temporary and understood that it could not be provided in Medway.  Experiences from users of the provision had not demonstrated problems of patients becoming unsettled in leaving the provision, as it was hospital based and therefore temporary, rather than set in a care home environment.

In relation to the ability of home care staff in caring for and supporting dementia patients at home, officers confirmed that the Dementia Support Team and the Psychiatric Liaison Team were crucial in supporting patients as was working with the Adult Social Care Commissioning Team.  A package of training would need to be provided and a single point of access would be developed for carers to use to make referrals and access support services.

The committee also heard from Major Bernard, who explained about his good experiences of support and care in Medway when his wife was diagnosed with and treated for vascular dementia 5 years ago, until she passed away in August 2010.  He had since been co-opted onto a group looking at older people’s care and was a local media representative for Dementia UK.  Major Bernard was thanked for his contributions to departments that have been developing services for dementia and for all care services across the health network.

The Associate Director, Integrated Commissioning, NHS Kent and Medway, explained that the trust did not consider the proposals to be  ...  view the full minutes text for item 409.

This report updates Members on the work of the Carers’ Partnership Board following the themed meetings held relating to carers’ support. 

Discussion:

The Commissioning and Service Improvement Manager introduced the report and explained that the Medway Carers Partnership Board had established three sub groups to focus on the following priorities: -

·        Carers assessments;

·        Carers breaks and respite support;

·        information and communication to carers.

Sub-groups had representations from family carers and colleagues across statutory organisations and had come up with a number of recommendations and initial findings, which were being developed.  GPs had also been surveyed and emerging issues included a need for better and more support and flexibility at earlier stages.  There was also a waiting list for the crossroads service and the demand was recognised as an area of support that needed to be widened.

The Director of Children and Adults added that she co-chaired the Medway Carers Partnership Board with a carer.  The Board was strategic as well as maintaining attention on personalised needs of different groups of carers.

A Member then raised concern, on behalf of a member of the public who cared for her son, that day care provision at Lordswood Community Hub had been withdrawn with little consultation.  The mother had been re-directed to an alternative service at Chattenden, which was much less local to the family.  In response the Director undertook to respond directly to the member of the public and to confirm the situation with the provision to all members of the committee.

The committee also asked officers further questions, which included: -

·        how elderly carers are approached and supported as there was concern that many felt isolated;

·        sharing information on carers to ensure services are provided to them;

·        communication of the services available for carers.

The Deputy Chief Executive of NHS Kent and Medway confirmed that work was being done to share information about carers so that support services could be provided for them.  For example, GPs were doing more around identifying carers and sharing that information with the relevant services.

Decision:

1)         The committee noted the report and requested that officers report an update to the committee in one year.

2)         The committee also requested a briefing note to include: -

·        details of the actions in appendix c to include who is responsible for them and to what timescales they are due to be delivered;

·        confirmation around the use of the Lordswood hub care service and the location of other community hub provisions in Medway;

·        details of the carers hotline service.

This two-year report summarises the safeguarding activities for Kent & Medway Councils for the periods 2009/2010 and 2010/2011.

Discussion:

The Principal Officer for Safeguarding Adults introduced the two-year report which summarised the safeguarding activities for Kent and Medway Councils for the periods 2009/10 and 2010/11.  Over the two years there had been an increase of 17% in adult protection referrals which it was believed was due to increased awareness of the safeguarding team.

Members asked if the statistics collected were the same across the authorities, which officers confirmed was the case as all used a national database to collect the information.

A Member also asked about the reference to pressure ulcers and how the committee could be assured that other similar nursing care was being delivered properly.  The Deputy Chief Executive of NHS Kent and Medway explained that deep dives were being instituted into every provider to quality check procedures and suggested that a report on this issue be brought to a future meeting of the committee.  The Director of Children and Adults added that the role of the Kent and Medway safeguarding Vulnerable Adults Executive Board was to hold partners to account on delivery and to enable the sharing of and learning from good practice.

In a response to how referrals were recorded in terms of the risk levels, officers confirmed that cases where an adult had died, were reviewed by the Serious Case Review Panel to see if lessons could be learned to prevent any future risks to other vulnerable adults.

Decision:

1)         The committee noted the report and suggested that when the next annual report was brought back to the committee that the committee looked at an area in-depth with the relevant agencies invited to the meeting.

2)         The committee also requested that a report on basic nursing care and how this is quality controlled be brought to a future meeting of the committee.

This report advises Members of the current work programme for discussion in the light of latest priorities, issues and circumstances.  This report gives Members the opportunity to shape and direct the Committee’s activities

Discussion:

The report updated the committee on its work programme and the Deputy Chief Executive of NHS Kent and Medway updated the committee on the proposed merger of Medway NHS Foundation Trust and Dartford and Gravesham NHS Trust.  She explained that both Trusts had met the previous week and had decided to proceed to more detailed investigations into a possible merger.

Decision:

The committee noted the report and added the following items to the work programme: -

·        Diabetes – a date would be set for this to come to the committee;

·        Future service provision at A Block at Medway Maritime Hospital – date to be determined but to be considered within this financial year;

·        Basic nursing care and how this is quality controlled – date to be determined.

·        An update on the proposed merger of Medway NHS Foundation Trust and Dartford and Gravesham NHS Trust - 15 December 2011 meeting.