Agenda and minutes

Apologies for absence were received from Councillors Ahmed, Aldous, Barrett, McDonald and Paterson.

(During this period, the Conservative and Labour and Co-operative political groups had informally agreed, due the Coronavirus pandemic, to run meetings with reduced number of participants. This was to reduce risk, comply with Government guidance and enable more efficient meetings. Therefore the apologies given reflected that informal agreement of reduced participants).

The Chairman referred to the recent announcement that Jackie Brown would be taking up the role of Assistant Director, Adults’ Social Care. Jackie had worked for the Council since its formation, working in and with a range of services in Adults services. Jackie had led on a range of projects including the Three Conversations Model in Adult Social Care and the work on the Kent and Medway Care Record as part of the wider Sustainability and Transformation Plan.  

On behalf of the Committee, the Chairman congratulated Jackie on her appointment and also thanked Suzanne Westhead, Interim Assistant Director, for her work in the interim period and her support and advice to this Committee.

To approve the record of the meeting held on 18 August 2020.

The record of the meeting of the Committee held on 18 August 2020 was agreed and signed by the Chairman as correct, subject to the reference in  Minute no 186 (Developing Medway and Swale Integrated Care Partnership)

to “Medway Community Action” at the end of the second paragraph on page 11 of the agenda pack being amended to read “Medway Voluntary Action”.

There were none. 

Members are invited to disclose any Disclosable Pecuniary Interests or Other Significant Interests in accordance with the Member Code of Conduct.  Guidance on this is set out in agenda item 4.

Disclosable pecuniary interests

There were none.

Other significant interests (OSIs)

There were none.

Other interests

There were none.

This report provides Members with an overview of MCH’s current position in relation to the COVID-19 pandemic and re-commencement of community health services.

Discussion:

The Director of Operations, Clinical Quality and Nursing at Medway Community Healthcare (MCH) introduced this report which provided Members with an overview of MCH’s current position in relation to the Covid-19 pandemic and re-commencement of community health services.

The following issues were discussed:

• MCH employees – Members expressed their appreciation and thanks for all the MCH employees who had continued to provide an excellent service during the pandemic, noting how valuable it would have been for those isolating to receive a visit from their community nurse.

Concern about staff stress and fatigue was expressed and information was sought about how this was being managed.  The Director of Operations, Clinical Quality and Nursing commented that stress and fatigue had been inevitable given the difficult circumstances staff had found themselves in. A great deal of support and advice was available to staff, including counselling and health and well-being tips. Staff were also good at supporting each other. Staff absences were being monitored and absence rates due to Covid were now 0.99%.  Non-Covid absence rates were not significantly high and were in line with other organisations in the region. However, more pressures were likely to come in the winter.

• Darland House – with regard to the deaths of 21 residents at Darland House, it was queried how this could be prevented during a second wave. The Director of Operations, Clinical Quality and Nursing commented that Darland House was a 40-bed dementia nursing home with highly complex and vulnerable residents. Sadly, a number of deaths had occurred during the very early months of the pandemic where a lack of information and PPE equipment meant that many residents were susceptible to infection. A number of measures were quickly put in place including better separation of residents and staff working in different, non-tactile ways. As a high proportion of the workforce were BAME, more risk assessments had been carried out to better support staff.

An undertaking was given that any significant developments at the home would be communicated to ward councillors.

In terms of how visitors were being managed, Members were advised that visits were by appointment. The process was the same in all the homes run by MCH.

• Physiotherapy service – in response to comments about the cumbersome processes involved in being referred for this service, the Director of Operations, Clinical Quality and Nursing commented this was a national referral system but she would discuss with the Team whether the process locally could be improved.

·      Further Lockdown – whether MCH was prepared for another possible local lockdown was questioned. The Director of Operations, Clinical Quality and Nursing commented that lessons learned from the early days of the pandemic had now been embedded and there was the resilience and confidence to cope with any increase in demand.

• Harmony House – noting the additional 8 beds with potential to increase up to 15, it was queried why 7 beds were not required. The Chief Operating Officer, MCH advised that they were not needed during the outbreak  ...  view the full minutes text for item 329.

This report highlights the key components of the NHS restart and recovery programme.

Discussion:

Members considered reports from the Medway and Swale Integrated Care Partnership and the Kent and Medway Clinical Commissioning Group (CCG) which highlighted the key components of the NHS restart and recovery programme.

The Kent and Medway NHS Restart Programme Director and the Chief Operating Officer for the Medway NHS Foundation Trust introduced the report and also updated Members on the winter plan. With regard to independent sector utilisation, Members were advised that, since the report had been written, two Independent Sector Providers had been removed from the West  Kent element of the national contract.

The Trust had re-commenced 100% of diagnostic cancer and elective services across the Medway and Swale Integrated Care Partnership and the Trust and was on target to meet its October targets.

In terms of winter preparedness, the Trust had submitted its Winter Resilience Plan and initial feedback was that the Medway and Swale element of the plan was seen as an exemplar. Planning for winter was more complicated this year due to EU exit, flu and winter related illnesses and also the second wave of the pandemic. The Winter Plan had been stress tested twice and needed further work but was more developed than ever before.

The following issues were discussed:

• Reporting symptoms - how to encourage people not currently being treated, but who had developed symptoms, to seek advice was queried. Members were advised that a key risk was restoring public confidence to use NHS and primary care services and for people to come forward if they developed symptoms. GP referrals for cancer were down 25% compared to the pre-Covid period. An engagement plan to restore confidence had been drawn up. In response to a query about how the Trust would deal with an increase in referrals, Members were advised that extra capacity and more use of virtual appointments would help reduce waiting lists.

• Cancer referrals – concern was expressed at the reduction in cancer referrals for the last week in the period that the report showed data for. The Committee was advised that the number of referrals had since increased and the figure in the report may increase when the data was re-validated.

• Waiting list targets – the point was made that the continuing to penalise Trusts for not meeting targets was unfair in the current circumstances and whether this was being resisted in Medway was asked. Members were advised that the regional team was encouraging the Trust to address waiting lists on a risk basis and for hospitals to help each other where they had spare capacity. No pressure was being placed on the Trust regarding access targets.

• Staff flu vaccinations – Members were assured this was a top priority and, while not mandatory, staff were strongly encouraged to receive a vaccination. 48% of staff had been vaccinated and the Trust hoped to achieve close to 100% in the coming months. In response to a concern that there may not be enough supplies, Members were assured that there was enough supply  ...  view the full minutes text for item 330.

This report provides an update from the Kent and Medway NHS and Social Care Partnership Trust (KMPT)

Discussion:

The Chief Operating Officer of KMPT introduced the report which provided an update from the Trust.

The following issues were discussed:

·       Increase in mental health problems due to Covid – how the Trust was coping with the increase in mental health problems in the population due to the pandemic was questioned. The Chief Operating Officer considered that patients during lockdown tended to know how to access mental health services and, similar to other health services, the Trust had seen a reduction in referrals.

Post lockdown it was clear that large groups of people who had not previously used the service were seeking help. This included people with autism, those who had lost their jobs, people who had not fully recovered from Covid and those who had been well for a long time but had a psychotic condition which had worsened due to the lockdown. There had not been a significant increase due to domestic violence.

·      Britton Farm – Members welcomed the opening of the new community mental health hub at Britton Farm and asked how the services available there were being communicated to the public. The Chief Operating Officer replied that the website had been refreshed to make it clearer what services were provided and other non-digital opportunities to engage with the public were being looked at. The possibility of an article in Medway Matters to highlight the available services was suggested by Members and accepted by KMPT.

·      Mental Health, Learning Disability and Autism Improvement Board – in response to a query, the Chief Operating Officer undertook to provide details of who from the Council was represented on the Board.

·      Individual Placement with Support (IPS) – the importance of increasing access to IPS to enable people with severe mental illness to find and retain employment was emphasised. The Chief Operating Officer commented that funding had now been provided so the Trust could provide this service in Medway and there were opportunities to bid for more funding to expand the service.

·      Section 136 health placed-based places of safety – whether there were sufficient places to cope with the increased demand from Covid was questioned. The Chief Operating Officer advised that the Trust were working with the police to ensure that the power to remove someone from a public place to a place of safety was only used where necessary. The Trust had not had to place anyone in an out of area placement due to Covid, unlike most other Mental Health Trusts. The Support and Signposting service was in place for people who needed crisis support for up to 24 hours where the person could get support and have time to  de-escalate. There were also safe havens for people who did not meet the S136 threshold. The Trust was working with partners to use resources as effectively as possible. There had been a decrease in the use of S136 powers in Medway. Many people did not require admission but rather additional, alternative support such as that described above. Kent Police  ...  view the full minutes text for item 331.

This report and appendix summarises performance in Quarter 1 (Q1) 20/20/21 on the delivery of the Council Plan priority relevant for this Committee: Supporting Medway’s people to realise their potential.

Discussion:

Members considered a report which summarised performance in Quarter 1 (Q1) 2020/21 on the delivery of the Council Plan priority relevant for the Committee: Supporting Medway’s people to realise their potential.

Members commended the work of the domiciliary care team during the pandemic.

Reference was made to the importance of increasing the possible alternatives to placements for younger adults. The Director of People - Children and Adults commented that a key focus was increase the range of opportunities for young people. Work had started on an accommodation strategy to look at improving the continuum of care so that, where appropriate, young adults can consider moving out of residential care into supported living placements and then for some to move on to independent living. There was evidence to show that there was sufficient capacity at present to meet current levels of demand.

Noting that the Strategic Risk Register presented to the Committee also contained risks which were a matter for the other O&S Committees, a suggestion was made that future risk reports only contain those risks relevant to the Committee.

Decision:

The Committee agreed to:

a)      note the Quarter 1 2020/21 performance against the measures used to monitor progress against the Council’s priorities.

b)      note the amended strategic risk register as set out in Appendix 2.

c)      request a briefing paper on new Strategic Risk SR09A - Changing Demographics of Older People and Working Age Adults.

d)      ask officers to look into whether future risk reports should only contain those risks relevant to the Committee.

Discussion:

Members considered a report regarding the Committee’s current work programme.

Decision:

The Committee agreed changes to the Work Programme as set out in paragraph 3 of the report.