Hounslow Council


Agenda and draft minutes

Venue: Committee Room 1, Civic Centre, Lampton Road, Hounslow

Contact: Ian Duke, telephone: 020 8583 2540 or e-mail:  ian.duke@hounslow.gov.uk. 

Items
No. Item

10.

Welcome and Introductions

Minutes:

The Chair welcomed members and officers to the meeting.

 

11.

Apologies for Absence, declarations of Interest and other Communication

Minutes:

Apologies were received from Councillors Kaur, Purewal, Savin and Barwood and from Mary Harpley and Tim Spilsbury.

 

12.

Minutes of the meeting held on 17 July 2017 pdf icon PDF 201 KB

Minutes:

The minutes of the meeting of 17 July were agreed as an accurate record.

 

13.

Matters Arising

Minutes:

It was noted that an update was due on how treatment nurses are used and options generated by Hounslow & Richmond Healthcare Trust to redeploy nurses within the community. Mary Clegg advised that the CCG was due to publish its meeting papers from the CCG August workshop on this topic but have not yet done so and she will continue to chase this up.

 

14.

Annual Report of the Safeguarding Adults Board pdf icon PDF 178 KB

Additional documents:

Minutes:

The Chair welcomed Hannah Miller (Independent Chair of Hounslow Safeguarding Adults Board) and Jo Carmody (Head of Safeguarding and Quality Assurance) and asked them to present the Annual Report 2016-17 and Business Plan 2017-20 of the Hounslow Safeguarding Adults Board (Board) and provide an overview of last year’s progress and plans and priorities for the year ahead.

The key points over the last year were:

·         Programme of interactive workshops/seminars held on domestic abuse, financial abuse, female genital mutilation, honour based violence and forced marriage.

·         The Board now has two elected representatives from the Hounslow Community Network. The Board also has representatives from Healthwatch.

·         The Board has set up a communications and Engagement Group who have launched a social media campaign to raise awareness of abuse of adults at risk. Posters and leaflets were tabled at the Panel and it was noted that leaflets have been circulated in multiple languages and there has been a good uptake of Polish language leaflets.

·         An introduction to adult safeguarding, mental capacity, mental health and safeguarding training event had been run for the voluntary and community sector with an online component on safeguarding.

·         In February 2017, the Board held a ‘Challenge Event’ where each agency presented their self-audit results on achievements and challenges and were questioned by fellow board member. Issues needing attention informed the new business plan for 2017-20.

·         An annual external audit of cases was completed in November 2016, which acknowledged the continuous improvement in safeguarding practice. If the audit had formed part of an external inspection, Hounslow would be judged as ‘good’, an improvement on the low base 3 years ago.

·         The comparative data with other boroughs (p.27 of the Annual Report) shows that the borough compares well with other boroughs.

·         The Board regularly reviews its indicators and has recently added adult safeguarding audit data from health partners to its indicators. Analysis is underway to identify what safeguarding data is currently collected by board agencies so the Board can gather a good data set and extend indicators to reflect other areas.


Plans and priorities for the year ahead included:

·         Following Hannah Miller’s appointment as Chair of the Children’s Safeguarding Board, links have now been strengthened between the Adults’ Safeguarding Board and the Children’s Safeguarding Board.

·         There are different statutory obligations but the Boards need to reconcile that both children and parents (particularly teenager parents) may be vulnerable and support the whole family. The Board is therefore concentrating on a ‘Think Family Agenda’ to address domestic abuse, mental health and drugs and alcohol abuse.

·         Area of transitions needs to be clarified so that transition from Children’s Services to Adult Services is seamless when an individual turns 18. This is particularly relevant for disabled groups and children subject to sexual exploitation.

·         The Board needs to ensure that lessons learned on modern slavery and domestic violence are cited to the Adults and Children’s Safeguarding Boards

·         The Police are funding a data analyst post working between community safety, children safeguarding and adult safeguarding.  ...  view the full minutes text for item 14.

15.

Rates of Falls pdf icon PDF 183 KB

Additional documents:

Minutes:

The Chair welcomed Martin Waddington, Director of Joint Commissioning, and asked him to run through the presentation that had been provided with the papers on the rates of falls in Hounslow.

 

The presentation highlighted the following:

·         There is a strong correlation between falls and social isolation, as highlighted in the JSNA

·         If the health issues from a fall are not addressed properly, further falls are likely leading to more complex health issues and occasionally death. After a second fall, the entry into high cost care accelerates. Although residents may live as long, it is likely they will have a lower quality of life.

·         Hounslow is spending almost £4million on falls related issues (£3.7m on treatment and £37,833 on prevention)

·         More attention in the community is needed on falls prevention, such as physio and working with health professionals, housing assessments to check whether hand rails are in place and improving referrals from domiciliary care providers and the voluntary sector.

·         Work Hounslow is currently doing includes:

o   270 falls assessments carried out in the last year

o   Otago training rolled out to voluntary sector identify people at risk of falling due to balance and strength problems. Hounslow continues to assess whether this program of work will prevent residents falling over

·         There is insufficient knowledge on what causes falls and why they are prevalent in Hounslow. While it was noted that poor pavements and tree roots can be a factor, the Panel acknowledged that more falls occur in the home.

o   What part do medication issues, balance, hydration, nutrition issues and conditions such as urinary tract infections play?

o   The Panel recognised the need to change residents’ attitudes to ageing and caring. Care is looking after yourself first

·         Professional home eye tests are currently available through private opticians

The following summary of key points emerged from the presentation and discussion that followed:

·         More work is needed to profile who are at risk to help target prevention work and this will be a core focus of a new Falls Co-ordinator post

·         One area of prevention being trialled is Otago training, which seeks to improve leg strength and balance of residents who are at risk of falls

·         We do not currently have an indicator on the number of falls, although Public Health were able to provide data

·         Hounslow is relying on direct referrals, while facing a reduction in monitoring officers, and so greater emphasis is being placed on wider referral routes and Councillors are encouraged to refer residents.

·         Different communities appear to be affected differently. White British Hounslow residents come in for more social care than other groups but it is not known whether they are more socially isolated. We can learn from other communities, who have the ability to look after people with dementia and the elderly.

Recommendations

1.    Communications Campaign: The Panel recommended that an awareness campaign to highlight the issue with the public. Communication materials should be organised and figures/information published in Hounslow magazine.

Actions

1.    Emma Cartwright to send contact details  ...  view the full minutes text for item 15.

16.

Joint Commissioning Intentions pdf icon PDF 181 KB

Additional documents:

Minutes:

The Chair welcomed Mary Clegg, Managing Director CCG and invited her to present on commissioning intentions for 2018/19 for the following CCG groups: (1) Hounslow and Richmond Community Healthcare (2) Chelsea and Westminster and (3) West London Mental Health Trust.

 

Mary Clegg highlighted that the presentation focused on changes that they were asking providers to make this year to improve services in 2022 so that:

·         Care is safe and appropriate

·         Residents receive support to deliver the best health and social care

·         Residents know how to use voluntary and community services

·         Residents are supported by co-ordinated care

·         Valuable resources are used effectively

Over the next 5 years, Hounslow CCG is making improvements as to how health services will be provided and is linking up services to ease the current strain practices are under. This will involve:

1.    Discussions with GPS to build on existing relationships

2.    Encourage and practices formally working together through shared contracts, finances, performance data, extended primary and community services

3.    Hospital hubs with extended opening times and innovative technology.

Priorities for the Chelsea and Westminster Trust are:

·         Diabetes services: are reviewing provision of services across primary community and secondary care with emphasis on intermediate care and primary standards of care

·         Falls prevention co-ordinator: expansion and existing services and improved hospital and residential home care links

·         Uro-gynaecology: new acute and community pathway

·         Outpatients: expanse of non-face to face outpatient activity so that can deliver outpatient clinics without requiring patients to go to hospital.

·         Pathology: to be provided under 1 contract

The following key points emerged from the discussion after the presentation:

·         Plans for major housing developments will be on line by 2020. New primary care centres will help meet the increase in demand in population. Further, community services will be closer to homes so less reliant on transport links.

·         The Panel noted that it was hard for residents to access therapeutic services. Mary Clegg confirmed that this was one area that did not have an issue with capacity and would revert on whether self-referrals were possible.

·         Martin Waddington clarified that Brentford House was a recovery hospital. No revenue to keep service going and its impact was unclear. Services will not be lost but picked up through the Cherry Tree development, which is a high-level support housing unit, with a recovery pathway.

·         Martin Waddington confirmed that he was meeting with Brentford councillors to take forward to include a dementia hub.

·         The Panel queried whether enough was being done to address the increasing incidents of diabetes. Mary Clegg advised that a follow up meeting could address diabetic care in the community and GP community results in working with patients to take better care of themselves. The Chair noted that diabetes was on the work plan so the Panel could address this issue in more detail and answer queries later.


Actions

1.    Mary Clegg agreed to follow up and revert with answers to the following:

·         Change of policy around free supply of testing kits

·         Availability  ...  view the full minutes text for item 16.

17.

Healthwatch Update

Minutes:

There was no representative from Healthwatch and no update was provided ahead of the meeting.

18.

GP Access Final report

Minutes:

The Chair invited Ian Duke, Head of Policy, Scrutiny and Intelligence to provide an update on GP access issues in Hounslow. Ian Duke reminded the Panel that this work looked at GP access in the borough to assess why residents were going to Accident and Emergency departments in avoidable circumstances. Work is continuing on this and he will invite appropriate people to present to the Panel once indicative results are available.

19.

Work programme pdf icon PDF 54 KB

Minutes:

The Panel noted that there was a large agenda on the work programme for the next meeting and agreed that the item relating to delayed discharge from hospital should be removed as this has been previously considered in some detail.

20.

Any other matters that the Chair considers urgent

Minutes:

No items raised.

 

21.

Date of Next Meeting - 5 December 2017

Minutes:

The next meeting is scheduled for 5 December 2017.