Hounslow Council

Agenda and minutes

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

Contact: Email: jane.medici1@hounslow.gov.uk 020 8583 2064 

No. Item


Welcome and Introductions


The Chair welcomed members and introduced the following guests:  Martin Waddington (AD for Joint Commissioning), John Morgan (Head of Prevention and Care Management), David Thangarajah (Team Manager Extended Hospital Social Work Team - WMUHT),Christina Richards (Clinical Services Manager for Older People and Head of Therapies – WMUHT), Andy Howlett (Deputy Director of Operations and General Manager for Medicine – WMUHT), Chris Pierre (Head of Care Act Implementation), Phil Howell (ASC Transformation Manager), Heidi Shearn (Care Act Implementation)



Apologies for Absence, declarations of Interest and other Communication


Apologies were received from Cllr Buttar.



Minutes of the meeting of 27 July 2015 and matters arising pdf icon PDF 127 KB


The minutes were agreed with the following changes:


Item 10.  Line 6


Cllr John Chatt, Mel Collins and Cllr Mukesh Malhotra are service users of West Middlesex Hospital.


Change to:


Cllrs John Chatt, Peter Carey, Mel Collins and Cllr Mukesh Malhotra are service users of West Middlesex Hospital.


Emma Cartwright declared an interest on behalf of the Mulberry Centre who are tenants of the West Middlesex University Hospital Trust.



'Patient Pathway': discharges from hospital, adult safeguarding, social care and accommodation pdf icon PDF 71 KB

Additional documents:


The Chair welcomed John Morgan, Christina Richards, Andy Howlett and David Thangarajah from WMUHT.


John Morgan talked to the attached paper.


It was clarified that the 1.5 staff employed at CRS would include one full time and one 18 hour post.


Cllr Bath asked how it was felt the changes were going and Andy Howlett responded that significant benefits had already been seen. 


Cllr Carey asked for a definition of the benefits spoken of and Andy Howlett responded that they even though there had been an increase in the number of patients with complex needs the new pathway had in fact created additional capacity without significant increases in the number of staff needed. A number of complex cases had been managed with the same resources.


David Thangarajah explained that people coming into hospital were now supported by a social worker to return home with added community based support where necessary and that each case was reviewed after 6 weeks to decide whether to increase or keep the level of support as it was.


John Morgan reported that frequent attenders were also being worked with on an individual basis to support a change in their behaviour.


Christina Richards confirmed that there had been a change in the way complex cases were being managed.


Cllr Bath questioned whether the changes were permanent.


John Morgan responded that it was hoped that it would be a permanent change and that plans were already in place to expand the services to outlying hospitals.  The co-ordination of this will be moved to hospital social work services.


Cllr Green questioned what made Park Lodge, extra care, unique among local services.


John Morgan responded that residents were able to have their own flat with extra care available as needed.  Park Lodge had carers on site 24 hours a day, able to respond to the dynamic and changing needs of residents.  Plans were being developed to expand the extra care places within the borough.  The intention was that residents with complex needs were supported to become independent and ultimately to enable them to return home.


Cllr Bath questioned whether Park Lodge was now full.


John Morgan responded that there were still 4 vacancies, however, these were set to be filled over the next few weeks and that there were already 8 people on the waiting list for places.


Cllr Collins reported that he would like to declare an interest in the matter being discussed as he had been involved in supporting the patient being discussed.  Cllr Collins asked whether there was a lower age limit for access to out of hospital support.  The patient he had been supporting had been told he was too young (55) to access help at discharge.


John Morgan responded that the support was available to anyone from the age of 18 who met the eligibility criteria.  The option of support would have been available to link an individual into a homeless person unit


Cllr Collins asked for clarification of the process where a vulnerable  ...  view the full minutes text for item 20.


Care Act phase 1 implementation pdf icon PDF 74 KB

Additional documents:


The Chair welcomed Chris Pierre and Heidi Shearn who spoke to the attached report.


Chris Pierre asked the panel whether anyone had looked at the Care Place website.  Cllr Bath and Cllr Malhotra had both been onto the website and agreed that the site was difficult to use and confusing with too many choices.  Feedback they had received from users was that they needed a site as a link to actual help and support rather than a source of further information.  Some of the concepts and language used on the site were difficult to understand and concern was expressed that users would not find it useful. The use of language on the site was considered baffling.  John Morgan confirmed that the telephonic help line was still available.  Heidi Shearn added that they had been actively working with the voluntary sector to train and show how the site could be used.  She was confident that once people knew how to use the website they would find it useful.  It was agreed that the search engine side of the site could be improved.  Cllr Malhotra suggested looking at widely available search engine programmes such as that developed by Google. 


Cllr Green questioned how people without access to computers were catered for.  Chris Pierre responded that hard copies of the two key documents (Guide to Adult Social Care and Accessible Guide to Services) were still available.  Fact sheets for specific services areas were also available.  These could be found at the Civic Centre, in hospital services, through the Social Care first contact number and in libraries.  Colleagues were also encouraged, through training, to access the online information and provide printed copies as needed for residents without computer access.


Cllr Bath questioned whether the council should also be providing advice about finding care to self-funders.  Chris Pierre responded that the services would do this.  Most work under Phase 1 had now been transferred to ‘business as usual’ unless further work was needed.  A Deafblind task and finish group had been established which is working with Celia Golden from Equality and Human Rights to improve the service.  The Deafblind group had been established as this was a group that was often overlooked, locally and nationally, and there was a need to ensure they were adequately supported.  John Morgan added that this group had not previously been as well covered within legislation and that the focus was now specifically on services for transitions and the deafblind.


Cllr Collins questioned whether there were any elected members of the task and finish group.  Chris Pierre responded that although there were none currently they would welcome an elected member. 


There are also currently task and finish groups for transitions and IT and advices.


Chris Pierre reported that they would expect to measure a greater impact on demand by the end of October when they would look at the statistics.  The panel agreed that if the statistics did not show a substantial impact they would want to look into  ...  view the full minutes text for item 21.


Better Care Fund and Personal Care Framework updates pdf icon PDF 87 KB

Additional documents:


The Chair welcomed Martin Waddington who spoke to the attached report.


Cllr Carey asked for an explanation of a Care Package.  Martin Waddington  referred to the example previously given of a patient being discharged from hospital with a care package to support his specific needs, allowing him to return safely home.


Cllr Green questioned the use of spot providers and whether this would continue.  Martin Waddington responded that they were currently only used where needed and only for the shortest possible periods.  The aim was to not use spot providers in the future.  Healthwatch were monitoring the situation.


Cllr Savin questioned what evidence there was that telecare worked.  Martin Waddington responded that the basic service was considered a success but that there were further options available which would need to be looked at, there was a need to be more ambitious in the use of available technology for instance, there was the option for skype to be part of the service.


Cllr Savin asked whether the issues around technology were generational.  Martin Waddington responded that it was being increasingly used by older people.  There was a project looking into future developments.


Cllr Bath questioned how it had been possible to reduce the number of providers to only 9 and was informed that this had been done through an elimination process of providers responding to requests and offers.


At 9:20 the Chair agreed to move standing orders.


Cllr Chatt commented that in the past an individual could have any number of care plans prepared for them by every service they dealt with and welcomed the changes.


Cllr Carey asked if it would be possible to see a care plan.  Martin Waddington agreed to send a copy of a care plan to the panel. 


Cllr Malhotra reported that it had not been possible previously for care plans to respond adequately to the changing needs of patients.


Cllr Bath questioned how many GP surgeries opened over the weekend.  Martin Waddington said that there was at least one in each locality, he offered to provide details.  Stephen Otter added that telephonic access may also be counted as access.


Cllr Savin asked for clarification on the minimum of 15 minutes spent with each client.  Martin Waddington confirmed that every visit was at least 15 minutes but could be up to 1 hour should there be a need.


Cllr Bath questioned what would happen to projects after the Better Care Fund ended.  Martin Waddington was confident that through a process of improved efficiency and because the service in Hounslow was an integrated one there should be little concern.





·         Martin Waddington to provide members with a sample of a care plan.

·         Martin Waddington to provide more information with regards to the identity and number of GP surgeries open at the weekend.



Panel Work Programme pdf icon PDF 36 KB


Ian Duke introduced the agreed workplan.


Cllr Collins requested that the 111 service be looked at urgently.  There were concerns that it was not being manned by trained care staff.  He asked that this be brought on board before Christmas.


Cllr Bath suggested that this fall under the prevention item.  JHOSC was looking at Mental Health and it might be possible to raise specific issues there rather than having them on the local agenda.


Cllr Green asked that the links between the walk in service and 111 be looked into.




  • To include the 111 service within the work programme for 7 December
  • Defer the Shaping a Healthier Future item as it will not be ready in time for 7 December


Any other matters that the Chair considers urgent


Ian Duke apologised that the Healthwatch update had not been on the agenda.


Stephen Otter reported that Healthwatch had conducted a deep-dive audit of GP surgeries. Findings included unhelpful reception staff and an unhelpful ‘front door’ to practices.  He added that changes were being seen and that GPs appeared to be open and receptive to making receptionists more helpful and less rude.  Evidence was being gathered to show unacceptable practice.


Cllr Bath asked whether there was an action plan.  Stephen Otter responded that the CCG do not commission GPs this was done through NHS Central although there may be some leverage over them as colleagues.


Ian Duke informed the panel that under the Social Care Act 2007 they had the power to raise concerns, even if this was with the Secretary of State.


The situation with the Bath Rd surgery was discussed and an update was requested.  This could be provided in the CCG update.


Stephen Otter reported that the friends and family test was not used by many although GPs were paid to do it.


Cllr Collins requested a full review of the closure of the Brentford Lodge with Healthwatch.  Cllr Collins also requested an update on Clayponds and the promised additional beds.  He requested that the Chair write to Sue Jeffers to request an update.





  • The results of the GP friends and family test to be circulated and included on the agenda for February 2016.
  • Ian Duke to provide cake or biscuits at the next meeting for missing Healthwatch off the agenda
  • The Chair is to write a letter to Sue Jeffers asking for an update with regards to the plans for Clayponds Hospital, specifically the status of the additional 6 beds commissioned.



Close and Date of Next Meeting - 7 December 2015