Members will be asked to make any declarations of interest in respect of items on this agenda.

In accordance with the code of conduct, the following declarations of interest were made –

To receive reports on business which, in the opinion of the Chair, should be brought forward for urgent consideration.

The Chair welcomed the Chair of Ambitious Plymouth for the Dental Provision agenda item.

To confirm the minutes of the last meeting held on 10 December 2015.

Agreed that the minutes of the meeting of the 10 December 2015 were confirmed.

The Panel to receive a report on Care Home Fees.

Councillor Tuffin, Cabinet Member for Health and Adult Social Care, Carole Burgoyne, Strategic Director for People, Caroline Paterson, Strategic Commissioning Officer, Joan Bird, and Helen Foote, Lead Accountant were present for this item.  It was reported that -

(a)           local authorities are required to provide residential care for people aged 18 and over and to set the cost of care.  This was included in the current financial plans for the next 3 years;

(b)          they have a good working relationship with care home owners and have heavily consulted with 58 residential and nursing homes;

(c)           it was important to get the correct price for care.

The main areas of questioning from Members related to the following -

(d)          whether the care fees vary as the needs of the service user change;

(e)          assurance that reviews would be kept up to date;

(f)            concerns on the pressure placed on residential care homes that cannot afford the clients and how many homes have closed in the past;

(g)           whether residential care homes can keep profitable;

(h)          what happens to unsupported older people that do not have family provision around them;

(i)            how elderly people with mental health issues were supported and whether homes were equipped to support these people.

The Caring Plymouth Panel agreed with the following recommendations as set out in the report -

·         to support an increase in the fees Plymouth City Council is paying to care homes to incorporate the rise from the National Minimum Wage (NMW) to the National Living Wage (NLW) starting April 2016 and to include the cost of the auto enrolment for pensions.

·         to support a three year strategy for uplifting fees by percentage of increase in the NLW and changes in the Consumer Price Index (CPI).

·         to support the development of the Plymouth Pricing Tool for adults under 65 in care homes.

The Caring Plymouth Panel also agreed –

1.            To receive a position statement on the number of Annual Reviews outstanding and levels of delay to assessments (via email).

2.            To support an increase in the fees Plymouth City Council is paying to care homes to incorporate the rise from the National Minimum Wage (NMW) to the National Living Wage (NLW) starting April 2016 and to include the cost of the auto enrolment for pensions.

3.            To support a three year strategy for uplifting fees by percentage of increase in the National Living Wage (NLW) and changes in the Consumer Price Index (CPI).

4.            To support the development of the Plymouth Pricing Tool for adults under 65 in care homes.

The Panel to receive a report on Dental Provision.

Rob Nelder, Consultant in Public Health, Andrew Harris, Dental Contracts Manager, NHS England and Councillor McDonald, Cabinet Member for Children and Young People were present for this item.  It was highlighted that -

(a)           although oral health in England had improved over the last 30 years, tooth decay and gum disease were still widespread, despite being largely preventable;

(b)          national surveys indicate that around 31% of adults and almost 28% of children have obvious tooth decay.  Oral health in Plymouth was similar to the national averages;

(c)           children with tooth decay not diagnosed early and treated appropriately by primary care dentists could be referred to hospital for specialist care;

(d)          there were currently 2,846 people on the waiting list to access a dentist in Plymouth.  In May 2012 the numbers waiting for a dentist in Plymouth were over 6,000;

(e)          for those people who do not have a regular dentist would normally be able to access urgent dental care with 24 to 48 hours via the Dental Access Centre on weekdays or the out of hours dental service at weekends and bank holidays.

The main areas of questioning from Members related to the following -

(f)            whether newly qualified dentists could spend a year going around to schools to educate children on dental care;

(g)           the length of time fluoride varnishing lasts on children’s teeth and at what age was the fluoride applied to children’s teeth;

(h)        whether schools can visit the Dental School.

Agreed that the Caring Plymouth Panel recommend to the Cabinet Member for Children and Young People and the Cabinet Member for Health and Social Care, that resources are sought either through the Integrated Fund or other partnership means for the provision of a fully co-ordinated supervised tooth brushing scheme and training of the ‘dental ambassadors’ for each Children’s Centre in the City.

The Panel to receive a presentation on the Success Regime.

Judith Dean, Success Regime Programme Manager, Carole Burgoyne, Strategic Director for People, Councillor Tuffin, Cabinet Member for Health and Adult Social Care and Ann James, Chief Executive, Plymouth Hospitals NHS Trust were present for this item.  It was highlighted that -

(a)           North, East and West Devon was one of three areas in the country to be put into the NHS England Success Regime;

(b)          the aim of the Success Regime was to deliver clinically and financially sustainable services;

(c)           three phases of work to deliver the Success Regime –

·         Phase 1:  diagnostic phase to understand the issues

·         Phase 2:  design and consultation on options for addressing the challenges

·         Phase 3:  implement changes to services;

(d)          Phase 1 was now complete and sets out a compelling case for change and includes a long list of transformation opportunities for further consideration.

The main areas of questioning from Members related to the following -

(e)          how would the Success Regime ensure actions were universal and proportional to the disadvantaged;

(f)            the impact of the Success Regime in Plymouth in comparison to Devon;

(g)           how would the Success Regime ensure a fair allocation to Plymouth;

(h)          the sharing of best practice with the other areas involved in the Success Regime;

(i)            GPs leaving the NHS and the impact and recruitment and retention of staff.

Agreed –

1.            To request that the Caring Plymouth Panel’s comments regarding the disparity of health funding between the Western Locality area and that of the Eastern Locality are addressed during the planning phase of the regime, with particular regard to levels of deprivation experienced in Plymouth.

2.                  That representative of the Success Regime return following the Planning Phase in the new municipal year.

The Panel to receive a presentation on the role of the Safeguarding Adults Board.

Andy Bickley, Chair of the Plymouth Safeguarding Adult Board and Jane Elliott Toncic, Safeguarding Adults Manager were present for this item.  It was highlighted that -

(a)         the Board provides a strategic and assurance role;

(b)        the core duties of the Board:

·         to publish an annual strategic plan;

·         to publish an annual report;

·         to conduct any safeguarding adults review.

(c)         service priorities for the Board include:

·         risk management and self-neglect;

·         Mental Capacity Act awareness and compliance;

·         Engagement and participation;

·         Safeguarding Adult Reviews.

(d)        next steps for the Board:

·         use Development Day feedback to develop work programme;

·         enhance service user engagement and participation;

·         map and enhance linkages with other governance and fora;

·         develop a robust quality assurance framework and performance process;

·         implement learning from Safeguarding Adult Review; and

·         maintain a focus on quality, learning and delivery.

The main areas of questioning following the presentation related to the following -

(e)        financial abuse faced by the elderly;

(f)          mental health of vulnerable adults and the Mental Capacity Act;

(g)         cyberbullying.

Agreed that the Caring Plymouth Panel –

1.         Commend Andy Bickley, Chair of the Safeguarding Adult and Children Board on the work since the beginning of his tenure.

2.         Review the Annual Report of the Safeguarding Adult Board when it becomes available.

The Panel to review and monitor the progress of tracking resolutions and receive any relevant feedback from the Co-operative Scrutiny Board.

The Panel noted the progress made with regard to the tracking resolutions.

The Panel to discuss and agree future items for the Caring Plymouth Work Programme.

The Panel noted the work programme and agreed that the following items are included -

·         Next phase of the success regime;

·         Review of NHS111.

To consider passing a resolution under Section 100A(4) of the Local Government Act 1972 to exclude the press and public from the meeting for the following item(s) of business on the grounds that it (they) involve the likely disclosure of exempt information as defined in paragraph(s) of Part I of Schedule 12A of the Act, as amended by the Freedom of Information Act 2000.

There were no items of exempt business.