Portsmouth City Borough Council Cabinet Member for Health, Wellbeing & Social Care Meeting

Apologies for absence were received from Councillor Brian Madgwick.

There were no declarations of interest.

Andy Biddle, Director of Adult Care, introduced the report.

In response to questions from members, Mr Biddle explained that physiotherapy and occupational therapy are essential to rehabilitation which is why the recommendations are being made. Transferring responsibility for the Southsea Unit to Solent NHS allows patients to benefit from their specialities. 

It is anticipated the Southsea Unit will be up and running by the end of September 2022. If it is not ready then the prospect of closing any beds would be unpalatable and cause anxiety. If HR matters can be resolved then the unit should be ready in time. If progress is derailed then a report would be brought back to the portfolio. There has been considerable work since the beginning of the calendar year on aligning communications between the council and Solent NHS.

With regard to staffing, if staff transfer under TUPE they normally transfer with the council's terms and conditions. However, a restructure would cause difficulties. The council would have to ensure reasonable stability of employment in order not to see any detriment to staff. Councillor Winnington acknowledged the council was resolving details and would want to avoid the threat of redundancy.

With regard to the closure of Jubilee House, it is an old building and sub-optimal. There have been concerns in the past about its integrity and reports have gone to the Health Overview & Scrutiny Panel in the last few years. Councillor Winnington noted that more care settings are being considered for the site and patients from Hampshire had been discharged there during the pandemic.

Richard Webb, Finance Manager, explained that officers were working with the Portsmouth Clinical Commissioning Group (CCG) to consider permanent funding provision for 40 beds; currently there is permanent funding for 30 beds with temporary NHS funding for 10 beds. Officers will not know with certainty about NHS funding for the additional 10 beds until the end of the financial year but they can fund at least 30 beds.

Mr Biddle explained that the CCG had been replaced by the Integrated Care System (ICS) with effect from 1 July. The ICS comprises the Integrated Care Board (an NHS body with statutory duties and functions) and the Integrated Care Partnership (which prepares a strategic plan and guides the Board). He anticipates a decision being made by the Board as it is a statutory NHS body. Councillor Winnington noted the Board had strong local representation as its membership includes, for example, Portsmouth's Chief Executive and social care and public health directors from across Hampshire and the Isle of Wight. He was confident funding would be secured for the future. Members noted that Discharge to Assess units have made a massive difference to people's lives and are much needed; the Southsea Unit builds on fantastic work.

DECISIONS

1.    Agreed to the transfer of staff to Solent NHS Trust via either TUPE or s113 of the Local Government Act 1972 as appropriate to deliver D2A services within the Harry Sotnick House site.

2.    Agreed that the Director of Adult Care continue negotiations and enter into the necessary agreements with Health & Care partners, in consultation with the s.151 officer and the City Solicitor, (or their delegates) to establish a permanent jointly funded and commissioned D2A unit within Harry Sotnick House.

Richard Webb, Adult Social Care Finance Manager introduced the report.

In response to questions from members, Mr Biddle explained that Adult Social Care's (ASC) statutory responsibility to provide care has not changed per se but guidance on the cost of care paid for by the local authority has changed slightly how it implements it. It is also helpful to see the fair cost of care in the round as preparation for the introduction of the care cap in October 2023; ASC will need to create individual accounts for clients. ASC has a well-established relationship with the market and has regular catch-ups with providers, which is how it fulfils its statutory duty.

Councillor Winnington said the report illustrated work that had come to fruition and been strengthened during the pandemic. The introduction of the cap will have particular challenges as there is concern at local level about the funding that will be received.

The Cabinet Member noted the report.

Andy Biddle, Director of Adult Care, introduced the report, explaining that he wanted to provide a "learning view" of what had happened with the meals delivery service in April. Adult Social Care (ASC) had the right intention but due to a combination of circumstances the service had not been carried out to the standard it should have been for which Mr Biddle, as Director of Adult Care, apologised. The dedication and care of council officers in trying to remedy the situation is worth noting.

In response to questions from members as to whether the number of drivers employed by the provider was adequate, Mr Biddle said he could not be precise about the exact number required to be in line with expected staffing levels. The initial agreement was for the provider to cover one postcode area but ASC asked them to step into the breach when the two other providers became unavailable. It would have been surprising if the provider had had the full resources but ASC were grateful for them stepping in.

With regard to the temperature of the meals, ASC asked strongly that the correct temperature should be maintained (the provider gave probes and check sheets to staff) and when this was not done the contract was terminated. Checks were carried out and food was not being kept at the correct temperature. The new provider (Age UK) has kitchen equipment so they can do their own checks. They use insulated boxes (combined with "space blankets") so one meal at a time can be removed with the others remaining insulated and at the correct temperature. Age UK was inspected in June about a week and a half before starting the meals delivery service; their food hygiene rating is 4.

With regard to spending more time to care for clients, ASC tried to guarantee everyone got a meal and for those receiving domiciliary care ASC extended the time funded.

ASC were aware in November 2021 that Apetito were going to increase the cost of the meals from £5.50 to £8. Councillor Winnington thought ASC was right to look for another provider in view of a price increase of nearly a third.

Mr Biddle explained that the traditional model of a meals delivery service was to transport frozen meals and then reheat them in specially adapted vans which have a negative impact on the environment. ASC therefore wanted to provide locally produced fresh food to avoid reheating meals. Apetito had to make a certain number of deliveries per hour regardless of whether clients lived in houses or blocks of flats. ASC wanted to spend more time with residents, who are often unable to leave their homes and put them in touch with local community resources. The service is more than just delivering meals. The current provider is Age UK Portsmouth and as a charity they have a range of resources that benefits the wider community. Members noted the smallest contact can make a massive difference to people.

The service will gradually cover more postcode areas over the summer and from August will start taking new referrals.

Councillor Winnington thanked Mr Biddle for his frankness and appreciated his honesty in accepting that things went wrong. Officers had to take decisions that took into account residents' needs. Initial feedback from the new provider has been very positive. Members thought the new service was the best option by far for residents because of the added value provided, for example, carrying out welfare checks. The approach links with that of Discharge to Assess in that it keeps people independent and out of hospital. It shows how the city can make the most of its strengths.

Members requested that an update be brought back to a portfolio meeting in about six months' time to show how the service was progressing. They thought it would be helpful for Age UK to attend to give their perspective. It would also be helpful for the report to include views and case studies from residents showing how the service has been received and improved.

The Cabinet Member noted the report. He thanked officers for their reports.