Agenda and minutes

To approve as a correct record the Minutes of the meeting of the Commission held on 2 December 2014.

The Minutes of the meeting held on 2 December 2015 were approved as a true and correct record and signed by the Chairman.

To remind Members of the need to record the existence and nature of any Personal, Disclosable Pecuniary or other interests in items on the agenda, in accordance with the Members’ Code of Conduct.

There were no declarations of interest received.

To receive an update on actions following the previous Commission meeting.

David Lowe advised that the first Self Insurance Fund task group had been scheduled to meet on 13 February 2015.

Purpose: To advise the Commission of items to be considered by West Berkshire Council from 17 December 2014 to 31 March 2015 and decide whether to review any of the proposed items prior to the meeting indicated in the Plan.

The Commission considered the West Berkshire Forward Plan (Agenda Item 5) for the period covering 17 December 2014 to 31 March 2015.

Resolved that the Forward Plan be noted.

Resolved that the work programme be noted.

To consider any items called-in by the requisite number of Members following the previous Executive meeting.

There were no Councillor Calls for Action.

There were no petitions received at the meeting.

Purpose: To understand the causes of the maternity unit closures during August 2014 and the action that is being taken to avoid reoccurrence.

Gill Valentine (Director of Midwifery) and Caroline Ainslie (Director of Nursing), at Royal Berkshire NHS Foundation Trust, introduced the report to the Commission and provided Members with a presentation. Gill Valentine advised that the presentation was divided in two sections – the services provided by the maternity unit and the outcome from the Care Quality Commissioning report (March 2014).

Members were informed that the Royal Berkshire Hospital (RBH) provided maternity services for West Berkshire residents which included the provision of antenatal care, homebirth and postnatal care. Members were presented with activity statistics which helped to illustrate the number of deliveries and births year on year and the projected activity for 2014/15:

In most cases mothers could choose where to give birth and they typically chose to use hospitals in or around their local area. The following table illustrated the use of providers in the nearby area:

Gill Valentine advised that RBH currently employed 183 full time equivalent midwives who provided a midwife to birth ratio of 1:32. Throughout 2014/15 the actual ratio at RBH had fluctuated between 1:31 – 1:36, the month on month fluctuation being caused by the number of births and staff in post. However, RBH achieved 1:1 care in 98%-100% of cases. Members were advised that that other providers reported care ratios of between 1:30 – 1:35. RBH had undergone a Birth-rate Plus Assessment to determine the maternity service level of staffing and skill mix. The results would be issued in January and would be followed by a recommended birth ratio based on the nature of cases.

RBH had reciprocal arrangements in place with neighbouring maternity service providers which enabled them to accept women from other units when support was required and similarly support could be requested by RBH. Diversions were only used when all other forms of escalation had been implemented. Gill Valentine explained that in August 2014 the fundamental reasons for diversions were predominantly midwifery staffing levels.

To alleviate the reliance on unit diversions RBH had taken the following actions:

·         Recruited into vacancies, 8.8 FTE current vacancies and expanded to 9.4 FTE, with the service aiming to recruit above the initial vacancy level in order to offset against staff leave.

·         Recruited permanent posts to cover staff maternity leave.

·         Used agency midwives on a semi-permanent basis to alleviate pressure.

·         Reviewed all the roles undertaken by midwives to ensure their specialist skills were put to best use.

·         Reduced the number of midwives on study leave at any one time to minimise the impact on staffing levels on the wards.  ...  view the full minutes text for item 69.

Purpose: To agree the recommendations from the Task Group review into the internal and partnership bodies governing the activities of Children's Services.

Councillor Peter Argyle, speaking as Chairman of the task group, introduced the report to the Commission. He advised that the evidence highlighted that, although each governing body fulfilled a vital role, there was some degree of duplication across some groups. However, it was advisable that the framework of governance bodies did not change.

Members heard that the task group had been reassured by the evidence received from the newly appointed Chairman of the Local Safeguarding Children’s Board (LSCB). The discussion highlighted that she would conduct a review of the attendees and tasks set on the agenda to maximise efficiency and effectiveness. Her overall intention was to ensure the board continued to meet its statutory duties.

The task group was disappointed to find that very few Members attended the Corporate Parenting Panel, even though each Member had a responsibility as a Corporate Parent. Councillor Argyle advised that recommendation 8.1(6) aimed to encourage a higher participation rate from Members.

Councillor Argyle concluded that, crucially, there were no gaps in the oversight framework but the recommendations contained within the report sought to improve the overall supervision of Children’s Services activities.

Councillor Keith Woodhams stated that the LSCB membership appeared excessive. Rachael Wardell advised that the LSCB was a statutory body and it was advisable to comply with the membership as detailed within the Children’s Act 2004.

In response to a question raised by Councillor Macro, Rachael Wardell advised that the Munro Board remained in operation due to the ongoing programme of projects.

Councillor Brain Bedwell thanked the task group for their work and recommendations as detailed within the report.

Resolved that:

1)    An update report would be considered by the Commission in September 2015.

2)    The proposed recommendations would be accepted.

Purpose: To examine the performance returns from across the Council and to consider, where appropriate, any remedial action.

Jenny Legge and Catalin Bogos introduced the report to the Commission. Members were advised that the report appraised the progress against 53 key accountable measures and activities aligned to the objectives set out in the Council Strategy. Of the 53 reported measures, outturns were available for 44, the remaining 9 referred to annual key accountable measures for which data was not yet available.

It was reported that, in summary:

1)    33 indicators were ‘green’ (on track to be delivered / achieved by year end).

2)    10 indicators were ‘amber’ (behind schedule or still anticipated as being delivered/achieved by year end).

3)    1 indicator was reported as ‘red’.

The 10 measures reported as amber were:

·         Child Protection cases which were reviewed within required timescales

·         Proportion of repeat safeguarding referrals through the monitoring and review of protection plans

·         Level of delayed transfers of care from hospital and those attributable to social care from acute and non-acute settings

·         % of people accessing a housing related support service who have been assessed as needing support who go on to achieve economic wellbeing by improving debt management skills

·         ‘Major’ planning applications determined within 13 weeks.

·         ‘Minor’ planning applications determined within 8 weeks.

·         Work with the Environment Agency and other partners to deliver flood alleviation scheme in Eastbury

·         KS1-2: Proportion pupils making 2+ levels of progress in Writing

·         The number of schools judged good or better by Ofsted under the new Framework

·         The proportion of people aged 16-18 not in education, employment or training (NEET)

The 1 measure reported as red was :

·         Work with the Environment Agency and other partners to deliver flood alleviation scheme in Purley

Councillor Roger Hunneman referred to the upwards trend of adult smokers in West Berkshire versus the decreasing national trend. He stated that the figures were disappointing.

Councillor Alan Macro was concerned about the reported number of people killed or seriously injured on roads in West Berkshire. Councillor Emma Webster stated that the local road network, in particular the M4 and A34, would undoubtedly contribute towards the reported figures and should be noted.

In response to a question raised by the Commission, Rachael Wardell advised that the percentage of agency staff in post related to the Children’s Services functions only. The number of staff employed had stabilised since a surge that had been required to address demands experienced within the service. Councillor Emma Webster suggested that it would be useful to know the number of employees in order to contextualise the report.

Members discussed the number of transactions through the Council website which had increased through Q1 to Q2. Officers were asked to provide clarification around how the number of tasks was reported. Members were encouraged to see that the number of online transactions had increased which in turn had decreased the number of transactions via telephone.

Officers advised that pages 66 and 67 of the report had been provided in error and therefore should not be considered by the Commission.

In response to questions asked, Nick Carter advised  ...  view the full minutes text for item 71.

Purpose: To receive the latest period revenue and capital budget reports.

Andy Walker introduced the report to the Commission and advised that the Quarter three report was due for discussion at the next Executive but that a summary of the most recent information had been provided.

Members were informed that the Month Eight position showed a forecasted decreased over spend of £418k.

In response to questions asked by the Commission, in respect of item 2.1(1), Rachael Wardell advised that the budget identified a need to provide preventative services but the responsibility to maintain statutory duties took primacy. Spending was managed so that funding could be available to minimise the impact if pressures upon statutory duties increased. Rachael Wardell stated that she was aware of the longer term impacts if preventative services were reduced but it was necessary in order to manage short term pressures.

Councillor Alan Macro asked why the report indicated an increased demand on independent fostering which incurred higher costs. Rachael Wardell advised that independent foster careers could be used if the child had complex care needs. Also, the number of Looked after Children had increased and the availability of foster careers was unable to meet the demand so the service looked for support from independent foster careers.

Resolved that:

1)    The report was noted.

Purpose: To agree the Terms of Reference for a task group review of Delayed Transfers of Care.

David Lowe introduced the report to the Commission and reminded Members that the topic had been added to the Work Programme following consideration at a previous meeting.

The report proposed the Terms of Reference and methodology for the review which Members were asked to consider for approval.

Councillor Roger Hunneman reinforced his request to review the topic and stated that although the waiting times had recently improved they were still lower than the national average. He requested that the review considered reasons why waiting times had been so long, how and why recent improvements had been made and considered ways in which waiting times could be maintained at a suitable level.

Councillor Brain Bedwell suggested that the review would benefit from comparing activities with neighbouring authorities who appeared to have better transfer times.

Resolved that:

1)    The task group review of Delayed Transfers of Care begin its work.