Minutes:
Councillor D Arnold explained that Thurrock has the second lowest spend on adult social care in the region. However, one third of the overall budget is spent on adult social care. 85 % of the budget is spent on just 7 % of the people living in Thurrock and that means only 15% can be spent on the remaining 93% of the population. Acute care packages are very expensive and any reduction in service level would carry enormous risk. Thurrock transformation programme is vital to support people from developing more complex illnesses and helping people stay healthier for longer. Transformation is needed now more than ever. The development of Wellbeing teams will allow for a team of professionals to talk to each other and work off the same assessment benefitting residents from having to have assessment after assessment. Transformation will also benefit staff too, Thurrock has an ageing working population in this area and it is not necessarily a popular career route for young people. Social Work apprenticeships are being offered. Councillor D Arnold highlighted that Thurrock positively has one of the lowest staff turnover rates in Thurrock for social workers.
The Chair raised that Thurrock First can help those with mental health problems where this impacts on them in other ways such as effecting their tenancy.
Councillor D Arnold agreed they could improve the communications around Thurrock First. They can give people that immediate link into help with the wellbeing team and urgent community response teams.
The Director for Adult Social Care and Community Development explained that Thurrock first primarily is a first point of contact for those who require community care or help with mental health. GP’s would probably refer those with mental health concerns into Gray’s Hall in the first instance. There is nothing to stop the Council increasing the accessibility to Thurrock First. A lot of mental health condition referrals come to their attention through community work. He further explained that a multi-disciplinary approach is required and they are looking to pull together services that can deal with the complexities involved where it is not uniquely mental health or substance misuse that leads to people leading a chaotic lifestyle. Good solutions need to be found and where you live and having a stable accommodation are so important.
The Chair commented that Thurrock carers service appeared to be centralised in Grays and queried if it could be rolled out in Corringham or Tilbury.
Councillor D Arnold confirmed it is an online service too. The Local Area Coordinators pick up carers in the community. They ask people if they know anyone caring for anyone at home.
The Chair raised whether anything more could have been done by the council regarding the IMC’s.
Councillor D Arnold said she had not been involved from the start and had been going round in circles trying to unpick what had happened. They need to draw a line under this and move forward. Once it is known what NHS England have got to say about the business cases, we will know more about how we can take the IMWC’s forward. Councillor D Arnold highlighted that the Borough has an ageing hospital that will eventually close and services need to be relocated.
Councillor Pothecary commented that this seemed like a shuffle away from the Council pushing for purpose-built buildings which is what we were promised - 4 IMWC’s in the borough.
Councillor D Arnold stressed that it is her focus to get those IMWC’s into the borough and to attract GP’s. She explained that the most important thing over bricks in a building is improving healthcare and outcomes for residents and protecting services. She stated that she cannot see it coming in within the original timescales set out.
Councillor Pothecary queried proposed cuts to voluntary sector grants for Thurrock MIND and SERRIC.
Councillor D Arnold responded that it is vital that we support the right services and those that fit within our strategy. She commented that she recognises the importance of community and voluntary organisations. The situation financially may mean a shortfall financially but they are looking at how they can support in alternative ways such as free space, or help them to find other ways to fund or jointly fund them with the NHS.
Councillor Pothecary stated that it was encouraging to hear those conversations are already happening.
The meeting discussed delays in discharging people from hospital. The Director of Adult Social Care and Community Development confirmed that they previously were fined for delayed transfers of care if they didn’t reach performance indicators and this was reported nationally. Since the Pandemic this has not happened. He confirmed that they are aware of how well they perform and they know how many people are delayed in hospital and share this information regionally. This could be captured in the Portfolio holder report. The medically well has shifted to medically optimised and instead of the test being, is this person fit enough to go home? It is now, does this person need to be in an acute setting? If the answer is no, they are put forward for discharge. A new performance framework will probably be brought out later this year.
Councillor Polley queried if the system is now being supported by virtual wards.
The Director of Adult Social Care and Community Development confirmed that they have kept the hospital team in place which a lot of Local Authorities haven’t. They therefore have a dialogue with wards and clinicians and try and ensure for people who are ready for discharge that we are aware of what they need and that we can meet those requirements. We do get some who come out and go back in because not ready for discharge. However, it is better for everyone if they can stop people going into the hospital in the first place.
At 21.14 standing orders were raised so the meeting could continue beyond 9.30pm
Councillor Polley discussed a new project at St Luke’s called WISH which is a wellbeing information and support hub when people first get diagnosed. She suggested that they should invite St Lukes into the Committee to talk about this.
Kim James confirmed that there is a commissioned service paid for by the better care fund that supports discharge from hospital. She explained that everyone 65 and over and frail will get a welfare call and 6 weeks of visits. They have got a handy man who can move beds downstairs if required. They can install key safes for carers and get equipment. They also collect food bank food for them and help get electricity and gas on. They take on over 250 referrals a month.
The Chair asked Councillor D Arnold if there is anything she could do better or focus on more.
Councillor D Arnold responded that an area she wants to gain more information on is mental health as she hasn’t focussed on it much this year and she will be taking this forward next year.
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