Apologies for absence were received from Councillor Tranter and Pat Harris (Non-voting Co-opted Member). 

It was reported that, in accordance with the wishes of the Conservative Group, the membership of the Sub-Board had been amended to include Councillor Barbara Lewis in place of Councillor Fellows.

To confirm as a correct record the minutes of the meeting of the Adult Social Care and Health Overview and Scrutiny Sub-Board held on 10 October 2024.

The minutes of the meeting of the Sub-Board held on 10 October 2024 were confirmed as a correct record and signed by the Chairwoman.

At the start of the meeting Councillor Johns declared a non-pecuniary interest as an employee for the NHS and her workplace was due an inspection in the near future from the Care Quality Commission (CQC).

To receive an annual review on improvements in dental access and planned oral health improvement initiatives.

(Note:  Lincoln Sargeant – Director of Public Health, Mark Richards – Public Health Specialist, Councillor Hayley Tranter – Cabinet Member for Adult and Community Services, Public Health and Inequalities, Paul Green, Director or Primary Care and Melissa Redmayne Senior Commissioning Manager (Pharmacy, Optometry and Dental) NHS Devon Integrated Care Board (ICB) have been invited for this item.)

The Director of Public Health together with the representatives from the NHS Devon Integrated Care Board (ICB) and Head of Service for Safeguarding, Early Help and Business Intelligence gave a presentation, as circulated prior to the meeting, on the Annual Review of Dentistry Provision in Torbay. 

Members asked questions in relation to the number of Family Hubs in Torbay and the capacity available at the Hubs to support families with oral health; what age did fluoride varnishing start; was there any evidence on vaping being linked to Oral Cancer, similarly to smoking and alcohol; was there possibility of a triage type system that could be introduced into dental surgeries; could dentists visit schools to carry out checks on children and young people; detail on the way the waiting list system operates; the likelihood of NHS patients being able to access a dentist; the age brackets of people who were no longer on NHS waiting lists; how families access dental services; if education was being carried out with young children attending nurseries; when teenagers become of age and they were no longer entitled to free dental treatment, were they being added to the NHS waiting lists; how a resident experiencing dental pain could access emergency treatment; if dental contracts were annually reviewed; and what outreach work was carried out with residents of Torbay experiencing homelessness. 

In response to questions, Members were advised that there is a Family Hub in Torquay, Paignton and Brixham.  In 2023, the footfall to all of the Family Hubs was 17,000 visits.  There were a lot of activities that were carried out within the Family Hubs including Health Visitors holding sessions.  There was also a website and a virtual Family Hub that could be accessed by residents Home - Family Hub.

Members were advised that the fluoride varnishing service starts from  2 years old children and the resources were provided at school for children to take home twice a year. 

In regard to the question on vaping and any evidence linked to oral cancer, Members were advised that there was currently no evidence regarding this but this could change over time.  There was still evidence linking smoking and alcohol use to oral cancer. 

Members were advised that the introduction of a triage type system into dental surgeries would be a difficult system to introduce due to the limitations on treatment that could be provided by staff other than professionally qualified dentists. 

Members noted that Public Health colleagues do visit local schools to provide services to work with teachers and parents on oral health education. 

Members were advised that NHS Devon were commissioning additional urgent dental care appointments and ‘stabilisation’ sessions across Torbay.  Work was being carried out to increase access to Dentistry by implementing measures to support dental services including an increase unit of dental activity (UDA) rates, increasing the recruitment and retention of the South West dental workforce and to rebase UDA activity for the dental workforce to achieve levels to support financial sustainability. 

Members  ...  view the full minutes text for item 21.

To receive an update on the actions being taken following the recent Adult Social Care Peer Challenge.

The Director of Adult and Community Services and Strategic Lead for Adult Social Care Quality and Assurance provided an update on the actions being taken following the recent Adult Social Care Peer Challenge as set out in the submitted report.

The Sub-Board asked questions in relation to the current ‘PARIS’ case management system used by Torbay Council, the replacement system and how many phases were being completed to replace the system; admission to care homes and comments within the report regarding residents who had been moved to a care home who it was believed should not have been; work being carried out by Adult Services to monitor residents at home and any safeguarding work; what comprehensive training would be provided to colleagues using the new case management system; what providers were being sought to help care for residents who were being discharged from hospital; if improvements were being identified in numbers of residents being discharged from hospital and if there was still preventative work being carried out to prevent care home residents from being admitted to hospital.

Members were advised that Torbay Council was currently in the second procurement phase to purchase a new case management system.  There were three phases in total.  The first phase was to identify if a new system was required, second phase was a procurement exercise and third phase would be awarding the contract. 

The Director of Adult and Community Services explained that there were challenges currently being experienced in discharging residents from hospital and into a short term placement to be stabilised to return to home address.  Housing played a crucial part when residents who were admitted to hospital, lose their property and where alternative accommodation was required to be found. 

Torbay Council Adult Social Care Team works very well with Re-enablement Services and the number of residents who were helped to return to living within their own home.  Actions were being taken to widen the Service to aim to reach a wider range of residents who require the Services. 

Members were advised that work was carried out to monitor residents within their own home and Torbay Council Adult Services have good relationships with local providers.  Safeguarding actions were taken as and when required if issues arise. 

Members noted that all colleagues within Adult Services Directorate would be provided with comprehensive training to ensure that there was confidence that the data was being inputted correctly into the new case management system.  Two systems would be operated whilst the new system was being introduced and ongoing support will be provided. 

Members were advised that there was an element of choice for residents as to the provider that provides their care at home.  Torbay Council was an industry leader in the performance of ensuring residents were discharged from hospital as a result of the Integrated Care Organisation.  It was a top priority for residents to be discharged from hospital as quickly as possible. 

There had been a lot of work completed in providing enhanced care within  ...  view the full minutes text for item 22.

To receive an update on domiciliary care provision.

The Divisional Director of Adult Social Care provided an update on domiciliary care provision as set out in the submitted report.

Members raised questions in relation to any other organisations involved with care and required equipment being provided to residents at home; flexibility with employee contracts and benefits; if a visit could be organised to visit Jack Sears Unit; and if there were specific areas within Torbay allocated to certain providers. 

Members were advised that there were two main contracts for Domiciliary Care – one for functional equipment i.e. beds, hoists etc. and one for technological equipment which was held with the NHS.  As a lot of the equipment provided to residents was generic, all care staff were trained in the use of the equipment including manual handling training.  As technology was one of the biggest enablers in the industry, Torbay Council and the NHS have to keep up with the latest technology to keep residents safe at home. 

Members noted that there were various providers of domiciliary care within Torbay and each had their own employment contracts for their employees.  All providers were encouraged to offer flexible working to attract new members of staff.  Domiciliary care staff were provided lanyards to enable staff to access similar discounts to NHS colleagues. 

Members were advised that there were no set areas allocated to certain providers.  Some domiciliary care providers chose to only work in one area of Torbay and some chose to operate in all areas of Torbay and this was self-regulated by the providers. 

Resolved (unanimously):

1.            that the Adult Social Care and Health Overview and Scrutiny Sub-Board notes the contents of the submitted report;

2.            that the Clerk be requested to organise visits to the Jack Sears unit for the Adult Social Care and Health Overview and Scrutiny Sub-Board Members; and

3.            that the Divisional Director for Adult Service be requested to organise for an Employment and Skills Board representative to be invited to attend a future meeting with Domiciliary Care providers. 

To receive an outline and overview of the Memorandum of Understanding between Torbay Council and Torbay and South Devon NHS Foundation Trust.

(Note:  this report includes an exempt appendix which has been circulated separately.)

This item was deferred to the meeting of the Adult Social Care and Health Overview and Scrutiny Sub-Board to be held on 16 January 2025. 

To receive an update on the implementation of the actions of the Sub-Board and consider any further actions required (as set out in the submitted action tracker).

The Sub-Board noted the submitted action tracker.

Resolved (unanimously):

1.            that the Clerk be requested to chase up the outstanding actions and provide an update at the next meeting;

2.            that an update be provided at a future meeting on the safety of the care home estate, linking with the Torbay Safeguarding Adults Board Annual report; and

3.            that the Sub-Board receive details of safeguarding adult’s reviews when they are published to look at lessons to be learned and consider a themed meeting on safeguarding issues.