Performance And Audit Committee (integration Joint Board) - 29/09/2021

At a MEETING of the PERFORMANCE AND AUDIT COMMITTEE OF THE DUNDEE CITY HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD held remotely on 29th September, 2021.

Present:-

Non-members in attendance at the request of the Chief Finance Officer:-

Trudy MCLEAY, Chairperson, in the Chair.

I APOLOGIES FOR ABSENCE

Apologies for absence were submitted on behalf of:-

II DECLARATION OF INTEREST

There were no declarations of interest.

III MINUTE OF PREVIOUS MEETING

The minute of meeting of the Committee held on 26th May, 2021 was submitted and approved.

IV DUNDEE HEALTH AND SOCIAL CARE PARTNERSHIP PERFORMANCE REPORT 2020/2021 - QUARTER 4 SUMMARY

There was submitted Report No PAC19-2021 by the Chief Finance Officer updating the Performance and Audit Committee on 2020/2021 Quarter 4 performance against the National Health and Wellbeing Indicators and Measuring Performance Under Integration indicators.

The Committee agreed:-

(i) to note the content of the summary report;

(ii) to note the performance of Dundee Health and Social Care Partnership, at both Dundee and Local Community Planning Partnership (LCPP) levels, against the National Health and Wellbeing Indicators as summarised in Appendix 1 of the report; and

(iii) to note the performance of Dundee Health and Social Care Partnership against the Measuring Performance Under Integration indicators as summarised in Appendix 1, table 2, of the report.

Following questions and answers the Committee further agreed:-

(iv) to note that Kathryn Sharp was examining the format of the report and that the next report would be in a different format to take account of feedback from members and Tony Gaskin and this would commence from the next financial year;

(v) to note following enquiry from Trudy McLeay in relation to availability of respondents answers so as to establish why it was perceived that performance was poor as indicated in Table 1 of the report that Kathryn Sharp would check what information was available in this respect and issue to the Committee accordingly;

(vi) to note following enquiry from Bailie Wright in relation to readmissions to hospital and whether or not it was the same people who were presenting on each occasion and whether or not care packages were in place for them when discharged from hospital the explanation from Jenny Hill as to what was meant by clinically fit and medically fit and she would look further at readmissions to see what could be identified in these cases;

(vii) to note following enquiry from Bailie Wright that work was ongoing in relation to strategic needs assessment and that this would examine trends and changes in these;

(viii) to note following enquiry from Trudy McLeay in relation to mental heath training for third sector workers the information from Diane McCulloch that the Partnership had specialist mental health officers and that processes were in place to support mental health support in other ways; and

(ix) to note following enquiry from Trudy McLeay that Diane McCulloch would examine what may be required in terms of Assurance in reports to the Committee.

V DUNDEE CARERS PARTNERSHIP PERFORMANCE REPORT 2019/2021

There was submitted Report No PAC20-2021 by the Chief Finance Officer informing the Performance and Audit Committee of the progress achieved through the Dundee Carers Partnership over the period 1st April 2019 until 31st March 2021. The Partnership had worked towards realising the ambitions of the local Carers strategy, A Caring Dundee 2017/2020 which was extended to October 2021.

The Committee agreed:-

(i) to note the content of the report and of the Dundee Carers Partnership Performance Report 2019/2021 as detailed in Appendix 1 of the report; and

(ii) to note the intention of the Carers Partnership to review and refresh the local Carers Strategy by October  2021 as detailed in section 6 of the report.

Following questions and answers the Committee further agreed:-

(iii) to note following enquiry from Councillor Short the work which was ongoing as explained by Jenny Hill in relation to awareness raising to help people understand that they were carers including involvement in schools through young carer ambassadors and to make them aware of the support which the Partnership could offer them; and

(iv) to note following enquiry from Donald McPherson in relation to statistics that only 35% of Carers said they felt supported the explanation from Kathryn Sharp that these figures were on a national measurement level rather than a local level.

VI CARE INSPECTORATE GRADINGS REGISTERED CARE HOMES FOR ADULTS /OLDER PEOPLE AND OTHER ADULT SERVICES 2020/2021

There was submitted Report No PAC21-2021 by the Chief Finance Officer summarising the gradings awarded by the Care Inspectorate to Dundee registered care homes for adults/older people and other adult services in Dundee for the period 1st April 2020 to 31st March 2021.

The Committee agreed:-

(i) to note the contents of the report and the gradings awarded as detailed in Appendix 1 of the report and highlighted in section 4.2 of the report;

(ii) to note the significant changes to the scale and scope of Care Inspectorate led inspections carried out in 2020/2021 due to the COVID-19 pandemic as detailed in section 4.1.2 of the report; and

(iii) to note the range of continuous improvement activities progressed during 2020/2021 as described in section 4.3 and Appendix 1 of the report.

Following questions and answers the Committee further agreed:-

(iv) to note as explained by Jenny Hill how any concerns would be discussed with Care Home Providers and that these would be identified and raised at an early stage and that a third round of oversight visits at Care Homes was currently being carried out by the Partnership and the contrast in the way inspections had been carried out over the period of the pandemic from an internal and external perspective and the work done by the Tayside Oversight Group to support Care Homes;

(v) to note following enquiry from Tony Gaskin in relation to level of assurance that could be ascertained from internal measures against external measures that Diane McCulloch would look at how this may be included in future reports; and

(vi) to note as advised by Vicky Irons that work was continuing on both weekly and daily reporting on a Scotland wide basis in relation to Care Homes and that prior to the Pandemic the Partnership had a Care Home Support Team in place.

VII GOVERNANCE ACTION PLAN PROGRESS REPORT

There was submitted Report No PAC22-2021 by the Chief Finance Officer providing the Performance and Audit Committee with an update on the progress of the actions set out in the Governance Action Plan.

The Committee agreed to note the content of the report and the progress made in relation to the actions set out in the Governance Action Plan as outlined in Appendix 1 of the report.

Following questions and answers the Committee further agreed:-

(i)                            to note following enquiry from Donald McPherson that Dave Berry would look to provide further information in the report explaining some of the descriptions on status and that the figure in relation to progress on workforce issues would be further examined.

VIII DUNDEE INTEGRATION JOINT BOARD INTERNAL AUDIT PLAN PROGRESS REPORT

There was submitted Report No PAC23-2021 by the Chief Finance Officer providing the Performance and Audit Committee with an update in relation to the progress on the completion of the 2020/2021 Internal Audit plan as well as work ongoing in relation to the 2021/2022 plan.

The Committee agreed to note the continuing delivery of the audit plan and related reviews as outlined in the report.

Following questions and answers the Committee further agreed:-

(i)                            to note that Tony Gaskin would submit a summary of all reports to the next meeting of the Health Board;

(ii)                           to note that a meeting of all Integration Joint Boards Chairs and Vice Chairs would be held in October 2021 in the interests of sharing good practice;

(iii)                          to note following enquiry from Bailie Wright the explanation from Tony Gaskin in relation to what was meant by Viability as indicated in the report and that a report on Key Risk Viability would be submitted to the February meeting; and

(iv)                          to note following suggestion by Donald McPherson that Tony Gaskin would look at possibility of including an additional column in future reports on how each of the Audits was progressing

IX DUNDEE HEALTH AND SOCIAL CARE PARTNERSHIP CLINICAL, CARE AND PROFESSIONAL GOVERNANCEASSURANCE REPORT

There was submitted Report No PAC24-2021 by the Clinical Director providing assurance regarding matters of Government policy directives and legal requirements. This aligned to the safe, effective and person centred quality ambitions of NHS Scotland.

The report was brought to the Committee to provide assurance on the clinical and care governance activities and arrangements across the Partnership as outlined in the Getting It Right For Everyone (GIRFE) Framework in accordance with the Partnership Integration Scheme. Clinical Governance was a statutory requirement to provide, at Board level, from Scottish Government as per NHS MEL (1998) 75. The Performance and Audit Committee was asked to provide their view on the level of assurance the report provided in regard to clinical and care governance within the Partnership. The timescale for the data within the report included April to May, 2021.

The Committee agreed: -

(i)                            to note the content of the report;

(ii)                           to note the Exception Report for the Dundee Health and Social Care Partnership Clinical, Care and Professional Governance Group as detailed in Section 4 of the report; and

(iii)                          with the Lead Officer for Dundee Health and Social Care Partnership that the level of assurance provided was: Moderate.

Following questions and answers the Committee further agreed: -

(iv)                          to note following enquiry from Bailie Wright the advice of Diane McCulloch that work was continuing to strengthen links between services to ensure that at time of discharge an agreed care plan was in place to support that person; and

(v)                           to note following enquiry from Donald McPherson the advice of Jenny Hill that significant interventions were in place to support the wellbeing of staff.

X ATTENDANCE LIST

There was submitted Agenda Note PAC25-2021 providing a copy of the attendance return for meetings of the Performance and Audit Committee held to date over 2021.

The Committee agreed to note the position as outlined.

XI DATE OF NEXT MEETING

The Committee agreed to note that the next meeting of the Committee would be held remotely on Wednesday, 24th November, 2021 at 10.00 am (unless otherwise advised by the Chief Officer).

Trudy MCLEAY, Chairperson.