Agenda item

7.1

The Committee received a joint report of Kevin Clifford, Chief Nurse, NHS Sheffield, Clinical Commissioning Group (CCG), Phil Holmes, Director of Adult Services, Sheffield City Council, and Liz Lightbown, Chief Nurse and Operating Officer, Sheffield Health and Social Care (SHSC), containing details of the investigations carried out by the SHSC NHS Foundation Trust and the City Council following concerns raised with regard to the quality of care within residential, short break and day services for adults with learning disabilities provided by the two organisations. 

7.2

The joint report contained, as appendices, Council Action Plans relating to Quality and Safeguarding and Finance and Management, the City Council’s Commissioning Strategy for Services for People with a Learning Disability and their Families 2015-2018 and the SHSC NHS Foundation Trust: Executive Summary Report on Review of Culture and Practice; SHSC Action Plan – Culture and Practice Review; the Trust Board Response to the Report and the SHSC’s Learning Disability Directorate Governance Framework and Quality Improvement Plan. Reference was also made to further appendices to the report which, due to their confidential nature, could not be made public.

7.3

 Also in attendance for this item was Councillor Mary Lea, Cabinet Member for Health, Care and Independent Living.

7.4

Kevin Clifford provided a brief history of the position, indicating that in August 2013, a number of issues had been identified in connection with the Joint Disability Service which, at that time, was ran jointly by the SHSC and the City Council.  The Service was subsequently split, and the two organisations took control of those areas where they had direct staffing responsibilities.  He stated that it was apparent that there were still a number of issues, and each organisation undertook investigations into their respective services, as well as an independent review being undertaken by Doctor Kathryn Houghton.  The matter was also referred to the Sheffield Safeguarding Board.  The investigations were completed within 18 months, which resulted in both organisations producing Action Plans, which were being submitted to this meeting.

7.5

Phil Holmes reported on the two Council Action Plans – Quality and Safeguarding and Finance and Management, highlighting the key findings, agreed recommendations and action taken. 

7.6

Liz Lightbown reported on the SHSC’s Action Plan - Culture and Practice Review, again, highlighting the key findings, recommendations and actions taken.

7.7

Members of the Committee raised questions and the following responses were provided:-

·                It was accepted that there had been issues in connection with service users, carers and families not receiving notification (within the City Council’s directly managed services) that the reviews were being undertaken or having been provided information on the outcomes, actions and progress.  The Council fully accepts the findings of Doctor Kathryn Houghton’s Quality Assurance Assessment in that service users and families were being further disadvantaged as they were being asked to participate in decisions on commissioning of their services, with an incomplete picture of the quality of City Council Learning Disability provision.  In response to this, the Council had arranged a consultation programme within the properties affected by the current stage of the commissioning programme.

·                Although this item was being considered by the Scrutiny Committee, as an urgent item, this term had only been used as the appropriate notice of the item being considered under the Local Government Act 1972, as amended, had not been given.  It had always been the intention to submit the report to this meeting but, concerns had been raised by the City Council in terms of the content of some of the appendices to the report, which had resulted in the report missing the relevant deadlines.  It had further been decided by the City Council that, due to the confidential nature of some of the information, those appendices to the report containing such information, could not be made available to the public or press.

·                It was acknowledged that there had been lapses in terms of appropriate staff supervisions and performance reviews, including a lack of proper audit trails.  This had been identified by management, and appropriate action had been taken to ensure that supervisions were now being carried out regularly, and being checked, and that staff were getting used to the new approach.

·                Service users, families and staff were all involved in looking at the quality outcomes and ensuring their feedback drove further improvements.

·                Discussions had been held in terms of how the Member Champions would operate, and it had been identified that, in order for them to undertaken their role properly, there would be a need for appropriate training.

RESOLVED: That the Committee:-

(a)       notes the contents of the report now submitted, together with the comments now made and the responses to the questions raised;

(b)       together with the representatives of the Clinical Commissioning Group and Sheffield Health and Social Care NHS Foundation Trust, expresses concerns with regard to the delays in publishing the report and the fact that some of the appendices to the report were not publicly available, specifically the Quality Assurance Assessment by Dr Kathryn Houghton, and therefore requests the Chair to raise this with relevant officers and Cabinet Members in the hope that the report can be made public;

(c)        acknowledges the need for further discussion with regard to the link between scrutiny and adult safeguarding;

(d)       supports the idea of Member Champions, specifically providing the ‘eyes and ears’ to oversee the Learning Disability Service;

(e)       requests the Director of Adult Services to report back to the Committee in 12 months’ time, providing an update on the Action Plans; and

(f)        expresses its thanks to Kevin Clifford, Phil Holmes and Liz Lightbown for attending the meeting and responding to the questions raised.

(NOTE: In accordance with Council Procedure Rule 26 of the Council’s Constitution and the provisions of Section 100B(4)b of the Local Government (Access to Information) Act 1985, the Chair decided that the above item be considered as a matter of urgency in order for the information contained in the report to be considered at the earliest possible opportunity, although it had not been possible to give five clear days’ notice that the item was to be considered.)