Report of the Executive Director Strategic Commissioning and Director of Adult Social Services

This report is intended to inform members of the Health Scrutiny Committee on the progress and development of a range of adult services including the equipment and adaptations services, reablement services; physiotherapy services and housing options for older people. It includes the progress made since the discussions at the last scrutiny meeting in December 2017.

The Committee considered the report of the Executive Strategic Commissioning and Director of Adult Social Services that informed Members on the progress and development of a range of adult services to support people at home including the equipment and adaptations services, reablement services, physiotherapy services and housing options for older people. It included the progress made since the discussions at the last scrutiny meeting in December 2017.

Officers referred to the main points of the report which were:-

·                Describing the background and description of the Manchester’s Service for Independent Living (MSIL) and how this service is accessed;

·                Current performance data on the Equipment and Adaptations Services in relation to both major and minor adaptations;

·                Customer satisfaction performance was reported, currently recorded as 95%;

·                Data on the performance of contractors;

·                Information and data on the Housing Options for Older People service (HOOP);

·                Reablement activity and progress, noting that reablement being defined as an evidence based approach to maximise people’s ability to return to their optimum, stable level of independence, with the lowest appropriate level of ongoing support;

·                The current challenges to the reablemement service and the response to these;

·                A description of different types of physiotherapy services across the city and the associated referral data; and

·                The Joint Strategic Needs Assessment regarding Fuel Poverty, noting that Manchester contained the highest number and proportion of fuel poor households of any local authority within Greater Manchester.

Members discussed the issue of fuel poverty and asked what was being done to tackle this, especially as the funding streams designed to address this had ceased. Members noted that a lot of older housing stock in the city were poorly insulated and private landlords needed to take more responsibility to ensure that the properties that they were renting out were of a decent standard. Members asked what standards were applied to privately rented properties and could conditions be attached as part of the landlord licensing scheme. 

A Member commented that improving fuel poverty would realise savings to the NHS and reduce carbon emissions. The Chair commented that consideration needed to be given to how this was evidenced so as to make the case for additional funding to support schemes to address fuel poverty.

Members noted the reported levels of customer satisfaction with the adaptions service, however asked what lessons were learnt from those residents who were not satisfied.

Members asked a question about the challenges presented to One Manchester, as the Council’s delivery partner to deliver major adaptions in East and Central Manchester.

Members sought clarification regarding the recruitment of staff to deliver reablement services, noting that a recruitment exercise was underway. Members asked for an update on this exercise.

The Director of Population Health and Wellbeing acknowledged that a significant amount of funding that had previously been available to address fuel poverty had now ceased nationally. He said that the Local Care Organisation (LCO) would develop responses and interventions to tackle the wider determinants of health by using Social Prescribing.

The Programme Lead Health and Social Care Integration informed the Committee that the delivery of services had now been transferred to the LCO. She said this was a positive development presenting an opportunity to build strong relationships between health professionals and establish joint working practices that would ultimately benefit the citizens of Manchester. She further described that funding had been secured to recruit an additional 62 reablement workers and 8 occupational therapists that would help improve referral rates and address the issues of capacity.

In response to the comments raised regarding those cases that were not satisfied with the service, the Programme Lead Health and Social Care Integration said that a complaint would always be fully investigated and responded to appropriately. She said that any lessons learnt would also be reviewed. She further clarified that a Minor Adaptation was classified as costing under £1000 and Major Adaptions as works costing above £1000, and this definition is prescribed nationally. She explained that Major works could sometimes take longer to deliver due to the complexity of each individual job.

The Programme Lead Health and Social Care Integration advised that for those cases where major adaptions were refused in favour of rehousing those decisions were reached following consideration by a Panel in full compliance with agreed Council Policy. She said that for those individuals/families affected social workers would intervene to support any vulnerable people and alternative sources of support would be accessed.

The Executive Member for Adults, Health and Wellbeing reported that a review of this policy would be undertaken and that she welcomed the views of Members on this issue.

The Head of Housing said that he acknowledged the comments made by Members in relation to the poor condition of properties in the Private Rented Sector. He informed the Committee that a strategy to look at this and other issues within the Private Rented Sector would be developed. He said that currently there was no funding to address fuel poverty, however there were limited grants and loans available that people could apply for. He commented that when a previous Right to Buy property became available to purchase the local Registered Provider would seek to buy back the property. He advised that he would refer the comments regarding property conditions contributing to fuel poverty being attached to licensing conditions to the appropriate team for consideration. 

The Executive Member for Adults, Health and Wellbeing advised that standards within the Private Rented Sector was an issue that contributed to the health and wellbeing of residents. She said more needed to be done to ensure that those landlords who were making a profit from renting homes should be made more responsible and accountable for the condition of their properties.

The Housing Programme Manager said that Registered Housing Providers had agreed to contribute 40% of costs associated with adaptions. He explained that 50% of the adaptions delivered by One Manchester were to other Registered Housing Providers in the city. He said that challenges arose as they had to coordinate this activity with a number of different providers who had their own agreements and systems for approving works, however the system was working well with good relationships and cooperation established between housing providers.

Decision

The Committee notes the report.