National Children’s and Adult Services conference

NCASC14 LogoVery early on Wednesday I left the house in darkness and caught a train bound for Manchester to go to the annual National Adults and Children’s conference #ncasc14

The day started with a thoughtful speech from David Pearson this year’s President of ADASS with whom I sit on the TLAP Board with. At the conference ADSS and the LGA launched the Adult care funding: 2014 state of the nation report which you can find at http://www.local.gov.uk/publications This report is a really good summary of the state of adult social care after a period of Local Government funding cuts, the funding crisis that is looming, readiness for the coming Care Act and the current state of play with regards the great ‘undiscovered country’ of Health and Social Care integration. In short if you never read another thing about this subject, probably the biggest domestic challenge this county faces, then read this, it makes for a sobering read. Not full of doom and gloom but a realistic assessment of where we are at.

It also neatly summed up the day and the various plenary and fringe events I attended. In one we heard from from a reinvented Shadow Secretary of State Andy Burnham MP, who surely can’t be the same chap who I knew of in the last Labour Government. But as usual in his session with the Shadow Children’s Minister Tristan Hunt lots of announcements that if they win in May 2015 they promised to implement but as usual with Labour nice ideas, but back in the real world how are you going to pay for it, always the flaw in their argument.

The conference covers both Children’s Services and Adults Services, but a read of the programme rather highlighted the impression I usually form each year that it is a programme that leans towards adult rather than children services. Of course the current funding cuts and demographic pressure rather demands the attention in local government as does the undiscovered (well for most councils and local Health economies) country of real health and social care integration.

The following morning I had a meeting with colleagues from the LGA and then with the TLAP team about the upcoming TLAP conference where I am speaking and co-chairing a session about Building Community Capacity. And then my conference was over, all too quickly for the 89 hours I spent travelling to and from it.

As I said to one colleague, most jealous I could not stay for the rest of the conference as so many important sessions and discussions to hear on this most difficult of subjects facing local government for the foreseeable future.

LGA CWB TLAP BCC – how’s that for Local Gov speak!

TLAP LogoToday I reach a small milestone in my blogging as this is my 300th blog, probably does not mean much to you but it seems a long way from when I first logged into word press, set up an account and well had a go. If you’re one of those kind people who follow it, thanks for reading. I do try to be as brief as possible, sometimes I succeed and sometimes I don’t. Hopefully it gives a bit of an insight into the things I get involved in and am passionate about.

Speaking of which, last Wednesday I was in London representing the LGA Community Wellbeing Board at two meetings firstly the Building Community Capacity steering group and later at the TLAP Board Meeting. I wanted to be a part of the Building Community Capacity work as it is very much what I started in Suffolk as we came up with the Supporting Lives Connecting Communities Programme (SLCC) about how the Council can develop services that communities truly need that compliment rather than crush the work that existing in Communities now and to help build community based services where there are none. In short how to delivery more services to an ever growing number of people who need care services but with less money with which to do so.

In the afternoon, the main Board meeting took place, where I am able to give the programme a sense of what Local Government and Councillors need from the various work streams and how the reports and initiatives its provides and funds can help Local Government can make its services more relevant and personal to those who need them.

The latest papers to shortly be available from their web site and being launched at this week’s National Adult and Children’s Conference in Manchester are called ‘Shaping the future- information, advice and brokerage in the context of the Care Act’  – essentially 3 reports co-badged with ADASS, DH and LGA to support the Care Act implementation.

I’ll pop the links to those papers up when they are on the TLAP website, the other recent ones that I think are useful reading are:

‘Getting Serious about personalisation in the NHS’ – Partner publication to the IPC (integrated Personal Commissioning) with ADASS LGA and NHS England http://bit.ly/1rxvKeD

‘No Assumption: a narrative for personalisation, co-ordinated care and support in Mental Health’ – with National Voices and NHS England http://bit.ly/1ywCMoU

‘A Wealth of information: your questions on personal health budgets answered’ – NHS Confederation briefing produced in partnership with TLPA http://bit.ly/1mG7gPW

Working with Public Health Professionals

lclg-logoLast Monday saw me travelling to Bristol to have dinner with the latest cohort of Public Health England Professionals attending the Leadership Centre for Local Government programme about working in a Political Environment. ahead of working with them on the Tuesday to help them develop their understanding of the political processes in Local Government. Alongside me was Cllr. Roz Gladden, who is the Deputy Mayor of Liverpool City Council and Cabinet Member for Adult Social Services, representing Labour Councillors and Cllr. Howard Sykes from Oldham Council who is Leader of the Liberal Democrat opposition group and has held various positions over a long and distinguished Local Government career. We joined the cohort midway through a two day course and to informally chat and gather some insights as to how we might tailor the sessions the following morning.

In short we do a sort of triple act discussing firstly why we got into politics and what keeps us interested, then we have a Chatham House question and answer session where the delegates were able to ask us at the differences and similarities of the various political parties and our own personal approaches to problem solving. Then we worked around the various tables over the course of the rest of the session exploring different scenario and ways to work with Councillors in this their new political environment.

As you discuss their issues you certainly do reflect on your own council’s approaches and the problems they face and in part this is what makes this work so worthwhile. As with all services over the coming years the backdrop of reduced funding is the new lexicon and Public Health is starting to develop its voice and narrative as to why it’s role in important in Councils and the lives of residents; and courses like this one are a part of that understanding and so I am pleased to play my small part in the process.

National Public Health England Conference

Public Health England logoJust before the Conservative Party Conference I was invited to speak and chair a session at another Conference, the Annual PHE Conference where with Public Health Professionals, myself and fellow panel members discussed Health and Wellbeing Boards progress against backdrop of the Better Care Fund.

Caroline Tapster CBE who heads up the work programme of the LGA’s work on Health and Well Being Boards, and was formerly the Chief executive of Hertfordshire County Council spoke first. Then Jane Milligan who is the Chief Officer of Tower Hamlets Clinical Commissioning Group and finally we heard from Tim Baxter Lead on Public Health at the DoH.

Caroline reflected in this the second year of their establishment, HWBs are beginning to consolidate the partnerships they have developed. It is now time to take on fully their role as strategic leaders of the health, social care and wellbeing systems of their areas. Recent reports suggest that in some cases, boards are already grasping the challenge, but have more to do in making the step change required from wherever on the journey they are starting to become effective system leaders. How this is done will differ according to local circumstances and Jane spoke about how their board in Tower Hamlets are facing this huge challenge.

The Better Care Fund (BCF) has dominated the agenda for HWBs over the past few months and will continue to be a key focus but it is vital that this is seen within the wider context of reconfiguring services, the importance of the prevention agenda and the role of public health in moving forward with integration  and continuing to deliver local priorities through Health and Wellbeing Strategies and Tim spoke about these issues from the DH perspective.

For my part I spoke about the interesting emerging picture around the Public Health spend, after all the scare mongering about Councils using Public Health monies for other things now its moved across. Beyond the flat Public Health allocation of £2.79 billion in 2015/16 (the same as last year), spending in Public Health is up some £150m. Information derived from DCLG Revenue Account Budget returns submitted by local authorities in England and published in July shows Councils plan to spend 6% (£150m) more on public health this year despite overall fall in local government spending. Figures show Councils rebalance towards higher priority needs with the headline figures spending on physical activity (children and Adults) increased investment of up to £78m this year compared with £43m last year not including the £905m councils are committed to spend on sport and recreation and the £797m spent on open space. Which is an extra £54m extra committed by Local authorities, above and beyond the grant received from the Department of Health. District Councils are also spending more with a commitment of £1.5m from their budgets to Public Health.

I concluded by saying that this increased spending is a testament to Councillors and Public Health teams who have come together to leverage the new environment. Public Health is back where it belongs and is having a greater impact than ever before.

Serious Concerns and what we do about them

On Wednesday I attended Suffolk’s Health Scrutiny Committee meeting when we looked at the recent damming report by the Care Quality Commission (CQC) into the newly opened Mildenhall Lodge Care Home by Care UK. Of course if you’ve read my blog you know that the replacement for Suffolk’s very old and not fit for purpose care homes is something I led on in my time as Cabinet Member of Adult Care Services. So the report which followed an inspection 6 weeks after opening the first of 10 new Care Homes across Suffolk, in Mildenhall, was doubly disappointing given the work Suffolk put into finding them as a partner. Equally it’s bizarre given that they are investing £60 million into the new homes that they would fail to keep their eye on the ball sufficiently to deliver a quality of care in this the first, which of course should be, was promised to be and was commissioned to be commensurate with the quality of buildings they are delivering.

At the start of the agenda item, Care UK apologised unequivocally for their failing and it was welcomed, but the point was made to them in no uncertain terms that an apology without an action plan and proper implementation was…well just words.

A colleague on the committee demanded to know why the failing had taken place, I rather thought and then said the reading of the CQC report clearly indicated a common thread of low staff numbers and to be fair Care UK did seem to recognise this and were putting in place the sort of actions that were demanded of them and promised by them during the commissioning process we originally undertook. This was built on the back of the work I and my officers found during the initial thinking about the issue we had before us, namely the longitudinal study by Birmingham University as Birmingham City Council closed all of their 26 care homes and rather than re-provide into new facilities, they dispersed their residents to the existing private sector care homes in the city. The study looked at the most effective ways to help people move homes and how best to support those transitions.

The point about provider and commissioner is an important one I’ll comeback to in this blog. Across Suffolk far wider, that the small percentage of the private total market that Care UK represents and in the number of beds Suffolk provides for those who need a residential Care Home but are unable to provide for themselves. Suffolk County Council purchases (commissions) on the basis of good care and inspects to make sure good care is provided. No distinction is made and no excuses accepted.

During the course of the scrutiny a couple of things emerged. At the start of it we had a presentation from CQC about the robust nature of its new inspection regimes and I reflected on the difference between the organisation and the initial thoughts when the coalition government came in, I recall a meeting between myself and my officers with the then local CQC team announced they were moving from a full time care inspection organisation to more of a light touch registration organisation and beyond our shock as such a move, for our part we began thinking about how we needed to react to this with our own inspection regime and how we went about our working relationships with the Care Homes in Suffolk. From the presentation we saw the conclusion of a quiet transformation of that organisation into a sort of OFSTED for Care. Those of us who watch this sector closely of course know this has been happening over the past couple of years firstly with the surprise recruitment of David Behan the former Permanent Secretary to the Care Minister to tis CE role and the well-respected Andrea Sutcliffe to head up its care sector. All, I have to say, brought about by a Government that properly recognised the significance of the likes of the Panorama TV Programme’s shocking investigation into care and a concerted efforts of Local Government and other care organisations as reported in the national press, to seek to rise the issues of care standards up the national agenda.

What also emerged from the scrutiny was that this Tuesday, the second of Care UK new homes has a ‘stop to new admissions order’ instigated not by CQC but by Suffolk County Council’s own team, equally the original suspension of Mildenhall Lodge by the same team was before the CQC inspection. These are important points because despite officers informing the committee that the department was reviewing if it needs to have more people inspecting Suffolk Care Homes in addition to the CQC work, actually they did pick up the failings before CQC and the robust quality of the Suffolk County Council team working with care providers, despite the close relationship they have with Care UK as it replace the Council’s former homes, the relationship of commissioner and provider is in place and Suffolk County Council are already properly holding them to account.

Equally I was really proud to sit on the Health Scrutiny on Wednesday as it robustly did its job. Last week I was in Scunthorpe and one of the things I was tasked with doing was to meet with the Chairman of their Health Scrutiny Committee, as we considered as a part of the LGA Adult Safeguarding Peer review if we thought it was fit for purpose (which it is). Such important consideration follows on from the Francis Report into Mid-Staffordshire Hospital where one of the system failing highlighted was the lack of robustness of that County Council’s Health Scrutiny to ‘shine a light into dark corners’ and hold a provider to account, in that case, the NHS trust which failed to keep people safe in that hospital.

Of course we all want Care UK to just keep to their end of the bargain and deliver the quality care they promised. From the Health Scrutiny Committee point of view we have charged them and the department’s officers to keep us up to date on the action plan and its implementation that they have learnt their lessons and the opening of each new care home will go as we want it to and I know we all hope these actions can be of comfort to worried residents, loved ones and families as they transfer into their new home.

Conseravtive Party Conference reflections

Time absolutely flies by in Local Government and it seems some time now since the Conservative Party Conference yet it was only 2 weeks ago. Of course since then we’ve seen the UKIP Landslide in Clacton and Labour almost slipping up in one of their so called safe seats. Indeed so good was UKIP performance in Manchester that I bet Labour are working on the figures even harder than Conservative Central Office. And of course now everyone is now focusing on Rochester. So finishing off my reflection from Manchester seems like old news but hey it’s my blog and I’ll write about what I want to!

At the conference on the Monday and Tuesday I attended a lot of events, speaking on behalf of Local Government promoting its positioning paper ‘The First 100 days’ of what we are all working hard to see happen a another term for the Conservative Party. I was also able to speak at various events as a member of the Community Wellbeing Board and I hope on what good things are happening in Suffolk and how we at both the County and District Level try to deliver the best services we can with the funding available. Also trying to fit in both main hall plenary sessions and a number of really interesting fringe events on a wide range of topics form Social Media to the role of Local Education Authorities in the future Conservative schools and schooling improvement agenda.

Following the Swanswell Fringe first thing on the Monday morning there was just time to meet with James Sandbach from The Low Commission to hear about their on-going work about legal advice, representation and advocacy in the new world of less Legal Aid. A quick meeting for another important subject about how people go about receiving sound advice they otherwise might not be able to afford. More info can be found on their website at http://www.thelowcommission.org.

After the morning speeches in the main hall I headed off to another Roundtable and lunch courtesy of the Alzheimer’s Society, where I was able to talk about the role of Communities in Dementia Care and of such wonderful Suffolk projects as the Debenham Dementia Project which I have talked about in this blog before.

Later on I was a speaker at a packed fringe event with about 120 people in the room joint hosted Kings Fund/NHS Confederation/LGA event alongside the CE of the Kings Fund Chris Ham, discussing the long awaited Kings Fund Barker which is another radical and challenging paper but it all feeds into the debate this country must have with itself as we are the victims of our own success with a healthier ageing population, as great news as it is it also requires the NHS to change as the needs of all of us change, I certainly think this will be a significant challenge for the next Government so a perfect topic for the Conservative Party Conference.

On the Tuesday my day seemed just as packed starting with a 7:30am breakfast meeting with the Royal College of Surgeons whom were discussing their recent finding about better Hospital Discharge. I suggested that it would be better to call it Hospital Transfer as the word discharge is a part of the problem where hospitals discharge patients but more often than not someone else usually carries on the caring for their patient, a carer, family member, loved one, GP, social services or residential or domiciliary provider usually then take over that patients care. Points made it was then off to grab my seat for the speeches by Theresa May and then Boris Johnson, for both the hall was packed and their speeches were interesting for more than just their words on the subject at hand, if the Conservatives fail to win the general election here were two of the front runners in what would follow and everyone knew it.

After that I rushed to my last speaking engagement of the conference being a roundtable hosted by Sports Leaders UK and the English Federation of Disability entitled ‘Inclusivity in sport and physical activity’ – giving the opinion of the LGA CWB that sport for all is a key factor in the nation’s health and my own personal prospective on the challenge as seen here in Suffolk.

On the Wednesday as the Conference drew to a close, for me it was an opportunity to have those last couple of meetings with Norfolk and Suffolk conservatives that we’d promised to have in Birmingham but that never quite happened. Then it was time for David Cameron to deliver his speech, George Osborne on the Monday had talked about talking about the additional £25bn of savings that were needed would come “entirely from spending cuts” which does not bode well for local particularly when coupled with the NHS being ring fenced until 2020 and the painless Whitehall cuts have already been made. So what would David Cameron offer in his last party conference speech before the General Election. He promised to support people who do the right thing and the promise to raise free personal allowances from £10,500 to £12,500 (so those on the minimum wage pay no tax) is not only the right thing to do but addresses the Labour living wage campaign.. He also said the next Conservative government would raise the threshold for 40p income tax from £41,900 to £50,000, welcomed news to middle England. So for a conference somewhat overshadowed at the start by the defection of Mark Reckless MP for Rochester and the resignation of Brooks Newmark as Minister., what one person described to me as a ‘wardrobe malfunction’ and such subsequent revelations that he has decided to stand down at the next election.

All in all the mood at the conference struck me that we are on the right course, and should be more confident about our strong Conservative message as we head out onto the doorstep. Yes clearly after Clacton and as we wait to see what happens in Rochester, the party needs to have a more in tune message to those voters who are genuinely feeling that the level of immigration we have seen in recent years is having a negative impact on their lives. Of course the single biggest issue at the next election is have the Conservative have got the message right as its delivers the sound fiscal policies that underpin this country’s economic recovery and that is how the majority of people will be voting but failure to address those concerns about immigration and it may well be that UKIP do just well enough at the General Election to do the very thing Conservatives and UKIP don’t want to see, a Labour Government. For me it’s not so much that they have said they will not hold a referendum but the notion of handing back the keys to the much the same team of people who brought this county to its financial knees 5 years ago is bizarre.

Suffolk Conservative’s Training Day

2014_10_11 Suffolk Conservatives Training DayOn Saturday Conservative Candidates from across Suffolk gathered in Stowmarket for a training day called the Road to 2015, looking at how to campaign in the local election and the general elections on the same day.

I kicked off the proceedings and spoke for 30 minutes about social media and a few reflections on what I think it is, what I think it isn’t and some of the things I have learnt over the past couple of years as I’ve dipped my toe in the water of the subject. At the start we did a short session about what people see as the advantage and disadvantages of social media. I then talked about the Facebook discussions that raged late last year as the Trustees of the Lakenheath Residential Care Home took the difficult decision to close it doors. We discussed twitter, blogs, ‘up my street’ and the many other ways to use social media to engage with residents and build networks as you work to get my message across.

Next up we heard from Richard from the CCA about canvassing and how to engage with people on the door step, later we heard from Paul from CCHQ about the software updates we would be getting shortly to help us in our canvassing and campaigning. And in between them we heard from Ben Gummer MP who spoke about that very morning’s canvass in Ipswich and the campaign he was engaged in, Vicky Ford MEP spoke about her reflections on may’s Euro Elections and the Clacton By-Election and then we had a flying visit from the Conservative Prospective Parliamentary Candidate in North Norfolk Ann Steward about her campaign to give North Norfolk the kind of local representation it deserves and how she is going about winning back voters and unseating the lib dems Norman Lamb.

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