The Health and Social Care Scrutiny Commission met on Tuesday 21 January 2020 to discuss the care of older people, mental health services for young people, and the quality of care homes. Decisions were made to provide further information on commissioning plans for new care homes, follow-up data on the mental health of children and young people, and details regarding care home monitoring and funding arrangements.

Interview with Cabinet Member for Children, Schools and Adult Social Care

Councillor Jasmine Ali, Cabinet Member for Children, Schools and Adult Social Care, was interviewed about her portfolio. Discussions covered challenges faced by older people with technology, the issue of loneliness and potential buddy up schemes, and the impact of funding reductions on social care and re-enablement services for older residents. The development of a community hub for older people and the quality of planned new care homes were also discussed. Following this discussion, officers were tasked with providing a brief summary of the commissioning plans for new care homes in Southwark.

Review of Mental Health of Children and Young People

Genette Laws, Director of Commissioning for Southwark Council, and Jean Young, Head of Primary Care Commissioning and Interim Head of Mental Health Commissioning, presented a report on the mental health of children and young people. The commission raised concerns about suicide rates and the disproportionate number of Black, Asian, and Minority Ethnic (BAME) citizens being sectioned under the Mental Health Act¹. As a result, officers were directed to provide follow-up information on a Lewisham project examining high rates of BAME sectioning, as well as more recent suicide statistics, including data broken down by race and ethnicity.

Review of Care Homes Quality Assurance

Esmé Dobson, a former user of care services, shared her experiences of a care home in Southwark and subsequently in Lewisham. She highlighted several areas for improvement, including the need for more suitable activities with dedicated coordinators, inadequate GP services, building maintenance issues affecting staff stress and dementia management, and difficulties in raising concerns about staff conduct. Ms. Dobson also noted that quarterly meetings for relatives were often not held, and that provision for dementia care sometimes only catered for lower needs, forcing residents to move as their conditions progressed. She emphasised the council's crucial role in monitoring care quality, especially for residents without family support, and the challenges even engaged families faced in resolving issues. Concerns were also raised about the functioning of the Lay Inspection team and a perceived lack of organisational commitment to its continuation.

Genette Laws, Director of Commissioning, stated that the issues raised by Ms. Dobson were historic, dating back to 2017, and assured the commission that the provider, Anchor, had taken steps to address shortcomings. She also confirmed that the monitoring team regularly visits Southwark Care Homes and offered to provide copies of the last ten monitoring reports as a closed item due to confidential information. The scrutiny project manager suggested contacting Anchor for an update on recent work to provide assurance on care home quality.

The commission discussed whether the monitoring team would assess the availability of activities and the functionality of appliances. The Director of Commissioning confirmed that activities and the general upkeep of the home would be reviewed, but not specific issues like a working washing machine. They would also consider family meetings and residents' experiences. Members expressed a desire to seek clarification from Age UK² on the Lay Inspectors scheme, receive more information on the visitation programme, and understand the commissioning arrangements.

A previous review of care homes by scrutiny, prompted by a series of poor Care Quality Commission (CQC)³ reports, including those for Tower Bridge Care Centre, was also discussed. The Director of Commissioning noted that Tower Bridge Care Centre had improved, with other homes closing and new ones being commissioned. She offered to provide a briefing to clarify providers and future plans.

Consequently, officers were resolved to provide the last six months of care home monitoring reports, a brief summary of current care homes commissioned in Southwark, and an outline of funding arrangements with Southwark Lay Inspectors. Age UK Lewisham and Southwark will be asked to provide a summary of Lay Inspector work and future plans.

Work Programme

Members of the commission will meet with the Strategic Director of Place and Well-Being to discuss planned changes to community pharmacy substance misuse services, which are commissioned by Public Health.