to 9 April 2008 Community Overview and Scrutiny Committee Will meet on Friday 18 April 2008 at 10.00 am in Allerdale House, Lonsdale Room Membership: Councillor Barbara Cannon (Chairman) Councillor Ron Munby Councillor John (Binky) Armstrong Councillor Carole Armstrong Councillor Trevor Fee Councillor Miriam Gainford Councillor Jeffrey Gardner Councillor John Heathcote Councillor Carni McCarron-Holmes Councillor Joe Mumberson Councillor Audrey Tinnion Councillor Martin Wood Members of the public are welcome to attend the meeting. If you have any questions or queries simply contact Jane Murray on 01900 702559. Agenda 1. Minutes of meeting Friday 14th March, 2008 of Community Overview and Scrutiny Committee (Pages 1 - 6) 2. Apologies for absence 3. Declaration of interests Councillors/Staff to give notice of any personal or prejudicial interest and the nature of that interest relating to any item on the agenda in accordance with the adopted Code of Conduct. 4. Questions To answer questions from members of the public – 2 days notice of which must have been given in writing or by electronic mail. 5. Forward Plan To consider the forward plan of key decisions to be taken by the Executive. 6. Homelessness To receive an update briefing from the Housing Services Manager on the homelessness service, prior to the development of a Homelessness strategy. 7. Derwent Forest To receive an update from Director of Community and Partnerships on the Derwent Forest site. 8. Work Plan (Pages 7 - 14) To consider the Committees current workplan. 9. Executive Minutes (Pages 15 - 18) To consider the draft minutes of the Executive held on 2nd April 2008. 10. Post Office Closures (Pages 19 - 90) To consider the proposed closure of post offices in Allerdale. Borough Solicitor Date of next meeting Friday 16 May 2008 at 10.00 am Derwent Room, Allerdale House, Workington Agenda Item 1 At a meeting of the COMMUNITY OVERVIEW AND SCRUTINY COMMITTEE held in Derwent Room, Allerdale House, Workington on Friday 14 March 2008 at 10.00 am Members Mr T M Fee (Chairman) Mrs C M Armstrong Mr J Heathcote Ms M Gainford Mrs C C McCarron-Holmes Mr J Gardner Mr J Mumberson Mrs A Tinnion Apologies for absence were received from Councillors Mr R Munby, Mr J Armstrong, Mrs B Cannon and Mr M G Wood Also Present - Mary Bradley, Age Concern; Ross Forbes and Charles Welbourn, Cumbria Primary Care Trust; Laurence Hilland, Alzheimers' Society; Cllr Lorraine Taylor, Keswick Town Council; Cllr Trevor Gear, Aspatria Town Council. Staff Present C Johnston and J Murray 651 MINUTES OF MEETING FRIDAY, 22ND FEBRUARY, 2008 OF COMMUNITY OVERVIEW AND SCRUTINY COMMITTEE The minutes of the meeting held on 22 February 2008 were agreed and signed as a correct record. 652 DECLARATION OF INTERESTS 5. Closer to Home - Preliminary Consultation Results. Councillor Audrey Tinnion; Personal; due to her association with Workington Infirmary. 5. Closer to Home - Preliminary Consultation Results. Councillor Carole Armstrong; Personal; due to her sister being a Community Psychiatric Nurse. 5. Closer to Home - Preliminary Consultation Results. Councillor Joe Mumberson; Personal; due to his daughter working in the health service in Carlisle. 5. Closer to Home - Preliminary Consultation Results. Councillor Trevor Fee; Personal; due to his membership of Cumbria County Council. 6. Adult Social Care Consultation. Councillor Carole Armstrong; Personal; due to being in receipt of payment from Adult Social Care. Page 1 6. Adult Social Care Consultation. Councillor Trevor Fee; Personal; due to his membership of Cumbria County Council. 653 QUESTIONS None received. 654 CLOSER TO HOME - PRELIMINARY CONSULTATION RESULTS Ross Forbes, Director of Corporate Affairs, Cumbria Primary Care Trust (PCT) gave a presentation on the preliminary findings from the Closer to Home consultation. It was explained that the board had met the day before to discuss these preliminary findings. The original proposals had 5 key components: • To help more people keep fit and well for longer; • To strengthen the capacity of community and primary care services, including providing local beds where necessary; • To complement these services with acute hospitals providing the specialist services that they are uniquely able to provide; • Services to reflect local priorities with local doctors, nurses and other professionals playing a greater role in setting local priorities; • Services which are more responsive to the needs of patients’ and families’. There were six criteria for assessing planned changes to health services; quality; sustainability; affordability; acceptability; accessibility; and timescale. The recommendations put to the PCT board were to confirm the five key components and the six criteria for assessing health services. They were also recommended to develop mechanisms to ensure that future health service developments are demonstrably based upon the vision described in the consultation and are assessed against the six criteria. Finally the board were recommended to approve the proposed structure for developing health services in Cumbria based on locality teams and care stream planning. It was noted that the PCT board had agreed all of the recommendations put to them. Addressing specific areas of concern, Mr Forbes highlighted the following issues: Acute Hospitals With regard to the future of emergency care proposed by ‘Closer to Home, which included the introduction of an integrated, three-tier emergency care system, it was recommended and agreed by the Board that the integrated emergency care proposals be adopted subject to the revisions agreed with the consultants at the West Cumberland Hospital in January. Page 2 This included the changes to bed numbers at the West Cumberland to 220 and clinical agreement on out of hours emergency surgery (which helped alleviate concerns about patient transfers). With respect to palliative care, maternity care and stroke rehabilitation, the development of the best way forward for West Cumbria would be delegated to the teams responsible for these services. Community Hospitals With regard to community hospitals, it was recommended and agreed by the Board that the community hospitals will continue to play a key role, providing step-up and step-down care and out-patient services and that the bed numbers be reduced to 140-170 beds. However, it was also agreed by the Board that there would be no changes to bed numbers for at least two years until the community support networks were in place, providing a ‘safety net’ during the transition process. Local health teams would determine the services for each site. Cumbria Primary Care Trust continued to be very confident that funding for the community hospitals/health villages would be secured. Members were generally content that most of their concerns would appear to have been addressed and looked forward a more detailed response in due course. 655 ADULT SOCIAL CARE CONSULTATION Members asked Mary Bradley, Director of Age Concern North West, whether she was content that the proposals represent the best available option for Allerdale. Mary Bradley explained that Age Concern chaired the group as advocates for older people. The meetings were well attended and there were representatives for older people present. Members raised the issue that they had heard that the numbers of residential care places are not to increase despite a growing elderly population, because it is felt that more people will be supported at home. Members asked whether Age Concern share that view. In response to questioning Mary Bradley noted that there was still number crunching to do and that it is difficult to predict personal choice. With an aging population there is a different sort of profile of needs and there needs to be much better options for people needing physical care such as extra care housing. We also need to make sure that there are beds for mental health patients. With regards to mental health, Laurence Hilland, West Lakes Branch Manager for the Alzheimer’s Society told Members that there will be an increase of 154% in dementia over the next 20 to 30 years and that different models need to be considered as many people with dementia do not require the level of care given in care homes. Page 3 Members asked Mary Bradley what the key issues facing elderly people in Allerdale specifically are. In response to questioning she explained that the key issues include not going into residential care unless it is their choice, and if they do chose to go into residential care the homes should be fit for purpose with the right equipment and residents must have the ability to get out and about and socialise still. It is important to make sure that extra care and sheltered housing is right. Laurence Hilland explained that with dementia, the carer support element is a key issue. Children move away and leave parents with dementia which means that isolation is a key problem. Members noted that many people retire to places such as Keswick and so don’t have the support of family to act as carers. Mary Bradley went on to explain that for extra care housing thay are trying to get a mixture of half traditional and half rental properties. A survey showed that people want to have the opportunity to sell their own house and part-buy the extra care house. Members asked what input the Alzheimer’s Society has had into the development of the proposals so far. Laurence Hilland explained that the Alzheimer’s Society was not involved in the development of the proposals however they are responding to the consultation paper. It was noted that within residential care two thirds of residents have dementia and it would be good to see recognition of that in the consultation document. Some of the challenging behaviour shown by residents in care homes can be due to environmental factors, such as the pattern on the floor covering or the colour of the walls.