Agenda and minutes

People's Board - Wednesday, 19th September, 2018 2.30 pm

Venue: Room 10

Contact: Mrs KM Howard 

No. Item


Apologies for Absence


Apologies were received from Councillor Burns, Phil Garrigan, Louise Harrison, Tom Hughes, Councillor Neal, Sarah O’Brien, John Quick and Rob Young.


Minutes pdf icon PDF 115 KB


*           Resolved that the minutes of the meeting held on 25 July 2018, be approved and signed.


Declarations of Interest


No Declarations of Interest from Members were made.


Sue Hill here entered the meeting.


Ofsted Focused Visit and Action Plan pdf icon PDF 111 KB

Additional documents:


The Director of Public Health presented the report on Ofsted focused visit and action plan.

A report was submitted which updated the People’s Board on a recent focused visit undertaken by Ofsted under the new Inspecting Local Authority Children’s Services (ILACS) Inspection Regime. The inspection had focused on Children in Need and Children Subject to a Child Protection Plan.


The letter attached at Appendix 1 to the report, highlighted that significant problems across Children’s Services had been discovered and three Priority Action Notices were issued.


This was of significant concern to the Council as it indicated some serious shortfalls, weaknesses and even failures within the current Children’s Social Care Services.  It also indicated the need to do further work with partners such as Health, Police and Education to strengthen the Council’s ability to safeguard children in the appropriate manner.


A draft action plan had been completed and submitted to Ofsted on 17 August 2018 and it was reported that the Strategic Director, People’s Services was working closely with Ofsted to ensure the action plan is robust.


A number of immediate priorities had been identified to assist in the delivery of the action plan. The priorities were:


·           improvements to IT hardware and software;

·           investment in a risk management training programme to inform social care 
       practice; and

·           additional staffing resources in the Permanence and Safeguarding teams.


In order to support the cost of these priorities, at it’s meeting held on 12 September 2018, Cabinet approved that additional funding be made available to the People’s Services Department, as set out in Section 6 of the report (Other Implications – Financial).

The Board was informed since publication of the agenda the five day Local Government Association (LGA) Peer Review had been scheduled for October 2018 and that an Independent Chair had been appointed to lead the Children Improvement Board.


*           Resolved that:


(1)       the Ofsted focused visit Inspection Letter dated 8 August 2018 be noted;


(2)       the draft Ofsted Action Plan be noted; and


(3)       the request for additional funding to support a number of immediate measures in respect of the action plan be noted.


Description of Need Document for Effective Support for Children, Young People and families pdf icon PDF 76 KB

Additional documents:


The Speciality Registrar and Service Manager, St Helens Council presented the report on Descriptions of Need Document (Threshold Document) which updates and brings together the 2014 ‘Thresholds of Need’ and ‘Continuum of Need’ Documents.


A Thresholds Document is a requirement of Working Together to Safeguard Children 2018, the government guidance on inter-agency working to safeguard and promote the welfare of children.

A recent OFSTED inspection evaluated the approach to Children in Need and Children subject to a Child Protection Plan and found, amongst other things, that the application of ‘thresholds’ is poorly understood across most levels of children’s services and in partner agencies. As a result of this work had been undertaken to develop the document.


The document purpose was:

·         To provide families and professionals with a practical understanding of the thresholds of need to support professional judgement and decision making;

·         To help families and professionals to better understand the services and support available across the levels of need;

·         To ensure both strengths and needs are assessed and action plans are formulated and agreed;

·         To encourage more professionals to feel confident to offer help at the earliest opportunity and to work closely with other agencies; and

·         For families to feel supported so they are encouraged and enable.

This document included a summary of the thresholds (levels), a description of the thresholds of need and the processes used, and the Assessment Framework, which was used to outline the indicators of need.


The St Helens Descriptions of Need Document 2018-2022 was attached to the report at Appendix 1.


The Board was informed that the document had been approved at the Safeguarding Children Partnership Board and once formally launched, it would be available on the
St Helens Safeguarding Children’s Partnership website and that there would be seven minute briefings for partners.


The Board raised questions which were answered at the meeting with regards to the update and review of referral forms as part of the review and anticipated timescales for the publication of the Early Help information leaflets and brochures.


*           Resolved that:

            (1)        the report be noted; and

(2)        the Description of Need Document be approved and launched at the end of September with recommendation for adoption by all Partner Organisations.


Briefing on E-Cigarettes pdf icon PDF 1 MB


The Director of Public Health presented the report on e-cigarettes, which provided an overview of what was happening nationally and locally around smoking and the use of


The report highlighted the current issues, concerns and opportunities regarding
e-cigarettes. It was noted that e-cigarettes had already made a contribution to the ongoing decline in smoking rates but that smoking remained one of the most significant preventable causes of morbidity and mortality.


It was acknowledged that, although e-cigarettes can have a role in supporting smokers to quit smoking altogether, this was separate issue to people using e-cigarettes not as a quit aid.

The report proposed, as the evidence was still emerging around the long term impact on health, the use of e-cigarettes to non-smoking population should not be encouraged or promoted and the Board should be aware of the risks of normalising vaping to young people, pregnant woman and vulnerable populations.

The Board discussed the recommendations in paragraph 4 of the report; in particular 4.1 which proposed undertaking exploratory discussions with e-cigarette companies.


*           Resolved that:

            (1)        the report be noted;

(2)        exploratory discussion with interested e-cigarette companies to develop ways to use e-cigarettes as a quit aid in our current smoking population was not considered appropriate at this time. Any future developments in this area should come back to The People’s Board for approval;


(3)        vaping will not be normalised or promoted by partners in any way, other than as an aid for the current smoking population in quitting cigarettes, in order to protect current non-smokers and children and young people;

(3)        current policies be updated to ensure a consistent approach across partners and to revise these on an annual basis to take account of any new evidence;

(4)        the policy be maintained that vaping is prohibited wherever smoking is prohibited; and

(5)        the Board continue to review, without prejudice, emerging evidence on e-cigarettes, particularly around take-up and use by children and young people; and

(6)        the Economy / Place Board be consulted as part of the review of the E-Cig policy.



Health Protection Forum Update pdf icon PDF 106 KB

Additional documents:


The Director of Public Health presented the update report on the Health Protection Forum.


The statutory responsibility to protect the population transferred to the Secretary of State in April 2013, with responsibility mainly discharged through Public Health England. Public Health England provides specialist advice and response to incidents. However, it is the Director of Public Health in the local areas who has a duty to prepare and lead the Local Authority’s response to incidents and present threats to the public’s health.

The Health Protection Forum has been in operation since Public Health moved to the Council in 2013 and considers issues relating to infectious diseases, environmental hazards, contamination and extreme weather events.


The report informed the Board of key issues under consideration by the health protection forum. Key issues included; Influenza, Healthcare associated infections, Anti-Microbial Resistance, Screening and Immunisations, Environmental Health and Emergency Planning and shared the revised Terms of Reference of the Health Protection Forum.


The Board discussed the contents of the report, in particular if there was evidence of a correlation between deprivation and antibiotic use and if there was an update on ‘point of care’ testing kit pilot, which had been introduced in high prescribing general practices as a tool to establishing if it was appropriate to prescribe antibiotics.

The Board also commented that the 14% reduction in anti-biotic use since 2017/18 was a positive improvement and that consideration should be given to the publicising promoting of this by Primary Care services via the
Antimicrobial Resistance (AMR) Board.

*           Resolved that:


(1)          the report be noted; and

(2)          the Terms of Reference for the Health Protection Forum be approved; and

(3)          an update on the ‘Point of Care’ pilot be provided to the Board.



Progress in Implementing the Integrated Local Care System, St Helens Cares pdf icon PDF 97 KB


The Associate Director Corporate Governance, St Helens CCG presented the report on Progress in implementing the Integrated Local Care System, St Helens Cares.


Since the Boards previous update a number of key milestones had been achieved in the implementation of the Local Care System, these included:


·         Continued development of the lead provider model and engagement with key stakeholders;

·         Decision on role and purpose of the Clinical Reference Group; and

·         Refresh of Transformational Priorities for the next phase of delivery


The Board was informed that the Executive Board had discussed and reviewed the role and function of the Clinical Reference Group and proposed that the Clinical Reference Group be dissolved with immediate effect and that an alternative Stakeholder Forum, to include relevant professionals and public representatives be implemented as an alternative. This work was now underway by the leads for Communication and Engagement.


For the next phase of St Helens Cares, the operational leads have been tasked by the Executive Board with identifying and implementing new transformational priorities; one of which was required to relate to provision of services/ support for Children and Young People.

It was noted that further information on the agreed key priorities would be available after the next meeting of the Executive Board.


The report also outlined the Target Operating Model, which included update information on the following areas:


Work Stream 1 – Early Intervention and Prevention;

Work Stream 2 – Contact Cares (Front Door);

Work Stream 3 – Primary and Care Management and Co-Ordination; and

Work Stream 4 – Urgent and Crisis Care


The Board was informed by the Chief Executive, St Helens & Knowsley Hospitals that the CCG and St Helens & Knowsley Hospitals had jointly appointed a Director of Integration, Wayne Longshaw to oversee the management of the workstreams.

Questions were raised and answered at the meeting regarding
how the Lead Provider Model would link into the third sector.


*           Resolved that the report and update be noted.



St Helens Cares : Community Engagement pdf icon PDF 105 KB


The Associate Director Corporate Governance, St Helens CCG presented the report on
St Helens Cares: Community Engagement which gave the Board an overview of the process for Community engagement to ensure that the community have the opportunity to engage with and participate in St Helens Cares programme of work.


In May 2018, St Helens Cares Executive Team agreed a model of delivery for community engagement and approved three goals to underpin the structure of future engagement:

·           Helping people and communities to understand what St Helens Cares is and what it means for them;

·           People within local communities taking care of themselves and each other; and

·           Understanding the health and social care system locally and when to access services


The group recommended using an Asset-Based Community Development (ABCD) model for community engagement. The aim of this will be to harness capabilities to address the challenges public sector and health face. The model will be introduced in the four localities of North, South, Central and Newton & Haydock.


The main reason for engaging residents and users in the co-design process is that they are best placed to articulate their needs and the kind of solutions that will work best locally.

The Board was informed that a stakeholder reference forum will be established to facilitate this model of co-design. Longer term the intention would be to use both models interchangeably.


*           Resolved that the report be noted.



St Helens Safeguarding Adults Annual Report 2017-2018 pdf icon PDF 2 MB

·         Tom Woolstencroft, Chair of Safeguarding Adult Board has been invited to attend the meeting.


The Chair of the Safeguarding Adults Board, Tom Wolstencroft was present at the meeting to present the St Helens Safeguarding Adults Annual Report 2017 - 2018.


The Board was informed that this was the 11th Annual Report produced by the Safeguarding Adults Board. It was reported that the actions agreed in the Annual Plan had been complete and commitment from individuals and agencies had been fostered to ensure that Adult Safeguarding.

The overview of performance activity demonstrated a stable profile of Adults with care and support need and that the commitment of resource to Safeguarding in St Helens has allowed a continued robust response and proactive approach to the management of risks posed to adults who social care and health needs makes them unable to protect themselves from abuse and neglect.

The St Helens Safeguarding Adults Annual report 2017-18 and appendices were attached to the report for the Board’s information.


*           Resolved that the St Helens Safeguarding Annual Report 2017/18 be noted.



JSNA Health Inequalities & Adults and Older People pdf icon PDF 64 KB

Additional documents:


The Director of Public Health presented a report which informed the Board on the 2018 update to the Joint Strategic Needs Assessment (JSNA) reports, Section 5 Vulnerable Adults and Older People and Section 6 Health Inequalities.


The key findings of the reports were:


Vulnerable Adults and Older People

·         1 in 10 deaths in 2017 were due to dementia or Alzheimer’s;

·         The rate of injuries due to falls in 85+ year olds in St Helens is higher than the England average;

·         In 2014/15 there were 615 people with a learning disability who received long term services in Adult Social Care; this is a 7.9% increase on 2014/15;

·         The proportion of people in St Helens with dementia is expected to increase from 2,369 in 2017 up to 3,948 in 2035. This is an increase of 67% and will be a key public and clinical health challenge in future years;

·         By the end of 2017/18, there were 12,015 active carers receiving a service from St Helens Carers Centre. The majority were for carers supporting partners who were frail and elderly or supporting someone with dementia; and

·         There were 1,534 adult safeguarding concerns made to the Contact Centre/Front Door in 2017/18. Physical abuse is the most common form of abuse recorded.


Health Inequalities

·         Life expectancy at birth for men varies by 9 years between wards, while female life expectancy varies by 7 years;

·         Mortality from all causes in Town Centre ward is about twice the rate it is in Rainford;

·         The rate of hospital admissions due to alcohol-specific conditions in Town Centre is five times higher than it is in Billinge and Seneley Green.

·         Teenage conceptions rates in Town Centre ward are significantly higher than in Rainhill; and

·         Eccleston is the least deprived ward in the Borough and performs the best overall, ranking in first or second position for eight of the sixteen indicators. Town Centre ward performs the worst for seven of the sixteen indicators and is the second most deprived ward.


There is a legal duty under the Health and Social Care Act 2012 for Local Authorities and Clinical Commissioning Group (CCG) to jointly undertake the JSNA and that duty was discharged through the Health and Wellbeing Boards. The process for development should be decided locally and take note of national guidance and that states the JSNA’s should support health and social care commissioning decisions and the development of Joint Health and Wellbeing Strategies, (People’s Plan in St Helens).


*           Resolved that


(1)                the updates to Section 5 and 6 of the JSNA be noted; and

(2)          a session be arranged for the Board to review the outcomes of the JSNA and set the strategic priorities and key focuses for the coming year.



Date of Next Meeting

Wednesday, 21 November 2018 at 2.30pm, Room 10 at the Town Hall.


Wednesday, 21 November 2018 at 2.30pm, Room 10 at the Town Hall.


Exclusion of the Public

Recommended that the public be excluded from the meeting during consideration of the following item:


Item     Reason


 14       Information relating to any individual (Para 1 of Schedule 12a)



*           Resolved that the public be excluded from the meeting during consideration of the following item:


Minute            Reason

   34                 Information relating to any individual (Para 1 of Schedule 12a)


Domestic Homicide Review


The Senior Assistant Director of Housing, Safer Communities, Recreation and Libraries presented the Domestic Homicide Review (DHR).


At a meeting of this Board held on 21 June 2017, the Board endorsed the decision to undertake this DHR, having agreed the criteria to complete a DHR had been met in accordance with the definition set out within Section 9 of the Domestic Violent Crime and Victims Act 2004.


The Domestic Homicide Review Overview Report, including conclusions, recommendations and action plan was attached to the report at Appendix 1 for the Board’s approval prior to submission to the Home Office for endorsement and official publication.


*           Resolved that:


(1)             the report be noted; and

(2)          the Action Plan arising from the Domestic Homicide Review be approved for submission to the Home Office.