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MAIDSTONE BOROUGH COUNCIL
Community, Leisure Services and Environment Overview & Scrutiny Committee (acting as the Crime and Disorder Overview and Scrutiny Committee)
Minutes of the meeting held on Tuesday 29 October 2013
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Present: |
Councillor Mrs Blackmore (Chairman), and Councillors Mrs Gibson, Mrs Joy, Vizzard and Yates |
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Also Present: |
Councillors Grigg, Councillor JA Wilson. |
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47. The Committee to consider whether all items on the agenda should be web-cast
RESOLVED: That all items on the agenda be web-cast.
48. Apologies
It was noted that apologies had been received from Councillors Brindle, Mrs Mannering, Munford and Mrs Parvin.
49. Notification of Substitute Members
There were no Substitute Members.
50. Notification of Visiting Members/Witnesses
The Cabinet Member for Community and Leisure services and Councillor JA Wilson and Mrs Grigg attended the meeting as Visiting Members. Councillor Mrs Grigg was a member of the Working group for the Health Inequalities Mental Health review which was to be the focus of the evening’s meeting.
51. Disclosures by Members and Officers
There were no disclosures.
52. To consider whether any items should be taken in private because of the possible disclosure of exempt information
RESOLVED: That all items on the agenda be taken in public as proposed.
53. Minutes of the meeting held on 26 April 2013.
A member felt that the wording of the second line of paragraph four on page two of the minutes could be misconstrued. It was agreed that the final part of the sentence ‘and nor would he want it to’ would be deleted.
RESOLVED: That the minutes of the meeting held on 26 April be approved as a correct record and duly signed subject to the suggested amendment on page two, paragraph four.
54. Accessing Mental Health Services before the point of crisis.
The Chairman welcomed to the meeting:
- Assistant Chief Constable Paul Brandon, Kent Police;
- Chief Inspector Martin Wilson,
- Penny Southern Director of Learning, Disability and Mental Health at Kent County Council;
- Janet Greenroyd, District Supervisor for Maidstone Community Wardens; and
- Liz Lovatt, Community Warden from Boughton Monchelsea, Loose and Chart Sutton.
Kent Police
Assistant Chief Constable Paul Brandon was invited to update the Committee. He informed Members that he was Kent Police’s gold lead for Mental Health. The following points were highlighted with regards to Mental Health:
- An estimated 14,000 Mental Health calls were received per year, 1,300 detentions were made using Section 136 and of these the conversion rate to inpatient treatment was 20%;
- An assessment of calls received by Kent Police had been undertaken to establish how many involved Mental Health between 20 January and 13 June 2013. 6099 of these calls had been linked to Mental Health, with varying degrees of severity. Some calls were from other agencies were regarding a person’s safety;
- The Police were not trained to make clinical assessments; their primary priority was to protect life;
- Officers would not leave a vulnerable person or person at risk alone; they would contact the crisis team. However an increased amount of time was spent supervising;
- The shortest amount of time for a handover from the police to a medical team was 19 minutes; the longest was 19 hours and 41 minutes. The resource involved was a minimum of one officer;
- More often than not taking a person to a ‘place of safety’ was a police cell which was not an ideal place for a vulnerable person; and
- The transportation of people to medical facilities was not a job for the police.
Concerns were raised was the lack of an assessment suite in the county. The Police could access suites at neighbouring authorities such as Sussex but had been offered suites as far a field as Yorkshire.
Members looked for reassurances that those commissioning services had the correct information about the level of service they needed to provide; was it the job of the police to intervene during out of hours because no one else was available? Was there enough training on duel diagnosis i.e. where other issues such as alcohol, drugs or self harm issues as well as a history of crime were presented in addition to mental illness?
The Assistant Chief Constable responded, informing the Committee that training was provided for those dealing with individuals in custody and training DVDs were being produced. There were also custody nurses available to provide advice to sergeants in custody suites. A reporting form was in development which included a variety of questions. It would provide the Police with the ability to challenge its own procedures as well as identify gaps with other agencies, providing a record as well as measuring outcomes.
A Member queried whether communication was an issue between agencies and whether data protection and the sharing of information, particularly between the NHS and the Police, presented a problem. Chief Inspector Martin Wilson informed the Committee that a new protocol had been signed off the previous year with partners; it was not a problem at a strategic level but exchanging information at the frontline could be more challenging.
The Committee was informed on the national triage pilot. Kent Police had bid for funding but was unsuccessful. It had managed to provide the scheme from internal resources. Chief Inspector Wilson was the project lead on the 12 week pilot street triage project. He explained that it was a countywide resource but mainly focused on East Kent. It involved a Police officer and a Mental Health nurse going out three times a week on 10 hour shifts. It enabled both access to information from the police and the professional expertise of the nurse. It was reported that early indications were that there had been significant reduction in the number of S106 issued due to more informed decision making, with multi agency assessments taking place in the street. There would be feedback from other agencies between now and Christmas.
In response to Member’s questions the Committee was told that the scheme was not a scalable concept. He explained that the Police would be informed by what they learned and it would be built into next year’s business model, leading to better decisions. The outcome envisaged forward was immediate access to telephony advice from a Mental Health professional. The Committee requested that the Mental Health ‘delivery plan’ be circulated to it.
Members felt that it would be beneficial to its inquiry if it interviewed the Mental Health nurse involved in the pilot scheme.
Community Wardens
Janet Greenroyd and Liz Lovatt were invited to update the Committee on their experiences on the frontline as Community Wardens.
Mrs Lovatt explained that their main work was signposting to services and dealing with residential conflicts. Their role was to monitor changes in the community and make referrals to partnership agencies
Mrs Lovett provided the Committee with a case study which demonstrated a Community Warden’s level of involvement in the community. The incident described was a dispute between a landlord and a long tem tenant who failing to comply with electrical requirements. An underlying Mental Health condition was revealed and addressed because of the level of engagement from the Community Warden.
The tenant was a hoarder who did not engage with society. The Community Warden established, through her own engagement with other agencies how best to communicate with the tenant. She established that the tenant had a hidden history of mental illness, believing she was being spied on and was sleeping on the kitchen floor. Ms Lovatt told the Committee that she had difficulty establishing who the tenant’s GP was which presented a barrier. However she persevered and was successful in getting the tenant to go to social services. Community Wardens were not a statutory service and therefore not seen as a ‘uniform’; Ms Lovatt had been successful in engaging with this tenant where other agencies had not.
Community Warden, Janet Greenroyd explained that there was a lower level of Mental Health issues that existed and did not necessarily present themselves through crime. A person could be ‘disruptive’ within their community but there were not necessarily any interventions taking place. It was an issue that was raised at Community Safety Unit meetings by the Community Wardens.
Other issued highlighted that it was felt were linked were Domestic Abuse and children being taken into respite care. It was explained that this resulted in self esteem issues and was being picked upon on by Community Wardens because of their consistent local knowledge.
The Committee commented on the valuable role of the Community Warden and questioned whether it was to be expanded and retained. It was felt that these were questions that should be raised with Kent County Council (KCC) as the witnesses present were unable to advise on the future of the service or funding. The Committee agreed that it would contact the Leader of KCC.
Kent County Council
Penny Southern, Director of Learning Disability and Mental Health at KCC informed the Committee that Social Care worked with the voluntary sector to prevent crisis. They worked with the Kent and Medway NHS and Social Care Partnership Trust (KMPT) on prevention through engagement with the community. She told the Committee that joined up working taking place and KCC were currently looking at the potential redesign of the service, adding that KCC were closely aligned with KMPT and CCG as commissioners.
It was emphasised that prevention was crucial however if it a situation did reach the point of crisis it was essential that the right services were available. These services were now being delivered by The Child and Adolescent Mental Health Service (CAMHS) in East Sussex. It was clarified that ‘young people’ were persons under 18.
Ms Southern highlighted the ‘Live it Well’ website, describing it as an accessible website; as well as ideas that could help everyone stay well, it had information for people who use mental health services, carers and mental health professionals[i]. She informed the Committee that both Public Health and Kent County Council invested in it. A Member questioned when the Live it Well Strategy’s priorities, or its 10 commitments, would be re assessed. Members were informed that these would be going to the Health and Well-Being Board (HWBB). The Committee requested that the Live it Well Strategy and its revised priorities be circulated to it.
A Member questioned the closure of Mental Health beds and whether Maidstone had lost any beds since 2011. Mrs Southern told the Committee that a report had gone to the Kent Health Overview and Scrutiny Committee containing information on the reconfiguration of beds and could be circulated to the Committee. She added that work on prevention was not always about ‘beds’; work was being undertaken on the issues surrounding the discharge process and access to appropriate services such as Housing.
Safer Maidstone Partnership/Community Safety Unit
Members considered Maidstone Borough Council’s role. Mr Littlemore, Head of Housing and Community Services, and lead officer for the Safer Maidstone Partnership explained that a Mental Health action plan was being developed through the local Health and Well Being Board (HWBB). He informed the Committee that Housing had invested in supported accommodation so that there were no longer any shared facilities (part of the supporting people programme) which could be an issue for someone with a Mental Health illness. Maidstone Borough Council was also currently developing its Homelessness Strategy and there was a clear link between homelessness and Mental Health that the Committee could consider and have input into as part of its involvement with the Strategy.
A Member questioned the use of housing estate managers. Community Warden, Ms Lovatt explained that there was a strong connection with housing providers via the Community Safety Unit. In terms of access to housing and issues highlighted previously discussed (i.e. hoarders); all local authorities had developed a protocol for vulnerable people.
The Committee questioned whether Maidstone Borough Council had a specific Hoarders Policy and if so requested that it be circulated to it.
RESOLVED: That
a) The Chairman would draft a letter on behalf of the Committee to Paul Carter, Leader of Kent County Council, in support of Community Wardens. The Chairman would also, via this means, seek further information on future funding for Community Wardens;
b) The Scrutiny Officer would arrange with Chief Inspector Wilson for the Mental Health nurse involved in Kent Police’s street triage scheme to be interviewed by the Committee;
c) Kent Police’s Mental Health delivery plan be circulated to the Committee;
d) The Live it Well Strategy and its revised priorities be circulated to the Committee.
e) The report to the Kent Health Overview and Scrutiny Committee containing information on the reconfiguration of beds be circulated to the Committee
f) That the Council’s Homelessness Strategy be the focus of the Committee’s meeting on 12 November, allowing it the opportunity to examine Mental Health;
g) The Local Health and Well-Being’s Board’s Mental Health Action Plan be circulated to the Committee; and
h) The Head of Housing and Communities to investigate the existence of a Hoarding Policy for circulation to the Committee.
55. INFORMATION ONLY: Crime and Disorder Reduction Partnership Protocols.
56. DURATION OF MEETING.
6.30pm to 8.30pm
[i] www.liveitwell.org.uk - the website was developed to support the five year Live It Well Strategy for Kent and Medway