Prior to the commencement of the meeting the Chair intimated that this meeting of the Committee would be recorded and that the recording would be available to watch on both the Council and HSCP websites.

There were no declarations of interest intimated prior to the commencement of the meeting.

The Minute of the meeting of the Integration Joint Board (IJB) Audit, Risk and Scrutiny Committee held on 18 November 2022 was submitted.

DECIDED: That the Minute be approved.

The Chief Finance Officer submitted a report relative to the Annual Audit Plan 2022/23 for the IJB which outlined Ernst & Young’s proposed audit approach of the financial records for the year ended 31 March 2023, a copy of which was appended to the report. 

The report intimated that, in terms of the Local Government (Scotland) Act 1973, the Accounts Commission for Scotland was responsible for appointing the external auditors for local government bodies and had appointed Ernst & Young as the external auditor for the IJB for the five-year period until 2026/2027. 

The report further advised that the proposed audit fee for the 2022/23 audit was £31,470 and was consistent with the fees for all IJBs and had been determined in line with Audit Scotland’s fee setting arrangement. Further, that the audit fee assumed receipt of the unaudited financial statements by 30 June 2023 and covered the cost of planning, delivery, reporting and the auditor’s attendance at committees. 

Rob Jones and Grace Scanlin presented the Annual Audit Plan to members. 

DECIDED: 

(a) That it be noted that Ernst & Young had been appointed as the external auditor of Renfrewshire IJB; and

(b) That the Annual Audit Plan, appended to the report, be noted.

The Chief Internal Auditor submitted a report providing an update on the progress of the Internal Audit Plan for 2022/23, a copy of which was appended to the report.

The report intimated that the plan set out a resource requirement of 55 days, including governance work, reviewing the adequacy and compliance with the Local Code of Corporate Governance, time for follow-up of previous recommendations, ad-hoc advice and planning and reporting.

The report advised that the fieldwork for the information governance engagement and the annual review of the Local Code of Corporate Governance had been completed; the engagement on risk management processes was currently planned to commence on 29 March 2023 with documentation provided to the contracted auditors Azets. Further, that the audit plan remained flexible and that these planned dates could change, in consultation with management. 

The report noted that time for planning and reporting continued to be used for regular reporting to this committee.

DECIDED: That the progress against the Internal Audit Plan for 2022/23 be noted.

The Chief Internal Auditor submitted a report providing a summary of internal audit reports issued.

The report advised that a risk-based Internal Audit Plan for 2022/23 had been approved by this Committee at its meeting on 18 March 2022 and, in line with the Public Sector Internal Audit Standards, Internal Audit must report the results of each engagement to this Committee.

The appendix to the report provided details of those audit engagements completed with the overall assurance rating and the number of recommendations in each risk category. The committee summaries for each report were also appended. 

DECIDED: That the content of the report be noted.

The Chief Internal Auditor submitted a report providing a summary of internal audit activity, relevant to the IJB, recently undertaken in partner organisations.

The report intimated that the IJB directed both Renfrewshire Council and NHSGGC to deliver services that enabled the IJB to deliver on its Strategic Plan. Both Renfrewshire Council and NHSGGC had internal audit functions and conducted audits across each organisation, the findings of which were reported to the respective audit committees. Members of the IJB had an interest in the outcomes of the audits at both Renfrewshire Council and NHSGGC that impacted upon the IJB’s ability to deliver the Strategic Plan or support corporate functions.

In relation to internal audit activity within Renfrewshire Council, the report noted that there had been no recent Internal Audit reports to Renfrewshire Council which were relevant to the IJB.

In relation to internal audit activity within NHSGGC, the report provided detail on the Covid-19 recovery plan and the post implementation review of the Telecommunications Project.

DECIDED: That the content of the report be noted.

The Chief Internal Auditor submitted a report relative to the annual Internal Audit Plan 2022/23, a copy of which formed Appendix 1 to the report.

The report intimated that in line with the requirements of the Public Sector Internal Audit Standards, a risk-based Internal Audit Plan for 2022/23 had been developed.  The plan set out a resource requirement of 35 days, including assurance and governance work, time for follow-up of previous recommendations, ad-hoc advice and planning and reporting.

The report advised that the allocation of internal audit resources was sufficient to allow emerging priorities and provide adequate coverage of governance, risk management and internal control to inform the annual assurance statement. It was noted that the plan might be subject to amendment during the course of the year due to the emergence of issues of greater priority, or for unforeseen circumstances which would be reported to the committee.

The report noted that the audit universe had been reviewed and updated during 2021/22 to ensure it covered all areas and reflected the maturity of the organisation and Appendix 2 to the report detailed the revised audit universe and the anticipated coverage over 2023/24 to 2027/28. It was intended that each engagement topic would be covered once in the five-year period.

DECIDED: 

(a) That the Internal Audit Plan 2023/24 be approved; and

(b) That it be noted that the Internal Audit Plan would be shared with the local authority and the health board.

Under reference to item 6 of the Minute of the meeting of this Committee held on 18 November 2022, the Strategic Lead & Improvement Manager submitted a report providing an update on the continued implementation of the IJB’s updated Risk Management Framework and the updates made to the IJB’s risk and issues register.

The report intimated that the Risk Management Framework set out the principles by which the HSCP and IJB identified and managed strategic and operational risks impacting upon the organisation and formed a key strand of the IJB’s overall governance mechanisms. The framework set out how risks and issues should be identified, managed and reported. 

DECIDED:

(a) That the further work undertaken to implement the revised Risk Management Framework across operational services within the HSCP, including the ongoing monitoring of the take-up of the online training module launched in August 2022 and the ongoing preparation with services for the planned internal audit of risk management arrangements commencing in late 2023, as detailed in section 4 of the report, be noted; and

(b) That the updates made to the existing risks and issues, following further assessment and engagement with the HSCP and partners, as detailed in section 5 of the report, be approved.

Under reference to item 4 of the Minute of the meeting of this Committee held on 26 October 2022, the Head of Health & Social Care submitted a report providing an update on the HSCP’s incident report position for the period 1 January to 31 December 2022.

The report provided information in relation to incident reporting; serious adverse events; RIDDOR; fire safety; health and safety compliance; and mandatory health and safety training.

DECIDED: That the content of the report be noted.

Under reference to item 5 of the Minute of the meeting of this Committee held on 26 October 2022, the Lead Officer, Communications & Public Affairs submitted a report providing an update on public interactions for the period 1 April to 30 September 2022.

The report provided detail on complaints; enquiries; freedom of information requests; subject access requests; compliments received in relation to the mental health inpatients team, the district nursing team, older people’s day services; and an overview of communication work and social media channel activity.

The report noted that the figures in this report included complaints, enquiries and subject access requests relating to Specialist Children’s Services (SCS) and that as of 2023, SCS would become a hosted service across the NHSGGC area managed by East Dunbartonshire HSCP and would no longer be reported to this Committee. Partial year’s figures would be reported in the full year report in September 2023.

DECIDED: That the content of the report be noted.

The Head of Health & Social Care submitted a report relative to the inspection of the Care at Home services by the Care Inspectorate which concluded on 14 September 2022 with the follow-up inspection concluded on 1 December 2022.

The report intimated that social care services were subject to a range of audit and scrutiny activities to ensure that they were undertaking all statutory duties and were providing appropriate care and support to vulnerable individuals and groups. The Care Inspectorate were the official body responsible for inspecting standards of care in Scotland and used a quality framework which set out the elements that addressed key questions about the difference care was making to people and the quality and effectiveness of the aspects contributing to those differences. The quality framework was framed around six key questions with up to five quality indicators associated with each question evaluated against a six-point scale, as detailed in paragraphs 3.2 and 3.3 of the report.

The report advised that on conclusion of the inspection, the Care Inspectorate published a report which detailed feedback from families/carers; their observations throughout the inspection including strengths and areas for improvement; any requirements, recommendations, or enforcement; and an evaluation. 

The report noted that Renfrewshire’s Care at Home services were subject to an unannounced inspection on 5 September 2022 with the inspection concluding on 14 September 2022. The inspection period reviewed the service between September 2021 and September 2022, and it was noted that throughout this period, Care at Home services operated against varying restrictions aligned to COVID-19 and that the outbreak of the COVID-19 Omicron variant in November 2021 placed increased pressures on the services until cases reduced across Scotland in April 2022. Other restrictions such as self-isolation guidance being replaced by ‘stay at home’ advice in May 2022 placed increased pressures on services, however, HSCPs across Scotland continued to take a cautious approach to reducing any measures in social care and health settings, aimed at ensuring the continued safety of staff and service users. It was noted that this approach had a direct impact on engaging and developing the workforce face-to-face within this period.

The report provided a breakdown of the key questions considered during the inspection and the quality indicators in connection with the inspection. 

The services were subject to a follow-up unannounced inspection on 28 November 2022 to 1 December 2022 which focussed on the key question of ‘how well do we support people’s wellbeing?’ which had been graded weak (2) in September 2022. Following conclusion of this inspection, it was noted that three previous requirements set in September 2022 had been met and the breakdown of the key questions considered during the inspection and a revised indicator were detailed in paragraph 4.9 of the report. The Care Inspectorate made two areas for improvement for the key question ‘how well do we support people’s wellbeing?’ and these were detailed in paragraph 4.12 of the report.

The report further advised that Care at Home services continued to be committed to the strategic vision where ‘Renfrewshire is a caring place where people are treated as individuals and supported to live well’ and acknowledged the points raised by the Care Inspectorate reports and had taken action to address these. The services were undertaking a range of development sessions to identify and implement improvements to support the services against challenges of increasing demand, recruitment and retention whilst addressing the requirements and areas for improvement from the Care Inspectorate reports.

Members thanked Care at Home services staff for all the work undertaken during very difficult times and congratulated them for the work they continue to do.

DECIDED:

(a) That the performance of Renfrewshire Health & Social Care Partnership’s Care at Home services be noted, with services graded on 14 September 2022 as adequate (3) for ‘how good is our leadership?’ and weak (2) for ‘how well do we support people’s wellbeing?’; and

(b) That it be noted that the follow-up inspection concluded on 1 December 2022 and that the revised grading for ‘how well do we support people’s wellbeing?’ went from weak (2) to good (4) with ‘how good is our leadership?’ remaining as adequate (3) as this was not inspected during the follow-up as there were no requirements placed on this.

The Head of Strategic Planning & Health Improvement submitted a report relative to the Audit Scotland publication ‘NHS in Scotland 2022’ published on 23 February 2022 which considered the Government’s progress against its NHS Recovery Plan published in August 2021. A copy of Audit Scotland’s publication was appended to the report.

The report intimated that Audit Scotland had concluded that the ‘Scottish Government must be clear on what progress is being made in reforming health and care services and what can realistically be achieved’ and provided a summary of the findings.

DECIDED: That the content of the report and the Audit Scotland publication, appended to the report, be noted.

The Clerk submitted a report relative to proposed dates of the Committee in 2023/24.

DECIDED:

(a) That it be noted that the next meeting of the Committee would be held at 10.00 am on 23 June 2023 and that this meeting would be held remotely on MS teams;

(b) That meetings of the Committee be held at 10 am on Monday 18 September and Friday 17 November 2023 and Friday 15 March and Friday 21 June 2024; and

(c) That members be advised of the arrangements for future meetings.

DECIDED: That it be noted that the next meeting of this Committee would be held remotely on MS teams at 10.00 am on 23 June 2023.