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HEALTHY LIVING AND SOCIAL CARE SCRUTINY COMMITTEE

 

Minutes of a meeting held on 16th May, 2016.

 

Present:  Councillor R.L. Traherne (Chairman); Councillors R.J. Bertin, Ms. R.F. Birch, S.C. Egan, H.C. Hamilton, Dr. I.J. Johnson, , S.T. Wiliam and Mrs. M.R. Wilkinson.

 

Also present: Councillor N. Moore.

 

 

26        APOLOGIES FOR ABSENCE – 

 

These were received from Councillors J.W. Thomas and E. Hacker

 

 

27        APPOINTMENT OF VICE-CHAIRMAN -

 

Councillor Dr. I.J. Johnson was duly elected Vice-Chairman for the current Municipal Year.

 

 

28        DECLARATIONS OF INTEREST -

 

No declarations were received.

 

 

29        REQUEST FOR CONSIDERATION (COUNCILLOR R.J. BERTIN) - PRESENTATION - THE FUTURE OF DENTAL SERVICES AT BARRY HOSPITAL -

 

Councillor R.J. Bertin had requested that the Committee receive a presentation around the provision of dental services from Barry Hospital.  In response to this, from the Cardiff and Vale University Health Board, the Committee was joined by Claire Evans, the Head of Primary Care Services Operations and Delivery and also Richard Holliday, Dental and Orthodontary Contract and Service Development Manager. 

 

In beginning the presentation Ms. Claire Evans stated that the dental provision was currently made up of three aspects: 

  • general dental services (GDS) - ‘high street’ dentists
  • community dental services (CDS) - ‘specialist’ community dentists working with special care and vulnerable groups
  • hospital dental services (HDS) -      specialist secondary care services, only provided from the University Dental Hospital (University Hospital of Wales site in the Heath, Cardiff).

With regards to general dental services or “high street dentists”, there were currently 23 contracts in 20 practices throughout the Vale of Glamorgan.  The Local Health Board’s role with these contracts was to performance manage the level of activity within these practices and through proper governance ensuring the quality of services. 

 

The Committee was asked to note that when contracts from dentists were returned it would be the duty of the Local Health Board to decide how to invest funding which would be based upon need.  Only if funding had been reduced, removed or relocated did consultation with the public need to take place. 

 

In terms of specific changes to the provision of services out of Barry Hospital, the Committee was advised that this service was provided as a general dental (high street dentist).  This service was a single dental practice, for which, during December 2015, the dentist had applied for retirement and had provided the three month contract notice.

 

Following this, the Local Health Board had considered the continued use of Barry Hospital and it had decided against tendering into the existing surgery in Barry Hospital because of the following aspects:

  • the CDS (special care service) planned to continue providing their core non-high street service from this facility
  • the Local Health Board had considered that it would not be beneficial to tender as a new practice because it was not comfortable in a tendering of a single handed practice for governance reasons and because it felt that the contract was too small so would require a significant level of private income.

As a consequence, between January and March 2016 the Local Health Board had put in place temporary arrangements.  For this, a letter had been sent informing all patients that were previously treated in the Barry Hospital high street practice.  Since then, the Local Health Board had decided that all funding used in  Barry Hospital would be committed to  new provision in Barry and it had agreed to expand two existing practices in order to accommodate the contract value.  The two successful practices through the tendering process were Park Crescent Dental Practice and Porthkerry Dental Care.  All patients were free to choose either of these practices with ex-Barry Hospital patients given priority. 

 

The Committee was advised that since 2013, £207,000 additional funding had been allocated by the Welsh Government.  During 2013, over £71,000 had been allocated to improve the access to dental services in Llantwit Major, Barry and Dinas Powys.  Furthermore, in 2015, £60,000 had been allocated to the western part of the Vale and awarded to the dental services in Cowbridge.  During 2016, an amount of £76,000 had been allocated in order to improve access to services within Rhoose.  This demonstrated that the Local Health Board was committed to continually looking at the development and improvement of dental services in the Vale of Glamorgan.

 

A Committee Member queried the registration process and asked what would happen to patients once their course of treatment had ended.  In reply, the Committee was advised that for all dental services in Wales there was not a registration facility.  What would normally happen was that dentists would have a contract value that they would need to achieve so it was to their benefit to “call patients” back.  In querying as to what could be done to encourage people to visit a dentist more often, Ms. Evans advised that it would be preferable for patients to access services in a planned way and not via an emergency route, so people would be encouraged to attend check-ups in a timely manner. 

 

The Chairman asked how many people accessed dental services in the Vale.  In reply, Members were advised that the actual numbers would be sent via e-mail but that this information would not contain the number of private patients.  Members were informed that the additional £207,000 from Welsh Government had covered approximately an extra 2,500 contacts. 

 

In reply to a query regarding the capacity of the new dental practices, Mr Holliday advised that letters had been sent out to all ex-patients of Barry Hospital.  Patients were required to take this letter along with them when attending their new dental practice.  Patients would need to inform the Local Health Board should they have any issues around accessing a service.  Furthermore, he stated that as part of the tendering process, all practices were asked to provide a business case around how they planned to increase capacity.

 

A Member, in relation to encouraging more people to have regular dental check-ups, enquired about the impact of this on the NHS budgets.  In reply, the Committee noted that there was a cash-limited budget that was provided by the Welsh Government.  The Health Board’s role would be to monitor the number of people accessing services and any growth in demand would lead to a business case being made for extra funding.

 

Having considered the Local Health Board’s plans the Committee

 

RECOMMENDED - T H A T the contents of the presentation be noted.

 

Reason for recommendation

 

For the Committee to be informed of changes to the provision of dental services out of Barry Hospital.

 

 

30        PRESENTATION BY DR. SUZANNE WOOD (PUBLIC HEALTH WALES) ON CHILD OBESITY -

 

For this item the Committee welcomed Dr. Suzanne Wood, the Consultant in Public Health Medicine, Ms. Christine Farr, Vale of Glamorgan Network of Healthy Schools Co-ordinator and also from the Cardiff and Vale University Health Board, Ms. Helen Nicholls, Community Dietetic Service Manager. 

 

Dr. Wood commenced the presentation by advising Members of the current situation.  She stated that for the child measurement programme - Reception Year children (aged 4 and 5) had been surveyed annually for the last three years, which had shown a year on year decrease in the Vale of Glamorgan.  The Vale of Glamorgan had the lowest levels of overweight and obesity in Wales for girls at 19.1% and also for boys at 22.7%.  However, she stated that there was no room for complacency. 

 

Members were advised that obesity was associated with levels of deprivation with more deprived groups being significantly more likely to be obese.  In the Vale of Glamorgan, this created much variation with more deprived areas such as Barry having around double the levels of obesity as compared to other areas. 

 

With regard to older children within secondary schools, current information from the national survey carried out every four years around the health behaviour of school age children between 11 and 16, showed that obesity levels in the Cardiff and Vale University Health Board area were the lowest in Wales at 15%.  Again, this masked a variation which was once again associated with deprivation. 

 

In terms of problems associated with high obesity rates, Members noted that if a person was obese as a young child they would be far more likely to become an obese older child and adult.  The obesity trajectory showed that over 4 in 5 Welsh children that were obese at Reception year (aged 4 to 5) would remain obese at Year 4 (aged 8 and 9).  Members were advised that the converse was also true and if a person had a healthy weight at Reception year then they were likely to have a healthy weight in Year 4 (78.4%).  However, the obesity trajectory continued and child obesity was associated with a higher chance of obesity, premature death and disability in adulthood.  In addition to increased future risks, obese children experienced breathing difficulties, increased risk of fractures, high blood pressure, potential cardio-vascular disease, insulin resistance and psychological problems.  Therefore, there needed to be action now in order to prevent an obesity crisis for future generations.  

 

In detailing actions to combat childhood obesity in the Vale, Dr. Wood advised that the ten steps to a healthy weight programme had been launched nationally by Public Health Wales.  This was an evidenced based account of what could be done, in steps, to prevent children becoming obese in their early years (under 5).  At a strategic level, there was an overarching healthy weight framework which was accompanied by The Eating Well and Physical Activity Action Plan.  The former would be re-launched shortly.  These plans reflected the priority actions from the Health Improvement Review, conducted nationally, around those actions which worked well.  In addition, much was going on in terms of the implementation, although at times this had been problematical due to limited resources. 

 

Furthermore, midwives and health visitors had an important role as obesity had been linked to an increased risk of complications during pregnancy and birth and they would actively encourage breastfeeding and would monitor growth.  Currently, 66% of mothers in Cardiff and the Vale breastfed at birth which was higher than the Wales average of 57.9%.

 

Other actions included the following:

  • Healthy and sustainable pre-school scheme –  Currently only 22 settings where engaged out of a potential of over 300. 
  • Healthy schools - 100% of schools were involved in the Vale.  The healthy eating in schools regulations (2013) were a legal requirement in all primary and secondary schools.  All schools appeared to be compliant, but monitoring was      unsatisfactory. As such, external caterers may not always be compliant in secondary schools.  In terms of physical activity, many schools had devised extra-curricular activities such as Llantwit Major Secondary School providing Zumba, Pilates and yoga for their children.  Active Travel Plans were promoted across schools.  National quality awards were encouraged but currently in the Vale only 4 primary and 1 secondary schools had been able to achieve these.
  • Barry Communities First area was supported by dietetics supervision, however, there was no overarching approach across all agencies in the Vale.  Whereas in Cardiff this existing through Families First and Flying Start.

In summarising the key challenges, Dr. Wood emphasised the following:

  • The need to address the maternal obesity dietetic service gap.
  • The need for more pre-school settings to be engaged in the healthy and sustainable pre-school scheme.
  • The need for a whole nutrition approach across Flying Start/Families First/Communities First.
  • The need for senior leadership teams to support the national quality awards in schools.
  • The need for a children’s obesity service (Level 2 and 3).

In ending the presentation, Dr. Wood asked the Committee to consider the following recommendations:

 

1.         To note the progress to date.

2.         To support a 10 steps to a healthy weight roll out.

3.         To further support the healthy and sustainable pre-school scheme e.g. through time in kind.

4.         To support the national quality award in schools.

5.         To support a whole nutrition approach in the Vale.

6.         To support the development and a Level 2 and Level 3 obesity service for children.

 

A Committee Member asked what could be done to encourage families to eat healthier.  In reply, Dr. Wood advised that education and encouragement was vital.  There was also a need to encourage families to partake in more physical activities, for example, by promoting walking and cycling over driving by the development of more 20 mph zones and increasing green spaces.  Members noted that a lot of advice and guidance on this was available on-line and there was also a lot in place in terms of signposting people for help and support.  The Vale of Glamorgan network of healthy schools co-ordinator then emphasised the Healthy School Initiatives, this was a whole school setting approach and which was linked to the Vale’s Active Travel Plan.  An important part of this was around providing training to parents to encourage their children to undertake more physical activities and to raise awareness around healthy diets. 

 

At this point, the Head of Children and Young People Services was asked for her thoughts.  Given the now wider remit of the Scrutiny Committee, the Head of Children and Young People Services shared contributions received from the Director of Learning and Skills and the Operational Manager for Leisure Services.  She advised that the Director of Learning and Skills had indicated that they would appreciate more clarity regarding how the Council and schools could contribute to the recommendations being made.  Dr. Wood indicated that it would be helpful to have senior leadership support to achieve a greater number of schools involved with the National Quality Award.  The Operational Manager for Leisure provided information to inform the Committee that the Vale of Glamorgan was ranked third in Wales when it came to the percentage of people undertaking the recommended amount of daily physical activity.  This information was received positively. 

 

With regards to the discussion about the contribution of the four poverty strands, the Head of Children and Young People Services welcomed the opportunity to take these discussions forward via the Poverty Alignment Group, which included Flying Start, Communities First, Families First and Supporting People  She suggested the focus should be on achieving a joint approach that streamlines current activity and maximises the contribution of all.

 

A Committee Member stated that during his role as Cabinet Member, which included school and catering services, he had noted that all schools in the Vale apart from one had facilities to prepare meals onsite.  Therefore, there was an increase in the number of healthy meals being provided.  One particular observation that he had made was that more work needed to be done with parents who prepared lunchboxes for their children, which were not always particularly healthy.  This was a particular issue within the more rural parts of the Vale.  Furthermore, there were issues around what children were eating during school holidays, when many children were not eating a nutritional meal.  Finally, he alluded to the need for food co-operatives to stock healthier foods such as fruit, which they could sell on at wholesale prices. 

 

In response to these comments, the Community Dietetic Service Manager stated that Public Health Dietetic work was also part of a national programme.  Through this, a lot of resources and training was provided to partner agencies such as Communities First.  In addition, the School Holiday Enrichment Programme had been rolled out which would look at the types of meals provided by catering services.  She went on to allude to the work undertaken in Cardiff which should also be as successful in the Vale.  Members also noted that there was a need to provide training for parents, such as cooking skills and budgeting for healthier diets.  There was a lot of work that could be done with parents but it was important for such work to be undertaken on a partnership basis in order to avoid duplication and to benefit from economies of scale. 

 

RECOMMENDED -

 

(1)       T H A T the Committee receives an update in a year’s time.

 

(2)       T H AT the presentation be referred to Cabinet for its consideration and action as necessary.

 

Reasons for recommendations

 

(1)       In order for the Committee to receive an update on the developments around child obesity in the Vale of Glamorgan.

 

(2)       In order to allow Cabinet to consider how best to tackle issues associated with child obesity.

 

 

31        THE VALE OF GLAMORGAN FAMILY INFORMATION SERVICE (DSS) -

 

The Team Manager, Innovation and Information, presented the report the purpose of the report was to update the Scrutiny Committee on the work on the Vale of Glamorgan Family Information Service (FIS). 

 

The report advised that the FIS was a one-stop information service for parents and carers of children and young people aged up to 20 years in the Vale of Glamorgan, as well as for professionals working with families.  It provided free information on a wide range of childcare options and activities for children, their families and their carers.  This included information on nurseries, childminders, out of school clubs, play groups and parent and toddler groups.  FIS also provided information on paying for child care and working in child care. 

 

The FIS maintained a database of over 1000 services.  Families and professionals could contact the service directly and information was also available online via a childcare search facility, play and leisure search facility, the family support directory and the SWOOSH website for young people.  Information was updated at least annually. 

 

FIS also provided an outreach service which supported parent groups in schools and new intake sessions.  The service worked with agencies such as Flying Start, Communities First, Job Centres, health visitors, PACE project and Play and Leisure to reach parents and carers whose need for help was greatest.

 

FIS was funded through the Families First Grant to administer the Disability Index, which was a directory of children and young people in the Vale who had specific impairments and requirements.  There were now 391 children and young people registered on the index and receiving regular information, an increase of 18% since last year and a 420% increase since the FIS took over the administration of the index in 2012. 

 

The report stated that FIS had increased its use of social media to promote the service and to reach parents and professionals.  Facebook and Twitter were used regularly to highlight important campaigns and promote events and activities.  ValeConnect had been used to send out e-bulletins to childcare providers, families of children on the index and also professionals.

 

FIS recorded information and aimed to gain feedback from all enquiries.  The following statistics were from April 2015 to March 2016 and highlighted the following: 

  • 1,422 enquiries direct to the service (2% decrease from the previous year);
  • 33,350 page views to the FIS web pages (stats for 10 months);
  • 1,797 online childcare enquiries (stats for 7 months);
  • 390 online family support enquiries (stats for 7 months);
  • 2,956 page views to the 'Children with additional needs' web pages (stats for 10 months);
  • 671 requests for childcare information;
  • 179 direct enquiries for special needs support and the Disability Index;
  • 341 direct enquiries for leisure and holiday activities;
  • 148 direct enquiries for help with childcare costs and financial help.

In terms of outcomes, 52% of those who contacted the FIS were able to find suitable childcare, 21% said their circumstances had changed or they had not started looking yet and 26% were unable to find childcare.  77% of those able to find childcare were also able to take up training, find work or remain in work.  For those unable to find childcare, the most important factor was that it was too expensive (4 people). 

 

It was advised that the type of enquires varied greatly.  It included requests for childcare information and advice, holiday activities, becoming a childminder, database updates, help with childcare costs, leisure activities, family support, nursery admission and education.  Some examples of these enquiries were set out in Appendix 1. 

 

It was evident that more people were using the service online, rather than contacting FIS directly.  FIS also gained many enquires (25%) from undertaking outreach work. 

 

Key achievements were outlined in Appendix 2 and these included the following: 

  • 64% of users said the information had made a difference to them and their families by improving their knowledge, enabling them to access services, ensuring that their child had made friends, improving their family situation, feeling positive about the future and being able to take up employment.
  • 96% of users were satisfied or very satisfied with the service received from FIS (4% didn't respond) and 87% would recommend the service to others (13% didn't respond).
  • 795 new enquirers received information from FIS (68% of all enquiries).
  • 2 more primary schools achieved the level 1 FIS School Certificate of Achievement (18 in total) and 2 more      schools have achieved level 2 (4 in total).
  • From feedback gained at focus groups with parents in schools and through Flying Start, we developed new online information for parents.
  • The service produced another successful Summer Holiday Activity Programme, available online, which resulted in over 11,000 web hits.
  • 391 children and young people are now registered on the Disability Index (an 18% increase) and the Vale      Disability Index model is being replicated in Cardiff.  FIS teams will work together to produce joint promotional materials and a joint Cardiff and Vale Index newsletter.
  • The FIS Family Support Directory had been transferred to the Dewis Cymru website (170 services), to ensure that services improving peoples well-being are accessible in one place, but it was still available also through the Council's website.
  • Social media was used as a key communication tool and the FIS Facebook page now has 828 people following the page (223 new followers in the last year).

Key actions for the new year included: 

  • Completing the Childcare Sufficiency Assessment (CSA) full report;
  • Working with Family Support service providers to encourage them to update their information on the Dewis Cymru website and working with the Dewis Cymru project team to transfer the remaining services from the FIS database to the Dewis Cymru site (including childcare information and leisure activities and services);
  • Working with Ysgol y Deri to promote the Disability Index and help it to gain the FIS School Certificate level 1;
  • Working with health visitors to ensure that new parents were aware of FIS, by attending baby clinics and parent & toddler groups;
  • Continuing to work with Job Centre Plus, PACE project and Gingerbread, to ensure that lone parents were aware of available childcare options;
  • Encouraging partner agencies to work towards the FIS certificate, prioritising Communities First, Flying Start and the FACT Team;
  • Develop parenting web pages to include information on the 'teenage years';
  • Working with Cardiff FIS to produce joint Index newsletters, improving access to information on services for children with disabilities across Cardiff and the Vale and achieving efficiencies for the Vale.

The FIS would also assist with the development of a proposal for how FIS and the Families First Advice Line would work with the new Vale of Glamorgan Information, Advice and Assistance Service under the Social Services and Well-being Act. 

 

The Chairman queried how FIS fitted in with new the Information, Assistance and Advice (IAA) service.  In reply, the Team Manager, Innovation and Information advised that there had been a lot of debate on this at a national level, but there was no easy answer as arrangements needed to be decided at a more local level.  For the Vale, she explained that there was an integrated approached being taken and that a task and finish group was looking at the Council’s referral pathway.

 

In reply to a Member's query regarding future growth of the Disability Index Register, the Committee was advised that this was difficult to answer because this would not be the same cohort of individuals that received support from Social Services or Education.  Individuals could choose not to be included on the Register. 

 

A Committee Member questioned the provision of child care through the medium of Welsh and was advised that this was a standard question asked of any enquirer or provider.  This meant that should someone require a child carer with the ability to speak Welsh, then they could be signposted.  In addition, FIS actively promoted services through Welsh.

 

In answer to a question regarding concerns about a child care providers, Members were informed that FIS and the Council had a duty to report these directly to the Care and Social Services Inspectorate for Wales (CSSIW) if they were Registered.  This also included concerns with providers that were not registered, where the Council’s own safeguarding process was used.  Furthermore, Members noted that all FIS staff had received appropriate safeguarding training.

 

With regard to enquiries and customer feedback, the Committee was informed that all enquiries would be responded to within 10 working days.  In terms of customer feedback, the FIS did not receive a large amount of responses, although the FIS did contact individuals 30 days after their enquiry as a means of learning if there was anything that the Service needed to look at.

 

RECOMMENDED -

 

(1)       T H A T Members of the Scrutiny Committee note the work of the FIS.

 

(2)       T H A T Members of the Scrutiny Committee note the need to plan for the impact of the Social Services and Well-being (Wales) Act 2014 upon the service, given that it requires the Council and its partners to put in place a broader well-being service (which provides people with information and advice relating to care and support and assistance in accessing care and support).

 

(3)       T H A T Members of the Scrutiny Committee request a further update on an annual basis.

 

Reason for recommendations

 

(1-3)    To ensure effective oversight of social care services.

 

 

32        ACCOMMODATION WITH CARE FOR OLDER PEOPLE - UPDATE REPORT (DSS) -

 

The Head of Business Management and Innovation, presented the report the purpose of which was to inform Members of progress made to date in providing a coherent strategy for the way in which the Council could help to ensure that the needs of older people for Accommodation with Care would be met. 

 

As a background summary, the report advised that across Wales and the rest of the UK, there were significant gaps in the range of accommodation options available to older people as they became increasingly frail, especially if they had significant needs for care and support.  The position had multiple and complex causes, including: 

  • demographic factors
  • growing demand
  • limited housing stock
  • increasing co-mobility and acuity in respect of the conditions that very old people characteristically suffer (including dementia)
  • uncertainties about paying for care
  • problems in ensuring that older people left on their own could live in close proximity with family members who could act as informal carers.

The report advised that as a consequence and despite increased provision, older people did not have sufficient access to facilities such as step up/step down accommodation which could help to avoid or shorten hospital stays.  Extra care and Reablement provision had grown but not kept pace with demand.  The properties owned by older people could be too big for them to manage or difficult to adapt. 

 

The Council’s Commissioning Strategy for Older People’s Services 2011-18 drew attention to the challenges involved in the provision of sufficient Accommodation with Care in a context where the market was not responding quickly enough to higher levels of need.  It identified the need to put in place new service models which would provide increased support options at all stages of the older peoples pathway.  The Commissioning Strategy was designed to make best use of resources available for Social Services by encouraging a Reablement approach to care and reducing the pressure to accommodate growing numbers of older people in traditional residential settings.  It involved developing further the use of assistive technology and a focus on partnership with other local authorities, the NHS, the Third and private sectors to ensure that people were supported proportionately and in a way that maintained independence for as long as possible. 

 

The work involved providing an improved range of services, some of which were accessible to all and some of which were specialist, but subject to eligibility criteria and for the need to cater for those with the most complex needs.  Efforts to put in place the new service model had remained a priority with the Council.  For example, recent proposals for use of the regional Intermediate Care Fund Grant for 2016/17 contained a number of relevant schemes, as did previous versions of the Fund and also the Regional Collaboration Fund 2013/16.  These matters had been reported to the Scrutiny Committee on a regular basis. 

 

In 2013, a market position statement was produced which identified the principles that the Vale of Glamorgan would apply in the re-designed services.  “Our first priority is to support people to remain independent for as long as possible, delaying and in some cases, avoiding the need for ongoing social care services.  Supporting people to stay healthy and helping communities support each other is very important as we know that poor health and social isolation are factors that lead people to require social care services.”  This focus on a preventative agenda would be strengthened further as the Council implemented the Social Services and Wellbeing Act 2014, which clearly articulated the need to support people at an earlier stage, before needs reach the point of crisis. 

 

The Vale of Glamorgan’s first extra care scheme, Golau Caredig in Barry, had been considered a success.  Tenancies were quickly filled and there was a waiting list in operation.  The scheme had demonstrated that, where suitable accommodation for older people exists, it was possible to maintain people in their own homes.  The Council had accommodated tenants in extra care who were previously in residential and nursing homes or in their own homes with very high levels of care provided to them.  Several people supported by the Learning Disability Scheme had been very successful in managing tenancies in extra care, as well as individuals with complex mental health needs.  As a consequence, there was a true community feel within the scheme. 

 

In 2011, a feasibility study was prepared regarding a site in Penarth that appeared suitable for creating an older peoples village, but this did not progress further at the time because of factors preventing access to the proposed site.  More recently, the Council had been approached to facilitate further discussions in this matter.  Some recent changes in assets meant that the Council was better placed to facilitate any proposal that may emerge.  It had been able to sell two buildings (Bryneithin and Gardenhurst) that were in the Council’s asset portfolio and managed by Social Services, which would allow funding to be reinvested.  In addition, the Council had resumed direct management of two additional residential homes, Ty Dyfan and Ty Dewi Sant.  The provision of funding through the Intermediate Care Fund Grant was intended to ensure that additional capacity within Ty Dyfan Residential Home could be used to support people being discharged from hospital. 

 

However, the report advised that significant challenges remained, given reduced financial resources available to the Council and rising demand for services to people aged over 65.  Given the need for both capital and revenue investment, changes in legislation and policy needed to be taken into account when planning service developments that would take some time to achieve.  For example, the impact of welfare reform was not fully understood for individuals in relation to access to benefits or the impact on Registered Social Landlords (RSLs) regarding the Social Housing Grant Allocation and the effects on affordable rent.  Social Services and Housing colleagues were working together to try to understand how these factors would implement any proposed developments.

 

A workshop was held on 7th January, 2016, which was attended by a large number of stakeholders including Elected Members, providers across the sector (including RSL) local authority departments (Social Care and Housing), the NHS and the Wales Co-operative Centre.  The aims of the workshop were to:

 

  • gain an understanding of the issues connected to care, accommodation and wellbeing of older people in the Vale of Glamorgan
  • unlock the potential for alternative delivery models of care to support older people with care needs
  • connect with others from the Sector to challenge perceptions and generate innovate ideas and solutions
  • plan next steps to implement sustainable change.

The workshop was well attended with good levels of interest and participation.  Following the workshop, officers met with the Wales Co-operative Centre to identify themes resulting from the workshop and develop a plan to move the agenda forward.  The themes identified in the workshop were attached at Appendix A.  The meeting to develop an action plan had been delayed because of the need to prioritise implementing other aspects of the Social Services and Wellbeing Act.  In the interim, discussions had taken place with Housing colleagues regarding other potential opportunities that needed to be explored.  In addition, organisations had approached the Council with proposals which should be considered carefully, given the scale of the challenges faced by the Council.  The Directorate was encouraging a partnership approach and seeking to organise an event with providers to seek their views as to how they could meet the objectives set out in the Council’s Corporate Plan.  A meeting was being held with the relevant officers and Cabinet Members to discuss options further before embarking on the next phase of this work stream.  Also, local authorities and local health boards now had a statutory obligation to undertake a population needs assessment which would contribute significantly to service planning in this area.

 

The Chairman queried the vision associated with the Accommodation Strategy.  In reply, the Head of Business Management and Innovation advised that this represented a difficult strategy as the associated challenges were constantly changing, such as the feasibility of sites and the changes in legislation around tenancy rental agreements.  She went on to state that the overall vision was still there but there was a need to once again undertake consultation in order to ensure that the Strategy was still valid.

 

Furthermore, the Committee was advised that over time specific elements of the Strategy would be progressed, but there was a need to see what came out of the Population Needs Assessment that was being undertaken by Public Health Wales.  This would be officially published in March 2017, but it was expected that Public Health Wales would share certain information over the period leading up to the publication.  A significant challenge within the Strategy was that the Service did not have direct control of what happened within the Private Sector, for example, providers could chose to cease to operate. 

 

A Committee Member enquired about the process around discharging people from hospital and back to their homes.  In answer to this, the Head of Adult Services explained that the Strategy of the service was aimed at keeping people at home through providing care and support.  For this, a number of funding streams were used with the main elements being reablement and rehabilitation which was centred on the Community Resource Service.  He further advised that the Service was trying to ensure that it could respond as quickly as possible. 

 

RECOMMENDED -

 

(1)       T H A T the Committee notes the work being progressed in order to provide a Strategy for the way in which the Council can help to ensure that the needs of older people for accommodation with care are met.

 

(2)       T H A T a further update report be presented in six months’ time.

 

Reasons for recommendations

 

(1&2)  To ensure that Members continue to exercise effective oversight of this important area of work.

 

 

33        SERVICE PLANS 2016-20: ADULT SERVICES, CHILDREN AND YOUNG PEOPLE SERVICES, BUSINESS MANAGEMENT AND INNOVATION (DSS) -

 

The purpose of the report was to allow the Scrutiny Committee to consider the Social Services Service Plans for 2016-20.

 

Service Plans were the primary planning document of the Council and a key building block in its Performance Management Framework.  Consequently an annual review of planning arrangements was undertaken to ensure that the Council’s plans continued to meet statutory requirements and to continuously improve the approach to performance planning and monitoring. 

 

Service Plans for 2016-20 specifically identified how each Head of Service would contribute towards achievement of Corporate Plan wellbeing outcomes by asking two questions: 

  • “Which wellbeing objectives does the service contribute to and what actions will be taken this year to achieve these?
  • How will we manage our resources to achieve these actions and support our service?”

Informed by the self-assessment, the Service Plans also comprised a brief overview of the issues facing the service against each of the corporate health perspectives.  The Plans also include an action plan for how resources would be used to support the delivery of wellbeing outcome actions as well as managing risks, collaboration and engagement activities. 

 

Appendix 1 contained the Service Plans for Adult Services, Children and Young Peoples Services and Business Management and Innovation.  Key areas of note within the Service Plans were as follows: 

  • Section 1 - Introduction: Sets the context for the Service Plan and provided an overview of the service area, the purpose of the plan, and the key service considerations which had informed development of the plan.
  • Section 2 – Council Priorities for 2016-20: Outlines the specific actions that the service would be taking during 2016/17 to contribute towards the corporate well-being objectives and outcomes. It also identified the key enabling actions the service would be taking to support its achievement of the well-being outcomes for example through reshaping of services.
  • Section 3 - How the Council works and Resources: Describes how the service will use its resources to deliver its priorities in the Service Plan and outlined key workforce development priorities, significant ICT projects, required budget savings and areas of focus in relation to assets, procurement and major capital projects.  This section also identified how the service would engage with stakeholders and work in partnership/collaborate to achieve its priorities and incorporates a service risk evaluation.
  • Appendix A and B (within the Service Plan) contains the Service Improvement Action Plan for 2016/17. This identified planned service actions, intended outcomes and key milestones, relevant performance measures to demonstrate progress, responsible officer, timescales for completion and the anticipated resources requirements of planned actions.
  • The revised Service Plan format, which took on board comments and feedback received by the Policy and      Performance Team (PPT) in the past, was intended to be easier to complete and would facilitate clearer links with Team Plans. It was recognised, however, that the format would continue to evolve over the next couple of years as the new performance management arrangements became bedded in.

With regard to the Business Management and Innovation Service Plan, the Chairman asked for more clarity around the risk associated with the impact of the Social Services and Wellbeing Act and the need for the Council to consider charges for services which would affect the ability to secure income, as detailed on page 15.  In reply the Head of Business Management and Innovation stated that Members would be aware that Welsh Government guidelines around the charges for services came very late in the process.  The new charging policy was currently being worked through and included some difficult areas such as the need to assess couples and a change around the charging for respite services which were now included within the £60 cap for charging. 

 

In discussing the Adult Services Service Plan, a Committee Member queried the programme around reshaping the Rondell House Day Service and the arrangements for disability respite care particularly in relation to the Rhoose Road Respite Care setting.  In reply, the Head of Adult Services stated that in terms of Rondell House, the approach undertaken for this service had been changed in order to include wider aspects such as dementia.  This was due to demographic changes in the Vale and the need to make the service more accessible to this client group.  With regard to the Rhoose Road Respite Care setting, Members were informed that the Council was looking to remodel the service in order to allow people to live as independently as possible.  The Committee noted that the timescale for the completion of this was still some way off. 

 

In answer to a Member’s query regarding the ability of the Council to cope with the rising demand for services, the Head of Adult Services commented that he had raised this before at previous Committee meetings and this was probably the biggest challenge facing the Council.  The rising demographic needs of the Vale of Glamorgan were huge but he considered that the Council was well placed to manage the rise in demand.  With regard to staffing resources, he advised that this would always be a challenge when faced with an increasing number of people contacting the Council for support services.  An aim of the Social Services and Wellbeing Act was to try and change this and to direct people to more preventative services.  He added that he was confident in the new Information, Assistance and Advice service and that it should be noted that a number of Performance Indicators showed that the Council was being successful in redirecting people to alternative services.  This could indicate that the Council had the correct strategy in place. 

 

The Chairman, raised a query regarding the transfer of Mental Health Services to Llandough Hospital, and the Head of Adult Services clarified that there would be financial implications for aftercare responsibilities.

 

With regard to the Children and Young People Services, a Committee Member queried the action around the further development of the Information, Assistance and Advice service.  In response, the Head of Children and Young People Services alluded to the milestones agreed to support this action.

 

A Committee Member queried the lack of mention around the provision of the Welsh Language, to which, Members noted that this would be detailed within individual team plans.

 

Having considered the Service Plans the Committee

 

RECOMMENDED - T H A T the Adult Services, Children and Young Peoples Services and Business Management and Innovation Service Service Plans for 2016-20 be endorsed.

 

Reason for recommendation

 

To confirm the Service Plans as the primary document against which performance for the three areas within Social Services will be measured.

 

 

34        EXCLUSION OF PRESS AND PUBLIC -

 

RESOLVED - T H A T under Section 100A(4) of the Local Government Act 1972, the press and public be excluded from the meeting for the following item of business on the grounds that it involves the likely disclosure of exempt information as defined in Part 4 of Schedule 12A (as amended) of the Act, the relevant paragraphs of the Schedule being referred to in brackets after the minute heading.

 

 

35        DISCLOSURE OF CONCERNS IN RELATION TO A DOMICILIARY CARE PROVIDER (EXEMPT INFORMATION PARAGRAPHS

 

The Chairman asked if the Head of Business Management and Innovation could update Committee about concerns in relation to a domiciliary care provider. 

 

Having received a verbal update the Committee requested a detailed report to be provided at a future Committee meeting.

 

RECOMMENDED - T H A T an update report be provided at the earliest opportunity.

 

Reason for recommendation

 

In order to apprise Committee of any concerns in relation to a domiciliary care provider in the Vale of Glamorgan.

 

 

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